{"id":14,"date":"2019-12-26T08:07:21","date_gmt":"2019-12-26T08:07:21","guid":{"rendered":"http:\/\/localhost\/fit\/?page_id=14"},"modified":"2024-03-25T06:28:44","modified_gmt":"2024-03-25T06:28:44","slug":"learn-about-tb","status":"publish","type":"page","link":"https:\/\/tbhelp.org\/?page_id=14","title":{"rendered":"Learn about TB"},"content":{"rendered":"\t\t
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What is TB?<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Tuberculosis (TB) is caused by bacteria called Mycobacterium tuberculosis<\/i><\/strong>.\u00a0 The bacteria usually attack the lungs, but they can attack any part of the body, including the kidneys, spine, and brain.\u00a0 Not everyone who gets infected with TB bacteria becomes sick. As a result, there are two types of TB conditions: TB infection and TB disease.<\/p><\/div><\/div><\/div><\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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What is TB?<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Tuberculosis (TB) is caused by bacteria called Mycobacterium tuberculosis<\/i><\/strong>.\u00a0 The bacteria usually attack the lungs, but they can attack any part of the body, including the kidneys, spine, and brain.\u00a0 Not everyone who gets infected with TB bacteria becomes sick. As a result, there are two types of TB conditions: TB infection and TB disease.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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How TB spreads<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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When people with TB of the lungs or throat cough, sneeze or spit, they propel the TB bacteria into the air. A non-infected person needs to inhale a few particles\u00a0 to become infected. People with TB disease often spread TB bacteria to people with whom they spend the most time with, including family members, friends, and coworkers or schoolmates.<\/p>

TB is NOT<\/b><\/span> spread by:<\/p>

  1. Shaking someone\u2019s hand<\/li>
  2. Sharing food or drink<\/li>
  3. Touching bed linens or toilet seats<\/li>
  4. Sharing toothbrushes<\/li>
  5. Kissing<\/li><\/ol>

    TB Infection<\/b><\/span><\/p>

    TB bacteria can live in the body without multiplying or making a person sick.\u00a0 This is called latent TB infection (LTBI) or TB infection.\u00a0\u00a0<\/p>

    People with TB infections:<\/p>

    1. Have no symptoms<\/li>
    2. Cannot spread TB bacteria to others<\/li><\/ol>

      For majority of people with TB infection, the TB bacteria will stay inactive for their entire life and never cause TB disease.\u00a0 However, for about 5-10% of the people, the TB bacteria will multiply and cause TB disease.<\/p>

      TB Disease<\/b><\/span><\/p>

      When a person\u2019s immune system cannot stop the TB bacteria from multiplying, it is called TB disease.\u00a0 People with TB disease can spread TB bacteria to those around them (learn How TB Spreads).\u00a0\u00a0<\/p>

      The symptoms of TB disease<\/a> vary in presentation and severity depending on how long and where in the body the TB bacteria have been multiplying. Common symptoms of TB disease in the lungs include:<\/p>

      1. Cough<\/li>
      2. Pain in the chest<\/li>
      3. Coughing up blood or sputum (phlegm from deep inside the lungs)<\/li>
      4. Fever<\/li>
      5. Unexplained weight loss<\/li>
      6. Sweating at night<\/li>
      7. Weakness or fatigue<\/li>
      8. No appetite<\/li>
      9. Chills<\/li>
      10. Swelling<\/li><\/ol>

        Difference between latent TB infection and TB disease:<\/p>

        TB infection<\/b><\/span><\/p><\/td>

        TB disease<\/b><\/span><\/p><\/td><\/tr>

        No symptoms<\/p><\/td>

        Presents one or more symptoms, including: prolonged cough, chest pain, fever, chills, night sweats, weight loss, loss of appetite<\/p><\/td><\/tr>

        Does not feel sick<\/p><\/td>

        Usually feels sick<\/p><\/td><\/tr>

        Not infectious, cannot spread TB bacteria to others<\/p><\/td>

        Infectious, may spread TB bacteria to others<\/p><\/td><\/tr>

        Normal chest X-ray and a negative sputum smear<\/p><\/td>

        May have an abnormal chest X-ray, or positive sputum smear or Xpert result<\/p><\/td><\/tr>

