Tuberculosis (TB)

Tuberculosis (TB) is an infectious disease is common and often deadly caused by mycobacteria, usually Mycobacterium tuberculosis in humans. Tuberculosis usually attacks the lungs but can also affect other parts of the body. It is spread through the air, when people who have the disease cough, sneeze, or spit. Most infections in humans in the outcome of infection, latent asymptomatic, and about one in ten latent infections eventually progress to active disease, which, if left untreated, kills more than half of the victims.

Under high magnification 15549x, this colored scanning electron micrograph (SEM) depicted some ultra detailed look at the configuration of the cell walls of some Gram-positive bacterium Mycobacterium tuberculosis. As an obligate aerobic organism M. tuberculosis can only survive in an environment containing oxygen. These bacteria are long ranged between 2-4 microns, and the width between 0.2 - 0.5 micron.

Classic symptoms are chronic cough with blood-tinged sputum, fever, night sweats, and weight loss. Infection of other organs causing various symptoms. The diagnosis relies on radiology (commonly chest X-rays), tuberculin skin tests, blood tests, as well as microscopic examination and microbiological culture of bodily fluids. Treatment is difficult and requires long courses of some antibiotics. Contacts are also screened and treated if necessary. Antibiotic resistance is a growing problem in the (wide) multi-drug-resistant TB. Prevention relies on screening programs and vaccination, usually with Bacillus Calmette-Guerin vaccine.

One third of the world population is estimated to be infected with M. tuberculosis'''', and new infections occur at a rate of about one per second. with many symptoms that overlap with other variants, while others are more (but not all) specific to a particular variant. Some variants may be present simultaneously.

When the disease becomes active, 75% of pulmonary TB cases, ie, TB in the lungs. Symptoms include chest pain, coughing up blood, and cough, productive prolonged for more than three weeks. Systemic symptoms include fever, chills, night sweats, loss of appetite, weight loss, pallor, fatigue and often the tendency is very easy. This occurs more commonly in immunosuppressed people and children. Pulmonary infection sites include the pleura in tuberculosis pleurisy, the central nervous system in meningitis, the lymphatic system in scrofula of the neck, the genitourinary system in urogenital tuberculosis, and bones and joints in Pott's disease of the spine. A very serious form of disseminated TB, more commonly known as miliary tuberculosis. Extrapulmonary tuberculosis can coexist with pulmonary TB as well.

Studies utilizing DNA fingerprinting of M.'' Tuberculosis strains'' have shown that reinfection greater contribution to TB relapse than previously thought, with between 12% and 77% of cases are due to re-infection (rather than reactivation).

Tuberculosis is one of the three major diseases of poverty along with AIDS and malaria. The Global Fund to Fight AIDS began in 2002 to raise finance to cope with infectious diseases. Globalization has led to increased opportunities for spread of disease. In 2007, a fear of tuberculosis occurred when Andrew Speaker flew on transatlantic flights infected with multi-drug resistant TB.

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Tuberculosis (TB)

Tuberculosis (TB)

TB disease is a disease which is categorized in infections caused by bacteria Mikobakterium tuberculosis. TB disease can strike at anyone not to mention men, women, old, young, rich and poor and anywhere. In Indonesia in particular, this disease continues to grow each year and currently reaches 250 million new cases of which 140 000 resulted in death. Even Indonesia occupied the third largest country in the world in this TB problem.

Cause Disease (TB)

TB disease is caused by bacteria Mikobakterium tuberculosis, rod-shaped bacteria and is resistant to acids also known as the Batang Resistant Acid (BTA). This type of bacteria was first discovered by a man named Robert Koch on March 24, 1882, to commemorate his services, the bacteria is given the name of the Koch bacillus. Even TBCpada lung disease was also known as Koch Pulmonum (KP).

