Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis and primarily affects the lungs.
It spreads through the air when individuals with lung TB cough, sneeze, or spit. Only a small number of inhaled bacteria are needed to cause an infection.
Each year, 10 million people contract TB, and despite being preventable and treatable, 1.5 million people die from the disease annually, making it the leading infectious killer worldwide.
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TB is the top cause of death among people with HIV and a significant factor in antimicrobial resistance.
While TB is widespread, it disproportionately affects low- and middle-income countries, with around half of all TB cases occurring in eight nations: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, the Philippines, and South Africa.
An estimated quarter of the global population is infected with TB bacteria, but most do not develop the disease. Those not yet ill cannot spread the infection.
People with TB bacteria have a 5–10% lifetime risk of becoming sick.
However, individuals with weakened immune systems, such as those living with HIV, malnutrition, or diabetes, as well as tobacco users, face a higher risk of falling ill.
Symptoms
Common symptoms of TB disease include:
- Persistent cough
- Chest pain
- Weakness or fatigue
- Weight loss
- Fever
- Night sweats
These symptoms are often mild and can persist for months, causing delays in seeking medical attention and increasing the risk of spreading the infection to others.
When a healthcare provider suspects TB, they will order tests.
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For suspected lung TB, a sputum sample is tested for TB bacteria. For non-lung TB, samples from affected body fluids or tissues are tested.
The WHO recommends rapid molecular diagnostic tests as the first option for diagnosing TB. Other diagnostic methods include sputum smear microscopy and chest X-rays.
TB infection occurs when TB bacteria enter the body but remain inactive.
This can develop into TB disease if the immune system weakens. People with TB infection show no symptoms.
To detect TB infection, healthcare providers screen at-risk individuals to rule out active TB, using skin or blood tests to check for the infection.
Treatment
Tuberculosis (TB) is a curable disease, typically treated with a standard six-month course of four antibiotics. Common medications include rifampicin and isoniazid.
However, in some cases, the TB bacteria may not respond to these standard drugs, resulting in drug-resistant TB.
Treating drug-resistant TB is more complex and takes a longer duration.
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Patients undergoing TB treatment receive their medications along with guidance, supervision, and support from a healthcare worker or trained volunteer.
Without such support, it can be challenging for patients to adhere to the treatment plan. Incomplete treatment can lead to drug resistance, increasing the risk of spreading the disease.
For individuals infected with TB bacteria but not yet ill (latent TB infection), preventive treatment can be provided to stop the disease from developing.
This treatment involves the same drugs but for a shorter duration.
Recent advances have reduced the length of preventive treatment to just 1 to 3 months, compared to the previous six-month regimen.
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