Some Question on TB-Answered by Chest Specialist from Singapore

Q : Does TB affect the lungs only or it can affect other organs? If so, what are the organs which may be affected by TB?

A : TB does not only affect the lungs. Chronic TB can be disseminated to other major organs of the body like the brains, kidneys, etc.

Q : Is BCG a sure protection against TB? If not, then why we should continue taking BCG vaccination?

A : BCG is not a sure protection against TB. However it is useful particularly for infants and young children as BCG does provide some amount of protection against TB. The level of protection BCG will vary among individuals.

Q : Are gland TB very harmful? Do they indicate that the patient had primary focus in the lungs?

A : The harmfulness of gland TB depends on which gland is affected. If the infected glands are not in a vital area, it may not be so dangerous. Gland TB does not necessarily indicate primary focus in the lungs or association with lung disease.

Q : How to define primary tuberculosis?

A : Primary Tuberculosis is the disease which develops soon after the patient is infected and falls ill a few weeks or months afterwards.

Q : It is told that persons infected with the human immuno-deficiency virus (HIV), with or without AIDS, are at increased risk of developing tuberculosis. Is it correct? If so why?

A : Yes it is correct that HIV-infected persons are at higher risk of developing TB. This is because the immune system that helps healthy persons fight TB, has been suppressed by the onset of HIV. As a result this makes HIV-infected persons more prone to TB.

Q : What could be the major risk of isoniazude prophy?

A : The most serious risk of the drug isoniazid in prophylaxis treatment is damage to the liver, which may lead to liver failure.

Q : Our experience shows that DOT programme has attained a considerable success. However, the DOT programme is a public programme assisted by UN agencies including WHO, World Bank etc. Could there be any other way to treat multidrug resistant TB cost effectively?

A : Currently most of the successful models for the DOT programme are public-assisted, be it through the government or through non-government organizations as you have specified. However if funding can be used creatively, the DOT programme need not be managed only by public-assisted organizations. Non-public organizations may also adopt and adapt the DOT programme to fit their respective needs and requirements.

Q : Who is vulnerable to TB? Are there different kinds?

A : Older people, those with chronic diseases, low immunity, and history of alcoholism are more vulnerable to TB. TB presents differently in health persons as opposed to those with low immunity or impaired immune system. TB in health persons usually presents in the lungs whereas TB in those with low immunity may spread and generalize into multi-organ TB.

Q : What could be the adverse effect of Anti TB drugs?

A : The most adverse effect of Anti TB drugs is liver toxicity. Some drugs may also affect the eyesight and interact with other medications leading to further complications.

Q : I wish to know about the patho-physiology of the TB, such as changes in tissue, cavity formation etc.

A : TB is a chronic infection, which can trigger an abnormal immune reaction, which results in damage to many organs causing cavities, hemorrhage or bleeding and scarring or fibrosis.

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