Tuberculosis: Causes, Symptoms, Treatment & Prevention in India

Overview

Tuberculosis (TB) is a serious infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs (pulmonary TB) but can also affect other parts of the body (extrapulmonary TB). TB is a major public health concern in India, which accounts for the highest number of TB cases globally. The disease spreads through the air when an infected person coughs, sneezes, or talks. While TB can be fatal without treatment, it is curable and preventable with appropriate medical care.

Causes

TB is caused by the bacterium Mycobacterium tuberculosis. The bacteria are spread through airborne droplets from an infected person. Factors that increase the risk of developing active TB include:

• Weakened immune system: HIV/AIDS, diabetes, malnutrition, or immunosuppressive medications.
• Close contact: Living with or spending time with someone who has active TB.
• Age: Very young children and older adults are more vulnerable.
• Poor living conditions: Overcrowding, poor ventilation, and lack of hygiene.
• Substance abuse: Smoking, alcohol, and drug abuse can increase risk.

Symptoms

Common symptoms of active TB include:

• Persistent cough: Lasting 3 weeks or longer, sometimes with blood-tinged sputum.
• Chest pain: Pain when breathing or coughing.
• Unexplained weight loss and loss of appetite.
• Fever and chills: Especially night sweats.
• Fatigue and weakness.
• Shortness of breath (in advanced cases).

Extrapulmonary TB may cause symptoms related to the affected organ, such as swollen lymph nodes, back pain, or abdominal pain.

Diagnosis

Diagnosis involves a combination of tests:

• Mantoux tuberculin skin test (TST): Injection of purified protein derivative (PPD) under the skin; read after 48-72 hours.
• Interferon-gamma release assays (IGRA): Blood test like QuantiFERON-TB Gold.
• Chest X-ray: To look for lung abnormalities.
• Sputum smear microscopy: Direct examination for acid-fast bacilli (AFB).
• GeneXpert MTB/RIF: Molecular test that detects TB and rifampicin resistance.
• Culture: Gold standard but takes weeks.

Treatment Options

TB is treated with a combination of antibiotics over 6-9 months. Standard treatment includes:

• First-line drugs: Isoniazid, Rifampicin, Pyrazinamide, Ethambutol (HRZE regimen).
• Directly Observed Therapy (DOTS): Ensures medication adherence through supervised intake.
• Drug-resistant TB (MDR-TB): Requires second-line drugs like fluoroquinolones, injectable agents, and newer drugs (bedaquiline, delamanid).

Treatment must be completed fully to prevent relapse and drug resistance. Side effects like hepatotoxicity require monitoring.

Prevention

Prevention strategies include:

• BCG vaccine: Given at birth in India, protects against severe forms of TB in children.
• Early detection and treatment: Reduces transmission.
• Good ventilation: Avoid crowded, poorly ventilated spaces.
• Hygiene: Cover mouth when coughing/sneezing, wear masks.
• Latent TB treatment: For high-risk individuals with positive skin test but no active disease.
• Nutrition: Adequate protein and calories to boost immunity.

Ayurvedic Perspective & Remedies

In Ayurveda, TB is known as Rajayakshma (the king of diseases) and is believed to result from imbalance of Vata and Kapha doshas, leading to weakened Ojas (vital energy). Ayurvedic treatment focuses on restoring immunity and balancing doshas. Common approaches include:

• Herbal remedies: Ashwagandha, Tulsi, Haridra (turmeric), Pippali (long pepper), and Vasa (Adhatoda vasica) are used for their antimicrobial and immunomodulatory properties.
• Dietary recommendations: Light, easily digestible, and nutritious foods like soups, khichdi, and warm milk with ghee. Avoid cold, heavy, and oily foods.
• Lifestyle: Adequate rest, stress reduction through yoga and meditation, and avoiding smoking and alcohol.
• Panchakarma: Detoxification therapies like Vamana (therapeutic vomiting) and Virechana (purgation) may be used under expert guidance.

Important: Ayurvedic remedies should complement, not replace, standard medical treatment. Always consult a qualified Ayurvedic practitioner and your doctor.