What causes tuberculosis?

The Mycobacterium tuberculosis bacterium causes TB. It is spread through the air when
a person with TB (whose lungs are affected) coughs, sneezes, spits, laughs, or talks.

TB is contagious, but it is not easy to catch. The chances of catching TB from someone
you live or work with are much higher than from a stranger. Most people with active TB
who have received appropriate treatment for at least 2 weeks are no longer contagious.

Since antibiotics began to be used to fight TB, some strains have become resistant to
drugs. Multidrug-resistant TB (MDR-TB) arises when an antibiotic fails to kill all of the
bacteria, with the surviving bacteria developing resistance to that antibiotic and often
others at the same time.

MDR-TB is treatable and curable only with the use of very specific anti-TB drugs, which
are often limited or not readily available. In 2012, around 450,000 people developed
MDR-TB.

Who is at risk?
People with compromised immune systems are most at risk of developing active
tuberculosis. HIV suppresses the immune system, making it harder for the body to
control TB bacteria. People who are infected with both HIV and TB are around 20-30
percent more likely to develop active TB than those who do not have HIV.
Tobacco use has also been found to increase the risk of developing active TB. Over 20
percent of TB cases worldwide are related to smoking.

Symptoms of tuberculosis
While latent TB is symptomless, the symptoms of active TB include the following:

Coughing, sometimes with mucus or blood

Chills

Fatigue
 Fever

Loss of weight

Loss of appetite

Night sweats

Tuberculosis usually affects the lungs, but can also affect other parts of the body. When
TB occurs outside of the lungs, the symptoms vary accordingly. Without treatment, TB
can spread to other parts of the body through the bloodstream:

TB infecting the bones can lead to spinal pain and joint destruction

TB infecting the brain can cause meningitis

TB infecting the liver and kidneys can impair their waste filtration functions and lead
to blood in the urine

TB infecting the heart can impair the heart's ability to pump blood, resulting in a
condition called cardiac tamponade that can be fatal

Diagnosis of tuberculosis
 TB is most commonly diagnosed via a skin test involving an injection in the forearm.

To check for TB, a doctor will use a stethoscope to listen to the lungs and check for
swelling in the lymph nodes. They will also ask about symptoms and medical history as
well as assessing the individual's risk of exposure to TB.

The most common diagnostic test for TB is a skin test where a small injection of PPD
tuberculin, an extract of the TB bacterium, is made just below the inside forearm.

The injection site should be checked after 2-3 days, and, if a hard, red bump has
swollen up to a specific size, then it is likely that TB is present.

Unfortunately, the skin test is not 100 percent accurate and has been known to give
incorrect positive and negative readings.

However, there are other tests that are available to diagnose TB. Blood tests, chest X-
rays, and sputum tests can all be used to test for the presence of TB bacteria and may
be used alongside a skin test.
MDR-TB is more difficult to diagnose than regular TB. It is also difficult to diagnose
regular TB in children.

Treatments for tuberculosis

The majority of TB cases can be cured when the right medication is available and
administered correctly. The precise type and length of antibiotic treatment depends on a
person's age, overall health, potential resistance to drugs, whether the TB is latent or
active, and the location of infection (i.e. the lungs, brain, kidneys).

People with latent TB may need just one kind of TB antibiotics, whereas people with
active TB (particularly MDR-TB) will often require a prescription of multiple drugs.

Antibiotics are usually required to be taken for a relatively long time. The standard
length of time for a course of TB antibiotics is about 6 months.

TB medication can be toxic to the liver, and although side effects are uncommon, when
they do occur, they can be quite serious. Potential side effects should be reported to a
doctor and include:

Dark urine

Fever

Jaundice
Loss of appetite

Nausea and vomiting

It is important for any course of treatment to be completed fully, even if the TB

symptoms have gone away. Any bacteria that have survived the treatment could
become resistant to the medication that has been prescribed and could lead to
developing MDR-TB in the future.

Directly observed therapy (DOT) may be recommended. This involves a healthcare

worker administering the TB medication to ensure that the course of treatment is
completed.

Prevention of tuberculosis
 If you have active TB, a face mask can help lower the risk of the disease spreading to other
people.

A few general measures can be taken to prevent the spread of active TB.

Avoiding other people by not going to school or work, or sleeping in the same room as
someone, will help to minimize the risk of germs from reaching anyone else. Wearing a
mask, covering the mouth, and ventilating rooms can also limit the spread of bacteria.

TB vaccination
In some countries, BCG injections are given to children in order to vaccinate them
against tuberculosis. It is not recommended for general use in the U.S. because it is not
effective in adults, and it can adversely influence the results of skin testing diagnoses.

The most important thing to do is to finish entire courses of medication when they are
prescribed. MDR-TB bacteria are far deadlier than regular TB bacteria. Some cases of
MDR-TB require extensive courses of chemotherapy, which can be expensive and
cause severe adverse drug reactions in patients.
Countries with higher tuberculosis rates
The following countries have the highest TB rates, globally:
Africa - particularly West African and sub-Saharan Africa

Afghanistan

Southeast Asia - including Pakistan, India, Bangladesh, and Indonesia

China

Russia

South America

Western Pacific region - including the Philippines, Cambodia, and Vietnam