World Tuberculosis Day: Do you have TB? Here’s what you should do

New Delhi: Most people still believe TB is a poor man’s disease, but they’re wrong. Two in five people in India have TB infection, but do not infect others or develop disease.

Have a cough that hasn’t gone away for more than two weeks? It could be tuberculosis (TB), a highly contagious disease that sickens 2.8 million persons and kills 480,000 each year – more than 1,400 persons each day.

Apart from a cough that lasts two weeks or longer and coughing up mucous or blood, signs of TB include fatigue, weight loss, loss of appetite, low fever and chills and night sweats.

Most people still believe TB is a poor man’s disease, but they’re wrong. Two in five people in India have TB infection, but do not infect others or develop disease because their strong immune system produces macrophages – type of white blood cells that gobble up foreign material – that form a hard shell around the tubercle bacilli to keep it contained.

But if your immunity plummets because of fatigue, poor diet, illnesses or medication, you raise your risk of developing disease manifold.

You are at risk if you are:

Dieting/eating erratically: Undernutrition not only turns latent TB infection to active disease, but also raises the risk of drug toxicity, relapse and death after a person gets the disease, reports a study by the Indian Council of Medical Research. In people who are sick, good nutrition helps to fight TB and leads to faster cure and better weight gain.

Apart from malnourished persons, those who diet, lose weight suddenly, eat erratically and have low-nutrition meals are also at risk. Those who weight 10% or less than their healthy weight are also at risk.

Smoking: Smoking substantially increases the risk of disease and death from TB, with more than 20% of global TB incidence attributable to smoking, says the World Health Organisation. In people with low immunity, it can double risk. As much as 40% of India’s TB is attributed to smoking.

Immune-compromised: People recovering from an illness or surgery, older adults, newborns, pregnant women and new mothers, people who have undergone weight-loss surgery, and people with HIV, chronic lung disease, uncontrolled diabetes and those with some cancers have impaired immunity, which puts them at risk of infection.

On certain medication: People on long-term corticosteroids, biologics used to treat rheumatoid arthritis and Crohn’s disease, or immune-suppressants after organ transplantation have weakened immune systems and must avoid close contact or use masks when they visit places where they are at risk of infection, such as public transport, clinics, hospitals, crowded public places, etc.

Treatment: India’s Revised National Tuberculosis Control Programme offers free diagnosis and treatment to everyone infected with TB, but it’s only used by those who cannot afford treatment in the private sector.

Bad idea! Treatment quality in India’s large and unregulated private sector, which is the first point of diagnosis and treatment for more than 80% of people with TB, is often marked with diagnostic delays, wrong treatment and poor outcome, which leads to growing drug-resistant TB. In India, 93,000 persons with multi-drug resistant TB were diagnosed and put on treatment till 2015, shows Union Ministry of Health data.

Most government centres provide far better care than neighbourhood clinics because they have updated training, new diagnstic tools and the most potent medicines to treat the disease. Medicines are given free, along with counseling and follow-ups.

Poor hygiene is always a concern at government hospitals, so make sure you avoid close contact with other infected persons and wash your hands/use a sanitiser after each visit.

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