Fight the stigma surrounding the disease

CONTROL & CURE

Despite being termed a deadly disease, there is little awareness on how to beat tuberculosis, says Dr Vishnu Sunil

Tuberculosis or TB, as it is commonly referred to, has undoubtedly secured its position on top of the panic chart in recent times. So the question is, do we really need to panic to the extent we actually do? 

The answer depends on whether we look at the disease individually or as part of the community we live in. You may not have cause to worry as an individual, although society needs to understand the negative implications of a rapidly-growing strain of TB-resistant bacteria and the standard treatment regimes.

TB is a contagious disease, most commonly spread by inhaling droplets containing the bacteria, Mycobacterium Tuberculosis, which enters the air when a person with active TB infection in the lungs or throat sneezes or coughs. But the fear associated with it has been blown out of proportion, as the bacteria does not affect a large number of people in an epidemic fashion. TB cannot be easily caught, as one has to be in close contact with a TB patient with an active infection for a long time (usually many hours or days) to be infected. The disease primarily affects the lungs (Pulmonary TB), intestines, bones, endometrium (lining of the uterus) and the nervous system. Also, patients rapidly become non-contagious after two-three weeks of regular medication.

Unfortunately, the disease has a huge stigma attached to it because of the misconception that it is a disease of the poor. The fact remains that it is equally prevalent among the rich. Therefore, there is a pressing need to increase awareness about the disease among the masses and to  encourage the community to avail medicinal help without being embarrassed.

Pulmonary TB commonly affects the lungs. When it affects the intestines, bones, endometrium or the nervous system, it is called extra pulmonary TB. It is curable (depending on the location of the primary infection) but can recur. Thus, it is imperative to have the treatment  monitored by a doctor on a regular basis.

Physicians examining a patient with extra pulmonary TB must be alert and diligent as it can be easily missed. As TB is a contagious disease, management of the disease should include the entire family and not be restricted to the treatment of the patient alone.

It is important to remind the patient that he/she can lead a normal life while on treatment and after.


Preventive measures

- For those with active pulmonary TB (sputum contains TB Bacilli), isolation may be required till the patient becomes non-contagious. As mentioned earlier, after the initial two -three weeks of regular medication, the disease becomes non-contagious. The usual

precautions include:

- Covering the mouth while sneezing, coughing, laughing, appropriately disposing of the sputum, tissue papers, etc.

- Leaving windows open for fresh air and sunlight

- Staying away from crowded areas, school/ office to avoid spread

- Vaccination: BCG (Bacillus Calmette-Guérin) vaccination at birth or soon after.
Some of the symptoms to watch out for are:

- Chronic cough for three or more months, not going away with general treatment/ antibiotics

- Bone swelling/ pain or sensation changes in limbs

- Bowel changes, with bleeding and other features as above

- Not being able to conceive a child

-  Irregular menstrual periods

- Recurrent urinary infection symptoms, with blood in urine, especially in adults, not being cured with regular antibiotics

 Who is at risk?

- Diabetic patients

- People with suppressed immunity

- HIV- infected individuals

- Those in contact with person having active pulmonary TB

- Malnourished individuals

- Alcoholics  

- Those living in overcrowded, poor hygienic living conditions

- Drug abusers

One of the most important aspects of treating TB is extensive counselling and emotional support from family and society. This should be supplemented with clinical treatment along with adequate nutrition, proper ventilation at home (clean environment), a clean and balanced diet and appropriate exercises, to bring back that lost smile.

(The author is in family medicine at the NationWide Primary Healthcare Services.)