Hyderabad: Observed on Monday, March 24th, World Tuberculosis Day serves as a crucial reminder to understand the impact of tuberculosis (TB) on our health and explore effective remedies.
Tuberculosis is a serious illness that primarily affects the lungs. It is caused by bacteria. TB spreads when an infected person coughs, sneezes, or sings, releasing tiny droplets containing the bacteria into the air. Others can inhale these droplets, allowing the bacteria to enter their lungs. The disease is contagious and spreads easily in crowded environments.
Speaking with Siasat.com, Pulmonologist Dr. Mohammed Sameer Ahmed from Care Hospital explained that there are two major types of TB:
Rifampicin-resistant TB (RR-TB): This form of TB occurs when the bacteria are resistant to rifampicin, a key anti-TB drug, often requiring treatment with second-line medications.
Multi-Drug Resistant TB (MDR-TB): This develops when the TB bacillus becomes resistant to two first-line drugs, rifampicin and isoniazid. Dr. Ahmed noted that RR-TB and MDR-TB are often caused by poor treatment adherence, inadequate doses, malabsorption, substance abuse, and conditions like HIV.
He further added that XDR-TB occurs when the patient develops resistance to Fluoroquinolones and second-line injectable drugs.
Tuberculosis develops when TB bacteria multiply in a person’s lungs. It can be classified into three stages: primary TB infection, latent TB infection, and active TB disease. While many patients remain asymptomatic, common symptoms include low fever, fatigue, and a persistent cough.
Consultant pulmonologist and Telangana Medical Council (TGMC) member, Dr. M Rajeev, highlighted several challenges in managing TB: delayed diagnosis, drug resistance, increasing MDR and XDR-TB cases, lengthy treatment durations (6–24 months), severe drug side effects, poor treatment adherence, comorbidities (HIV-TB interactions, diabetes, malnutrition), limited availability of second-line drugs, inadequate contact tracing, stigma, and resource limitations in peripheral centres.
Dr. V. Nagarjuna Maturu, a Hyderabad-based pulmonologist from Yashoda Hospital, emphasized that contact tracing is a vital method for controlling TB. He clarified that the goal is to curb the spread, not eradicate, a disease that has been prevalent for many years. Contact tracing involves identifying individuals who have been in close contact with a TB patient.
These contacts, particularly those at risk of early and latent TB, must be treated to prevent further transmission. Dr. Maturu stressed that early diagnosis and TB prevention are essential for controlling the disease.
He categorized contact tracing into household contacts, individuals living with the patient, who are at the highest risk and close contacts-Individuals such as coworkers.
Household contacts should be screened compulsorily, and close contacts screened as needed.
Contacts with symptoms should undergo a sputum test for active TB. Asymptomatic contacts should be tested for latent TB.
The government has initiated treatment for latent TB to prevent its progression to active disease. Dr. Maturu urged individuals to voluntarily seek testing.
The doctor emphasized the importance of educating patients about the significance of TB and destigmatizing the disease. In India, many TB patients are isolated after diagnosis. Patients are advised to isolate for two weeks, avoid public places, and rest.
The doctor explained that TB treatment is lengthy, lasting at least six months, and potentially 1 to 1.5 years for brain or bone TB. Adherence to the prescribed medication regimen is crucial. Abruptly halting treatment can cause TB to resurface.
Patients who miss medication for two weeks may need to be retested and restart treatment. Nutrition is also vital. Patients with low BMI are recommended a high-protein, nutritious diet, and advised to abstain from alcohol and smoking.
Dr. Amreen, a pediatrician from Hyderabad’s Caspian Hospital, discussed the role of technology in TB diagnosis. There are two types of diagnoses: microbiologically confirmed and clinically diagnosed.
Microbiological confirmation: This involves isolating the TB bacillus from a sputum sample, which helps detect drug resistance. CBNAAT (Cartridge-Based Nucleic Acid Amplification Test) significantly improves detection rates.
Clinical diagnosis: This is used when TB is suspected but the bacillus is not identified. First-line TB drugs are administered.
Dr. Amreen highlighted the Nikshay App and website, developed by the Indian government, which is used by healthcare professionals and officials.
The app facilitates online notification of TB cases. Patients receive monthly financial assistance through the Nikshay Poshan Yojana, addressing malnutrition.
The app also provides information on TB testing and DOTS (Directly Observed Treatment, Short-course) medication availability at government hospitals, and sends appointment reminders.
Malnutrition is a major barrier to TB prevention in India. While 90% of Indians may be infected with TB, this does not mean they have active tuberculosis.
Active disease develops when immunity is weakened by malnutrition, low BMI, and vitamin and mineral deficiencies.
The doctor called for improved counselling on nutrition and better financial support to enhance dietary habits.
Dispelling harmful food myths, such as avoiding eggs in summer or fruits in winter, is also essential.
