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TB Can Affect These 4 Parts Of The Body, Know The Symptoms From The Doctor

Tuberculosis (TB) is a contagious bacterial infection caused by Mycobacterium tuberculosis. It primarily affects the lungs but can also target other parts of the body. Understanding the symptoms associated with TB in different parts of the body is crucial for early detection and treatment. Let's delve into the various manifestations of TB and the corresponding symptoms as outlined by medical professionals.

1. Pulmonary Tuberculosis: Affecting the Lungs

Pulmonary tuberculosis is the most common form of TB, affecting the lungs. It is typically transmitted through the air when an infected individual coughs or sneezes, releasing bacteria-containing droplets. Once inhaled, the bacteria can settle in the lungs and multiply, leading to infection. Symptoms of pulmonary TB include:

Coughing One of the hallmark symptoms of pulmonary tuberculosis is a persistent cough that lasts for more than three weeks. The cough may produce sputum or phlegm, which can be thick, bloody, or tinged with blood. Chest Pain As the infection progresses, individuals may experience chest pain, which can vary in intensity. The pain is often felt during coughing or deep breathing and may worsen over time. Breathing Difficulties As the lungs become inflamed and damaged, breathing difficulties may arise. Individuals with pulmonary TB may experience shortness of breath, especially during physical activity or exertion. Fatigue and Weakness The body's immune response to TB infection can lead to fatigue and weakness, even after adequate rest. This persistent tiredness is often accompanied by other symptoms of infection. Fever and Chills Fever is a common symptom of TB, particularly during the later stages of infection. Individuals may experience episodes of fever, often accompanied by chills and sweating, especially at night. 2. Extrapulmonary Tuberculosis: Targeting Other Organs Extrapulmonary tuberculosis occurs when the bacteria spread from the lungs to other parts of the body. It can affect various organs and tissues, leading to diverse symptoms. Common sites of extrapulmonary TB include: Lymph Nodes Lymph nodes are small, bean-shaped structures that play a vital role in the body's immune system. In extrapulmonary TB, the bacteria can spread to the lymph nodes, leading to swelling and tenderness, particularly in the neck, armpits, or groin. Spine (Pott's Disease) One of the distinctive manifestations of extrapulmonary TB is its impact on the spine, a condition known as Pott's disease or spinal tuberculosis. In Pott's disease, the bacteria infect the vertebrae, leading to back pain, stiffness, and deformity of the spine. Brain and Nervous System Extrapulmonary TB can also affect the central nervous system, including the brain and spinal cord. Symptoms may include headaches, confusion, seizures, and other neurological deficits, depending on the location and severity of the infection. Abdomen TB can affect various organs in the abdomen, including the liver, spleen, and gastrointestinal tract. Symptoms may include abdominal pain, swelling, and digestive issues such as nausea, vomiting, or diarrhea. 3. Genitourinary Tuberculosis: Affecting the Kidneys and Reproductive Organs Genitourinary tuberculosis primarily affects the kidneys, bladder, and reproductive organs. It can lead to significant complications if left untreated. Symptoms of genitourinary TB include: Blood in Urine One of the hallmark symptoms of genitourinary TB is the presence of blood in the urine, known as hematuria. This occurs due to inflammation and damage to the urinary tract caused by the bacteria. Frequent Urination Individuals with genitourinary TB may experience an increased frequency of urination, particularly during the night. This symptom is often accompanied by a sense of urgency and discomfort. Pelvic Pain In women, genitourinary TB can cause pelvic pain, which may be persistent or intermittent. The pain may be localized to the lower abdomen or pelvic region and can vary in intensity. Testicular Pain In men, genitourinary TB can lead to pain and swelling in the testicles. This symptom may be accompanied by other signs of infection, such as fever or fatigue. 4. Skeletal Tuberculosis: Impacting the Bones and Joints Skeletal tuberculosis primarily affects the bones and joints, leading to significant morbidity if not promptly treated. Common symptoms of skeletal TB include: Joint Pain One of the early symptoms of skeletal TB is joint pain, which may be localized to the affected area. The pain can be dull or sharp and may worsen with movement or weight-bearing activities. Bone Deformities As the infection progresses, skeletal TB can lead to bone deformities, particularly in the spine, hips, and knees. These deformities may result from bone destruction and collapse, leading to instability and functional impairment. Limited Mobility Individuals with skeletal TB may experience limited mobility and stiffness, especially in the affected joints. This can significantly impact daily activities and quality of life if not adequately managed. Abscess Formation In severe cases of skeletal TB, abscesses or collections of pus may form in the affected area. These abscesses can cause localized swelling, pain, and tenderness and may require drainage or surgical intervention. Understanding the diverse symptoms of tuberculosis across different parts of the body is essential for early diagnosis and timely intervention. If you experience any of these symptoms or suspect TB infection, it is crucial to consult a healthcare professional promptly for proper evaluation and treatment. If you are worried about tanning then get such full sleeve blouse made If you are having a party at home with friends, then what could be better than a kaftan? Digital creator Rutvi Brahmbhatt's videos catch fire on Instagram! Goes viral, garnering millions of views

