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Thursday, September 21, 2023

Tuberculosis: Management and Prevention

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Tuberculosis, TB, or MTB is an infectious disease that generally affects the lungs and can sometimes affect other parts of the body. Also called phthisis, phthisis pulmonalis, or consumption, tuberculosis is caused by different strains of mycobacteria, with Mycobacterium tuberculosis as the most common strain.

The mode of transmission for tuberculosis is airborne, since the causative agent is spread through air when people who have the disease cough, sneeze, or release respiratory fluids though the air.

According to Centers for Disease Control and Prevention (CDC), tuberculosis is one of the deadliest diseases in the world and it accounts for one-third of the world’s population. The publication also mentioned that 9.6 million people around the world became infected with tuberculosis in 2014 and there were 1.5 million cases of mortality cases related to the disease globally. It was also mentioned that the number of cases reported and case rate decline by 1.5 to 2.2 percent, as compared to 2013, and this serves as the narrowest decline in more than a decade.

Tuberculosis exhibit several symptoms. According to Mayo Clinic, the common symptoms of tuberculosis include coughing that lasts more three weeks or more, hemoptysis or coughing up blood, chest pain that is associated with coughing or breathing, unintentional fat loss, fatigue, fever, night sweats, chills, and loss of appetite.

Following the appearance of the symptoms, it is also noted that tuberculosis can also present other signs and symptoms, as it affects other parts of the body, such as the kidneys, the spine, and the brain. A case in point is back pain for a spin affectation while presence of blood in the urine may be a symptom of tuberculosis in the kidneys. While complications are not presence in some people, tuberculosis complications may be mild to severe. According to Medicine Net, these include damage in lung and liver function, bone pain, cardiac tamponade, meningitis, visual disturbances, among others.

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Non-Pharmacological Management

Non-pharmacological management for tuberculosis revolve around nutrition and balance in activity and rest for oxygen conservation and improved oxygenation. According to the World Health Organization (WHO), undernutrition elevates the risk of tuberculosis in people and the disease itself could result to malnutrition. It is also noted as a highly prevalent condition in people with tuberculosis and it can accelerate the condition to an active state, from the time of diagnosis.


Pharmaceutical Management

For active tuberculosis, medical management includes the administration of multiple drugs, which aim to yield bacterial clearance, decrease the risk of transmission, and avoid the drug resistance. According to National Institute of Health, directly observed therapy stands as the preferred management therapy for people who are being treated for tuberculosis. The therapy involves direct observation of patients taking anti-tuberculosis medications, as well as close collaboration among health care professionals and local public health programs, with a patient-centered approach.

For latent tuberculosis infection, treatment is started only after active tuberculosis has been ruled out by both clinical and radiographic evaluations, as failure to exclude them may lead to insufficient treatment and the emergence of drug resistance. Isoniazid is part of the treatment regimen for nine months and supplementation of Vitamin B6 or Pyridoxine is done to prevent the risks of having neuropathy. The combined doses of Rifampicin and Pyrazinamide are no longer recommended for the treatment of latent tuberculosis infection because of the high incidence of liver injury, leading to hospitalization and death.


Tuberculosis Prevention

To prevent tuberculosis, setting up a bar against the transmission is recommended. According to Web MD, one should not spend long periods of time in closed and crowded rooms with anyone with active tuberculosis until the person has been treated for at least two weeks. As protective measures like face masks (N95) can be used if one works in a facility that cares for people who have the condition. Moreover, strict medical compliance is emphasized on a person who has active tuberculosis.

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One should consider seeking immediate medical consult if signs and symptoms, such as fever, with unexplained weight loss, night sweats, and persistent cough, are present.

Overall, tuberculosis can be managed by strict pharmaceutical compliance, along with proper nutrition, adequate activity, sleep, and rest, and positive outlook in life.

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