Tuberculosis

Using preventive drug therapy to destroy dormant bacteria that might become active in the future treats latent TB infection. Patient is given a daily dose of isoniazid for 6 months.

The short standard treatment for active pulmonary TB is isoniazid, rifampicin, pvrazinamide and ethambutol for 2 months and then isoniazid and ridampicin for another four months. After the 6-month course patient is considered to be cured.

However depending upon the result of susceptibility test and drug resistance ability medication may be changed or stopped after a few months.

Once treatment starts, sputum smears are done regularly to examine the improvement in individuals.

Surgery is only used to when patient with multi-drug resistant TB bacteria does not respond effectively to the treatment. A patient, who has TB culture result positive after many months of treatment, may be referred for lobectomy or peumonoectomy, where the infected tissue is surgically removed.

Majority of TB relapses occur within 6 months of finishing treatment. Patients that took medication irregularly are more likely to relapse. However studies show most of patients who relapse do so with fully sensitive strain and is possible that these patients have not relapsed but perhaps has been re-infected. Such patients can be re-treated with the same medication regimen as before.

Side Effects of Tuberculosis Medication

• Jaundice/ hepatitis
• Persistent itchiness
• Upset stomach
• Nausea
• Loss of appetite
• Pins and needles, numbness or tingling in the hands or feet
• Rash, bruising or yellowing of the skin
• Dark colour urine [orange/ red]
• Tenderness/ soreness in abdomen
• Blood in urine
• Blurred vision/ coloured blindness

Side Effects of Specific TB Medication

• Isoniazid -
  • Tired or nauseous or loss of appetite
  • Numbness or tingling in your hands or feet
• Rifampicin -
  • Reduces the effectiveness of the contraceptive pill
  • It can stain lens implants and contact lenses
• Ethambutol -
  • Cause visual problems
• Pyrazinamide -
  • Nausea and a loss of appetite
  • Unexplained rashes, fever, aches or joint pains

Prevention

1. The Bacillus Calmette-Guérin vaccination is used in many part of the world. It prevents the spread of TB bacteria in babies but does not prevent the infection.
2. Preventive therapy is used for people at risk of developing active TB disease before they become affected. It is of significant importance to people with:
   1. Latent TB
      1. Lose contact with infectious pulmonary TB patient
      2. At risk of / are HIV infected
      3. Medical conditions known to increase risk of TB e.g. renal disease
3. Ultraviolet overhead light used to help prevent the spread of disease at hospital where non-infected people come in contact with contagious TB patients

Control

1. Screening to identify persons who have active TB disease or latent TB infection
2. People who have suspected or confirmed TB disease/ infection should be identified promptly and initiate appropriate medical treatment
3. People suspected of having infectious TB disease should be placed immediately in an appropriate TB isolation room
4. People infected with M. tuberculosis, especially those in high-risk groups, should have a thorough medical evaluation and preventive therapy when appropriate. Preventive therapy should be directly observed.
5. People who are careless about taking their medication and risk the chance of creating multi-drug resistant TB bacteria should contact the Directly Observed Therapy Short-course [DOTS] program, where a heath care professional administrate the drugs so the patients don't have to remember to take it on their own

Treatment and prevention has greatly reduced the number of tuberculosis cases in developed countries. But it still remains as a major problem in homeless people and third world countries.