World TB Day 24 March is observed to create public awareness about tuberculosis which is one of major epidemic in the world, causing the deaths of nearly one-and-a-half million people each year, mostly in developing countries.
Tuberculosis (popularly known as “TB”) is a disease caused by the bacteria Mycobacterium tuberculosis. It mainly infects the lungs, although it also can affect other organs.
It has been estimated by the World Health Organisation (WHO) that worldwide there are 490,000 cases of active TB and sickness in children, and 64,000 deaths of children from TB each year.
India has the highest burden of TB in the world, an estimated 2 million cases annually, accounting for approximately one fifth of the global incidence. about 40% of the Indian population is infected with TB bacteria
THIS YEAR’S THEME IS “REACH, TREAT, CURE EVERYONE”
A child gets TB by inhaling TB bacteria which are in the air as a result of being released into the air by someone with active TB.
The source of infection for children is usually an adult in their household who has active TB, is coughing and is infectious, although there have also been instances of children being infected in a communal setting such as a school.
Once the TB bacteria have been inhaled they may reach the lungs, where they can multiply and then spread through the lymph vessels to nearby lymph nodes.
The child’s immune response then develops a few weeks after this primary infection. In most children their immune response stops the TB bacteria from multiplying further although there may continue to be a few dormant bacteria.
This primary infection usually resolves on its own as a child develops immunity over a 6- to 10-week period. But in some cases, it can progress and spread all over the lungs (called progressive tuberculosis) or to other organs.
In reactivation tuberculosis, the primary infection has resolved, but the bacteria are dormant, or hibernating. When conditions become favorable (for instance, due to lowered immunity), the bacteria become active.
Pulmonary tuberculosis (TB) may manifest itself in several forms, including endobronchial TB with focal lymphadenopathy, progressive pulmonary disease, pleural involvement, and reactivated pulmonary disease.
Symptoms of primary pulmonary disease in the pediatric population are often meager.
Fever, night sweats, anorexia, nonproductive cough, failure to thrive, and difficulty gaining weight may occur. Signs of disease depend on the site involved i.e. pulmonary or extrapulmonary.
Stages of TB in Children
Exposure has occurred, implying that the child has had recent contact with an adult who has contagious TB. The child has no physical signs or symptoms and has a negative tuberculin skin test (TST) result
This second stage is heralded by a positive TST result. No signs and symptoms occur, although an incidental chest radiograph may reveal the primary complex
In stage 3, TB disease occurs and is characterized by the appearance of signs and symptoms depending on the location of the disease. Radiographic abnormalities may also be seen.
Stage 4 is defined as TB with no current disease. This implies that the patient has a history of previous episodes of TB or abnormal, stable radiographic findings with a significant reaction to the TST and negative bacteriologic studies. No clinical findings suggesting current disease are present.
TB is suspected, and the diagnosis is pending
Symptoms of TB:
1.Pulmonary TB is TB in the lungs.
The specific symptoms of pulmonary TB are having a bad cough that lasts longer than three weeks, having pain in the chest, and coughing up blood or phlegm from deep inside the lungs.
2. Extrapulmonary TB
symptoms are the same as for pulmonary TB, but there can then be specific symptoms relating to the particular site or sites in the body that are infected.
may be painless slowly enlarging lymph nodes, as there are often no general TB symptoms. The swollen lymph nodes are often in the neck area, although they can be in the groin.
4. Bone TB
symptoms include pain, but it depends on the bone or joint that is affected. There may also be curving of the affected bone or joint, as well as loss of movement in the affected bone or joint. The affected bone may also be weakened and may fracture easily
does not start with classic meningitis symptoms. It begins with vague, general symptoms of aches and pains, a fever, and generally feeling unwell. This lasts for anywhere from about 2 to 8 weeks. symptoms like vomiting, severe headache, a dislike of lights, neck stiffness and seizures
6. Abdominal TB
has abdominal pain, diarrhea, and bleeding from the anus or rectum
1. Acute pulmonary TB can be easily seen on an X-ray
2. TB skin test he Mantoux TB test
3. The Interferon Gamma Release Assays (IGRAs)
4. Serological tests for TB
5. Smear microscopy of sputum
6. fluorescent microscopy
8. drug susceptibility tests
First-line agents include
rifampin, isoniazid (INH), pyrazinamide, ethambutol, andstreptomycin.
Second-line agents are capreomycin, ciprofloxacin, cycloserine,ethionamide, kanamycin,ofloxacin, levofloxacin, and para-aminosalicylic acid
1. The first part of TB prevention is to stop the transmission of TB from one adult to another. identifying people with active TB, and then curing them through the provision of drug treatment.
2. To prevent people with latent TB from developing active, and infectious, TB disease.
3. Bacillus Calmette-Guerin (BCG) provide children with excellent protection against the disseminated forms of TB
4. Isoniazid should be taken daily for at least six months and preferably nine months.
5. Covering your nose and mouth when coughing or sneezing
6. Using face masks
Spread more Awareness…
Lets make a TB free world….