TUBERCULOSIS (TB

ABSTRACT

Tuberculosis caused by Mycobacterium tuberculosis, is the leading infectious cause of death

worldwide. It is one of the most ancient diseases of mankind and one of the top three infectious
killing diseases in the world. Mycobacterium tuberculosis and spreads from person to person
through air. TB usually affects the lungs but it can also affect other parts of the body, such as brain,
intestines, kidneys, or the spine. Tuberculosis spread when a person with active TB disease in their
lungs coughs or sneezes and someone else inhales the expelled droplets, which contain TB bacteria.
Most TB affects the lungs, which can cause a persistent cough that lasts more than 3 weeks and
usually brings up phlegm, which may be bloody and breathlessness that gradually gets worse. TB
affecting other parts of the body is more common in people who have a weakened immune system. .
You will not have any symptoms, but the bacteria will remain in your body. This is known as latent
TB. For treatment, if you have latent TB, your doctor will give you medication to kill the bacteria so
the infection doesn’t become active. The doctor will give antibiotics like isoniazid, rifapentine, or
rifampin, either alone or combined, also combination of medicines treats active TB, the most
common are ethambutol, isoniazid, pyrazinamide, and rifampin and if the patients are drug-resistant
TB, your doctor might give one or more different medicines that might take longer medication. To
help stop the spread of TB, limit your contact with other people. Cover your mouth when you laugh,
sneeze, or cough. Wear a surgical mask when you’re around other people during the treatment.

Keywords: Tuberculosis; Mycobacterium tuberculosis; drug resistance; pulmonary; latent TB;

antibiotics, isoniazid; rifapentine; rifampin; ethambutol.

Overview of the Disease

Tuberculosis (TB) is an airborne disease caused by Mycobacterium tuberculosis (MTB) and

other closely related Mycobacterium species that spread through inhaling tiny droplets from the
coughs or sneezes of an infected person. It mainly affects the lungs but it can affect any part of the
body, including the tummy (abdomen), glands, bones and nervous system. TB is a potentially
serious condition, but it can be cured if it's treated with the right antibiotics. TB that affects the lungs
(pulmonary TB) is the most contagious type, but it usually only spreads after prolonged exposure to
someone with the illness. 

Tuberculosis is one of the most ancient diseases of mankind, with molecular evidence
going back to over 17,000 years Tuberculosis was originated in East Africa about 3 million years ago.
A growing pool of evidence suggests that the current strains of M. tuberculosis is originated from a
common ancestor around 20,000 – 15,000 years ago. According to World Health Organization
(WHO), TB is a worldwide pandemic. In spite of newer modalities for diagnosis and treatment of
TB, unfortunately, millions of people are still suffering and dying from this disease. TB is one of the
top three infectious killing diseases in the world (Geneva: WHO, 2010). Tuberculosis is a
worldwide health problem of all ages especially in developing countries which is associated with
unexplained weight loss. The burden of tuberculosis falls most heavily on developing countries.
Among the estimated 1.8 million deaths due to TB, over 95% occurred in low- and middle-income
countries in 2015 (Luba et al., 2019).
The Cause of the Disease

It is a chronic disease caused by the bacillus Mycobacterium tuberculosis and spreads

from person to person through air. TB usually affects the lungs but it can also affect other
parts of the body, such as brain, intestines, kidneys, or the spine. Tuberculosis spread when a
person with active TB disease in their lungs coughs or sneezes and someone else inhales the
expelled droplets, which contain TB bacteria. Although TB is spread in a similar way to a cold or flu, it
is not as contagious. You would have to spend prolonged periods (several hours) in close contact
with an infected person to catch the infection yourself.

Anyone can get TB, but those at greatest risk include people: who live in, come from, or have spent
time in a country or area with high levels of TB; in prolonged close contact with someone who's
infected; living in crowded conditions; with a condition that weakens their immune system, such
as diabetes; having treatments that weaken the immune system, such as chemotherapy or biological
agents; who are very young or very old – the immune systems of people who are young or elderly
tend to be weaker than those of healthy adults; and in poor health or with a poor diet because of
lifestyle and other problems, such as drug misuse, alcohol misuse, or homelessness.

