TUBERCULOSIS

INDEX
1. Certificate.

2. Acknowledgement.

3. What is Tuberculosis?

4. Causes.

5. Signs and Symptoms.

6. Diagnosis.

7. Treatment.

8. Prognosis.

9. Epidemiology.

10. Bibliography.
 CERTIFICATE
DELHI PUBLIC SCHOOL, VJA.

This is to certify that …..of class…. bearing the Roll No: 2 has satisfactorily completed the Biology Project
during the academic session 20…..

Teacher In-Charge
 Acknowledgement
I would like to express my special thanks of gratitude to my teacher ….. ma'am as well as ……. who gave
me the golden opportunity to do this wonderful project on the topics related to health problems , which
also helped me in doing a lot of research about the topic I chose, Tuberculosis and I came to know
about so many new things I am really thankful to them.

Secondly I would also like to thank my parents and friends who helped me a lot in finalizing this project
within the limited time frame.
 WHAT IS TUBERCULOSIS
Tuberculosis -- or TB, as it’s commonly called -- is a contagious infection that usually attacks the lungs.
It can also spread to other parts of the body, like the brain and spine.
A type of bacteria called Mycobacterium tuberculosis causes it.
Types of Tuberculosis
A]. Pulmonary tuberculosis [85%]
B]. Extra Pulmonary tuberculosis [15%]
-L.N -Bone of joint
-Intestinal
-CNS (TBM, tuberculoma)
-Renal
-Genital
-Disseminated [ miliary]
 CAUSES
Tuberculosis (TB) is caused by a type of bacterium called Mycobacterium tuberculosis.
It's spread when a person with active TB disease in their lungs coughs or sneezes and someone else
inhales the expelled droplets, which contain TB bacteria. Although TB is spread in a similar way to
a cold or the flu, it isn't as contagious.
TB is contagious, but it’s not easy to catch. The germs grow slowly. You usually have to spend a lot of time
around a person who has it. That’s why it’s often spread among co-workers, friends, and family members.
Tuberculosis germs don’t thrive on surfaces. You can’t get the disease from shaking hands with someone
who has it, or by sharing their food or drink.
 SIGNS AND SYMPTOMS
Although your body may harbour the bacteria that cause tuberculosis, your immune system usually can prevent you from
becoming sick. For this reason, doctors make a distinction between:
Latent TB. In this condition, you have a TB infection, but the bacteria remain in your body in an inactive state and cause no
symptoms. Latent TB, also called inactive TB or TB infection, isn't contagious. It can turn into active TB, so treatment is
important for the person with latent TB and to help control the spread of TB. An estimated 2 billion people have latent TB.
Active TB. This condition makes you sick and can spread to others. It can occur in the first few weeks after infection with the
TB bacteria, or it might occur years later.
■ Signs and symptoms of active TB include:
■ Coughing that lasts three or more weeks
■ Coughing up blood
■ Chest pain, or pain with breathing or coughing
■ Unintentional weight loss
■ Fatigue
■ Fever
■ Night sweats
■ Chills
■ Loss of appetite
Tuberculosis can also affect other parts of your body, including your kidneys, spine or brain. When TB occurs outside your
lungs, signs and symptoms vary according to the organs involved. For example, tuberculosis of the spine may give you back
pain, and tuberculosis in your kidneys might cause blood in your urine.
 DIAGNOSIS
During the physical exam, your doctor will check your lymph nodes for swelling and use a stethoscope to
listen carefully to the sounds your lungs make while you breathe.
The most commonly used diagnostic tool for tuberculosis is a simple skin test, though blood tests are
becoming more commonplace. A small amount of a substance called PPD tuberculin is injected just
below the skin of your inside forearm. You should feel only a slight needle prick.
Within 48 to 72 hours, a health care professional will check your arm for swelling at the injection site. A
hard, raised red bump means you're likely to have TB infection. The size of the bump determines whether
the test results are significant.
Results can be wrong
The TB skin test isn't perfect. Sometimes, it suggests that people have TB when they really don't. It can
also indicate that people don't have TB when they really do.
A false-positive test may happen if you've been vaccinated recently with the bacillus Calmette-Guerin
(BCG) vaccine. This tuberculosis vaccine is seldom used in the United States but is widely used in
countries with high TB infection rates.
False-negative results may occur in certain populations — including children, older people and people
with AIDS — who sometimes don't respond to the TB skin test. A false-negative result can also occur in
people who've recently been infected with TB, but whose immune systems haven't yet reacted to the
bacteria.
Blood tests
■ Blood tests may be used to confirm or rule out latent or active tuberculosis. These tests use
sophisticated technology to measure your immune system's reaction to TB bacteria. QuantiFERON-TB
Gold in-Tube test and T-Spot. TB test are two examples of TB blood tests.
■ These tests require only one office visit. A blood test may be useful if you're at high risk of TB infection
but have a negative response to the skin test, or if you've recently received the BCG vaccine.
Imaging tests
■ If you've had a positive skin test, your doctor is likely to order a chest X-ray or a CT scan. This may show
white spots in your lungs where your immune system has walled off TB bacteria, or it may reveal
changes in your lungs caused by active tuberculosis. CT scans provide more-detailed images than do
X-rays.
Sputum tests
■ If your chest X-ray shows signs of tuberculosis, your doctor may take samples of your sputum — the
mucus that comes up when you cough. The samples are tested for TB bacteria.
■ Sputum samples can also be used to test for drug-resistant strains of TB. This helps your doctor
choose the medications that are most likely to work. These tests can take four to eight weeks to be
completed.
 TREATMENT
With the proper treatment, tuberculosis (TB, for short) is almost always curable.
Doctors prescribe antibiotics to kill the bacteria that cause it. You’ll need to take them for 6 to 9 months.
What medications you take and how long you’ll have to take them depends on which works to eradicate
your TB. Sometimes, antibiotics used to treat the disease don’t work. Doctors call this "drug-resistant" TB.
If you have this form of the disease, you may need to take stronger medications for longer.
Treatment for Latent TB
There are two types of TB -- latent and active.

