World Tuberculosis Day is observed on March 24 annually, with the main intention to build awareness among the populace that tuberculosis remains an epidemic in most countries, resulting in the deaths of nearly one and a half million people every year, majorly in developing countries. Tuberculosis is highly treatable, but it lies dormant and undetected for years, thus it’s essential to spread awareness. The World Health Organization (WHO) chose March 24 as World TB day to honour the day Dr Robert Koch discovered TB bacillus, the bacterium that manifests the disease. In the year 1882 Dr Robert Koch astounded the scientific community by announcing the discovery of TB, bacillus at the time when tuberculosis was ramping up in Europe and America causing the death of 1 out of every 7 people. Dr. Koch’s discovery opened the way and hope for prompt diagnosis and treatment of tuberculosis.

This year’s theme is “Yes! We can end TB”, which works to encourage high-level committees to increase investments and faster adaptation of new WHO guidelines, implementation of innovations, enhanced action, and multisectoral collaboration to fight the TB epidemic. As per statistics 10.6 million people fell sick with TB in the year 2021, 1.6 million people died in 2021 due to this infectious disease and 74 million lives have been also saved because of the global initiative to end TB.

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Significance of World Tuberculosis Day

Tuberculosis is caused by Mycobacterium tuberculosis, and it mostly affects the lungs. TB is easily spread via the air when people with lung tuberculosis cough, sneeze, or spit droplets. A person just needs to inhale only a few pathogens to become infected. Despite being preventable and curable disease tuberculosis remains the globe’s top infectious killer disease. It is the leading cause of death of people with HIV and a chief contributor to antimicrobial resistance.

Most of the people who are infected with TB live in low and middle-income countries, but TB is prevalent across the globe. However, about half of the population with TB survives in 8 countries including Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines, and South Africa. Also, a quarter of the global populace is projected to have been infected with TB bacteria, but most people will not develop the disease, and some will clear the infection. Further, those who are infected but not ill with the disease cannot transmit it.

While people infected with TB bacteria have a 5-10 % lifetime risk of falling sick with TB. And those with compromised immune systems such as people living with HIV, malnutrition or diabetes or people using tobacco are at higher risk of falling sick.

Also Read: World Tuberculosis Day 2022: Debunk These 5 Common Myths Of This Bacterial Infection

This World Tuberculosis Day let’s understand the importance of systemic screening and how it helps to prevent the risk of infection.

Importance Of Systemic Screening

Certain people should be tested for TB infection as they are at a higher risk for being infected with mycobacterium bacillus bacteria, this includes:

• Those who are in close contact with someone who has tuberculosis
• Those living in countries where TB infection is very common like Latin America, the Caribbean, Africa, Asia, Eastern Europe and Russia
• People who work in high-risk settings such as hospitals, nursing homes and homeless shelters
• Medical workers who care for patients at increased risk for TB disease
• Infants, children and adolescents exposed to people who are at increased risk for latent TB infection or TB disease

Most people with latent TB infection would never develop TB disease, but a few may likely develop TB disease, those who are at risk for developing TB disease include:

• HIV infection
• People infected with TB bacteria in the last 2 years
• Infants and young children
• Those who use illegal drugs
• People with a poor immune system
• Elderly people
• People who were not treated appropriately for TB before

The World Health Organisation (WHO) recommends that screening should be carried out systematically in people who are at greater risk of developing TB, as prompt detection and appropriate treatment can improve the outcomes and reduce the incidence of TB and avert future disease.

Also Read:  Tuberculosis Diet: Here’s What You Should Eat And Avoid When Recuperating From TB

What Are Screening Options Available?

There are several ways to screen for tuberculosis. Screening tests consist of symptoms screens, chest X-rays and molecular rapid diagnostics tests (mWRDs) recommended by WHO like Xpert MTB/RIF and Truenat on sputum. C-reactive protein is a simple blood work that can also be used to screen for TB among people living with HIV patients. Multiple screening tests may be done, either in parallel or one after the other.

Tests for TB infection like tuberculin skin test (TST, Mantoux test) and interferon-gamma release assay (IGRAs) are no longer used for screening TB infections.

What Happens If My Screening Test Is “Positive”?

Well, the screening test is not a confirmation that you are infected with TB. Your healthcare provider may suggest further testing to confirm your TB diagnosis. The confirmatory test comprises the collection of sputum, urine, blood, X-ray or other investigations.

What Happens If My Screening Test Is “Negative”?

This means that no further screening is needed and there is no evidence that you have TB disease. In very rare cases, a second screening test will be done to confirm the negative result of the first screening test. But high-risk people should be tested for TB on a regular basis and may be benefitted by following TB prevention treatment (TPT).

What Is Tuberculosis Preventive Treatment ( TPT)?

TPT comprises a course of one or more anti-tuberculosis medications given with an aim of averting the development of TB disease. And TPT is only provided to those infected with TB bacteria or who have been exposed to it and who are at a higher risk. TPT is very potential in getting rid of TB bacilli that have infected the system before they can harm other organs and cause illness. Moreover, for those individuals who are at a greater risk of developing TB infection, effective TPT was found to lessen the risk considerably.

How Often Should People Get Screened For TB?

Those people who are at high risk of developing TB infection or who have constant exposure to infectious TB may need repeated screening.

People with an abnormal CXR that is similar to TB but who were not diagnosed with TB disease at the time of screening, healthcare workers, prisoners and people living with HIV need regular screening.

Patients suffering from HIV/AIDS should be screened for symptoms of TB at every encounter with a health worker. 

Annual or semi-annual workplace screening is a feasible option for people with a higher risk of TB, such as miners with silica exposure and healthcare workers.