Tuberculosis (TB)

Background

1. Tuberculosis is an airborne infectious disease caused by bacteria (usually Mycobacterium Tuberculosis (MTB)). TB bacteria contained in body secretion are put into the air when an infectious TB patient coughs, sneezes, speaks, or sings. Healthy people nearby TB patients may breathe in these bacteria and become infected. The incubation period of the bacteria is estimated to be between 4 and 12 weeks. TB bacteria typically attack lungs, but can also invade other organs and tissues of the body, such as lymph nodes, meninges, pleura, kidney, bone, skin, gastrointestinal tract, urogenital tract, etc.
2. Not everyone infected with TB bacteria will develop TB. Generally, they are under control and will not develop TB when host’s immunity is strong enough. Such state of balance is called latent TB infection (LTBI). However, TB may develop when their immune system become weak. Therefore, family members of infectious TB patient, elderly, people with diabetes, silicosis, renal dialysis patients, long-term users of steroids, other immunosuppressive drugs users, alcoholics, and immunocompromised individuals are more likely to develop TB.
3. According to the researches, people infected with TB bacteria have a 10% risk of falling ill with TB. Treating TB is necessary to TB patients, and most of the patients can be cured with proper treatment. On the contrary, 50% of the patients will die if they do not receive treatment. Although 30% of patients will survive, they will continue to disseminate bacteria and infect people who are in close contact with them, which may cause more infected cases and place a large financial burden on themselves and society.
4. Furthermore, when TB patients do not take medication regularly, the bacteria in their body will develop resistance to the drugs, such that the commonly used anti-TB drugs will become ineffective. Drug resistant TB (DR-TB) is spread the same wat that drug-susceptible TB is spread. For DR-TB patients, especially in multi-drug resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) situation, they need to face with more difficulties to recover, and might need to be detained in hospitals if they failed comply with the treatment according to the Communicable Disease Control Act.

Latent Tuberculosis Infection (LTBI) 

1. When TB bacteria enter human body, they form an organized structure called granuloma in the lung. Generally, they are under control and will not develop TB when host’s immunity is strong enough. Such state of balance is called latent TB infection (LTBI). Although LTBI individuals are asymptomatic and not contagious, they may develop TB when their immune system become weak, and symptoms include coughing with or without sputum over 2 weeks, hemoptysis, night sweats, poor appetite, weight loss, chronic fatigue and discomfort, mild fever, chest tightness and pain might occur. Please stay vigilant when symptoms occur, and wear a medical mask properly then consult a doctor to receive TB examinations.
2. To prevent LTBI individuals develop TB disease, diagnosis and treatment are critical. Two tests, Interferon-γ release assays (IGRAs) and Tuberculin skin test (TST), are available for different ages of target. For people who have ever been in contact with contagious TB cases, public health authorities will refer them to receive chest X-ray and LTBI test. Receiving the completed course of LTBI treatment provides efficacy over 90% to prevent the subsequent development of TB.
3. TB patients are recommended to join the “Directly observed therapy (DOTS)” program, and LTBI individuals should join the “Directly Observed Preventive Treatment (DOPT)” program provided by public health authority, where a trained caregiver (e.g., DOTS/DOPT worker) will provide individual care and medication service. DOTS/DOPT workers ensure patients/individuals take every prescribed pill of the medication regularly, provide care and support, evaluate discomforts or side effects derived from the medication so as to help patients/cases complete the treatment.