Depending on your risk factors, latent TB can re-activate and cause an active infection. That’s why your
doctor might prescribe medication to kill the inactive bacteria -- just in case.
These are the three treatment options:
■ Isoniazid (INH): This is the most common therapy for latent TB. You typically take an isoniazid
antibiotic pill daily for 9 months.
■ Rifampin : You take this antibiotic each day for 4 months. It’s an option if you have side effects or
contraindications to INH.
■ Isoniazid and rifapentine: You take both of these antibiotics once a week for 3 months under your
doctor’s supervision.
Treatment for Active TB
If you have this form of the disease, you’ll need to take a number of antibiotics for 6 to 9 months.
These four medications are most commonly used to treat it:
■ Ethambutol
■ Isoniazid
■ Pyrazinamide
■ Rifampin
Your doctor may order a test that shows which antibiotics will kill the TB strain. Based on the results,
you’ll take three or four medications for 2 months. Afterward, you’ll take two medications for 4 to 7
months.
You’ll probably start to feel better after a few weeks of treatment. But only a doctor can tell you if
you’re still contagious. If you’re not, you may be able to go back to your daily routine.

Treatment for Drug-Resistant TB

If you have a TB strain that doesn’t respond to certain medications, you’ll need to see a TB specialist.
If several types of medications don't do the job, you have what doctors call “multidrug-resistant TB.”
You’ll need to take a combination of medications for 20 to 30 months. They include:
■ Antibiotics called fluoroquinolones
■ An injectable antibiotic, such as amikacin, kanamycin, and capreomycin
■ Newer antibiotic treatments, such as linezolid and bedaquiline. These are given in addition to other
medications. Scientists are still studying these medicines.
A rare and serious type of the disease is called "extensively drug-resistant TB." This means that many of
the common medications -- including isoniazid, rifampin, fluoroquinolones, and at least one of the
antibiotics that are injected -- don't knock it out. Research shows that it can be cured around 30% to
50% of the time.
 PROGNOSIS
■ Follow treatment schedule: Long-term prognosis for most treated patients with TB is generally good.
Appropriate treatment (the right drugs for right duration) can cure more than 90 percent of TB
patients. Patients with TB require treatment with multiple drugs for several months. Most people
improve after a few weeks upon starting treatment, but the TB bacteria are still active in their bodies.
Complete cure of infection needs months of treatment. Discontinuing medication after a few months
of treatment makes cure more difficult as these people may develop drug-resistant TB. Drug-resistant
TB does not respond to the standard medications, needs more number of medications, is much
harder to treat and has a higher risk of death than non-drug-resistant TB. To ensure good prognosis of
TB, it is important to take all the medications at the recommended dose for the entire duration of
treatment. Not following the recommended schedule (altering the schedule of medication, missing
doses or failing to take the medication) increases the risk of complications and death in TB.
■
Warning: TB does not go away without treatment. Prognosis of people with untreated TB is far worse
than those, who seek treatment. Estimates show that about 50 percent of people with untreated TB
die within 5 years.
■
Relapse: In some people, TB bacilli are not completely eradicated even after completion of therapy
(correct medications for the recommended duration). These people may experience a relapse after
the successful completion of prescribed treatment plan. These people need longer treatment perhaps
with different drugs than those they received previously for cure.
 EPIDEMIOLOGY
■ Tuberculosis (TB) is one of the top 10 causes of death worldwide.
■ In 2017, 10 million people fell ill with TB, and 1.6 million died from the disease (including 0.3 million
among people with HIV).
■ In 2017, an estimated 1 million children became ill with TB and 230 000 children died of TB
(including children with HIV associated TB).
■ TB is a leading killer of HIV-positive people.
■ Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat. WHO
estimates that there were 558 000 new cases with resistance to rifampicin – the most effective first-
line drug, of which - 82% 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 54 million lives were saved through TB diagnosis and treatment between 2000 and
2017.
■ Ending the TB epidemic by 2030 is among the health targets
of the Sustainable Development Goals.
 BIBLIOGRAPHY
■ scholar.google.co.in
■ worldhealth.med.ucla.edu
■ www.thetruthabouttb.org
■ www.google.com
■ erj.ersjournals.com
■ www.ncbi.nlm.nih.gov
■ www.sciencedaily.com
■ www.emedicinehealth.com
■ www.webmd.com