Tuberculosis

According to Medilexicon`s medical dictionary, tuberculosis is "A specific disease caused by

infection withMycobacterium tuberculosis, the tubercle bacillus, which can affect almost any tissue or
organ of the body, the most common site of the disease being the lungs."

When a person becomes infected with tuberculosis, the bacteria in the lungs multiply and
cause pneumonia along with chest pain, coughing up blood, and a prolonged cough. In addition,
lymph nodes near the heart and lungs become enlarged. As the TB tries to spread to other parts of
the body, it is often interrupted by the body's immune system. The immune system forms scar tissue
or fibrosis around the TB bacteria, and this helps fight the infection and prevents the disease from
spreading throughout the body and to other people. If the body's immune system is unable to fight
TB or if the bacteria breaks through the scar tissue, the disease returns to an active state with
pneumonia and damage to kidneys, bones, and the meninges that line the spinal cord and brain.

TB is generally classified as being either latent or active. Latent TB occurs when the bacteria are
present in the body, but this state is inactive and presents no symptoms. Latent TB is also not
contagious. Active TB is contagious and is the condition that can make you sick with symptoms.

TB is a major cause of illness and death worldwide, especially in Africa and Asia. Each year the
disease kills almost 2 million people. The disease is also prevalent among people with HIV/AIDS.
Global tuberculosis campaign threatened by multi-drug resistance
In October 2012, Dr. Mario Raviglione, Director of the WHO Stop TB Department, warned thatthe
number of people becoming infected with MDT-TB (multi-drug-resistant) tuberculosis has risen
considerably. He added that too few are being diagnosed and treated.

The global campaign to reduce TB infections by half by 2015 could be seriously jeopardized by
MDT-TB.

We are now at a crossroads, Dr. Raviglione emphasized - either we eradicate TB in our lifetime, or
the disease becomes increasingly resistant, harder to treat, and gains ground.

In March 2013 WHO, warned about a serious funding shortage. Dr. Margaret Chan, Director-
General of WHO warned that without expanded treatment and funding, the global fight against TB
will be seriously undermined. Dr. Chang said "We are treading water at a time when we desperately
need to scale up our response to MDR-TB. We have gained a lot of ground in TB control through
international collaboration, but it can easily be lost if we do not act now."
What causes tuberculosis?
Tuberculosis is ultimately caused by the Mycobacterium tuberculosis that is spread from person to
person through airborne particles. It is not guaranteed, though, that you will become infected with TB
if you inhale the infected particles. Some people have strong enough immune systems that quickly
destroy the bacteria once they enter the body. Others will develop latent TB infection and will carry
the bacteria but will not be contagious and will not present symptoms. Still others will become
immediately sick and will also be contagious.
What are the symptoms of tuberculosis?
Most people who become infected with the bacteria that cause tuberculosis actually do
not present symptoms of the disease.
How is tuberculosis diagnosed?
Tuberculosis diagnosis usually occurs after a combination of skin, blood, and imaging tests.

Who gets tuberculosis?
Although anyone can become infected with TB, some people are at a higher risk, such as:
Those who live with others who have active TB infections
Poor or homeless people
Foreign-born people who come from countries with endemic TB
Older people, nursing home residents, and prison inmates
Alcoholics and intravenous drug users
Those who suffer from malnutrition
Diabetics, cancer patients, and those with HIV/AIDS or other immune system problems
Health-care workers
Workers in refugee camps or shelters
How is tuberculosis treated?
Treatment for TB depends on the whether the disease is active of latent. If TB is in an inactive state,
an antibiotic called isoniazid (INH) is prescribed for six to twelve months. INH is not prescribed to
pregnant women, and it can cause side effects such as liver damage and peripheral neuropathy.

Active TB is treated with INH as well as drugs such as rifampin, ethambutol, and pyrazinamide. It is
also not uncommon for TB patients to receive streptomycin if the disease is extensive. Drug
therapies for TB may last many months or even years.

