What is tuberculosis?

tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (MTB), which can infect almost all tissues and organs of the body, with tuberculosis being the most common. Although public health measures against TB have saved tens of millions of lives, as a curable disease, TB remains the leading cause of infectious disease death, with about a quarter of the world's population having been infected with TB. Tuberculosis remains one of the world's major public health problems.

Second, what situation to consider whether to have tuberculosis?

      If you have a cough and sputum that lasts for more than two weeks, especially if there is blood in the sputum, go to the hospital to check whether there is a possibility of tuberculosis. In addition to respiratory symptoms such as cough, phlegm, and hemoptysis, TB infection will also have systemic symptoms, mostly long-term afternoon low fever, that is, body temperature begins to rise in the afternoon or evening, and body temperature drops to normal in the morning. As well as fatigue, night sweats, loss of appetite, weight loss and other systemic manifestations. If you have the above symptoms, you need to be highly vigilant about tuberculosis and go to a medical institution in time. The elderly have weak immune response and decreased immune function, which may lead to atypical symptoms of early tuberculosis. The underlying diseases and comorbidities existing in the elderly will also cover up the clinical manifestations of tuberculosis to a certain extent.

How to prevent TB?

The source of infection in the population is mainly tuberculosis patients, and droplet transmission is the most important way of transmission. When tuberculosis patients expel bacteria into the air through coughing, sneezing, talking, etc., Mycobacterium tuberculosis will be spread. Therefore, ventilation to reduce the density of M. tuberculosis in the air is an effective measure to reduce transmission. In addition, it is also important to develop good hygiene habits, do not spit, sneeze to cover the mouth and nose, pay attention to environmental hygiene, and wear masks in densely populated places. Strengthening nutrition, exercise to enhance physical fitness, improve immunity, also help prevent tuberculosis.

Some people are infected with Mycobacterium tuberculosis, but have no clinical symptoms and imaging findings, known as mycobacterium tuberculosis latent infection. Latent mycobacterium tuberculosis patients may develop tuberculosis when their immune function is low, and prophylactic medication can be taken under the guidance of a doctor. People with low immunity, such as the elderly, immunosuppressant users, people living with HIV, and people with chronic diseases, are more susceptible to TB infection than healthy people. Prophylactic medication can also be used in high-risk groups and close contacts who are TB positive.

 

4. How is TB treated?

      The treatment of tuberculosis should follow the principles of early, regular, full course, appropriate amount and combination of drugs to kill mycobacterium tuberculosis and prevent the emergence of drug-resistant bacteria. The commonly used anti-tuberculosis drugs are isoniazid and rifametine, the initial treatment plan takes 6 months, the retreatment takes 8 to 12 months, and the treatment time of drug-resistant bacteria is longer. Tuberculosis has a long course of disease and is prone to relapse. Regular outpatient visits are needed during treatment to understand the changes in the condition. Medication should be carried out under the supervision of medical personnel.

 

References:

[1] Global tuberculosis report 2022. Geneva: World Health organization; 2022. licence: cc bY-Nc-sa 3.0iGo.

[2] Classification of tuberculosis WS 196-2017 [J]. Chinese Journal of Infection Control , 2018, (4) : 367-368.

[3] Zhou Lin, Chu Naihui, Lu Wei. Expert consensus on detection and preventive treatment of Mycobacterium tuberculosis latent infection in high-risk population [J]. Journal of Chinese Defense Consumption , 2021 lancet (9) : 874-878.

 

(The opinions expressed are those of the author. Some pictures in this article are from the Internet, if there is infringement, please contact to delete)

 

Author:

Chinese Geriatric Society Respiratory branch invited science experts

Lv Xiaoshuang, Beijing Chaoyang Hospital, Capital Medical University