Is it necessary to treat tuberculosis?
Before the world was ravaged by COVID-19, there was another highly infectious deadly disease — tuberculosis.
Tuberculosis is the second most deadly infectious disease in the world. It was only relinquished of its title of “most deadly infectious disease” when COVID-19 appeared. While COVID-19 is usually easy to treat, with most people not requiring any medication, tuberculosis can be fatal if not treated and treatment takes a minimum of 6 months.
According to the World Health Organization (WHO), approximately 10.6 million people fell ill with tuberculosis in 2021. In Singapore alone, tuberculosis is endemic, with 1,306 new cases of active tuberculosis among Singapore residents .
To understand the gravity of being infected with tuberculosis, we must learn more about what it is and how it affects us.
What is tuberculosis?
Tuberculosis, commonly known as TB, is a highly infectious disease caused by a bacteria known as Mycobacterium tuberculosis. TB usually affects the lungs but can spread to other parts of the body such as the brain and spine. It is passed from person to person via respiratory droplets, but not everyone exposed to TB will develop symptoms.
There are two types of TB:
- Latent TB: you have been infected with the TB-causing bacteria but your immune system is keeping it at bay and preventing it from spreading and manifesting. You will not have any symptoms and you are not contagious. However, your infection may become active if your immune system weakens or you start consuming immune-compromising drugs.
- Active TB: you are showing symptoms of TB and are contagious, most active TB infections progress from latent TB.
What are the symptoms of active TB?
The symptoms of active TB are as follows:
- Persistent cough lasting longer than 3 weeks
- Low-grade fever
- Night chills
- Unintended weight loss
- Chest pains
- Coughing up sputum (phlegm) or blood
How is TB diagnosed?
TB is diagnosed in the following ways:
- Skin test: also known as the Mantoux tuberculin skin test, a small amount of fluid is injected into your arm. If the spot swells after 2-3 days, you are considered positive for TB.
- Blood test: also known as interferon-gamma release assays (IGRA), TB proteins are mixed with a small amount of your blood to see the reaction.
- Sputum test: your sputum or phlegm is tested for the presence of TB bacteria.
- Chest x-ray or CT-scan: the appearance of your lungs can be studied for the presence of TB.
How is TB treated?
Both latent and active TB must be treated to prevent symptoms or the worsening of symptoms. Treatment usually involves a combination of antibiotics that must be taken over the course of 6 months to a year. After a few weeks of treatment, you will no longer be contagious — but you must continue with your treatment until the course of antibiotics is complete.
While most TB infections can be cured using antibiotics, there are some TB infections that are drug resistant. This means that the TB-causing bacteria have developed and is now resistant to certain medications. Hence a different group of medications will be used to treat it and must be taken for a much longer period of time, approximately 30 months or two and a half years.
Since TB is treated using antibiotics, the whole course of medication needs to be completed regardless of how you feel or if your symptoms are alleviated. If you do not complete the whole course of antibiotics, the TB-causing bacteria can multiply and grow back and may even become drug-resistant, making them even harder to eradicate.
What happens if TB is left untreated?
TB is not a disease that will go away on its own.
In fact, if TB is left untreated, 45% of HIV (human immunodeficiency virus) negative individuals will die, while nearly all HIV-positive individuals will die.
Furthermore, if you have untreated active TB, you can go on to infect 5-15 people at any one time as TB is easily spread when you speak, cough, sneeze, laugh, or spit, and it does not require a high concentration of bacteria to spread and infect others.
If active TB is left untreated, it could:
- Be fatal
- Spread to other parts of your body such as your brain, spine, kidneys, etc.
Although individuals with latent TB do not have any symptoms and are not contagious, it is still important to treat them because their infection can progress to active TB if their immune system weakens or if they start taking immunosuppressive drugs.
What are the possible side effects/complications of TB medications?
Some individuals may experience the following side effects from TB medications:
- Jaundice, characterised by yellow skin or eyes
- Nausea or stomach discomfort
- Dark urine
- Itchy skin
What should I do if I have TB?
TB is curable if you adhere strictly to your treatment regime. If you have just been diagnosed with TB, you must observe the following to keep your loved ones safe:
- Wear a mask when in contact with them, especially during the first two weeks of treatment.
- Cover your mouth with a tissue when you sneeze or cough.
- Stay at home and isolated during the first two weeks of treatment.
- Complete your full course of TB medications.
What can I do to reduce my risk of an active TB infection?
There are various ways in which you can reduce your risk of an active TB infection, these are:
- Good hygiene habits such as washing your hands thoroughly and often
- Avoid close contact with others
- Getting vaccinated with the BCG vaccine
- Healthy lifestyle habits that help to boost your immune system
In conclusion, treatment for TB is absolutely necessary and should be started immediately once you have tested positive. Remember to complete all medications and isolate yourself for the first two weeks of treatment. TB is curable and is no longer the death sentence it once was. Get treated and get cured!
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- World Health Organization. (2022, October 27). Tuberculosis. Retrieved from World Health Organization: https://www.who.int/news-room/fact-sheets/detail/tuberculosis
- Ministry of Health Singapore. (2022, March 24). Update on Tuberculosis Situation in Singapore. Retrieved from Ministry of Health Singapore: https://www.moh.gov.sg/news-highlights/details/update-on-tuberculosis-situation-in-singapore-2022