Tuberculosis is a life threatening ailment that has claimed many lives; this is why its management calls for serious prevention and management techniques.

Doctors stress the relevance of practicing safety methods when it comes to fighting tuberculosis noting that it is important for patients with the disease to avoid coughing and sneezing when in public places.

It is hence advisable to cover the nose and mouth with one’s forearm when coughing or sneezing; this is very vital as far as preventing the transmission of the tuberculosis virus to another person is concerned.

Also, just like covering the mouth and nose, medics advice against one spitting on the floor as this also could facilitate the transmission of the disease. When housing a TB patient, it is very ideal to always open windows and doors every day to allow enough ventilation.

Experts say these are simple vital practices that people should adopt to stop and prevent transmission of this contagious disease.

A closer look at TB cases

Every year, around 6,000 people test positive for TB and 99 percent among them start immediate treatment, according to information from Rwanda Biomedical Centre.

Officials however indicate that there are still TB patients who don’t take their drugs as prescribed, and they don’t get healed.

Statistics from Rwanda Biomedical Centre show that 20% of TB patients don’t go to the hospital for treatment thus end up infecting others in their communities.

About 88 percent of those under treatment heal while 8 percent of them die yet 3 percent of them do not heal, and they are put under new treatment, while 2 percent don’t undergo treatment at all.

TB prevalence is higher among children under 15 because of their weak immune system; it is also high among prisoners and the elderly.

Dr. Vianney Byiringiro Rusisiro, director of TB Infection Control Unit at RBC says TB is an infectious and contagious disease caused by mycobacterium tuberculosis that generally affects the lungs (pulmonary tuberculosis).

He says mycobacterium tuberculosis is a bacterial agent that can also affect other parts of the body (extrapulmonary tuberculosis).

According to him, the infection by mycobacterium tuberculosis does not mean that the person should immediately suffer from tuberculosis disease.

"A person may be infected by this bacteria but not end up suffering from tuberculosis disease. This is because some conditions may be required to prevail for the infection to turn into the tuberculosis disease,” he says.

He adds that this mostly happens especially when the immune response within the body decreases.

Dr. Yves Habimana Mucyo, the director of multidrug resistance at RBC (MDR) says the general symptoms of tuberculosis disease are chronic cough, persistent fever, night sweats, and weight loss among others.

In the case of infection affecting other organs, this can then cause a wide range of other symptoms, he says.

He however notes that there is a type of tuberculosis called multidrug-resistant tuberculosis. This, he explains as the type that can’t be cured by usual first-line treatment and usually requires a second line treatment.

He also asserts that being exposed to mycobacterium tuberculosis does not necessarily mean getting tuberculosis in the following days.

He explains that the risk of becoming infected increases with the density of the population, which is particularly high for people who share confined and poorly ventilated housing (with a contagious patient) as well as in penitentiary institutions and boarding schools.

"The risk of infection depends on the number of contagious cases in the community and the length of time these cases remain contagious. The frequency, proximity, and duration of contacts between susceptible persons and infectious cases as well as the immune response of individuals also matters,” he says.

TB and HIV

According to Rusisiro, Sputum smear-positive pulmonary TB cases are the most contagious and if left untreated, they can infect an average of 10 to 15 people per year.

"The risk of infection from a patient with smear-negative pulmonary TB is low, but it is not zero if the culture is positive,” he says.

He says 90 percent of people infected with mycobacterium tuberculosis if they not infected with HIV, develop TB.

"HIV infection is the main factor that facilitates progression of tuberculosis disease. It does this by either reactivating a latent tuberculosis infection or by causing the disease in the first place. This is especially among the people living with HIV who become infected with mycobacterium tuberculosis,” he says.

Other risk factors, he says include malnutrition, the sequelae (a condition which is the consequence of a previous disease or injury); in this case, a previous case of untreated tuberculosis, diabetes, corticosteroid therapy, physical or emotional stress, smoking, and excessive alcohol consumption.

He says that poverty on the other hand, is still strongly associated with tuberculosis.

He explains that this is because poverty promotes promiscuity and consequently transmission of contagious diseases.

"Poverty can as well limit access to care, which prolongs the period of contagiousness and increases the risk of infection for those around the patient,” he adds.

Prevention

Patrick Migambi, the manager of Tuberculosis Division at RBC says early diagnosis of tuberculosis disease as well as the immediate initiation of treatment prevents spreading or transmission of the mycobacterium tuberculosis.

He notes that all people who have signs like coughing for over two weeks, have a fever, experience weight loss, asthenia among others should make a point of consulting from the nearest health centre for TB diagnosis.

He also says that when a tuberculosis patient takes his or her treatment regularly and completely, they stop transmitting the disease to other people who are not infected.

Treatment

Rusisiro says, because tuberculosis is transmitted through air, when a person who has it coughs, sneezes, spits or talks it can be easily transmitted.

He therefore notes that if people are aware of the signs of tuberculosis, it becomes easier to seek quick consultation and diagnosis at any health facility across the country.

He notes that the Government of Rwanda through the Ministry of health availed means and facilities for tuberculosis diagnostic, and ensured free treatment for all diagnosed with tuberculosis disease.

The duration of treatment, he says, depends on the form/type of tuberculosis disease. For instance, the form of meningitis tuberculosis or bone tuberculosis needs the duration of 9 to 12 months of treatment; while the form of pulmonary tuberculosis calls for 6 months of treatment and the person will be completely cured.

"The patient diagnosed with tuberculosis must show compliance and follow advice and guidance provided by health care personnel for proper treatment,” he says.

When it comes to tuberculosis treatment, he says drugs are given to the patient either by the health care personnel or by the community health worker on a daily basis.

He adds that the treatment of tuberculosis disease is free and any person with signs of tuberculosis must go to the nearest health facility to get the help that is needed

editor@newtimesrwanda.com