        Positive TST test or blood test result indicating TB infection<\/p><\/td>

        Positive TST test or blood test result indicating TB infection<\/p><\/td><\/tr>

        Needs treatment for latent TB infection to prevent TB disease<\/p><\/td>

        Needs treatment to treat TB disease<\/p><\/td><\/tr><\/tbody><\/table>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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        How TB spreads<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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        When people with TB of the lungs or throat cough, sneeze or spit, they propel the TB bacteria into the air. A non-infected person needs to inhale a few particles\u00a0 to become infected. People with TB disease often spread TB bacteria to people with whom they spend the most time with, including family members, friends, and coworkers or schoolmates.<\/p>

        TB is NOT<\/b><\/span> spread by:<\/p>

        1. Shaking someone\u2019s hand<\/li>
        2. Sharing food or drink<\/li>
        3. Touching bed linens or toilet seats<\/li>
        4. Sharing toothbrushes<\/li>
        5. Kissing<\/li><\/ol>

          TB Infection<\/b><\/span><\/p>

          TB bacteria can live in the body without multiplying or making a person sick.\u00a0 This is called latent TB infection (LTBI) or TB infection.\u00a0\u00a0<\/p>

          People with TB infections:<\/p>

          1. Have no symptoms<\/li>
          2. Cannot spread TB bacteria to others<\/li><\/ol>

            For majority of people with TB infection, the TB bacteria will stay inactive for their entire life and never cause TB disease.\u00a0 However, for about 5-10% of the people, the TB bacteria will multiply and cause TB disease.<\/p>

            TB Disease<\/b><\/span><\/p>

            When a person\u2019s immune system cannot stop the TB bacteria from multiplying, it is called TB disease.\u00a0 People with TB disease can spread TB bacteria to those around them (learn How TB Spreads).\u00a0\u00a0<\/p>

            The symptoms of TB disease<\/a> vary in presentation and severity depending on how long and where in the body the TB bacteria have been multiplying. Common symptoms of TB disease in the lungs include:<\/p>

            1. Cough<\/li>
            2. Pain in the chest<\/li>
            3. Coughing up blood or sputum (phlegm from deep inside the lungs)<\/li>
            4. Fever<\/li>
            5. Unexplained weight loss<\/li>
            6. Sweating at night<\/li>
            7. Weakness or fatigue<\/li>
            8. No appetite<\/li>
            9. Chills<\/li>
            10. Swelling<\/li><\/ol>

              Difference between latent TB infection and TB disease:<\/p>

              TB infection<\/b><\/span><\/p><\/td>

              TB disease<\/b><\/span><\/p><\/td><\/tr>

              No symptoms<\/p><\/td>

              Presents one or more symptoms, including: prolonged cough, chest pain, fever, chills, night sweats, weight loss, loss of appetite<\/p><\/td><\/tr>

              Does not feel sick<\/p><\/td>

              Usually feels sick<\/p><\/td><\/tr>

              Not infectious, cannot spread TB bacteria to others<\/p><\/td>

              Infectious, may spread TB bacteria to others<\/p><\/td><\/tr>

              Normal chest X-ray and a negative sputum smear<\/p><\/td>

              May have an abnormal chest X-ray, or positive sputum smear or Xpert result<\/p><\/td><\/tr>

              Positive TST test or blood test result indicating TB infection<\/p><\/td>

              Positive TST test or blood test result indicating TB infection<\/p><\/td><\/tr>

              Needs treatment for latent TB infection to prevent TB disease<\/p><\/td>

              Needs treatment to treat TB disease<\/p><\/td><\/tr><\/tbody><\/table>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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              Preventing TB<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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              Groups at high risk for developing TB disease include:<\/p>

