Introduction: – Most People Who Are Exposed To Tb Never Develop Symptoms Because The Bacteria Can Live In An Inactive Form In The Body. But If The Immune System Weakens, Such As In People With HIV Or Elderly Adults, Tb Bacteria Can Become Active. In Their Active State, Tb Bacteria Cause Death Of Tissue In The Organs They Infect.
Tb Affects All Age Groups And All Parts Of The World. However, The Disease Mostly Affects Young Adults, And People Living In Developing Countries.
Definition: – Tb Is A Bacterial Infection That Can Spread Through The Lymph Nodes And Bloodstream To Any Organ In Your Body. It Is Most Often Found In The Lungs.
Causes: – The Mycobacterium Tuberculosis Bacterium Causes Tb. It Is Spread Through the Air When A Person With Tb (Whose Lungs Are Affected) Coughs, Sneezes, Spits, Laughs Or Talks.
Sign &Symptoms:-
• Coughing, Sometimes With Mucus Or Blood
• Chills
• Fatigue
• Fever
• Loss Of Weight
• Loss Of Appetite
• Night Sweats.
Tb Can Spread To Other Parts Of The Body Through The Bloodstream:
• Tb Infecting The Bones Can Lead To Spinal Pain And Joint Destruction
• Tb Infecting The Brain Can Cause Meningitis
• Tb Infecting The Liver And Kidneys Can Impair Their Waste Filtration Functions And Lead To Blood In The Urine
• Tb Infecting The Heart Can Impair The Heart’s Ability To Pump Blood, Resulting In A Condition Called Cardiac Tamponade That Can Be Fatal.
Diagnosis:-
The Mantoux Tuberculin Skin Test, Or Tst, Is Performed By Placing An Intradermal Injection Of 0.1 Ml Of Purified Protein Derivative Containing 5 Tuberculin Units Into The Volar Surface Of The Forearm. The Injection Should Be Made With A Disposable 27-Gauge Tuberculin Syringe, Just Beneath The Surface Of The Skin, With The Needle Bevel Facing Upward. This Should Produce A Wheal 6 Mm To 10 Mm In Diameter.
Administering The Mantoux Tuberculin Skin Test
The Reaction Is Read By Measuring In Millimeters The Diameter Of Induration (Palpable Raised Hardened Area) Across The Forearm. If There Is No Induration, The Result Should Be Recorded As 0 Mm. The Area Of Erythema Should Not Be Measured, Just The Induration.
Reading The Mantoux Tuberculin Skin Test: (Left, Correct) Only The Induration Is Being Measured; (Right, Incorrect) The Erythema Is Being Measured.
Reactions ≥5 Mm. A Tst Reaction Greater Than Or Equal To 5 Mm Of Induration Is Interpreted As A Positive
Reactions ≥10 Mm. A Tst Reaction Greater Than Or Equal To10 Mm Of Induration Is Interpreted As A Positive Result In Individuals Who Do Not Meet The Preceding Criteria But Who Have Other Risk Factors For Tb.
Reactions ≥15 Mm. A Tst Reaction Greater Than Or Equal To 15 Mm Of Induration Is Interpreted As A Positive Result In All Cases.
Confirmation Is Done By Sputum Test.
Blood Test
Chest X-Ray etc.
Medical Management:-
DIRECTLY OBSERVED THERAPY (Dot)
Dot Means That A Nurse Or Another Designated Individual Watches The Patient Swallow Each Dose Of Tb Medication. Dot Can Significantly Reduce The Development Of Drug Resistance, Treatment Failure, Or Relapse After Treatment Ends. Establishing A Relationship With The Patient And Addressing Barriers To Adherence Is The Core Of A Successful Dot Program.
Therapy May Be Directly Observed In A Medical Office Or Clinic Setting But Can Also Be Observed By An Outreach Worker In The Field.
Dot Is Recommended For All Children And Adolescents With Tb. Even When Drugs Are Given Under Dot, Tolerance To The Medications Must Be Monitored Closely. It Is Not Advised To Rely On Parents Alone To Supervise Dot
Recommended Regimen
• Isoniazid (Inh), 300 Mg, Daily For At Least 6 Months, And Preferably For 9 Months
• Isoniazid (Inh), 900 Mg, Plus Rifapentine (Priftin), 900 Mg, Weekly For 3 Months (Dot)
• Rifampin (Rifadin), 600 Mg, Daily For 4 Months
• Isoniazid (Inh), 300 Mg, Plus Rifampin (Rifadin), 600 Mg, Daily For 3 Months
• Isoniazid (Inh), 900 Mg, Plus Rifampin (Rifadin), 600 Mg, Twice Weekly For 3 Months