If a patient has a drug-resistant strain of TB, several drugs in addition to the main four are usually
required. In addition, treatment is generally much longer and can require surgery to remove
damaged lung tissue.

The largest barrier to successful treatment is that patients tend to stop taking their medicines
because they begin to feel better. It is important to finish medications in order to completely
eradicate the TB bacteria from the body.

In December 2012, Sirturo (bedaquiline) was approved as part of a combination therapy for adults
with multi-drug resistant TB. According to the FDA, bedaquiline was the first TB drug to be approved
in the USA in forty years.
Vitamin C helps destroy drug-resistant tuberculosis
Researchers at Albert Einstein College of Medicine, Yeshiva University, reported in the
journalNature Communications (May 2013 issue) that vitamin C, when added to existing TB
medications, can shorten treatment duration.

The team say that their finding may change how new TB medications are designed.

The scientists say they had been analyzing how TB bacteria become resistant to a first line drug for
TB called isoniazid when they made their surprising discovery.

Team leader, William Jacobs, Jr., Ph.D., explained that they had noticed that the TB bacteria that
were resistant to isoniazid were lacking in mycothiol (a molecule). "We hypothesized that TB
bacteria that can't make mycothiol might contain more cysteine, an amino acid. So, we predicted that
if we added isoniazid and cysteine to isoniazid-sensitive M. tuberculosis in culture, the bacteria
would develop resistance. Instead, we ended up killing off the culture - something totally
unexpected."

Dr. Jacobs believes that cysteine helps destroy TB bacteria by acting as a reducing agent that elicits
the creation of free radicals, which can damage DNA.

Jacobs, said "To test this hypothesis, we repeated the experiment using isoniazid and a different
reducing agent - vitamin C. The combination of isoniazid and vitamin C sterilized the M. tuberculosis
culture. We were then amazed to discover that vitamin C by itself not only sterilized the drug-
susceptible TB, but also sterilized MDR-TB and XDR-TB strains."






Narrative Report on Tuberculosis
Tuberculosis (TB) is an infectious disease that is caused by a bacterium called
Mycobacterium tuberculosis. TB primarily affects the lungs, but it can also affect organs
in the central nervous system, lymphatic system, and circulatory system among others.
The disease was called "consumption" in the past because of the way it would consume
from within anyone who became infected. In March 2013 WHO, warned about a serious
funding shortage. Dr. Margaret Chan, Director-General of WHO warned that without
expanded treatment and funding, the global fight against TB will be seriously
undermined. Dr. Chang said "We are treading water at a time when we desperately
need to scale up our response to MDR-TB. We have gained a lot of ground in TB
control through international collaboration, but it can easily be lost if we do not act now."
Tuberculosis is spread from person to person through tiny droplets of infected
sputum that travel through the air. If an infected person coughs, sneezes, shouts, or
spits, bacteria can enter the air and come into contact with uninfected people who
breath the bacteria into their lungs.
Most people who become infected with the bacteria that cause tuberculosis
actually do not present symptoms of the disease. However, when symptoms are
present, they include unexplained weight loss, tiredness, fatigue, shortness of
breath, fever, night sweats, chills, and a loss of appetite. Symptoms specific to the lungs
include coughing that lasts for 3 or more weeks, coughing up blood, chest pain, and
pain with breathing or coughing.

There is a vaccine available to prevent tuberculosis called the BCG vaccine that
is used in several parts of the world where TB is common. This vaccine usually protects
children and infants from the disease, but adults can still get TB after being vaccinated
as children. In addition, Researchers at Albert Einstein College of Medicine, Yeshiva
University, reported in the journal Nature Communications (May 2013 issue)
that vitamin C, when added to existing TB medications, can shorten treatment duration.

Better methods of preventing tuberculosis or TB relapses include eating a
healthful diet that takes care of your immune system, getting a TB test regularly if you
work or live in a high risk environment, and finishing TB medications. To prevent
transmitting the disease to others if you are infected, stay home, cover your mouth, and
ensure proper ventilation.

Vanessa Kristine G. Dagooc
BSN-4, BSU-College of Nursing