TUBERCULOSIS

Tuberculosis, MTB, or TB (short for tubercle bacillus), in the past also called
phthisis, phthisis pulmonalis, or consumption, is a widespread, and in many cases
fatal, infectious disease caused by various strains ofmycobacteria, usually Mycobacterium
tuberculosis.[1] Tuberculosis typically attacks the lungs, but can also affect other parts of the
body. It is spread through the air when people who have an active TB infection cough,
sneeze, or otherwise transmit respiratory fluids through the air.[2] Most infections do not have
symptoms, known as latent tuberculosis. About one in ten latent infections eventually
progresses to active disease which, if left untreated, kills more than 50% of those so infected.
The classic symptoms of active TB infection are a chronic cough with bloodtinged sputum, fever, night sweats, and weight loss (the latter giving rise to the formerly
common term for the disease, "consumption"). Infection of other organs causes a wide range
of symptoms. Diagnosis of active TB relies onradiology (commonly chest X-rays), as well as
microscopic examination and microbiological culture of body fluids. Diagnosis of latent TB
relies on thetuberculin skin test (TST) and/or blood tests. Treatment is difficult and requires
administration of multiple antibiotics over a long period of time. Social contacts are also
screened and treated if necessary. Antibiotic resistance is a growing problem in multiple
drug-resistant tuberculosis (MDR-TB) infections. Prevention relies on screening programs
and vaccination with the bacillus Calmette-Gurin vaccine.
One-third of the world's population is thought to have been infected with M. tuberculosis,
and new infections occur in about 1% of the population each year.[4] In 2007, an estimated
13.7 million chronic cases were active globally,[5]while in 2013, an estimated 9 million new
cases occurred.[6] In 2013 there were between 1.3 and 1.5 million associated deaths,[6][7] most
of which occurred in developing countries.[8] The total number of tuberculosis cases has been
decreasing since 2006, and new cases have decreased since 2002.[8] The rate of tuberculosis in
different areas varies across the globe; about 80% of the population in many Asian and
African countries tests positive in tuberculin tests, while only 510% of the United States
population tests positive.[1] More people in the developing world contract tuberculosis
because of a poor immune system, largely due to high rates of HIV infection and the
corresponding development of AIDS.
[3]

Signs and symptoms

Tuberculosis may infect any part of the body, but most commonly occurs in the lungs (known
as pulmonary tuberculosis).[11] Extrapulmonary TB occurs when tuberculosis develops outside
of the lungs, although extrapulmonary TB may coexist with pulmonary TB, as well.[11]
General signs and symptoms include fever, chills, night sweats, loss of appetite,weight loss,
and fatigue.[11] Significant nail clubbing may also occur.[

CAUSES
The main cause of TB is Mycobacterium tuberculosis, a small, aerobic, nonmotilebacillus.
[11]
The high lipid content of this pathogen accounts for many of its unique clinical
characteristics.[21] It divides every 16 to 20 hours, which is an extremely slow rate compared
with other bacteria, which usually divide in less than an hour.[22]Mycobacteria have an outer
membrane lipid bilayer.[23] If a Gram stain is performed, MTB either stains very weakly
"Gram-positive" or does not retain dye as a result of the high lipid and mycolic acid content
of its cell wall.[24] MTB can withstand weak disinfectants and survive in a dry state for weeks.
In nature, the bacterium can grow only within the cells of a host organism, but M.
tuberculosis can be cultured in the laboratory.[25]
Using histological stains on expectorated samples from phlegm (also called "sputum"),
scientists can identify MTB under a microscope. Since MTB retains certain stains even after
being treated with acidic solution, it is classified as an acid-fast bacillus (AFB).[1][24] The most
common acid-fast staining techniques are the ZiehlNeelsen stain, which dyes AFBs a bright
red that stands out clearly against a blue background,[26] and the auramine-rhodamine
stain followed by fluorescence microscopy.[27]
The M. tuberculosis complex (MTBC) includes four other TB-causing mycobacteria: M.
bovis, M. africanum, M. canetti, andM. microti.[28] M. africanum is not widespread, but it is a
significant cause of tuberculosis in parts of Africa.[29][30] M. boviswas once a common cause of
tuberculosis, but the introduction of pasteurized milk has largely eliminated this as a public
health problem in developed countries.[1][31] M. canetti is rare and seems to be limited to
the Horn of Africa, although a few cases have been seen in African emigrants.[32][33] M.
microti is also rare and is mostly seen in immunodeficient people, although the prevalence of
this pathogen has possibly been significantly underestimated.[34]
Other known pathogenic mycobacteria include M. leprae, M. avium, and M. kansasii. The
latter two species are classified as "nontuberculous mycobacteria" (NTM). NTM cause
neither TB nor leprosy, but they do cause pulmonary diseases that resemble TB.[35]

