HALT - Hear Act Learn Treat Tuberculosis

By Dr. Ramana Prasad.V .Velamuru

Consultant Interventional Pulmonologist Respiratory Intensivist, KIMS Hospitals

India is the country with the highest burden of TB. The World Health Organisation (WHO) TB statistics for India for 2015 gave an estimated incidence figure of 2.2 million cases of TB for India out of a global incidence of 9.6 million. The TB incidence for India is the number of new cases of active TB disease in India during a certain time period (usually a year).

The estimated TB prevalence figure for 2015 is given as 2.5 million. The TB prevalence is the number of people in India who are living with active TB. Prevalence is usually, but not always given as a percentage of the population.It is estimated that about 40% of the Indian population is infected with TB bacteria, the vast majority of whom have latent TB rather than TB disease.

TB, is a contagious infection that usually attacks the lungs. It can also spread to other parts of the body, like the brain and spine. A type of bacteria called Mycobacterium tuberculosis causes it. Through the air, just like a cold or the flu. When someone who’s sick coughs, sneezes, talks, or laughs, tiny droplets that contain the bacteria are released. If you breathe in these nasty germs, you get infected.

TB is contagious, but it’s not easy to catch. The germs grow slowly. You usually have to spend a lot of time around a person who has it. That’s why it’s often spread among co-workers, friends, and family members. Tuberculosis germs don’t thrive on surfaces. You can’t get the disease from shaking hands with someone who has it, or by sharing their food or drink.

A TB infection doesn’t mean you’ll get sick. There are two forms of the disease:

Latent TB: You have the germs in your body, but your immune system stops them from spreading. They become inactive. That means you don’t have any symptoms and you’re not contagious. But the infection is still alive in your body and can one day become active. To prevent this, doctors will often prescribe antibiotics. Without treatment, 5% to 10% of cases develop into active TB.

Active TB disease: This means the germs multiply and can make you sick. You can spread the disease to others.

Signs of active TB disease are cough that lasts more than 3 weeks

Chest pain
Coughing up blood
Feeling tired all the time
Night sweats
Chills
Fever and loss of appetite

PEOPLE AT RISK OF DEVELOPING TB ARE IF THEY ARE SUFFERING WITH

HIV or AIDS
Diabetes
Severe kidney disease
Head and neck cancers
Cancer treatments, such as chemotherapy
Low body weight and malnutrition
Medications for organ transplants
Certain drugs to treat rheumatoid arthritis, Crohn’s disease, and psoriasis

Babies and young children also are at greater risk, because their immune systems aren’t fully formed.

Diagnosis is by doing sputum examination, chest xray, mantoux test, and some times by doing bronchoscopy. Treatment varies from 6-9months in pulmonary and extrapulmonary tuberculosis. if it is MDR Tuberculosis then treatment would continue for 18 months.

Drug resistant TB in India

Drug resistant TB has frequently been encountered in India. If a person has drug resistant TB it means that their illness will not respond to at least one of the main TB drugs. The prevalence of multi drug resistant MDR TB has though been believed to be at a low level in most regions of the country. Various studies have found MDR TB levels of about 3% in new cases and around 12-17% in retreatment cases. However even if there is such a small percentage of cases it still translates in India into large absolute numbers.

Tips to prevent the spread of Tuberculosis

Avoid close contact with people affected with TB. If you cannot avoid contact with them, wear protective masks and gloves.If you work at a hospital, wear good-quality microfiltration masks. Wash your hands with a disinfectant cleanser after contact with the patient. Avoid crowded, stuffy and unhygienic places.

Work on improving your immunity by including diet rich in antioxidants. Have at least 4-5 servings of fresh vegetables and fruits every day. If you cannot eat it due to certain practical constraints, make sure you take your daily dose of antioxidants/multivitamins after consulting your doctor. Antioxidants help fight free radicals produced in the body due to any kind of disease/stress and help in cell repair.

Include at least 2 good servings of protein in your daily diet. They are the building blocks of all our cells and help in cell repair too.

Do not go on a low-carbohydrate diet. You require a good mix of all the elements of food to be healthy. Carbohydrates, proteins, vitamins and fats all have their place in maintaining your immune system.

Get your daily exercise. Walk regularly for atleast 45 minutes at the least. The improved circulation improves your immunity. Set aside a few minutes for meditation every day. This reduces your daily stress which directly has a bearing on the condition of your immune system.

Maintain good hygiene, wherever you are. Washing hands with a good disinfectant soap often is a very under-valued habit. As prevention is always better than cure, it is wise to get your kids vaccinated with the Bacillus Calmette-Guerin (BCG) vaccine to protect them against TB. This will ensure that antibodies against Mycobacterium tuberculosis are developed and thus, the chances of suffering from tuberculosis are low. NEVER stop course of drugs midway it gives an opportunity to TB bacteria to develop resistance to the drugs. When these resistant bacilli are expelled into air, they can be taken in by healthy individuals. This in turn leads to increase in the number of people suffering from multiple drug resistant TB (MDR TB).’ Hence, makes sure that the prescribed course of treatment is completed.

BOOK AN APPOINTMENT