Combatting TB Epidemic: Progress Must Be Accelerated

Tuberculosis (TB) is increasingly considered as a public health scourge, a health security threat and development challenge. Though it is preventable and curable, evidence suggests that TB was a second leading cause of death yet in 2022 from a single infectious disease after COVID-19, and caused almost twice as many deaths as HIV and AIDS.

Given this ground reality, the TB epidemic is more serious in low- and middle- income countries. In the recent years, TB is largely considered as a social disease as it has several differential effects on the lives of poor and socially marginalised populations who are in their most productive ages. Moreover, TB is perceived as a disease of poverty, and its wider socio-economic impacts on individuals, families and communities are profoundly adverse. Undoubtedly, it causes prolonged socio-economic distress, marginalisation, stigma and discrimination in the families and health care settings.

Nepal still has a heavy burden of TB with an estimated incidence of 69,000, as per the first ever TB prevalence survey in 2018/19. The estimated TB prevalence and incidence are 416 and 245 per 100, 000 people, respectively. Sadly, majority of the TB patients are in their productive ages (15-55). Moreover, the TB prevalence among men is more than in women.

Again, the drug-resistant TB is a serious challenge in TB response. Even after full treatment of TB, many people still suffer disability. The worrying part is that a large proportion of the people with TB are missed by the TB programme either because they are not diagnosed or not reported when diagnosed.

In order to confront the burden of TB, Nepal's strategic plan to end TB (2021/22-2025/26) largely aims to strengthen patient-centered care and prevention, enhance bold policies and supportive systems to address the social determinants of TB, and tackle the emerging risks and vulnerabilities among people who are very poor, socially marginalised such as people living with HIV, migrants and so forth. In addition, the strategy sheds light on critical needs to intensify operational research for the design, implementation, and scaling up of the innovative interventions.

In this context, Nepal is embarking on an exciting journey with its TB free initiative. The overarching aim of this initiative is to enhance the role and accountability of local governments in the fight against TB. We stand at a crossroads as Nepal is committed to Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs) for 2030.

However, we need multi-sector actions to make the initiative a reality by targeting people who are most affected by it: the poorest, socially marginalised and inequitably served. Therefore, effective implementation of the UHC is critical along with the provision of social protection services to empower people with TB and their families for their overall social well-being and dignified lives.

Additionally, the TB free Nepal initiative is considered as an ambitious and innovative strategy to end the TB epidemic by 2035. It is being implemented in 25 of the 753 local levels, and has now been scaled up in an additional 100 local levels from this fiscal year. In the federal context, local health systems are consistently facing diverse challenges in ensuring adequate human resources for health, essential equipment and good health infrastructure, regular supplies of drugs and laboratory consumables, robust monitoring and reporting practices for tracking the progress.

Moreover, pandemics such as COVID-19 and other natural disasters significantly increase vulnerabilities to TB and limit the ability of local health systems to provide quality TB prevention, treatment and care services. Therefore, effective implementation of the TB free initiative is still a key question as there still lacks coordinated and coherent actions across federal, provincial and local governments.

Despite the technical support from external development partners, Nepal needs to mobilise additional resources to address the programmatic gaps for achieving wider service coverage. For this, Nepal should effectively regulate a multi-sectoral accountability framework for better coordination and collaboration with a range of relevant stakeholders beyond the health sector

Recent review of the strategic plan to end TB reveals that there are emerging needs to enhance key interventions to scale up active case findings to cover large proportions of targeted populations while using sensitive, cost-effective and efficient approaches.

Considering the emerging challenges of climate change, migration, and socio-political and economic transition, the TB epidemic imposes a high socio-economic burden on the country as it is mostly concentrated in young adults. Issues of gender inequality, social exclusion, stigma and discrimination in the communities have profound impacts on people's vulnerabilities to TB and HIV co-infections, and their access to prevention, treatment and care. Therefore, it is necessary to consider socio-cultural, economic and political determinants of TB for ensuring a holistic approach in the fight against the epidemic.

In addition, the role of communities and civil society is critical for sustained TB response. Therefore, the importance of community and civil society engagement to end TB has been highlighted in various strategies and global commitments. Furthermore, the political declaration of the 2023 United Nations High-level Meeting on TB highlights the need to ensure people-centered health services, with meaningful engagement of communities to harness a coordinated TB response. Undoubtedly, Nepal has a long way to go for meeting the challenge of ending the epidemic by 2035.

