March 24th is World Tuberculosis (TB) Day. The World Health Organization reports that the global TB burden has grown in recent years, with approximately 10.6 million people contracting TB in 2021, and approximately 1.6 million people dying from it. In Canada, approximately 2,000 people were diagnosed with TB, and Saudi Arabia reported approximately 3,000 cases.
TB is spread through microdroplets in air when an infected person coughs, sneezes, speaks, etc., making it highly contagious, however, it can be prevented and successfully treated.
Tuberculosis Infection and Treatment
TB is a bacterial infection that most commonly affects the lungs. This is known as pulmonary tuberculosis. It can also affect other organs, including the kidneys, spine, or brain. Left untreated, TB can damage the lungs to the point of death. In some cases, the bacteria can infect a person without causing symptoms. This is known as latent TB, and it is not transmissible. Active TB causes symptoms such as coughing, fever, fatigue, and chills. Patients with active TB can infect other people with the illness.
Like other bacterial infections, TB responds to treatment with antibiotics. To treat patients with TB, you can administer a combination of drugs, which may include:
- Rifampin (Rifadin, Rimactane)
- Ethambutol (Myambutol)
Treatment duration could be 4, 6, or 9 months depending on the drug regimen being used.
Certain strains of TB are considered antibiotic resistant and require additional drugs. The medications Bedaquiline (Sirturo) or Linezolid (Zyvox) can be used for treating drug-resistant TB.
It’s critical your patients understand they must follow all TB treatment guidance, as stopping treatment too soon can result in the bacteria becoming treatment-resistant. In addition, patients must follow appropriate guidelines to avoid spreading TB to others.
In addition to effective treatment, TB prevention is possible. Reducing exposure and engaging in good infection control procedures can drastically reduce the risk of TB infection. Avoiding contact with people known to have active, contagious TB will nearly eliminate the risk. Exposure avoidance is especially important for those with risk factors for developing active TB, such as HIV infection, immune conditions, very young or elderly people, and those who have had prior TB infections.
People with latent TB can undergo treatment to eliminate the infection and prevent the risk of TB becoming active. Treatment for latent TB is similar to treatment for active TB. Patients undergo a regimen of multiple drugs, including:
- Isoniazid (INH)
- Rifapentine (RPT)
- Rifampin (RIF)
The Impact of COVID-19 on Tuberculosis Patients
The full scope of how COVID-19 affects people with TB is still unknown. Early studies indicated that it was possible for people with TB to contract COVID-19. There is a risk that TB, or a history of past TB infection, can exacerbate the effects of COVID-19.
One study from Thailand revealed that prior history of COVID-related pneumonia correlated with a higher risk of active TB infection among people in TB-endemic regions. There does not appear to be data confirming that COVID-19 can trigger active TB in people who have latent TB.
The symptoms of active TB and COVID-19 can be similar, which may lead to a delay in testing for TB. Healthcare providers should engage in TB awareness and ask about possible TB exposure if symptoms can’t be explained by a COVID-19 diagnosis.
To learn more about the treatment and prevention of TB, explore related courses and join the MDBriefCase community to stay current on guidelines.