Tuberculosis disease is an infectious disease caused by the microbe called Mycobacterium tuberculosis. One third of the world's population has encountered tuberculosis microbe. According to the data of the World Health Organization, approximately 8.4 million people suffer from this disease every year and 2 million people die from this disease. Tuberculosis is a serious public health problem.
How is Tuberculosis Transmitted?
Tuberculosis is transmitted through the respiratory tract. Respiratory secretions are thrown into the air in the form of droplets when sick people cough, sneeze, talk. Healthy individuals become infected by inhaling these droplets, which also contain the tuberculosis bacillus (microbe). Not everyone who is infected will develop the disease. The ingested bacilli remain hidden in the body without making the person sick and cause disease when the body's resistance drops. The period with the highest risk of disease development is the first two years. The risk of developing a disease for life is 10%, 5% in the first two years and 5% thereafter. There is no contamination with food utensils such as spoons, forks, glasses, clothes, and sheets.
What are the Risk Factors for the Development of Tuberculosis Disease?
The risk of developing the disease is high in people with low body resistance.
These are:
- Children and infants under the age of five,
- The elderly,
- Additional disease that reduces body resistance (diabetes, chronic kidney disease, cancer) , AIDS)
- Organ transplant patients,
- Drug and alcohol dependence,
- Patients using treatments that suppress the immune system (such as cortisone).
What are the Symptoms of Tuberculosis Disease?
Symptoms of Tuberculosis Disease can be grouped into two groups as general complaints and lung-specific complaints. General complaints are fever, night sweats, weight loss, loss of appetite and fatigue, especially towards the evening. Pulmonary-specific complaints are cough lasting more than two weeks, sputum production, coughing up variable amounts of blood, chest pain and shortness of breath.
Complaints usually start mildly and progress slowly. Patients may attribute these complaints to other causes and go to the doctor late. This situation causes the disease to spread more and more destruction of the involved organ. Meanwhile, the patient spreads germs around him and causes more people to become infected. For this reason, it is very important for people with cough and other complaints that last longer than two weeks to apply to the health center as soon as possible.
How to Diagnose Tuberculosis?
The diagnosis of tuberculosis is made by showing the tuberculosis bacillus in the sputum. . The patient's complaints and chest X-ray findings lead to suspicion. The definitive diagnosis of tuberculosis in a suspected patient is made by showing the tuberculosis bacillus in the microscopic examination of the sputum and producing the bacillus in the medium. Diagnosis, treatment and follow-up of tuberculosis disease is done free of charge in Tuberculosis Dispensaries, which are common in our country.
How to Treat Tuberculosis Disease?
Before the discovery of powerful drugs effective against tuberculosis bacillus, The basis of treatment was good nutrition, rest and long-term sanatorium treatment. Today, there are very powerful drugs that kill the tuberculosis bacillus. In order to effectively kill microbes and prevent the development of drug resistance, 4 types of drugs are used together in the treatment.
After the first two months of treatment, the number of drugs is reduced. In some special cases, the treatment period may be extended. It is very important that the treatment is taken regularly every day. Regular treatment not only ensures the recovery of the patient, but also protects the health of the community by rapidly preventing contagion. The main reason for the need for DGT is that some of the patients cannot regularly continue a treatment that will last for at least 6 months. Which patient's treatment is regular? DGT should be performed on all tuberculosis patients since it cannot be predicted whether they can be used or not. DGT has started in many cities in our country. In these provinces, the medicines of the patients are given under the supervision of the health institution closest to their homes.
Tuberculosis is a disease that can definitely be cured. Almost all of the patients who take their medications for a sufficient amount of time without interrupting their medication as recommended are successfully treated. Patients with drug-resistant tuberculosis do not recover with known basic drugs. Scientifically, it has been observed that there is no difference in disease recovery and contagiousness between hospitalized or outpatients. However, patients with poor general condition, widespread disease, excessive blood spitting, additional medical problems, drug side effects and non-compliant patients should be hospitalized and treated.
How to Diagnose Tuberculosis in Childhood?
Characteristics in children Children under 5 years of age have a much higher risk of developing the disease after getting the tuberculosis germ than adults. Tuberculosis should be considered in children who have complaints such as cough, fever, night sweats, weakness, loss of appetite, and weight loss lasting more than 2-3 weeks. However, sometimes these complaints may not be as pronounced as in adults.
In a child with symptoms suggesting the presence of tuberculosis disease, tuberculosis is strongly considered if chest X-ray findings and tuberculin skin test are also positive. It is also important for the child to have contact with an adult with tuberculosis. Family screening should be done in a child who is suspected of having tuberculosis. If the child can produce sputum, a sputum sample or gastric juice examination can be done to examine swallowed sputum. Tuberculosis treatment in children is similar to adults. However, the drug called ethambutol should not be used in children who cannot express visual impairment.
How to Treat Tuberculosis in Pregnant and Nursing Mothers?
Treatment should be started as soon as possible in a pregnant woman diagnosed with tuberculosis. All essential drugs except streptomycin can be used safely during pregnancy.
All essential drugs in breastfeeding mothers It can be used with a vein. Tuberculosis drugs are found in very low concentrations in breast milk. This does not have a harmful effect on the baby.
How long does it last to be contagious?
Infectiousness disappears quickly after drug treatment is started. If the drugs used are effective, contagiousness disappears to a large extent 2-3 weeks after the treatment.
Relatives of patients diagnosed with tuberculosis should go to the Tuberculosis Dispensary for control. After the control in the dispensary, people who are deemed necessary should receive preventive treatment. Preventive treatment is also provided by Tuberculosis Dispensaries free of charge.
Most Frequently Asked Questions
1) Are there any side effects of tuberculosis treatment? What should be done in case of side effects?
Side effects may occur during treatment. The most common side effects are skin rash, itching, loss of appetite, nausea, vomiting, abdominal pain and visual disturbance. If these conditions occur, you should stop taking the medication immediately and consult your doctor. One of the main drugs of treatment, rifampicin, can turn urine, tears and stools orange. It is nothing to worry about.
2) Do birth control pills interact with tuberculosis drugs? Yes. The drug called rifampicin reduces the effectiveness of birth control pills. For this reason, you should either be protected by a different method or consult your doctor and use birth control pills with high estrogen content. Vitamin B6 should be taken together with tuberculosis drugs in pregnant women.
4) What is the importance of nutrition in the success of tuberculosis treatment?
Regular and adequate nutrition required for healthy people is also valid for tuberculosis patients. The mainstay of treatment success is drug therapy.
5) Does tuberculosis vaccine (BCG) protect against tuberculosis disease? Tuberculosis vaccine is a vaccine administered to children. It prevents tuberculosis in children, not from pulmonary tuberculosis, but serious forms of tuberculosis, which spread by blood (miliary) and involve the lining of the brain (meningitis). It is not protective for the disease in adults.
6)How and where should a tuberculosis patient live at home The tuberculosis patient should stay in a sun-exposed and frequently ventilated room. He/she should cover his/her mouth and nose while coughing, sneezing and talking. What is tuberculosis skin test (PPD)? For whom is it done? How is it interpreted? The tuberculosis skin test is a test performed by applying an antigenic protein obtained from the cell wall of the tuberculosis bacillus into the arm skin with a small needle and evaluating the swelling that occurs 2-3 days later. The formation of a blister indicates the presence of tuberculosis bacillus and the presence of infection. If there is no swelling, it means that tuberculosis bacillus is not encountered. other drugs should not be used.
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