The challenge of extra-pulmonary TB

Sub: Science and tech

Sec: health

Tags: extra-pulmonary TB, Multidrug-Resistant TB (MDR-TB), Mycobacterium

Context:

The World Health Organization (WHO) reports over 10 million new cases of TB every year and India alone accounts for 27% of the global TB burden.

What is Tuberculosis?

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis.
TB commonly affects the lungs (pulmonary TB) but can also affect other parts (extrapulmonary TB)
Tuberculosis spreads from person to person through the air, when people who are infected with TB infection cough, sneeze or otherwise transmit respiratory fluids through the air.
The most common risk factor associated with TB is HIV & other conditions that impair the immune system.
Common symptoms of tuberculosis are Chronic coughs with blood-tinged sputum, Loss of weight, Loss of appetite, Fever and night sweats, Fatigue , etc.

What are Pulmonary and Extra Pulmonary Tuberculosis?

Pulmonary TB:

Pulmonary TB is caused by the bacterium Mycobacterium tuberculosis (M tuberculosis).
Pulmonary tuberculosis (TB) is a serious infection caused by the bacterium Mycobacterium tuberculosis (MTB) that involves the lungs but may spread to other organs.
When it affects the lungs, it’s called pulmonary TB.

Extra Pulmonary TB:

TB outside of the lung is called extrapulmonary TB.
It can also be categorized as being either active or latent
Extrapulmonary tuberculosis (EPTB) is tuberculosis outside of the lungs.
EPTB includes tuberculosis meningitis, abdominal tuberculosis (usually with ascites), skeletal tuberculosis, Pott’s disease (spine), scrofula (lymphadenitis), and genitourinary (renal) tuberculosis.
EPTB is often stain negative, which means it is not detectable on regular TB stain tests.
The infection may surface in any part of the body and present itself like other non-TB conditions.
In 2014, a group of experts from different health institutions across the country, the WHO, and the Cochrane Infectious Disease Group came together to formulate INDEX-TB, a set of guidelines for EPTB management in India.

What are other various types of Tuberculosis?

Multidrug-Resistant TB (MDR-TB):

In MDR-TB, the bacteria that cause TB develop resistance to antimicrobial drugs used to cure the disease.
MDR-TB does not respond to at least isoniazid and rifampicin, the 2 most powerful anti-TB drugs.
Treatment options for MDR-TB are limited and expensive.
CBNAAT (Cartridges Based Nucleic Acid Amplification Test) is used for early diagnosis of MDR-TB.

Extensively Drug-Resistant TB (XDR-TB):

XDR-TB is a form of multidrug-resistant TB with additional resistance to more anti-TB drugs.
People who are resistant to isoniazid and rifampicin, plus any fluoroquinolone and at least one of three injectable second-line drugs (amikacin, kanamycin, capreomycin) are said to have XDR-TB.

What is Mycobacterium?

The mycobacterium that causes TB was first isolated in the eye just a year after Robert Koch identified the organism.
Mycobacterium is a genus of over 190 species in the phylum Actinomycetota, assigned its own family, Mycobacteriaceae.
This genus includes pathogens known to cause serious diseases in mammals, including tuberculosis and leprosy in humans.

Efforts to Control TB in the country:

The National TB Control Programme was started in 1962 with the aim to detect cases earliest and treat them. In the district, the programme is implemented through the district Tuberculosis Centre (DTC) and the Primary Health Institutions.
Directly Observed Therapy (DOT) is the practice of observing a patient swallow his or her tuberculosis (TB) medications. National guidelines recommend DOT as part of the standard of care for TB treatment, and DOT is used by TB programs throughout the U.S. and around the world.
NI-KSHAY-(Ni=End, Kshay=TB) is the web enabled patient management system for TB control under the National Tuberculosis Elimination Programme (NTEP).