Detail Analysis on Tuberculosis

Tuberculosis is a chronic inflammation in terms of medicine called granulomatous inflammation in humans. The cause of this infection is a bacteria known as tubercle bacillus or mycobacterium tuberculosis which affects lungs and other tissues of the human body.

This bacteria have different strain out of which hominis and bovis infective to humans.

We have seen great advancements in chemotherapy and immunology but TB still its world widely distributed. More common in poor countries like Africa, Latin America and Asia. Some factors that can increase the incidence of tuberculosis are Malnutrition, Inadequate medical care, Poverty, Crowding and some chronic diseases like diabetes, AIDS

The infection is transformed from man to man in many ways like Inhalation the organism may be inhaled present in fresh cough droplet or in dried sputum from an infected person, by ingestion of the organism present in milk of an infected cow or by swallowing own’s sputum in infected case causing tuberculosis of tonsils and intestine and rarely fetus can be infected through placenta by the infected mother.

The basic mechanism of tuberculosis is not the toxins or enzymes that are usually released by the microorganisms by the to cause infection but instead they form a microscopic structure which on biopsy shows a typical granulomatous arrangement known as granuloma or tubercle granuloma which then mediates a delayed type of hypersensitivity reaction called cell-mediated hypersensitivity or type IV reaction. These hypersensitivity reactions are generally known as Allergies. These reactions sensitize the host causing characteristic lesions.

Tuberculosis is classified into primary and secondary tuberculosis.

Primary tuberculosis is referred to the infection to the individuals who has not been previously infected by the causative organism or immunized. It also named as Ghon’s complex or childhood tuberculosis. Most common sites involved in such type of TB are lungs and hilar lymphnodes. Other tissues like tonsil, cervical lymph nodes, intestine in case of ingestion and mesenteric lymphnodes may also be involved. Secondary TB is the infection to the individuals who has been previously infected or sensitized. Also named as post-primary or reinfection or chronic tuberculosis.

Some common signs and symptoms of the TB in lungs are productive cough that may b with hemoptysis, pleural effusion, dyspnoea, chest X-ray may show typical apical changes like pleural effusion, nodularity, and miliary or diffuse infiltrates in the lung parenchyma. Some associated features like fever, night sweats, fatigue, loss of weight and appetite. Causes of death in pulmonary tuberculosis are usually pulmonary insufficiency, pulmonary hemorrhage, and sepsis.

Tuberculosis is the public health problem in the world. The global burden of disease is 35.8 million. Every year 8 million people develop TB.during the year 2000 about 1.66 million people died due to TB. The annual incidence of disease is in Europe and North America is 100 per 100,000 populations while in Africa it is 250 per 100,000 populations. 8 out of ten of all those struck by tuberculosis are in economically productive age group of 15-49 years thus it kills more adults in any infectious disease. The annual incidence of disease is decreasing as said by WHO but due to HIV/AIDS, the incidence of TB has started inclining because persons with HIV are100 times more at risk of the disease.

Diagnosis of TB is made by the presence of acid-fast bacilli or mycobacterium tuberculosis. If there is pyrexia of unknown origin for more than 3 weeks with persistent cough, it should be considered for TB. Some tests that are performed for the diagnosis of TB are tuberculin test, Montoux test, time multiple puncture test.

WHO has introduced several programs to control TB on both national and international levels and the declining rate of the TB is due to these efforts of WHO. In 1993 WHO declared a global TB program. Objectives of this program were to carry out surveys for detection and diagnosis of TB cases and their treatment and also to provide health education for preventive measures. The resistance against TB is greatly improved by immunization of the individuals through BCG vaccination which used of developing immunity against TB.

The treatment of TB has been made possible by some strong chemotherapeutic drugs however it requires full cooperation and isolation of the patient and requires a minimum time frame of 8 months.