Tuberculosis (TB) is a contagious infection usually affecting the lungs, caused by the pathogenic bacteria called Mycobacterium tuberculosis. It is a well-known and stigmatised major public health challenge globally and can practically affect any organ of the body. The most common are lungs, pleura, lymph nodes, intestines, spine and brain. Not only this, it is the leading cause of death from a single infectious agent. To understand more about it, we spoke to our expert Dr Bandana Mishra, Head of Department, Senior Consultant, Department of Pulmonology, SHALBY Sanar International Hospitals, Gurugram, who explained the differences between infectious and non-infectious TB.
Infectious Vs Non-Infectious Tuberculosis
Tuberculosis disease in the throat and lungs is considered to be infectious because it can spread through coughing and sneezing. It is also called Pulmonary Tuberculosis. According to the Centers for Disease Control and Prevention (CDC), in certain individuals, TB bacteria breach the immune system's defences and proliferate, leading to the transition from latent TB infection to active TB disease. While some individuals may develop TB disease shortly after infection, others may experience it later when their immune system is compromised.
If the bacteria and disease are present in the pleura, lymph nodes, intestines, kidneys, spine, bones and brain, it is said to be mainly non-infectious because the infection is contained and does not spread to other people. According to the CDC, the sole indication of TB infection is a positive response to either the tuberculin skin test or TB blood test. Individuals with latent TB infection are non-contagious and incapable of transmitting the infection to others.
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Causes Of Tuberculosis
“TB is a disease that is often caused by overcrowding, malnutrition, smoking, and poverty. It is considered a societal disease because it affects people from both ends of the socioeconomic spectrum. Those living below the poverty line and those coming from affluent societies are equally susceptible to TB”, said Dr Mishra.
Patients suffering from Diabetes mellitus, HIV or any other disease which leads to suppression of the immune system are at very high risk of acquiring TB.
Survey, Statistics and The Story
According to the Global TB Report 2023, tuberculosis is responsible for causing almost twice as many deaths as HIV/AIDS. Shockingly, over 10 million people still suffer from TB every year. In 2022, 87% of the world's TB cases were reported in 30 countries that are highly affected by the disease. According to the report, there will be 3,42,000 TB-related deaths in India during 2022, of which 3,31,000 will be caused by HIV/AIDS and 11,000 by TB.
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Multidrug Resistant Tuberculosis (MDR-TB)
According to the 2023 report, MDR-TB is a type of tuberculosis caused by bacteria that do not respond to the two most powerful first-line anti-TB therapy drugs. This makes it difficult to treat and hence it is called multidrug-resistant.
“MDR-TB is usually caused by missing doses and not following the treatment regimen properly. However, it can be treated with second-line drugs. People who have contracted MDR-TB are screened and monitored for latent TB. The treatment of MDR-TB has a duration of two years and it is considered expensive for some populations”, said Dr Mishra.
India recorded 1.1 lakh cases of Multidrug-Resistant TB (MDR-TB) in 2022, highlighting the continued challenge of MDR-TB as a public health crisis, according to the report. “Extensively drug-resistant TB (XDR-TB) is a far more serious form of MDR-TB in which the causative bacteria does not respond to the most effective second-line anti-TB drugs, often leaving patients without any further treatment options”, added Dr Mishra.
As per the stages of pulmonary tuberculosis and the extent of the organ involved, the treatment mainly involves medical management and occasionally surgical management.
The earlier the Diagnosis, the better the Prognosis
Dr Mishra highlighted, “In India, stigma related to the diagnosis and the treatment of TB is reported majorly by women among other patients. Apprehensions related to the prospects of marriage, fear of separation or divorce after the diagnosis and losing their job are the primary reasons behind the stigmatisation. Patients undergoing the Directly Observed Treatment Short-course (DOTS) experience both psychological and social suffering.”
Bottomline
Dr Mishra concluded, “Encouraging them to come forward, consult with a doctor and take complete and proper treatment can help reduce the stigma and achieve successful treatment outcomes. Tuberculosis, like any other serious illness, is completely curable and has a good prognosis if diagnosed early.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your expert if you are dealing with any health issues to get the necessary treatment.]