Tuberculosis
Tuberculosis, abbreviated as TB, is a disease caused by bacteria called Mycobacterium Tuberculosis (MTB). This bacteria belongs to the family of bacteria called Mycobacteriacaeae. In this family there is also bacteria called Mycobacterium Leprae, notorious in biblical times for causing Leprosy, which at the time was considered a curse.
The commonest form of Tuberculosis is Pulmonary Tuberculosis, abbreviated as PTB, which is TB of the lungs.
How does it spread?
The mode of spread of TB is via inhalation droplets containing TB bacteria, which have been coughed or sneezed out by an infected individual.
Conditions and situations that make TB spread easily include overcrowded spaces/halls/ homes/offices, and poorly ventilated spaces/halls/homes/offices.
Who is at risk of getting TB?
Alcoholics, people who are HIV positive, people with diabetes, people with poor or unbalanced diet, people working or staying in overcrowded and/or poorly ventilated conditions.
Can TB infect other parts of the body?
Yes. You can get TB of just about any body part, but the common ones outside of the lungs include lymph nodes (glands commonly found in neck, armpits and groins), meninges (covers of the brain), skin, bones, liver, intestines, kidney, heart, pericardium (cover of the heart), testicles and ovaries.
What are TB symptoms?
The symptoms depend on which part is infected by the TB bacteria. In Pulmonary TB, symptoms include cough for 3 weeks or longer, chest pain, loss of weight and night sweats. In intestinal TB symptoms include nausea, vomiting, diarrhea, weight loss, bloatedness and indigestion. For TB meningitis, symptoms include a constant headache that doesn’t respond to pain killers, painful eyes when exposed to normal light or entering a lit room and stiff & painful neck.
How is TB diagnosed?
For Pulmonary TB a sputum must be sent to the lab to look for MTB, also a chest Xray. For others, fluid or tissue sample from that relevant organ is sent to the lab to look for MTB.
Is TB treatable?
Yes. A combination of 4 drugs (Rifampicin, Isoniazid, Pyrazinamide and Ethambutol) combined into one drug called Rifafour and given according to your weight (eg if you weigh < 40kg you take 3 Rifafour tablets). The treatment is taken for a minimum of 6 months depending on the type of TB you have and body organ involved.
What is MDR-TB and XDR- TB?
MDR-TB, called Multidrug resistant TB, is a TB that is resistant to at least Rifampicin and Isoniazid, the two most potent TB drugs. In this case, second line drugs which include tablets called fluoroquinilones and injectables drugs are used to treat it. And there is XDR-TB, called Extensively drug resistant TB, a rare type of MDR-TB that is resistant to Isoniazid, Rifampicin plus any fluoroquinolone antibiotic and at least one of the injectable second line drugs. Resistance is caused by not finishing the entire course of treatment, which often happens when the patient feels better and looks better, usually after only one or two months of taking the treatment.
COVID-19
Which virus?
COVID-19 disease is caused by the SARS-Cov-2 virus.
How does it spread?
It is spread by inhalation of droplets that have been coughed and/sneezed by an infected person, or ingestion of such infected droplets. It is also spread by touching people and/ or surfaces that have the virus. Once in the lungs, the virus can cause inflammation of the airways and clotting of the small blood vessels in the lung tissue. From the lungs it can also enter the blood stream and affect the nervous system, more blood vessels causing more clots and the muscles.
What are the symptoms?
Cough, fever, soar throat, body pains, headache and shortness of breath are the commonest symptoms. Others include loss of smell and taste as well as diarrhoea and vomiting.
What is the treatment?
There is as yet no approved cure for the SARS-Cov-2 virus. The treatment used is mainly aimed at preventing and reducing clots and inflammation mainly in the lungs and blood vessels.
COVID-19 and TB
It is possible to be infected with TB while you have COVID-19 and vice versa. In that case both disease can cause inflammation and clotting in the lungs. The shortness of breath or difficulty in breathing, loss of appetite and fever tend to be more marked in this case. Depending on how much of the lung(s) is infected by TB you may need to be ventilated in an ICU. The treatment is generally the same as it would be if you were infected by one or the other.
It is important to mention however that the lungs and the body in general cope better with one disease than both and the recovery is quicker with one disease than with both. Also, having TB does increase the chances of getting COVID-19 and vice versa because each disease lowers or compromises the local lung defense system.