He had a nose mask running across his face. I was not sure, so I decided to confirm this elderly looking patient’s diagnosis. It is Tuberculosis. This is what a normal Tuesday clinic looks like. Most Tuberculosis patient report for a check in this day. The crowd can be astounding, and people of all age groups, come in from the hinterlands and report to this centre, a secondary health facility where I am currently doing my rural posting.
Tuberculosis, also called Koch’s Disease in medical circles, is an airborne chronic infections, transmitted by droplet infections from a smear positive patient to a apparently healthy person. It is caused by the Mycobacterium tuberculosis organism, an acid fast bacilli.
It is a killer especially in immunosuppressed people. Hence, it is fatal in the extremes of age, the little children and the elderly. But it should be noted that this disease is transmitted predominantly, not by the young or the elderly but by the active members of a society between the ages of 15 and 50. Hence, it is regarded as a disease of public health importance.
As a chronic disease, symptoms may not be seen until much later. If symptoms manifests earlier, it could be missed or dismissed as a case of flu or acute asthma, expect the doctor have a high index of suspicion.
The commonest type of Koch’s disease is the Pulmonary TB, seen in over 70% of cases. Other types, called extra pulmonary TB, includes Miliary TB, TB of the spine, Abdominal TB etc. They are all deadly if not treated early enough or if treatment is inadequate.
Classically, pulmonary TB manifest as cough, chest pain, weight lose weakness, or haemoptysis etc. On Xray, lung opacities, fluid on the lung bases may be elicited. Three Sputum samples are collected, smeared and assayed for the Mycobacteria. A smear positive result indicates the patient is highly infective.
Most patients who survive present early, or their doctor had a high index of suspicion and appropriate non-pharmacologic and drug regimen are instituted.
Prevention is always better than cure. So, appropriate vaccination of neonates with the BCG vaccine, healthy diet, living in a non-crowded, airy room are measures at preventing the disease. Other preventive measures are sneezing, coughing into a handkerchief, consulting a doctor when symptoms begins etc.
Tuberculosis thrives in a community where poverty, ignorance and disease is seen. Adequate personal and community hygiene breaks the chain of transmission. Health Workers must be protected from the disease by regular vaccination, continuous education on current epidemic in any locality.
Finally, TB is curable!!!
Go to the closest Tuberculosis centre today if you notice a chronic or prolonged cough, Greater than 3weeks, or you have drenching night sweat or you are having weight loss. It may just be TUBERCULOSIS.