Tuberculosis: a disease that affects the lives of millions of people every year (Part2)

In this second part of the tuberculosis (TB) blog we will explain how tuberculosis is diagnosed, what is its treatment and what are the preventive measures that all people with tuberculosis should take into account, for themselves and for the people with whom they live.

CONTENT

  1. How is tuberculosis diagnosed?
  2. All people are screened for tuberculosis?
  3. What is the treatment for tuberculosis?
  4. What is the care that I should have at home if I have tuberculosis disease?

1. How is tuberculosis diagnosed?

Tuberculosis can usually be diagnosed by laboratory tests in the context of a person with symptoms consistent with the disease or a history of close contact with a person diagnosed with tuberculosis. Below we will name the main laboratory tests for the diagnosis of the disease:

Chest X-ray: Look for lesions or masses in the lung
Bacilloscopy: It looks for tuberculosis bacteria in the sputum (phlegm), it serves both for the diagnosis and for the follow-up of the treatment.
Bacteriological culture: After the Bacilloscopy is done, the sputum is left in a culture medium for the bacteria to grow, the result can take weeks
Tuberculin test: Used for the diagnosis of latent TB, since it only informs if the person was infected by the bacteria and does not clarify whether or not they have a TB disease at the time. It can be repeated but it would be necessary to do it in another part of the body. It is safe during pregnancy
Blood tests or gamma interferon release: like tuberculin test it will only report if the person has been infected by the tuberculosis bacteria, not if they have an active disease at the time. It has the advantage that it is not altered by the BCG vaccine.
PCR or sensitivity tests: Bacteria can sometimes become resistant to certain antibiotics, which is why resistance tests should be carried out before starting treatment to know in advance which antibiotics will work or not in a certain person.

2. All people are screened for tuberculosis?

The answer is no, only people at high risk for the infection are tested for TB, including:

  • People with HIV
  • People who will take or use immunosuppressive medications
  • People who live with other people with TB disease
  • Health workers
  • People with symptoms compatible with the disease

So if you have symptoms of the disease or a family member who lives with you has been diagnosed with tuberculosis, the best decision is to go to your doctor.

3. What is the treatment for tuberculosis?

As we explained in the previous blog, tuberculosis has two presentations: latent tuberculosis infection (in which there are no symptoms) and tuberculosis disease (in which one or more of the symptoms may appear). Both require treatment since failure to do so could put the person at risk of complications from the disease.

For latent tuberculosis infection, treatment includes the use of isoniazid or rifampin or rifapentine. Treatment can last from 3 to 9 months depending on the dose and combination of drugs used. Who decides the duration and medications is the treating physician.

For tuberculosis disease, treatment includes the use of four antibiotics: isoniazid, rifampin, pyrazinamide, and ethambutol. The scheme is divided into 2 phases, the first called intensive or initial where the four antibiotics will be used with an approximate duration of two months and the second called continuation in which the antibiotics to be used will be reduced to two, but its duration will be approximately four to seven months.

4. What is the care that I should have at home if I have tuberculosis disease?

The Colombian Ministry of Health gives the following recommendations to people with tuberculosis disease:

  • Tuberculosis disease is curable, so you must take the medicines the way your doctor sent them
  • Taking the right medicines reduces the transmissibility of the infection
  • Do not skip any dose of the treatment
  • In case of presenting any symptoms related to the consumption of medicines such as itching, vomiting, yellow coloration of the skin, you should inform your doctor
  • If you live with a person under 15 years of age, or who has diseases that lower the defenses such as HIV, cancer, diabetes, request your valuation; to rule out the risk of having acquired the infection.
  • It is not necessary to separate cutlery or personal utensils since tuberculosis is not transmitted by food or by saliva. Adequate washing with soap and water is sufficient.
  • Avoid coughing or sneezing without covering your mouth
  • Avoid visits from people under 5 years old, people with HIV, diabetics or those who have other immunosuppressants, during the first 15 days after starting treatment
  • If possible, the bedroom should be ventilated with access to sunlight, with large windows that allow air to circulate.
  • Smoking should be avoided.
  • Alcohol consumption should be avoided.

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