Tuberculosis is the thirteenth leading cause of death. According to the World Health Organization (WHO), tuberculosis is also the second leading infectious killer disease.

Estimates from the WHO show that in 2021, a total of 1.6 million people died from tuberculosis in 2021. This included 187 000 people with HIV.

“In 2021, an estimated 10.6 million people fell ill with tuberculosis (TB) worldwide. 6 million men, 3.4 million women and 1.2 million children,” the WHO data cites.

The WHO declares that tuberculosis is currently present in all countries and all age groups.

In Kenya, data from the Ministry of Health show that by the start of 2020, Kenya was reporting up to 86,500 cases of tuberculosis, with 10 per cent of these cases being children.

Causes and transmission

According to the Centre for Disease (CDC), tuberculosis is caused by bacteria known as mycobacterium tuberculosis. The bacteria usually affect the lungs.

However, the CDC cites that any part of the body including the kidney, brain, and spine can be impacted by the bacteria. “Not person who is infected with the tuberculosis bacteria becomes sick.

This is because there are two tuberculosis -related condition known as latent tuberculosis infection (LTBI) and the tuberculosis disease,” the CDC states.

This means that the tuberculosis bacteria can live in the body without making its carrier sick. The tuberculosis bacteria usually spreads from an infected person to an uninfected person through the air.

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“If a person with tuberculosis disease of the throat or the lungs coughs, sneezes, sings or speaks, the tuberculosis bacteria may get into the air and get breathed in by an uninfected individual,” the CDC explains.

When it is breathed in, the tuberculosis bacteria will first settle in the lungs. The CDC says that it may however spread through the blood to other parts of the body.

These include the kidney, spine, brain, lymph nodes, bones and joints, the digestive system, bladder, and the reproductive system.

“Whereas tuberculosis in the throat and lungs is highly infectious, tuberculosis in the kidneys or the spine is usually not infectious,” the CDC cites.

Tuberculosis and HIV

HIV and tuberculosis have a very close relationship. According to the CDC, people with HIV are more likely to get infected with tuberculosis than people without the HIV infection.

The WHO puts the level of risk at 18 times more likely than people without HIV.

At the same time, the CDC states that a person who has untreated latent tuberculosis infection and the HIV infection is more likely to develop the tuberculosis disease during their lifetime than someone who doesn’t have the HIV infection.

This makes HIV infection the biggest risk factor for progressing to full blown tuberculosis disease in people with latent tuberculosis infection.

“Tuberculosis is ranked as one of the leading causes of death among people living with HIV worldwide,” cites CDC. “A person who has both the HIV infection and the tuberculosis disease has an AIDS-defining condition.”

The CDC cites that apart from HIV, other health conditions that may compromise the immune system and raise the risk of tuberculosis include severe kidney disease, head and neck cancer, organ transplants, and silicosis which is a long term lung disease.

Symptoms

Symptoms of tuberculosis are not severe at their onset. According to the WHO, they can remain mild for a long time as the infection establishes itself in the body.

This increases the risk of the unsuspecting patient spreading tuberculosis to other people.

According to the CDC, the tuberculosis disease in the lungs will tend to produce the following symptoms:

• Terrible cough that lasts three weeks or longer
• Pain in the chest
• Coughing with sputum and, or blood
• Breathlessness that gradually gets worse

The general symptoms of tuberculosis will usually include:

• Weakness or fatigue
• Weight loss
• Lack appetite
• Chills
• Fever
• Sweating at night

The symptoms of tuberculosis outside the lungs will usually include:

• Persistently swollen glands
• Abdominal pain
• Pain and loss of movement in an affected bone or joint
• Confusion
• Persistent headache
• Seizures

Diagnosis and Treatment

According to the CDC, there are two types of tests that are done to determine if a patient has the tuberculosis infection.

“A tuberculosis infection may be diagnosed through either a blood test or a skin test,” the CDC states.

A positive result will only determine if a person has the infection or not and does not determine if the person tested has latent tuberculosis infection or if they have progressed to tuberculosis disease.

“To determine if a person has the tuberculosis disease, other tests might have to be conducted. These include a chest x-ray exam and a test on a sample of sputum,” cites the CDC.

Tuberculosis is a treatable and curable disease. According to the WHO, the tuberculosis disease is treated with a standard 4-month or 6-month course of 4 antimicrobial drugs.

“These drugs are not to be administered over the counter. They are to be provided upon a diagnosis conducted by licensed and qualified medical professional,” the WHO states.

After a diagnosis, the CDC cites that a tuberculosis treatment plan will be determined based on drug-susceptibility results, coexisting medical conditions, and potential for drug-drug interactions.

Coexisting medical conditions usually include chronic ailments such as HIV/AIDS and diabetes. If you have tuberculosis in the lungs, you will be put through a six-month treatment plan that will involve a combination of antibiotics.

For instance, you may be treated with 2 antibiotics (isoniazid and rifampicin) for 6 months and, or 2 additional antibiotics (pyrazinamide and ethambutol) for the first 2 months of the 6-month treatment period.

The WHO however says that medical research has made progress and made it possible to treat certain cases of tuberculosis within a month.

“Where an individual has tuberculosis infection but is not ill, tuberculosis preventive treatment may be administered to stop the onset of disease. This treatment will be similar for symptomatic tuberculosis, but it will last for a shorter period,” the WHO states.