              1. People with HIV infection<\/li>
              2. People who became infected with TB bacteria in the last 2 years<\/li>
              3. Babies and young children<\/li>
              4. People who inject illegal drugs<\/li>
              5. People who are sick with other diseases that weaken the immune system<\/li>
              6. Elderly people<\/li>
              7. People who were not treated correctly for TB in the past<\/li><\/ol>

                To minimize the risk of TB infection, individuals should avoid close contact with known TB patients in crowded, enclosed environments such as clinics, hospitals, nursing homes, factories or prisons.\u00a0<\/p>

                People working in health care facilities where TB patients are likely to be encountered should consult infection control or occupational health experts and inquire about administrative and environmental procedures for preventing exposure to TB.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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                Preventing TB<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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                Groups at high risk for developing TB disease include:<\/p>

                1. People with HIV infection<\/li>
                2. People who became infected with TB bacteria in the last 2 years<\/li>
                3. Babies and young children<\/li>
                4. People who inject illegal drugs<\/li>
                5. People who are sick with other diseases that weaken the immune system<\/li>
                6. Elderly people<\/li>
                7. People who were not treated correctly for TB in the past<\/li><\/ol>

                  To minimize the risk of TB infection, individuals should avoid close contact with known TB patients in crowded, enclosed environments such as clinics, hospitals, nursing homes, factories or prisons.\u00a0<\/p>

                  People working in health care facilities where TB patients are likely to be encountered should consult infection control or occupational health experts and inquire about administrative and environmental procedures for preventing exposure to TB.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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                  Diagnosing TB<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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                  Testing for TB infection<\/b><\/span><\/p>

                  Mantoux Tuberculin Skin Test (TST)<\/span><\/span><\/p>

                  The Mantoux tuberculin skin test (TST) requires two encounters with a healthcare provider.\u00a0 On the first visit, a small amount of fluid (called tuberculin or purified protein derivative [PPD]) is injected into the skin on the lower part of the arm.\u00a0 The person being tested must return within 48 to 72 hours to have a health care worker assess the injection site. If a raised, hard area or swelling of sufficient size appears, this means the person being tested has been infected with TB bacteria.\u00a0\u00a0<\/p>

                  Interferon Gamma Release Assay (IGRA)<\/span><\/p>

                  TB infection can also be tested through TB blood tests, or IGRAs. In Viet Nam, the blood test that is available is the QuantiFERON\u00ae\u2013TB Gold Plus test (QFT). Blood tests are the preferred TB test for people who have received the BCG vaccine. A health care provider will draw a patient\u2019s blood and send it to a laboratory for analysis and results.<\/p>

                  A positive test confirms that a person has been infected with TB bacteria and should begin TB preventive treatment.\u00a0<\/p>

                  Testing for TB disease<\/b><\/span><\/p>

                  A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria.\u00a0 These tests cannot distinguish between TB infection and TB disease. Additional tests, such as a chest X-ray and a sputum examination are then needed to determine whether the person being tested has TB disease.\u00a0<\/p>

                  Sputum Microscopy<\/span><\/span><\/p>

                  In many countries, including Viet Nam, the commonly used method for diagnosing TB is sputum smear microscopy. Trained laboratory technicians look at sputum samples under a microscope to see if TB bacteria are present. However, smear microscopy detects only half the number of TB cases and cannot detect drug-resistance.\u00a0<\/p>

                  Xpert MTB\/RIF<\/span><\/span><\/p>

                  The Xpert MTB\/RIF\u00ae is a WHO recommended test which has been increasingly used to test for TB disease since 2010. The test detects TB disease and resistance to rifampicin, a potent first line antitubercular drug, within as little as 2 hours.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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                  Diagnosing TB<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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                  Testing for TB infection<\/b><\/span><\/p>

                  Mantoux Tuberculin Skin Test (TST)<\/span><\/span><\/p>

                  The Mantoux tuberculin skin test (TST) requires two encounters with a healthcare provider.\u00a0 On the first visit, a small amount of fluid (called tuberculin or purified protein derivative [PPD]) is injected into the skin on the lower part of the arm.\u00a0 The person being tested must return within 48 to 72 hours to have a health care worker assess the injection site. If a raised, hard area or swelling of sufficient size appears, this means the person being tested has been infected with TB bacteria.\u00a0\u00a0<\/p>

