About Tuberculosis

  

Tuberculosis is one of the world’s biggest killer diseases. It kills more than 2 million people worldwide every year, and is the leading cause of AIDS related deaths. It is not just a disease of the past or the poor, anyone can catch it, and over 8000 new cases of Tuberculosis are reported in the UK each year, with these figures continuing to rise.

More information on TB in the UK

What is Tuberculosis?

Tuberculosis (TB) is an infection caused by bacteria (Mycobacterium Tuberculosis), which mainly affects the lungs, but can affect other parts of the body such as the spine or brain. Only TB carried in the lungs is infectious.

If not treated properly, TB can be fatal. An individual might be infected with TB for years (latent disease) but have no symptoms as the body is able to control the disease. However, if the immune system becomes less effective, the disease can become active.

How is TB transmitted?

In a person with active disease, the bacteria grow and begin to destroy tissue, such as the lungs, and the TB becomes infectious. If a person with active TB coughs or sneezes, they may pass the disease to others, particularly those they are in close contact with.

Who can get TB?

Anyone can get TB. However, most of us in developed countries, such as the UK, are healthy and have a strong immune system which stops the disease developing. TB is an opportunistic disease which preys on those who have weaker immune systems. Those who are particularly vulnerable are, for example, children, the elderly, and individuals who are HIV positive.

TB and HIV – the deadly duo

A person with HIV is 400 times more likely to get TB than a person without HIV. HIV and TB each speed up the progression of the other. As a result, the WHO estimates that TB accounts for up to 1/3 of AIDS deaths worldwide, making it the leading cause of death among people with HIV. This is why countries with a high HIV rate, such as Africa and Asia, are seeing a resurgence in TB rates.

As a curable disease, the worldwide eradication of TB is therefore paramount in the fight against AIDS.

TB and Poverty

Tuberculosis is predominantly a disease associated with poverty. Malnutrition and poor living conditions increase the risk of being infected with TB. In addition, people living in poor-income countries are less able to access treatment, either because the health services just aren’t available or the associated costs of accessing these , such as
transportation or reduced working hours, are too high. In order to stop the spread of TB, the disease needs to be tackled globally.

Women and TB

TB is the single biggest killer of young women in the world, with more than 900 million infected with TB world-wide. It affects women in their economically and reproductively active years, when they are also more susceptible to HIV infection, and therefore has a huge impact on their children and families. Having close contact with their mothers,
children also have a significant risk of contracting TB.

Women in many countries are faced with a number of barriers before they can access healthcare. They delay seeking help to avoid using valuable family resources, women are particularly vulnerable to the stigma associated with HIV and TB, and they are often prevented from leaving their homes or work in order to seek treatment.
 
Target TB works to overcome gender discrimination throughout all of its work, and projects aim to look at associated issues affecting people with TB such as poverty and HIV.

What are the symptoms of TB?

Active TB may start with a persistent, dry cough which worsens over weeks or months, and the individual may cough up phlegm or even blood. Weight loss, night sweats, fatigue and fever are also common.

How is TB diagnosed?

Tuberculosis is diagnosed by analysing sputum samples under a microscope, and a chest x-ray may also be necessary.

Doesn’t the BCG vaccine prevent TB?

The BCG vaccine has helped to protect against TB for many years but it does not prevent it in all cases. Whilst no longer routinely given in the UK, it is still recommended for those who are at high risk of catching tuberculosis. In many developing countries, where the chance of being infected in the early years is high and may lead to devastating widespread disease, the BCG vaccine is given at birth. However, it is not effective in preventing TB in the long-term.

More information on the BCG vaccine

Can TB be cured?

Yes. Treatment is cheap, and involves three or four different kinds of antibiotics, in combination, over a period of 6 to 9 months. Most countries now offer TB treatment free of charge. The disease is entirely curable, but drug-resistant tuberculosis (resistance to at least 2 of the main first line drugs) is becoming problematic. This is extremely expensive and difficult to treat. The way to avoid resistance is by taking multiple medicines, and taking them as directed by a chest physician, until the individual is confirmed as being disease-free.

Why is multi-drug resistant TB (MDR-TB) on the increase?

A volunteer supports
patients on treatment



One weeks TB drugs
in India

Bacteria become resistant to drugs for a number of reasons. Medication may not be taken correctly, or patients may stop taking medication as soon as the symptoms disappear, but before the course is finished. In many developing countries, prescribing by private doctors is unsupervised. MDR-TB is also then transmitted to others, which exacerbates the problem. The WHO has stressed the importance of the DOTS strategy to ensure patients complete their course of treatment and avoid further spread of the disease.
Of even greater concern is the emergence of XDR-TB (extensive drug-resistant TB), which is MDR-TB with additional resistance to 3 or more of the second-line treatments.

More information on MDR-TB, XDR-TB and the Global Plan to Stop TB 

What is DOTS?

The DOTS (Direct Observed Therapy Short course) programme, developed by the World Health Organisation, is the global standard for TB control. It has five crucial elements to make it effective:

1. Sustained commitment from the government
2. Access to quality-assured TB sputum microscopy to check for the presence of bacteria
3. Standardised short-course chemotherapy using a range of antibiotics for all cases of TB under proper case-management conditions
4. Uninterrupted supply of quality-assured drugs
5. Recording and reporting system enabling outcome assessment

A key feature of DOTS is treatment supervision, either at home or in hospital with trained nurses or community workers. This support has proved to be very successful but there is a need to expand the programme, and increase the speed of expansion worldwide.

More information on DOTS

How can I get further information?

You can sign up to our quarterly newsletters or email us for more information at This e-mail address is being protected from spambots, you need JavaScript enabled to view it .
We also have a school pack available for download which gives more information about TB. This is aimed at students aged 13-16 years. (PDF 5.5MB which may take time to download).