11/25 2018

Disease Paper # 2
Tuberculosis:

Tuberculosis is potentially fatal and contagious disease that can affect almost any part of
the body but mainly affects in the lungs. About One-third of the world population is affected
by the disease that is considered one of the top ten cause of death worldwide 1. People who
suffer from the disease are going thru unintentional weight loss, fatigue, chills, and chronic
coughing and bloody sputum for late stage.

Disease Overview:
The infection of tuberculosis or TB varies depending on the immune system of person.
Some infected person specially children can be initially exposed, fortunately, during the
exposure only 30 percent of those can get infected. Of the infected people only, five percent
of the infected will progress to active disease, this is called Active TB. The rest will maintain
the bacterium in the body and remain dormant without symptoms and can be activated in
the future, this is called latent TB.2

Tuberculosis is caused by rod shaped bacterium or a bacillus called mycobacterium

tuberculosis. An infection is initiated following inhalation of mycobacteria in aerosol
droplets atmosphere discharge by a person with an active infection. 3 Once in the lung, the
bacteria meet the first-line of defense which is the alveolar macrophages. The bacteria are
ingested by the macrophages but is not fully eliminated. However, it will be internally
enclosed by the body’s defense mechanism. The strength of the body’s immune response
determines whether an infection is arrested completely by immunity or progress to the
next stage.

For healthy people the infection may stops but for people with compromised immune
system like HIV, aging, malnourished, diabetes, tobacco smoking, the probability of
developing the disease is high. If there is a dormant mycobacterium in the body, there is
chance that it gets re activated. This reactivation may occur months or years after the initial
infection. In some cases, the bacteria may also spread to other organs via lymphatic
systems or in the bloodstream and can affects the brain, kidney and spine. This widespread
form of TB disease is called decimated TB or military TB can occurs in early and latent
infection or with HIV.

Testing for Tb often starts with a purified protein derivative or PPD intradermal skin test,
also known as tuberculin test or Mantoux test. This process involved in injecting tuberculin
between layers of the dermis. Because tuberculin is a component of the bacteria, it will
react to immune system if the person has previously been exposed to TB, by producing
wheal bigger than 5mm in the skin. If tested positive it won’t determine if the infection is

1
http://www.who.int/en/news-room/fact-sheets/detail/tuberculosis
2
http://www.infectionlandscapes.org/2013/04/tuberculosis.html
3
https://www.atsjournals.org/doi/abs/10.1164/rccm.200308-1101OC
latent or active so different criteria to diagnose could be done like chest x-ray and sputum
analysis.

The treatment available for TB varies depends on the infection. For latent infection a
therapy of Isoniazid for nine months is the best approach. For active infection, a
combination of antibiotics would be given to kill the bacteria. However, at this period a
patient is infectious to others so to avoid spreading the disease the patients are kept or
reside in a negative pressure room. It is also advisable to wear protective mask for
everyone who get in contact with the patient to avoid infection. Typically, even the
patientcare no longer contagious, they would still be given a medication to successfully get
rid of the bacteria in the system.

Undetected and untreated tuberculosis can generally result in widespread infection to

other organs. This can potentially lead to serious complications because it also weakens
your immune system specially people with HIV. Most people die from the disease are due
to severe lung problem like bacterial pneumonia due to septic shock. Some may also suffer
from Meningitis, liver cirrhosis, spinal pain, damaged joint, and kidney problems 4.

According to World Health Organization (WHO), someone dies of the disease every 15
seconds and eight million people have developed active TB every year worldwide. It is
prevalence in Asia specially in sub- Saharan Africa and countries is former Soviet Union.
Each one can infect between 10 and 15 people in one year just by breathing. A Report on
Global Tuberculosis Control the global incidence rate of TB is growing at approximately
0.4%/year. TB kills more people in India and throughout the South-East Asia Region
compare to other infectious disease such HIV, STD, malaria, and tropical diseases. 5 Overall,
about 90% of cases occur among adults, with more cases among men than women. The
male: female ratio among adults is approximately two and one. 6

Globally, tuberculosis is a burden in countries who have greater infections due to health
risk. International agencies like WHO response aggressively by providing support and
facilitating the needs to end the widespread infections of TB. In United States it monitored
by CDC and a vaccine is also available which makes it safer for the public.

Conclusions. Tuberculosis is indeed a threat due to its complications, however its

treatable. To successfully treat this disease the treatment regimen must be followed
accordingly. For countries with heavy infection, it is there best interest to be educated
about the health risk of TB and an easy access to medication should cut fatality rates

4
Chou-Han & Lin, Chou-Jui & Kuo, Yao-Wen & Wang, Jann-Yuan & Hsu, Chia-Lin & Chen, Jong-Min & Cheng, Wern-
Cherng & Lee, Li-Na. (2014). Tuberculosis mortality: Patient characteristics and causes. BMC infectious diseases.
14. 5. 10.1186/1471-2334-14-5.
5
http://www.who.int/genomics/public/geneticdiseases/en/index4.html#TB
6
http://www.who.int/tb/publications/global_report/en/