Mode of transmission of TB Disease

TB disease transmission is through contaminated air by Mikobakterium tuberculosis released / issued by the TB patient during coughing, which in children is generally the source of infection comes from adults who suffer from tuberculosis. These bacteria enter the lungs and come together to develop into many (especially in people who have low immune system), even these bacteria also may have spread through the blood vessels or lymph nodes, causing infection of other organs such as brain, kidney , gastrointestinal tract, bone, lymph nodes and other top despite the lung is an organ.

The entry into the organ Mikobakterium pulmonary tuberculosis cause infection in the lungs, which occurred immediately colony growth of bacteria that is round (globular). With the immunological reaction, cells in the lung wall trying to inhibit the TB bacteria through mechanisms alamianya forming scar tissue. As a result, the TB bacteria will stay / rest (dormant) as they appear as tubercles on the X-ray examination or x-ray photo.

A person with the condition of the immune system (Immune) is good, these tubercles form will remain dormant throughout his life. Other things to people who have low body kekebelan system or less, these bacteria will have breeding tubercles grow so much. So many of these tubercles are assembled to form a space within the lung cavity, this space will become a source of sputum production (ripple / phlegm). So the people who produce sputum and lung cavity found tuberculosis microbe called tubercles and is experiencing positive growth infected with TB.

The development of TB disease in Indonesia is nothing related to the deteriorating socio-economic conditions, ineffective public health service facilities, the increasing number of people who do not have a place to live and an epidemic of HIV infection. It is also of course have a major impact from a weak immune system / decrease, virulence and the number of germs that plays an important role in the occurrence of TB infection.

Symptoms of TB Disease

Symptoms of TB disease were classified into two parts, the general symptoms and specific symptoms. Difficult to detect and diagnose TB is caused by a clinical picture of the person that is not typical, especially in new cases.

1. Common symptoms (Systemic)
- Not very high fever which lasts longer, is usually felt at night accompanied by night sweats. Sometimes such as influenza and fever attacks are intermittent.
- Decreased appetite and weight.
- Cough-cough for more than 3 weeks (can be accompanied by blood).
- Feelings of not feeling (malaise), weakness.

2. Specific symptoms (Typical)
- Depending on which organs are affected, in case of partial bronchial obstruction (the channel leading to the lungs) due to suppression of enlarged lymph nodes, will cause the sound of "wheezing" sound accompanied by shortness of breath weakened.
- If there is fluid dirongga pleura (covering the lungs), can be accompanied by chest pains.
- When the bone, there will be symptoms such as bone infection at some point to form a channel and empties into the skin above it, in this estuary will discharge pus.
- In children to the brain (brain wrapper layer) and referred to as meningitis (inflammation of the lining of the brain), the symptoms are high fever, an impairment of consciousness and convulsions.

In patients age children if not cause symptoms, so TB can be detected if there are known contacts with adult TB patients. Approximately 30-50% of children who comes in contact with adult pulmonary TB patients gave a positive tuberculin test results. In children ages 3 months - 5 years old who live with adult pulmonary TB patients with sputum smear positive, 30% reported infected based on serological examination / blood.

Enforcement diagnosis of TB

If a person suspected of suffering from or infected with TB disease, then there are some things that need to be done to check memeberikan proper diagnosis, among others:

- Diagnose both the patient and his family.
- Direct physical examination.
- Laboratory tests (blood, sputum, cerebrospinal fluid).
- Examination of anatomical pathology (PA).
- X-ray chest (thorax photo).
- And the tuberculin test.

Treatment of TB Disease

Treatment for patients with TB disease will undergo a long process, and it ranged from 6 months to 9 months or even more. TB disease can be cured completely if the patient regularly taking medication that a doctor can improve endurance and body with good nutrition.

During the treatment process, to know better their development is recommended in patients to undergo either blood, sputum, urine and X-ray or x-rays every 3 months. The drug is generally given is obtan Isoniazid and rifampin as basic treatment for patients with tuberculosis, but because of the possibility of resistance to both drugs, the doctor will decide to provide additional drugs such as pyrazinamide and streptomycin sulfate or Ethambutol HCL as a single entity known as' Triple Drug '.

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