Bhandari is a health policy analyst

Tuberculosis Can Have A Lasting Impact On The Lung Health Of Successfully Treated Individuals

New research being presented at this year's ESCMID Global Congress (formerly ECCMID) in Barcelona, Spain (27–30 April) has found compelling evidence that tuberculosis (TB) can have a lasting impact on the lungs of individuals who have been successfully treated for the disease.

TB survivors have smaller lungs with narrower airways and slower air flow, the analysis of data on tens of thousands of individuals from around the world found.

"This damage could have a profound effect on long-term health, reduce quality of life and affect ability to work and carry out day-to-day tasks," says lead researcher Dr. Sharenja Ratnakumar, of St George's, University of London, London, UK.

"And, with growing numbers of people being successfully treated for TB, the finding strongly indicates that post-TB lung disease is an under-recognized global challenge."

TB can be cured with antibiotics and, worldwide, an estimated 155 million people are alive today as a result of successful diagnosis and treatment of the bacterial infection.

However, although significant progress has been made in combating TB in recent decades, the number of new diagnoses has increased since the COVID-19 pandemic. Some 7.5 million were diagnosed globally in 2022—the highest number since monitoring began in 1995 and above the pre-COVID baseline of 7.1 million in 2019, according to WHO's 2023 Global Tuberculosis Report.

The burden is highest in sub-Saharan Africa and south east Asia but even low incidence countries such as the UK are seeing diagnoses increase. According to provisional data from the UK Health Security Agency, there were 4,850 new diagnoses in England in 2023. This is above pre-COVID levels and represents a rise of more than 10% on 2022, when there were 4,380 diagnoses.

Previous research has found that between 18% and >80% of survivors will be left with lung damage that reduces their quality of life and life expectancy but data on the size and type of respiratory impairment is scarce. To find out more, Dr. Ratnakumar and colleagues carried out a systematic review and meta-analysis of existing research on the topic.

The Medline, Embase and CINAHL databases were searched from 1/01/00 to 31/01/23 for studies that compared the lung function of individuals with a history of TB with that of healthy controls.

The meta-analysis included data on 75,631 individuals from 15 studies conducted in 17 countries with varying TB incidence and income levels.

The 7,377 TB survivors had an average age range of 11–65 years. Many of the studies were skewed towards a younger population (<50years) from mainly low- and middle-income countries.

Four measures of lung function were included in the analysis: forced expiratory volume in 1 second (FEV1, the volume of air can be forcefully exhaled in one second); forced vital capacity (FVC, the volume of air that can be forcefully exhaled in a single breath); FEV1/FVC ratio; FVC as a percentage of the predicted value (compares the volume to the average of a healthy person of the same age, sex and height).

The study found that, compared to the healthy controls, the participants with prior TB had significantly lower results on all four measures of lung function, with FEV1 more affected than FVC.

Dr. Ratnakumar says, "FEV1 was 230 milliliters lower compared to healthy controls and FVC was 140 milliliters lower. A decrease in FEV1 of 100 milliliters is considered clinically significant and is associated with an increased risk of cardiovascular and respiratory disease."

The results as a whole point to the TB survivors having smaller lungs (restrictive disease) and narrower airways with slower air flow (obstructive disease). This means that the breaths they take are smaller and take longer; breathing is less efficient and less able to respond to increased ventilatory demands such as during exercise.

Analysis of data from five of the studies showed the TB survivors to have 65% higher odds of airflow obstruction (AFO) than the healthy controls.

The results suggest TB can leave a lasting and widespread impact on the lungs, especially in terms of how the airways are structured. This valuable insight can help guide rehabilitation strategies and, in the longer term, aid in the development of new therapies, say the researchers.

Dr. Ratnakumar explains, "Our results strongly indicate that post-tuberculosis lung disease is an under-recognized global challenge—and one that has significant implications for clinical practice and policy.

"The focus, until now, has been on the treatment of acute TB, but even when treatment is successful, individuals can be left with significant lung damage.

"This can cause breathlessness that can affect their ability to work and go about their day-to-day lives and reduces their quality of life.

"This legacy of TB has been overlooked for too long and it is vital it is recognized.

"With an estimated 74 million lives saved through tuberculosis treatment between 2000 and 2020 and a rising life expectancy, there is an urgent need for evidence-based recommendations on the diagnosis, treatment and management of post-tuberculosis lung disease.

"Our study also provides compelling evidence that the long-term care of individuals with post-tuberculosis lung disease should be an explicit component of the WHO's End TB strategy."

Provided by European Society of Clinical Microbiology and Infectious Diseases

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