Students

Tuberculosis (TB) is a chronic, systemic, infectious disease caused by the bacterium called *Mycobacterium tuberculosis*, that most often affect the lungs.

TB is the leading cause of death among infectious diseases and one of the top 10 causes of death worldwide and the leading killer of HIV-positive people (in 2016, 40% of HIV deaths were due to TB). Seven countries account for 64% of the total TB cases, with Indian, Indonesia, China, Philippines ,Pakistan, NIGERIA and South Africa. Lagos state carries 8.4% of Nigeria’s TB burden. *Multidrug-resistant TB (MDR-TB)* remains a public health crisis and a health security threat. WHO estimates that there were 600 000 new cases with resistance to rifampicin – the most effective first-line drug, of which 490 000 had MDR-TB. Globally, TB incidence is falling at about 2% per year. This needs to accelerate to a 4–5% annual decline to reach the 2020 milestones of the End TB Strategy. An estimated 53 million lives were saved through TB diagnosis and treatment between 2000 and 2016. Ending the TB epidemic by 2030 is among the health targets of the Sustainable Development Goals.

TB affects different organs in the body such as kidneys, intestines, liver, womb, testes, skin, bones, joints etc but 80% of all cases affect the LUNGS.

*Mode of transmission*: TB is transmitted through the AIR. When a person with TB of the LUNGS or throat coughs, sneezes, spits or talks loudly, the germs get into the air. People nearby may breathe in these bacteria and thereby become infected.

*TYPES OF TB*: There are two types of TB conditions: *latent TB infection* and *Active TB disease*. TB bacteria can live in the body without making you sick. This is called latent TB infection. About one-quarter of the world’s population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit the disease. People infected with TB bacteria have a 5–15% lifetime risk of falling ill with TB. However, persons with compromised immune systems, such as people living with HIV, malnutrition or diabetes, or people who use tobacco, have a much higher risk of falling ill. In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. People with latent TB infection do not feel sick, do not have any symptoms, and cannot spread TB bacteria to others, but may still need treatment. If TB bacteria become active in the body and multiply, the person will go from having latent TB infection to being sick with TB disease. For this reason, people with latent TB infection are often prescribed treatment to prevent them from developing TB disease.

*Who is most at risk?*
Tuberculosis mostly affects adults in their most productive years. However, all age groups are at risk. Over 95% of cases and deaths are in developing countries.

–People who are infected with HIV are 20 to 30 times more likely to develop active TB.

–The risk of active TB is also greater in persons suffering from other conditions that impair the immune system.

–One million children (0–14 years of age) fell ill with TB, and 250 000 children (including children with HIV associated TB) died from the disease in 2016.

–Tobacco use greatly increases the risk of TB disease and death. 8% of TB cases worldwide are attributable to smoking.

–People living in or traveling to countries that have high rates of tuberculosis and drug-resistant tuberculosis, including: Africa, Eastern Europe, Asia, Russia, Latin America, Caribbean Islands.

–Other conditions that put one at risk of contacting TB include diabetes, malnutrition, severe kidney disease, certain cancers, cancer treatment, such as chemotherapy, drugs to prevent rejection of transplanted organs, some drugs used to treat rheumatoid arthritis, Crohn’s disease and psoriasis.

*Signs and symptoms:* Chest pain, difficulty in breathing, coughing out of blood, fever, weight loss, night sweats, chills, weakness. THE MOST IMPORTANT SYMPTOM OF TB IS PROLONGED, *PERSISTENT COUGH*. Anyone with cough of 3 weeks or more should be tested for tuberculosis.

*Diagnosis:* Many countries still rely on a long-used method called sputum smear microscopy to diagnose TB. Microscopy detects only half the number of TB cases and cannot detect drug-resistance. The use of the rapid test Xpert MTB/RIF® has expanded substantially since 2010, when WHO first recommended its use. The test simultaneously detects TB and resistance to rifampicin, the most important TB medicine. Diagnosis can be made within 2 hours and the test is now recommended by WHO as the initial diagnostic test in all persons with signs and symptoms of TB. Another method include chest x-ray. A diagnosis should be established promptly and accurately.

*Treatment:* TB is a treatable and curable disease. Active, drug-susceptible TB disease is treated with a standard *6 month course of 4 antimicrobial drugs* that are provided with information, supervision and support to the patient by a health worker or trained volunteer. Without such support, treatment adherence can be difficult and the disease can spread. The vast majority of TB cases can be cured when medicines are provided and taken properly.

BEWARE: The number and size of bacilli (bacteria) released in the AIR when;
Talking 0-200, Cough 0-3500, Sneezing 4500-1,000,000

*Prevention*: These include Active immunization using BCG, Screening of contacts of TB patients, Control of HIV/AIDS , Cough Hygiene (cover the mouth).

*Have a great Night Rest*