PREVENTION
Tuberculosis prevention and control efforts primarily rely on the vaccination of infants and
the detection and appropriate treatment of active cases.[9] The World Health Organization has
achieved some success with improved treatment regimens, and a small decrease in case
numbers.[9]
Vaccines

The only available vaccine as of 2011 is bacillus Calmette-Gurin (BCG).[71] In children it

decreases the risk of getting the infection by 20% and the risk of infection turning into
disease by nearly 60%.[72]
It is the most widely used vaccine worldwide, with more than 90% of all children
being vaccinated.[9] The immunity it induces decreases after about ten years. [9] As tuberculosis
is uncommon in most of Canada, the United Kingdom, and the United States, BCG is
administered to only those people at high risk. [73][74][75] Part of the reasoning arguing against
the use of the vaccine is that it makes the tuberculin skin test falsely positive, so is of no use
in screening.[75] A number of new vaccines are currently in development.[9]
Public health
The World Health Organization declared TB a "global health emergency" in 1993, [9] and in
2006, the Stop TB Partnership developed a Global Plan to Stop Tuberculosis that aims to save
14 million lives between its launch and 2015.[76] A number of targets they have set are not
likely to be achieved by 2015, mostly due to the increase in HIV-associated tuberculosis and
the emergence of multiple drug-resistant tuberculosis.[9] A tuberculosis classification system
developed by the American Thoracic Society is used primarily in public health programs.[77]

ADVICE
1.
2.
3.
4.

make sure the sunlight into the house because sunlight kills the germs of tuberculosis.
make sure your home is a perfect ventilation by opening doors and windows
practice a healthy lifestyle and a balanced diet
need to practice cough etiquette, namely covering your nose and mouth when
coughing and sneezing

TREATMENT
Tuberculosis is curable with standardized treatment. For a new or fresh case of tuberculosis
the duration of treatment is six months, where for the first two months, four drugs
Rifampicin, Isoniazid, Ethambutol and Pyrazinamide are used and for the next four months,
two drugs Rifampicin and Isoniazid are used. Treatment is daily and adherence to TB
treatment is critical for curing tuberculosis. If the treatment is not followed, the TB can come
back or the TB bacteria can become drug resistant.
WHO recommends Directly Observed Treatment Short course (DOTS) strategy that
emphasizes the use of the most effective standardized, short-course regimen, and of fixeddose drug combinations (FDCs) under observation to facilitate adherence to treatment and to
reduce the risk of the development of drug resistance. By doing so, it stops TB at the source,

and prevents the spread of the disease, the development of MDR-TB, and complications of
TB, relapse and death. WHO provides guidelines for treating tuberculosis.

OTHER PREVENTION
The following measures have been shown to reduce the incidence of new cases of clinical
tuberculosis

Teaching TB patients to cough into cupped hands

Treating TB patients with standardized treatment under medical supervision

Wearing of tight- fitting mask by attending personnel

Vaccination of newborns in an endemic area with an effective Bacillus Calmette

Gurin (BCG ) strain

Ensuring adequate air ventilation in rooms where TB patients are kept

HISTORY
Tuberculosis has been present in humans since antiquity. Skeletal remains show prehistoric
humans (4000 BC) had TB, and researchers have found tubercular decay in the spines
of Egyptian mummies dating from 30002400 BC.[105] Genetic studies suggest TB was
present in the Americas from about 100 AD

Egyptian mummy in the British Museum tubercular decay has been found in the spines
of Egyptian mummies.