Tuberculosis remains an important health problem in India. According to WHO, every day over 4000 people lose their lives to TB, and close to 30,000 people fall ill with this preventable and curable disease. Awareness about this disease, diagnosis, and treatment among the public will help in controlling the killer disease.

At Medicircle, we present you with The World TB Day Awareness Series where we feature eminent clinical oncologists, immunologists, and chest physicians treating tuberculosis. We aim to create public awareness about the impact of TB around the world. 

Dr.Sonam Solanki is a Consultant Chest Physician. She is an experienced chest physician and is associated with many eminent healthcare organization like Wockhardt hospital, Masina Hospital, and Bhatia Hospital 

Complete Elimination of TB by 2025 

Dr.Sonam Solanki says,” It is an ambitious declaration about TB. There are many programs for TB like the National Tuberculosis Control Programme. It is very ambitious to claim the elimination of TB by 2025. I absolutely support the Government of India. All of us have to align the efforts for the elimination of TB and then we will be able to reach this target. All the initiatives are taken by the government like new drugs. However, due to COVID19, there has been a major setback. It is delayed by 1 year. Many initiatives like the availability of newer drugs, public-private partnerships, new diagnostic modalities are coming into existence. It’s a target and we are going to work towards it.”

The Importance of Latent Tuberculosis Infection Test (LTBI) 

Dr.Solanki explains, “ Latent Tuberculosis Infection Test (LTBI) occurs when TB bacteria lie dormant in the body and does not cause any infection in the body. Out of 10 Latent Tuberculosis Infection cases, one might get infected in the body.  Latent Tuberculosis Infection means there is the presence of TB bacteria but it does not cause any infection. If you test 100 doctors for the Latent Tuberculosis Infection Test, then 80 doctors will show the presence of TB bacteria. When the immune system is low, there are higher chances of latent infection converting into active infection. The high-risk factors for Latent Tuberculosis Infection are:

Malnutrition  Uncontrolled diabetes  Long term medications such as steroids and immunosuppressants  Vitamin D deficiency Anticancer medications HIV patients with a high CD4 count

Test for TB 

Dr.Solanki informs, “There is the certain test like:

Mantoux test  IGRA test 

The IGRA test is much better and more sensitive than the Mantoux test for detecting TB. High-risk patients are given Latent Tuberculosis Infection treatment. In abroad all the patients with Latent Tuberculosis Infection are treated whereas in India, it is treated only in cases of autoimmune diseases. Latent Tuberculosis Infection in India is to be left alone with good nutrition and regular follow up.”

Latent Tuberculosis Infection can convert into “Active Infection” 

Dr.Solanki says, “Latent Tuberculosis Infection bacteria when it enters the body can lie dormant throughout life. But, if you are a high-risk patient or having low immunity, the bacteria can get active in the body. This is the nature of the bacteria. You can eliminate the disease, but the bacteria can remain dormant in the body for years.” 

Tuberculosis is curable 

Dr.Solanki emphasizes, “Many people are aware of the COVID19 virus. The cycle of COVID is of the inflammatory stage for 7 days and the resolution stage on the completion of 14 days. On the other hand, the organism of TB is slowly progressing and can affect any organ of the body right from the brain, lungs, stomach with varied clinical presentation. It is a slow-growing disease. By the time you identify, there is quite a delay. If you are diagnosed with lung TB, then there are higher chances that you can spread it to others. Being positive for lung TB can account for infecting others as well. 

Prevention of TB: Your social civic responsibility 

Dr.Solanki states, “Early identification and prevention of TB is very important. Covering your mouth while coughing, avoiding spitting on the road, and wearing a mask are basic civic responsibilities of all people. These are now highlighted among the people due to the pandemic. Patients do not disclose their infection with TB. If anybody is having TB in your neighborhood, do not sidetrack them. This is social civic responsibility” 

Understanding the Importance of completing the TB treatment course. 

Dr.Solanki informs, “The minimum course of treatment for TB is six months. Some patients take treatment for 2 months and stop it. They do not understand the importance of completing treatment courses for TB. Some patients have to undergo a 2-year treatment in which they might have to take injections during the initial months as prescribed by the doctor. The long-term treatment of TB is very challenging and difficult for TB patients and their families. You might feel better after 2 months of treatment and think of stopping the medications but it might lead to relapse or reactivation if you stop the anti-TB medications abruptly or discontinue the course.” 

MDR TB 

Dr.Solanki says,” Multidrug-Resistant TB is difficult to cure as there are not enough medications available for it. MDR-TB has higher chances of relapse. MDR-TB is one of the major reasons behind the struggle for the elimination of TB for so many years.” 

(Edited by Dr.Rati Parwani)