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Tuberculosis

Basic facts on tuberculosis (TB) in the WHO European Region

Administration of TB drugs, Khersonska Oblast Tuberculosis Dispensary (Photo: Aleksandr Kozachenko)

TB and its symptoms

  • TB is a contagious disease caused by Mycobacterium tuberculosis. Like the common cold, it spreads through the air. People who are infected with pulmonary TB (TB of the lungs, the site most commonly affected) can spread the disease by coughing, sneezing or even talking. If the disease goes untreated, each person with active TB infects, on average, 10–15 others every year.
  • The symptoms differ, depending on the area of the body infected. In pulmonary TB, common symptoms are a cough with sputum production (sometimes with blood), shortness of breath and chest pain. There are also general symptoms, such as fever in the evening, night sweats, loss of weight, loss of appetite, fatigue and muscle weakness.

Diagnosis and treatment

  • The main tools for diagnosing TB are clinical assessment and bacteriological and radiological investigation. The examination of a sputum smear by microscopy is the simplest, cheapest and most direct way to identify the presence of TB bacteria and confirm pulmonary disease in 1–2 days. To evaluate drug susceptibility, however, the bacteria need to be cultivated and tested in a suitable laboratory for 6–16 weeks. This makes it possible to identify drug-resistant forms of TB. X-ray findings may indicate TB but usually need confirmation by other tests.
  • TB can usually be treated with a course of four standard (first-line) drugs. There is usually an intensive two-month phase of treatment with the use of all drugs, followed by a four-month continuation phase with only two. Because many people clearly do not finish a course of drugs, with negative consequences, the DOTS (directly observed treatment, short-course) strategy has been adopted, whereby a health worker carefully watches the patient take each dose. Direct observation of treatment intake and support to patients in different forms are recommended. If a patient takes treatment incorrectly or incompletely, resistance to TB drugs may develop and a cure becomes much more difficult, or impossible in some cases.