Tuberculosis is the leading cause of mortality from infectious diseases all over the world. Though it is not highly infectious in general it is possible for Mycobacterium Tuberculosis, the cause of TB, to infect people via the respiratory tract. By coughing, the organism is released into the air which may be inhaled by others and may cause infection. But the people who are in more serous risk of TB are those who have had prolonged contact with an infectious person.
After a person inhales this organism, the bacteria starts to multiply in the lungs and then spread through the body. In most cases, however, the body’s immune system is able to sensitize or control the bacteria. The tuberculin or PPD skin test and the QuantiFERON blood test can directly measure the body’s sensitization to the bacteria. In some cases, however, persons infected with the bacteria merely carry the infection in its dormant form called the Latent Tuberculosis Infection (LBTI). If the latent infection becomes active, TB Disease follows. Among the indications of the presence of TB disease are: cough productive of sputum, fevers, weight loss, night sweats and general fatigue; swollen lymph nodes, and tuberculous meningitis.
TB is also closely associated with HIV. According to Bernard and Roncarati, those who have HIV have a higher risk of exposure to TB and TB disease. Because HIV weakens the body’s immune system, it allows the entry of TB infection into the body. In some cases, it can also re-activate the latent TB infection for those who have been previously infected.
Bernard and Roncarati suggest that treatment for TB should vary depending on whether the person has TB infection or a TB disease. If the person has TB infection or has LBTI, they must undergo what Bernard and Roncarati calls “preventive therapy.” Preventive therapy targets those persons having TB infection who are at risk of reactivating their LBTI to develop into active TB disease. This usually consists of a nine-month daily intake of isoniazid. On the other hand, for those persons who have TB disease, medical treatment consists of taking different drugs administered daily for at least six months. The treatment regimen includes four anti-tuberculosis drugs: INH, RIF , PZA, and either ethambutol or streptomycin.
The article written by Bernard and Roncarati is quite exhaustive as it deals extensively with the different issues surrounding TB infection and TB diseases including its treatment and its association with HIV. I disagree however on two important points. The first is that there are other indicators of the presence of TB infection aside from those mentioned. I also would like to add that aside from the other indicators mentioned by Bernard and Roncarati, other indicators that may suggest TB infection are abdominal pain, blurred vision, dark urine, loss of appetite, fever, nausea, vomiting, rash or itching tingling or burning feeling in hands and feet and yellow color of eyes or skin.
The second point is that Bernard and Roncarati seem to have forgotten or ignored the tuberculosis treatment for children. They may have committed the same mistakes as the other health experts by ignoring the importance of tuberculosis treatment for young children who according to recent research comprises at least 20% of the new cases for active tuberculosis (Hindustan Times, 2008, p.1). I think young children should be included and made part of every long-term solution or plan to the treatment of Tuberculosis.
It can be concluded that Tuberculosis is a deadly disease. It is not something that should be taken for granted. Without treatment, quality of life may be affected and may even lead to death. TB is curable. The patient must keep in mind that once he has the infection or the disease he must follow the prescriptions by the doctor and finish it as the doctor advised. Starting the therapy without finishing it properly or taking the medications as doctors advised will only make it drug-resistant making therapy more difficult.
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