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INCREASING THREAT OF TUBERCULOSIS IN INDIA

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Every year 24th March is celebrated as World TB day. Even today Tuberculosis is a leading cause of death in India. Know more about this deadly disease from this article authored by
Dr. Shamma Shetye, HOD, Microbiology, Metropolis Health Services(I) Ltd.

India has more new TB cases annually than any other country, ranking first among the 22 high-burden TB countries worldwide according to the WHO Global TB Report 2006. TB remains one of the leading infectious causes of mortality in India, resulting in 364,000 deaths annually. There were more than 1.8 million new TB cases in India in 2004, representing over one-fifth of all TB cases worldwide. The estimated incidence rate in 2004 was 168 per 100,000 people.

The proportion of tuberculosis cases co-infected with human immunodeficiency virus (HIV) was also found to be rising. The association with HIV and increasing multi drug resistant tuberculosis (MDRTB) appears to be a serious issue, especially for the developing nations. Around 10% of people infected with TB actually develop the disease in their lifetimes, but this proportion is changing as HIV severely weakens the human immune system and makes people much more vulnerable. TB causes more deaths among women than all causes of maternal mortality combined, and more than 900 million women are infected with TB worldwide. Once infected with TB, women of reproductive age are more susceptible to developing TB disease than men of the same age. Women in this age group are also at greater risk of becoming infected with HIV.

You are at risk, if you have:

  • Lower Immunity
  • Close contact with someone with infectious TB
  • Age, older adults
  • Substance Abuse
  • Malnutrition
  • Lack of Medical Care

Some of the signs & symptoms to keep a watch for:

  • Unintended weight loss
  • Fatigue
  • Slight fever
  • Night Sweats
  • Chills
  • Loss of appetite
  • Pain with breathing or coughing

SOME MYTHS AND TRUTH ABOUT TB

  • Myth – TB is a life-threatening disease
  • Truth – TB can be cured by taking a course of medicine
  • Myth – You can become infected by TB by touching someone who has it or being with someone who has it for a few minutes
  • Truth – TB is transmitted only by prolonged close contact with coughing infectious patients
  • Myth – If someone has TB they are infectious
  • Truth – TB patients who have taken their treatment for 2 weeks and are still taking treatment are usually not infectious
  • Myth – Only the poor and malnourished get TB
  • Truth – Anyone can get TB rich or poor and become unwilling host to bacteria
  • Myth – Once you have TB you are doomed and cannot get treated
  • Truth – TB treatment is freely available, and correct treatment cures the vast majority of cases

Rapid Diagnosis of TB is important for the treatment of the individual patient and to implement appropriate public health precautions. Timely diagnosis at reputed and accredited laboratories can help in determining the infectiousness and assess drug susceptibility. Since the treatment is prolonged the tests have to be done periodically to analyze the situation and path of treatment. Once TB is diagnosed, tests are conducted every two to three months till the patient is declared completely cured. The RNTCP (Revised National TB Control Programme) has also laid guidelines to ensure consistency in treatment.

Key tests on TB offered by Metropolis Health Services

Metropolis provides the widest test menu for TB, costs ranging between Rs. 100 to Rs.4000. Metropolis maintains high standards of quality and is a NABL, CLIA & CAP Accredited Laboratory. The quality of equipments and standardized reagents ensure the high accuracy of the results.

  1. Microscopy– A basic screening test with a turnaround time of a day, rapid and the first step to diagnosis of TB.
  2. Culture A definitive diagnosis of TB that requires identification of the mycobacterium tuberculosis form a specimen. The microbe is made to grow in artificial medium to analyze the strain. The turnaround time is between 3-6 weeks.
  3. Automated liquid culture/ Rapid culture- This is also a form of culture wherein the turnaround time is brought down to as low as 10 – 15 days. The microbes are made to grow in liquid medium which is fully automated.
  4. Drug susceptibility- This is a drug sensitivity test, primarily to determine that whether the drugs are reacting in the proper direction or not. This is usually recommended after the treatment has begun, ideally 2-3 months from detection.
  5. Molecular methods- Turnaround time is as low as a day, it largely deals with rapid detection of the infection, directly from specimens. This is highly sensitive nad specific for the diagnosis of M. TB complex.
  6. Quanteferon TB Gold test- A higly advanced and gold standard test. It is a whole blood test used as an aid for diagnosing different strains of TB including latent tuberculosis infection ( LTBI). This has been approved by FDA in 2005.
  7. DNA probe- To figure out the strain of the mycobacterium tuberculosis, it is a step forward in identifying the culture.

 


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Written by sreelakshmi

25 March, 2009 at 8:09 pm

Tobacco addiction is a major cause of Tuberculosis!

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Half of all male deaths by tuberculosis in India a result of smoking

“I Am Stopping TB”this is the slogan that has been adopted worldwide for the World TB Day, 2009. “I Am Stopping TB” is the start of a two-year campaign internationally in support for control of TB. In keeping with the theme, a significant effort should be made to highlight the fact that a significant amount of TB deaths in India are caused by smoking – most starkly, including half the amount of males who succumb to TB in the country. Almost 200,000 people a year in India die from tuberculosis because they smoked, and half the smokers killed by TB are still only in their thirties, forties or early fifties when they die. 

On the occasion of World TB Day (24th March 2009), Dr.P.C.Gupta, Director, Healis Sekhsaria Institute for Public Health, said “Smokers expose themselves to a plethora of diseases and illnesses, and as research and studies show, Tuberculosis is one of the most life threatening diseases caused by tobacco.
We therefore urgently need to take extensive measures to increase social awareness about tobacco as a cardinal cause of tuberculosis and make an effort to educate society about the dangers of the disease.”

Studies have shown that half the male tuberculosis deaths in India are caused by smoking, and three quarters of the smokers become ill with tuberculosis (TB) through smoking. A major study led by the Epidemiological Research Center in Chennai, India and funded by the UK Medical Research Council and Cancer Research UK have come up with detailed results on tobacco being a major cause of tuberculosis. The study found that in India male smokers are about four times as likely to become ill with TB as non-smokers, and consequently four times as likely to die from the disease. The study also showed the smokers had higher death rates from heart disease and from various types of cancer. In total, about a quarter of the smokers studied were killed at ages 25-69 by their habit, those killed at these ages losing, on average, 20 years of life.

Tuberculosis still causes about 1.6 million deaths a year worldwide, including more than a million in Asia, 400,000 in Africa and 100,000 in the Americas and Europe, and in some countries it is now becoming more common.