TUBERCULOSIS (TB), as defined by the Center for Disease Control and Prevention (CDCP), is a disease caused by a bacterium called Mycobacterium Tuberculosis.
“The bacteria usually attack the lungs, but the TB bacteria can attack any part of the body such as the kidney, spine and brain,” it adds.
Gerard Tortora, a medical microbiologist, writes in his Microbiology: An Introduction that Mycobacteria is classified as an ‘acidfast.’
Meaning, “this characteristic reflects the unusual cell composition of the [bacterial] cell wall, which contains large amounts of lipids.”
“These lipids might be also responsible for the resistance of mycobacteria to environmental stresses such as drying,” he explains.
He emphasizes that “these bacteria can survive for weeks in dried sputum and are very resistant to chemical antimicrobials used such as antisepics and disinfectants.
For CDCP, if left untreated, “TB can be fatal.”
“The TB germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks or sings,” it informs.
The Public Health Nursing in the Philippines, a manual published by the National League of Philippine Government Nurses states that the following are the manifestations of TB:
(1) Cough for two weeks or more;
(3) Chest or back pains not referrable to any musculoskeletal disorders;
(4) Hemoptysis or recurrent blood streaked sputum;
(5) Significant weight loss; and
(6) Other unclassified signs and symptoms such as sweating, fatigue, body malaise and shortness of breath.
According to the health statistics of the Department of Health (DOH), TB in the Philippines is the sixth leading cause of mortality and morbidity.
The World Health Organization (WHO) has declared TB as a global emergency in 1993 after a resurgence of the disease in many parts of the world.
According to several medical literatures, TB is treated by taking several drugs lasting for six to 12 months that includes three to four different kinds of antibiotics.
According to Tortora, the first effective antibiotic for TB was streptomycin, which was introduced in 1944.
“It is still used but is now considered as a second-line drug,” he maintains.
“The prolonged treatment is necessary because the tubercle bacillus [Mycobacterum] grows veryslowly and it may be hidden for long periods.”
The CDCP informs that diagnosis of TB will depend on the following: medical history; physical examination; test for TB infection such as TB skin test or TB blood test; chest x-ray; and other appropriate laboratory tests.
The Public Health Nursing in the Philippines maintains that preventive measures include:
* Prompt diagnosis and treatment of infectious cases;
* BCG vaccination of newborn, infants and grade school pupils;
* Public health education in the mode of spread and methods of control;
* Improve social conditions like overcrowding; and
* Provision of access to medical laboratory services such as x-ray and other diagnostics.
In the Philippines, the primary diagnostic tool used is Direct Sputum Smear Microscopy (DSSM).
According to the National Tuberculosis Control Program (NTP) of the DOH, all TB symptomatic will be asked to undergo DSSM for diagnosis prior the start of treatment, whether or not they have available X-ray results or whether suspected to have extra-pulmonary TB or TB involving body parts other than the lungs.
NTP is a health programme with the goal of reducing prevalence and mortality from TB by half by the year 2015 in line with the Millennium Development Goal.
On the other hand, WHO endorses the Directly Observed Treatment Short course to aid in reduction of TB by making certain TB patients comply with the prescribed anti-TB treatment that encompasses the following elements:
* Sustained political commitment;
* Access to quality-assured sputum microscopy;
* Standardized short course chemotherapy for all cases of TB under case management;
* Uninterrupted supply of quality-assured drugs; and
* Recording and reporting system enabling outcome assessment of all patients and assessment of overall program performance.
Meanwhile, the NTP recommends that patients suspected with TB with the following conditions must be hospitalized:
(1) Massive hemoptysis (blood in sputum);
(2) Pleural effusion (fluid in lungs) obliterating more than half of a lung field;
(3) Miliary TB;
(4) TB meningitis;
(5) TB pneumonia; and those TB requiring surgical interventions or with complications.
For the DOH, August is also known as the Tuberculosis Awareness Month.