Tuberculosis, a public health disease that affects us all

World Tuberculosis Day is celebrated every year on March 24th, to increase awareness about the disease and its impact on global public health.

Tuberculosis is an ancient disease that has affected humanity for thousands of years, but it remains a significant public health problem worldwide. According to the World Health Organization (WHO), tuberculosis is one of the top 10 causes of death worldwide, and in 2019, there were about 10 million new cases reported worldwide.

In other words, tuberculosis (TB) is an infectious disease caused by a bacteria called Mycobacterium tuberculosis. This disease mainly affects the lungs, but it can also affect other organs of the body, such as the kidneys, brain, and spine.

It is transmitted through the air when an infected person coughs or sneezes and releases the bacteria into the air. Therefore, people who inhale these bacteria can develop the disease.

Symptoms include persistent cough that lasts for more than two weeks, chest pain, coughing up blood or sputum with blood, weakness or fatigue, involuntary weight loss, fever, and night sweats.

In cases of extrapulmonary tuberculosis, that is, tuberculosis that affects other parts of the body such as the kidneys, spine, or brain, symptoms may be different. For example:

Back pain in the case of spinal tuberculosis.

Painful urination and blood in the urine in the case of renal tuberculosis.

Headache, nausea, and vomiting in the case of cerebral tuberculosis.

It is important to note that some people with tuberculosis may not have symptoms and instead have a positive tuberculosis test on a chest X-ray or a tuberculin test. Therefore, it is important to get tested if you have been exposed to someone with tuberculosis or if you have a weakened immune system.

The diagnosis of tuberculosis is based on a combination of medical tests and clinical evaluation. Some of the most common diagnostic methods include:

Tuberculin skin test (PPD): This is done by injecting a small amount of protein derived from the tuberculosis bacteria under the skin of the forearm. If a skin reaction develops within the next 48 to 72 hours, it is considered that the person has been exposed to the tuberculosis bacteria. However, this test cannot differentiate between a past infection and an active infection.

Chest X-ray: A diagnostic imaging test used to examine the lungs and detect any anomalies, such as the presence of spots or lesions.

Sputum culture: Involves collecting a sample of sputum for culturing in a laboratory. The culture can determine the presence of the tuberculosis bacteria and can also help determine which medications will be effective in treating the disease.

Molecular tests: Used to detect the presence of genetic material from the tuberculosis bacteria in samples of sputum, saliva, or urine. These tests can be faster and more accurate than sputum cultures.

Regarding treatment, it generally involves a combination of medications taken over a period of several months. Treatment for tuberculosis is very effective, but it is important to complete the treatment without interruption to prevent drug resistance and disease relapse.

The medications used to treat tuberculosis are specific antibiotics that kill the bacteria. The most common ones include isoniazid, rifampin, and ethambutol. It should be noted that treatment for tuberculosis can last from 6 to 12 months, depending on the severity of the disease.

It is also important to emphasize the importance of taking medications as prescribed and following the doctor's instructions. If treatment is interrupted or medications are not taken as prescribed, disease relapse may occur and the tuberculosis bacteria may become resistant to medications, making treatment more difficult.

In addition to medication treatment, it is important to have good nutrition and get enough rest to help the body fight the infection. It is also important to take measures to prevent the spread of the disease, such as covering the mouth and nose when coughing or sneezing, and limiting close contact with other people until no longer contagious.

It is worth noting that some factors that may increase the risk of developing tuberculosis include having a weakened immune system, such as in the case of people with HIV/AIDS, diabetes, or who take medications that weaken the immune system; living or working in overcrowded conditions; and having close contact with a person infected with tuberculosis.

As this is a global public health disease, we emphasize the best centers, institutions, and doctors to treat this disease in the United States, including:

Centers for Disease Control and Prevention (CDC): A federal public health agency that works to prevent and control diseases, including tuberculosis. The CDC provides information and resources for the treatment and prevention of tuberculosis.

Local tuberculosis clinics: are community health centers that offer diagnostic, treatment, and follow-up services for tuberculosis. These clinics can be operated by the local health department or nonprofit organizations.

Hospitals and university medical centers: often have specialized programs for the treatment of infectious diseases, including tuberculosis. These programs may be led by specialists in infectious diseases, pulmonology, and/or tropical medicine.

Research institutions across the country: are conducting research on tuberculosis and working on the development of new treatments and vaccines. These institutions may offer treatments and services for patients with tuberculosis in the context of clinical trials.

Dr. Richard E. Chaisson: is a professor of medicine, epidemiology, and international health at the Johns Hopkins Bloomberg School of Public Health in Baltimore. He is a recognized expert in the research and treatment of tuberculosis, and has worked on several projects to combat the disease worldwide.

Dr. Lee Reichman: is a professor emeritus of medicine and epidemiology at the Rutgers New Jersey Medical School in Newark. He is a recognized leader in the research and treatment of tuberculosis and has published several books on the disease.

Dr. Marcos Burgos: professor of medicine and has been recognized for his work in the prevention and treatment of tuberculosis in marginalized and low-income communities.

Dr. Susan Swindells: is a professor of medicine and infectious diseases at the University of Nebraska in Omaha. She is an expert in the treatment of tuberculosis and has led several important clinical trials in the field.

In summary, World Tuberculosis Day is celebrated to raise awareness and sensitize society about the importance of preventing and treating tuberculosis properly, and to support global efforts to eradicate the disease.

If you or someone you know is suspected to have tuberculosis, it is important to see your primary care doctor and undergo relevant testing to confirm the diagnosis and determine the extent of the disease, preventing serious complications and the spread of the disease to others.

References:

Centers for Disease Control and Prevention. (n.d.). Tuberculosis (TB) - español. Centers for Disease Control and Prevention. Retrieved March 6, 2023, from https://www.cdc.gov/tb/esp/default.htm 

Mayo Foundation for Medical Education and Research. (2021, April 3). Tuberculosis. Mayo Clinic. Retrieved March 6, 2023, from https://www.mayoclinic.org/es-es/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250 

World Health Organization. (n.d.). Tuberculosis. World Health Organization. Retrieved March 6, 2023, from https://www.who.int/es/news-room/fact-sheets/detail/tuberculosis 

Department of Health. Tuberculosis (TBC). (n.d.). Retrieved March 6, 2023, from https://www.health.ny.gov/es/diseases/communicable/tuberculosis/fact_sheet.htm 

Dr. Richard E. Chaisson - https://www.hopkinsmedicine.org/profiles/details/richard-chaisson

Dr. Lee Reichman - https://health.usnews.com/doctors/lee-reichman-446567

Dr. Marcos Burgos - https://vivo.health.unm.edu/display/n3893

Dra. Susan Swindells - https://www.unmc.edu/intmed/divisions/id/faculty/swindells.htm