Tuberculosis: Causes, Prevention and Management
Written By THT Editorial Team
Reviewed by Sujata Shakya, Public Health Practitioner, Assistant Professor, Public health (IOM)
Tuberculosis (TB) is a contagious infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs but can also impact other parts of the body. Understanding the causes, prevention, and management of TB is essential for controlling its spread and reducing its impact on public health.
Causes of Tuberculosis:
Tuberculosis is caused by the transmission of Mycobacterium tuberculosis from an infected individual to a susceptible person. The bacteria can be spread through the air when an infected individual coughs, sneezes, or speaks, releasing respiratory droplets containing the bacteria (1). Factors such as overcrowded living conditions, poor ventilation, and compromised immune systems increase the risk of TB transmission (2).
Prevention of Tuberculosis:
Preventative measures play a crucial role in reducing the incidence of TB. Some examples of preventative measures include:
Vaccination: Bacille Calmette-Guérin (BCG) vaccine is used to prevent severe forms of TB in children. It provides partial protection against TB and reduces the risk of disseminated TB in infants and young children (3). However, the BCG vaccine’s effectiveness in preventing pulmonary TB, the most common form of the disease, varies and is generally less effective in adults.
Infection Control: Implementing effective infection control measures is crucial to prevent the spread of TB. This includes identifying and promptly isolating individuals with active TB, ensuring proper ventilation in healthcare facilities, and promoting cough etiquette (4).
Screening and Testing: Active case finding and early detection of TB cases are essential for preventing further transmission. Regular screening of high-risk populations, such as close contacts of TB patients, healthcare workers, and individuals living with HIV, is recommended. Diagnostic tests such as sputum smear microscopy, molecular tests, and chest X-rays are used to detect TB infection (5).
Treatment of Latent TB Infection: Individuals with latent TB infection, who have the TB bacteria in their bodies but do not have active disease, can progress to active TB if not treated. Treating latent TB infection with antibiotics, such as isoniazid or rifampin, can prevent the development of active TB disease (6).
Management of Tuberculosis:
TB management focuses on early diagnosis, appropriate treatment, and adherence to medication. Some key aspects of TB management include:
Directly Observed Therapy (DOT): DOT is a strategy in which healthcare providers or trained community health workers directly observe patients taking their TB medications. This approach ensures treatment adherence and helps prevent the development of drug-resistant TB (7).
Drug Therapy: TB is treated with a combination of antibiotics for a specific duration. The standard treatment regimen for drug-susceptible TB includes a combination of isoniazid, rifampin, ethambutol, and pyrazinamide. Drug-resistant TB requires more complex treatment regimens using second-line drugs (8).
Contact Investigation: Identifying and testing individuals who have had close contact with TB patients is crucial for early detection of TB cases and preventing further transmission. Contact investigation involves screening and testing close contacts to identify latent TB infection or active TB disease (9).
Adherence Support: Ensuring treatment adherence is vital for successful TB management and prevention of drug resistance. Providing patient education, counseling, and support services can improve medication adherence and treatment outcomes (10).
Conclusion:
Preventing and managing tuberculosis requires a comprehensive approach involving vaccination, infection control measures, screening and testing, treatment of latent infection, and effective management of active TB cases. By implementing evidence-based preventative measures and ensuring early diagnosis and appropriate treatment, communities can work towards reducing the burden of tuberculosis and protecting public health.
REFERENCES
- World Health Organization. (2020). Tuberculosis (TB). Retrieved from https://www.who.int/news-room/fact-sheets/detail/tuberculosis.
- Centers for Disease Control and Prevention. (2020). Tuberculosis (TB) transmission and prevention. Retrieved from https://www.cdc.gov/tb/topic/basics/transmission.htm.
- World Health Organization. (2020). Bacille Calmette-Guérin (BCG) vaccine. Retrieved from https://www.who.int/news-room/fact-sheets/detail/bacille-calmette-gu%C3%A9rin-(bcg)-vaccine.
- World Health Organization. (2019). WHO guidelines on tuberculosis infection prevention and control: 2019 update. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/311259/9789241550512-eng.pdf.
- World Health Organization. (2020). WHO consolidated guidelines on tuberculosis: Module 3: Diagnosis – Rapid diagnostics for tuberculosis detection. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/331588/9789240007048-eng.pdf.
- World Health Organization. (2015). Guidelines on the management of latent tuberculosis infection. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/136471/9789241548908_eng.pdf.
- World Health Organization. (2021). WHO consolidated guidelines on tuberculosis: Module 4: Treatment – Drug-resistant tuberculosis treatment. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/340205/9789240016026-eng.pdf.
- World Health Organization. (2019). WHO consolidated guidelines on tuberculosis: Module 1: Prevention – Tuberculosis preventive treatment. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/311255/9789241550529-eng.pdf.
- World Health Organization. (2012). Recommendations for investigating contacts of persons with infectious tuberculosis in low- and middle-income countries. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/77741/9789241504492_eng.pdf.
- World Health Organization. (2014). Adherence to long-term therapies: Evidence for action. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/42682/9241545992.pdf.