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Tuberculosis (T.B.)

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TB is a killer disease and India has about one third of patients the world over. It is estimated that there are about 14 million TB cases in India with an annual infection rate of 5 lakh patients and about 1000 patients dying everyday. The annual loss to the nation due to TB is estimated at Indian Rs.12,000 crores.


History and definition
Tuberculosis, better known as TB, is an infectious disease prevalent in many parts of the world. It is caused by a bacterium called mycobacterium tuberculosis. Normally TB affects the lungs; it can also affect the brain, back, knees, bones and some other organs.

TB is one of the most ancient diseases and is mentioned in the Vedas and Samhitas. Unfortunately, there were no effective drugs to treat the disease. The body’s resistance power alone could give some help to mitigate the suffering. Patients were removed to open-air sanatoriums where they could breathe fresh air and take sufficient rest, and avail of the good nourishing food provided to enhance their resistance power.

When was a line of treatment introduced to combat TB?
It was only in 1948 that, as a protective measure, BCG vaccination was introduced in India as a pilot project in two centers. In 1949 it was extended to schools. However, after prolonged trials, it was found that BCG vaccination did not offer any protection against TB in adults. It was however recommended to give prescribed BCG doses to children at a very early age, preferably by the end of the first year after birth, as a preventive measure.

When were the modern drugs to cure TB introduced and what were they? 
It was only by the middle of the 20th century that some drugs were tried out, but as no single drug was found sufficient to cure TB, a combination of four drugs viz. Isoniazid, Rifampicin, Ethambutol and Pyraxinamide were introduced which ultimately proved to be sufficient to cure TB. Of these four, Rifampicin is the most important drug and its discovery in the year 1967 was the turning point in the effective treatment of TB.

What are the common symptoms of TB?
  • Cough for three weeks or more, sometimes with blood-streaked sputum.
  • Fever especially at night.
  • Loss of body weight.
  • Loss of appetite.

How is TB spread? 

TB is airborne. It is spread by breathing the air that someone suffering from TB has coughed, but it requires several such exposures for one to get infected. One is more likely to get TB by living with an untreated patient in the same room. Infection with TB germs does not denote disease. Almost 50% of Indians have TB germs inside them, whereas about 14 million people in India are affected by the disease . A single infected untreated person can spread the disease to 10-15 individuals.

Can anything be done to avoid getting TB?
By taking nutritious food and by observing the basic principles of cleanliness and personal hygiene, one can build one’s resistance power. When the resistance is good, it will not be easy for the invaded bacteria to survive. This is the only thing that can be done as a precautionary measure.

What is the duration of treatment for complete cure?
TB is treated for a period of six to eight months. Some types of TB may require treatment of longer duration. It is very necessary that patients should not discontinue treatment midway on their own volition. If such persons get TB again, it will be difficult to treat them, as some may develop drug resistance.

Do TB patients need isolation? 
Usually, short period of quarantine is needed to prevent spread of infection to others. For those patients who are under treatment for at least two months, no isolation is necessary.

How is Diagnosis of TB done?
Diagnosis is made through quality sputum microscopy, by examining three sputum samples of the chest symptomatics. Diagnosis and supply of anti-TB drugs for full course of treatment are available free of cost to patients in hospitals and clinics run by Govt. and NGOs.

What is DOTS?
Directly Observed Treatment Short-course is known as DOTS and it is the only proven strategy for effective control of TB on a mass basis. DOTS was introduced in India in 1993 with excellent results.

TOP Benefits of DOTS.
  • DOTS more than double the accuracy of TB diagnosis.
  • Its success rate is up to 95%.
  • It prevents the spread of tuberculosis by prioritizing sputum positive patients for diagnosis and treatment, thus reducing the incidence and prevalence of TB.
  • It helps in alleviating poverty by saving lives, reducing the duration of illness and preventing new infectious cases.
  • It improves the quality of care and removes stigma.
  • It prevents treatment failure and the emergence of MDR-TB by ensuring patient adherence to treatment and uninterrupted supply of anti-TB drugs.
  • It lends credence of TB control efforts.

Role of NGOs in TB Control Programme

Involvement of NGOs and private practitioners in the National TB Control Programme is of vital importance as a good proportion of patients seek treatment from them. The Programme encourages participation of NGOs & private practitioners in programme implementation.

Depending upon the NGO’s capacity, the area of their involvement can be –

  • Health education and community outreach.
  • Provision of directly observed treatment.
  • In-hospital care.
  • Microscopy and treatment centre.

Myths and Facts about TB

Some of the myths are that TB is a hereditary disease; TB occurs only in lower socio-economic group, smoking causes TB and TB patients should be hospitalized. Whereas the facts about TB are that it is a disease which spreads through air. Anyone can get TB irrespective of socio-economic status. Smoking aggravates TB. TB patients can be treated at home and they can continue to work.

Key statistics about TB
  • More adults die from TB in India than from any other infectious disease, say more than 1,000 a day. India’s share of the global burden of Tuberculosis is very high – as high as 1/3rd.
  • The National Tuberculosis Programme started in 1962 created infrastructure for TB control throughout the country. Since 1993, with DOTS as the main strategy, Revised National Tuberculosis Control Programme (RNTCP) was introduced. RNTPC covers 100% of Indian population.
  • It is estimated that the national average rate of new cases is 85 per 1,00,000 population.

Tell others, tell everyone

  • TB is an infectious and airborne disease caused by a germ called Mycobacterium tuberculosis.
  • Early symptoms include cough for 2 weeks or more sometimes with blood streaked sputum.
  • Fever especially at night.
  • Loss of body weight.
  • Loss of appetite.
  • Approach the doctor in government dispensary/hospital or those run by NGOs. Treatment for TB is free of charges.
  • Treatment is for a period of 6 to 8 months.
  • Though the patient may feel better after 2/3 months treatment, it should be continued for the full period. Stoppage may result in complicated drug resistant disease.
  • An untreated patient may infect 10-15 persons.

World ‘No TB Day’
Every year 24th March is observed as the `World No TB Day’ because it was on 24th March 1880 that TB was discovered by Robert Koch.


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