Organisms Response to the Disease

The symptoms of tuberculosis (TB) vary depending on which part of the body is affected.
TB disease usually develops slowly, and it may take several weeks before you notice you're unwell.
Your symptoms might not begin until months or even years after you were initially infected.
Sometimes the infection does not cause any symptoms. This is known as latent TB. It's called active
TB if you have symptoms. However, in some cases, symptoms might not develop until months or
even years after the initial infection.

General symptoms of TB includes having lack of appetite and weight loss, high temperature,
night sweats, extreme tiredness or fatigue. These symptoms can have many different causes,
however, are not always sign of TB. Most TB affects the lungs, which can cause a persistent cough
that lasts more than 3 weeks and usually brings up phlegm, which may be bloody and breathlessness
that gradually gets worse.

Less commonly, TB infections develop in areas outside the lungs, such as the small glands
that form part of the immune system (the lymph nodes), the bones, joints, the digestive system, the
bladder and reproductive system, and the brain, and nerves (the nervous system). Systems can
include persistently swollen glands, abdominal pain, pain and loss of movement in an effected bone
or joint, confusion, a persistent headache, and fits (seizures).

When it comes on how the immune sytems works with the disease, TB affecting other parts
of the body is more common in people who have a weakened immune system. In most healthy
people, the body's natural defense against infection and illness (the immune system) kills the
bacteria and there are no symptoms. Sometimes the immune system cannot kill the bacteria, but
manages to prevent it spreading in the body. You will not have any symptoms, but the bacteria will
remain in your body. This is known as latent TB. People with latent TB are not infectious to others. If
the immune system fails to kill or contain the infection, it can spread within the lungs or other parts
of the body and symptoms will develop within a few weeks or months. This is known as active TB.
Latent TB could develop into an active TB disease at a later date, particularly if your immune system
becomes weakened.

Treatment, Prevention, and Control

The treatment will depend on your infection. If you have latent TB, your doctor will give you
medication to kill the bacteria so the infection doesn’t become active. You might get antibiotics like
isoniazid, rifapentine, or rifampin, either alone or combined. You’ll have to take the drugs for up to 9
months. If you see any signs of active TB, call your doctor right away. A combination of medicines also
treats active TB. The most common are ethambutol, isoniazid, pyrazinamide, and rifampin. You’ll take
them for 6 to 12 months. If you have drug-resistant TB, your doctor might give you one or more different
medicines. You may have to take them for much longer, up to 30 months, and they can cause more side
effects. Whatever kind of infection you have, it’s important to finish taking all of your medications, even
when you feel better. If you quit too soon, the bacteria can become resistant to the drugs.

To help stop the spread of TB, If you have a latent infection, take all of your medication so it
doesn’t become active and contagious. If you have active TB, limit your contact with other people. Cover
your mouth when you laugh, sneeze, or cough. Wear a surgical mask when you’re around other people
during the first weeks of treatment. If you’re traveling to a place where TB is common, avoid spending a
lot of time in crowded places with sick people.

If you're diagnosed with pulmonary TB, you'll be contagious up to about 2 to 3 weeks into

your course of treatment. You will not usually need to be isolated during this time, but it's important
to take some basic precautions to stop TB spreading to your family and friends.

You should stay away from work, school or college until your TB treatment team advises you
it's safe to return, always cover your mouth – preferably with a disposable tissue – when coughing,
sneezing or laughing, carefully dispose of any used tissues in a sealed plastic bag, open windows
when possible, to ensure a good supply of fresh air in the areas where you spend time and not sleep
in the same room as other people – you could cough or sneeze in your sleep without realizing it.

When someone is diagnosed with TB, their treatment team will assess whether other people
are at risk of infection. This may include close contacts, such as people living with the person who
has TB, as well as casual contacts, such as work colleagues and social contacts. Anyone who's
thought to be at risk will be asked to go for testing, and will be given advice and any necessary
treatment after their results.

References

Geneva: WHO (2010) World Health Organization. Fact Sheet No.104: Tuberculosis.
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Hirsh, A. E., Tsolaki, A. G., DeRiemer, K., Feldman, M. W., & Small, P. M. (2004). Stable association
between strains of Mycobacterium tuberculosis and their human host populations.
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Luba, T. R., Tang, S., Liu, Q., Gebremedhin, S. A., Kisasi, M. D., & Feng, Z. (2019). Knowledge,
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