Tuberculosis, abbreviated as TB, is a contagious and common disease which spreads through air. It is caused by a bacterium called Mycobacterium tuberculosis.
Mycobacterium tuberculosis is the primary cause of TB. It is an aerobic bacterium which multiplies in an extremely slow rate of every 16 to 20 hours, while other bacteria usually divide in less than an hour.
Tuberculosis most commonly attacks the lungs but can also affect the central nervous system, circulatory system, lymphatic system, genitourinary system, bones, joints and even the skin. All parts of the body can be affected, though it rarely affects the heart, skeletal muscles, pancreas and thyroid.
There are two major types of Tuberculosis:
Pulmonary Tuberculosis (PTB): This is a primary infection of tuberculosis, usually occur in children. PTB mainly involves the lungs but it may spread to other organs. The symptoms include chest pain, coughing up of blood and prolonged cough for more than three weeks and include fever, chills, night sweats, weight loss and often fatigue.
Extrapulmonary Tuberculosis (EPTB): This is secondary tuberculosis seen mostly in adults. EPTB does not occur in the lungs but affects other parts such as neck, bones, joint, spine, gastro-intestinal tract, uterus, abdomen and urinary bladder causing headache, swelling, neurological dysfunction etc.
Speaking to Star of Mysore, Superintendent of PKTB & CD Hospital Dr. Y. Laxman said, “The person who is infected with TB expel the TB germs called bacilli from their mouth while speaking, coughing, breathing out, yawning, sneezing or spitting. They also expel infectious aerosol droplets. When someone inhales these bacilli, they are also infected with TB; the chances are more when the resistance power of the person is weak.” (See picture).
“TB is a disease caused by micro-organisms. Once the organism enters the body, the immune system of the body resists. In my case, as my resistance is good, I can overcome the infection. If my body resistance becomes weak, then the organism will gain upper hand by spreading infection throughout the body. The chances are more in a person who is HIV positive or who is a habitual smoker. TB associated HIV is more prevalent. Otherwise the rate of infection would have come down. According to recent studies, diabetes also increases the risk of tuberculosis. Everyday 60 to 75 patients undergo TB diagnosis, out of which nearly 50 patients are found infected. Overall, one-third of the world’s population is infected with the TB at any time,” says Dr. Laxman.
“TB is most commonly spread from a patient who is left untreated to those who share the same living or working space. A patient who is not treated for tuberculosis will infect 10-15 people per year. The probability of transmission of disease depends upon the number of infectious droplets released by the infected person,” he added.
“Once a patient is diagnosed with TB, the treatment box will come in the particular patient’s name for six months. It’s completely free. TB requires long-term treatment, from 6 to 12 months to completely eliminate the bacteria from the body. In case if the patient is transferred to some other place, there is no need to carry the tablet, wherever he goes the tablet box will be sent to the nearby DOT centre where he is transferred. The patient will be given a card and he can take the medicine from the DOT centre,” he added.
Dr. Laxman said, “After the implementation of TB programme (DOT) we are avoiding the admission of patients into the hospital. Only complicated cases like blood in the cough, chest pain or life-threatening cases are admitted."
District Health and Family Welfare Officer Dr. Anand said, “TB rate has come down due to the implementation of Directly Observed Therapy (DOT), a Nationalised Programme which was implemented in India in 1992. But in Karnataka it came into existence in 1996 and later on it was implemented in Mysore in 2003. It is a short term course. In this therapy, a health care worker will look after the person who is infected with TB”.
A TB patient should take medicines for at least 6 to 8 months, but more than one-third of the pa-tients discontinue the treatment when they feel better or they may forget to take their medicines. Once they do this, the patients may fall sick again and the TB germs become resistant to the medicines which can lead to Multi-Drug Resistant Tuberculosis (MDR-TB) which is extremely difficult to treat and takes a long time for cure.
Hence, the World Health Organisation (WHO) came out with a novel programme with an intention to eradicate the disease which is known as DOT. This center helps a TB patient to complete his treatment by providing medicines in time as well as it makes the patient to consume the drug in front of them, Dr. Anand added.
Mysore city has five DOT centers. Every DOT center covers a population of one lakh. DOT centre volunteers will give the tablets thrice a week, the patients should go to the nearby centre and swallow the drugs in front of volunteers.
The volunteers keep the record of the patients and in case if the patients do not turn up for the medicine, the volunteers will go to their house and create awareness regarding the ill effects of discontinuing the medicines.
“Our main motto is to reduce the rate of TB patients to 1 per million before 2050, which is currently 2000 per million. To reach the task we are going all out in our effort”, said Dr. Anand.
DOT centers also arrange community meetings. In this they interact with people and create awareness about the disease. They inform people that TB does not indicate mortality and make them to realise about HIV; if HIV rate is low TB can be controlled. They examine the people whom they suspect and collect the sputum sample.
Sputum examination and treatment are free of cost at DOT centre. The presence of DOT has been felt in the society and the cases are more day by day. The cure rate is also nearly 81% which is really a good sign. Awareness among people about the importance of DOT centres is increasing.
For more information contact the District Health Centre: 0821-2442669.
How can we avoid TB?
• One should maintain a good resis-
tance power by keeping themselves healthy.
• Using proper protective equipment, like TB masks and gowns to prevent the inhalation of infected droplets exhaled in from the air.
• Those who are in high-risk situations are the people who work in hospitals, the homeless and prison inmates; these should undergo a TB test annually.
• By preventing HIV.
Designated Microscopic Centers (DMC) in Mysore District
Mysore: 1. DTC 2. PKTB 3. Mysore Medical College (Krh) 4. Jss Medical College 5. Central Hospital
T.N. Pura: 1. T. Narasipura GH 2. Bannuru 3. Talakad 4. Sosale 5. Keelanapura
H.D. Kote : 1. H.D.Kote Govt. Hospital (GH) 2. Saraguru 3. Vivekananda Hospital 4. Antharasante 5. M.C.Tholalu
K.R. Nagar: 1. KR Nagar GH 2. Hosur 3. Saligrama 4. Yelawala 5. Gavadagere
Hunsur: 1. Hunsur GH 2. Hanagodu 3. Belikere 4. Periyapatna GH 5. Bylukuppe 6. Bettadapura 7. Ravandur
Nanjangud: 1. Nanjangud. GH 2. Hosakote TQ 3. Hullahalli 4. Tagaduru 5. Jayapura
[Wednesday 6th August 2008]
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