                  Interferon Gamma Release Assay (IGRA)<\/span><\/p>

                  TB infection can also be tested through TB blood tests, or IGRAs. In Viet Nam, the blood test that is available is the QuantiFERON\u00ae\u2013TB Gold Plus test (QFT). Blood tests are the preferred TB test for people who have received the BCG vaccine. A health care provider will draw a patient\u2019s blood and send it to a laboratory for analysis and results.<\/p>

                  A positive test confirms that a person has been infected with TB bacteria and should begin TB preventive treatment.\u00a0<\/p>

                  Testing for TB disease<\/b><\/span><\/p>

                  A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria.\u00a0 These tests cannot distinguish between TB infection and TB disease. Additional tests, such as a chest X-ray and a sputum examination are then needed to determine whether the person being tested has TB disease.\u00a0<\/p>

                  Sputum Microscopy<\/span><\/span><\/p>

                  In many countries, including Viet Nam, the commonly used method for diagnosing TB is sputum smear microscopy. Trained laboratory technicians look at sputum samples under a microscope to see if TB bacteria are present. However, smear microscopy detects only half the number of TB cases and cannot detect drug-resistance.\u00a0<\/p>

                  Xpert MTB\/RIF<\/span><\/span><\/p>

                  The Xpert MTB\/RIF\u00ae is a WHO recommended test which has been increasingly used to test for TB disease since 2010. The test detects TB disease and resistance to rifampicin, a potent first line antitubercular drug, within as little as 2 hours.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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                  Treating TB infection and TB disease<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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                  TB infection\u00a0<\/b><\/p>

                  Regimens for latent TB infection (LTBI) use isoniazid (INH), rifapentine (RPT), or rifampin (RIF). It has been proven that patients are more likely to complete shorter treatment regimens. When possible, healthcare providers should prescribe the more convenient shorter regimens.<\/p>

                  Where available, WHO has updated the recommendations for use of once-weekly isoniazid-rifapentine for 12 weeks (3HP) for treatment of latent TB infection.<\/p>

                  Drugs<\/b><\/p><\/td>

                  Duration<\/b><\/p><\/td>

                  Frequency<\/b><\/p><\/td><\/tr>

                  Isoniazid (INH)<\/p><\/td>

                  6 months<\/p><\/td>

                  Daily<\/p><\/td><\/tr>

                  9 months<\/p><\/td>

                  Daily<\/p><\/td><\/tr>

                  Rifampicin (RIF)<\/p><\/td>

                  4 months<\/p><\/td>

                  Daily<\/p><\/td><\/tr>

                  Isoniazid (INH) and Rifapentine (RPT)\u00a0<\/p><\/td>

                  3 months<\/p><\/td>

                  Weekly<\/p><\/td><\/tr><\/tbody><\/table>

                  TB disease<\/b><\/p>

                  It is very important for people with TB disease to finish taking all of their anti-TB medicine exactly as prescribed. If medicines are stopped early, TB disease can return (relapse).\u00a0 If doses or certain medicines are skipped, the TB bacteria can develop drug resistance.<\/p>

                  Drug-susceptible TB disease is treated by taking a combination of several anti-TB medicines for at least six months.\u00a0 The treatment course is split into an intensive phase containing four medicines for two months (eight weeks) and a continuation phase containing two medicines for an additional four months (18 weeks).<\/p>

                  Intensive Phase<\/b><\/p><\/td>

                  Continuation Phase<\/b><\/p><\/td><\/tr>

                  • Four anti-TB medicines<\/li><\/ul>
                    • Rifampin (R, RIF)<\/li>
                    • Isoniazid (H, INH)<\/li>
                    • Pyrazinamide (Z, PZA)<\/li>
                    • Ethambutol (E, EMB)<\/li><\/ul>
                      • Seven days per week for 56 doses (8 weeks)<\/li><\/ul><\/td>