India has a very high burden of tuberculosis, which if not diagnosed and treated on time, is associated with significant morbidity and mortality. The country was already grappling with multidrug resistant tuberculosis, the treatment for which is expensive and highly toxic, and now since the past two decades, increasing cases of XDR (extensively drug resistant) and TDR (totally drug resistant) TB are being seen. Tuberculosis can be pulmonary (affecting the lungs) and extrapulmonary (affecting other organs of the body). Pulmonary tuberculosis which is transmitted by the airborne route is contagious and is easily spread via the droplets containing mycobacterium tuberculosis, ( the organism causing tuberculosis ) which are released during coughing.
It is spread by being in close contact with individuals, who may not have been diagnosed or have not taken adequate treatment. Due to overcrowding, travelling in public transport, in elevators and being in centrally air conditioned areas it is very difficult to avoid coming in contact with the bacillus.
Everyone who is exposed to the organism, does not suffer from active infection. This is because the body’s cell mediated immunity, walls off the infection and majority of the people who harbour the organism, never have symptoms in their lifetime. The immune system plays a very crucial role in deciding whether the individual will completely clear off the bacillus or contain the organism or suffer from clinical disease. The individuals who are exposed and harbor the organism, are said to have latent tuberculosis where they have no clinical or radiological evidence of TB.
However, if the immunity declines due to any reason such as diabetes, malnutrition, chronic alcoholism, chronic smokers, HIV positive status, chronic steroid usage, drug abuse, malignancy, etc, then the bacilli multiply uncontrolled, giving rise to symptoms. The individuals with the above conditions have a defective immune system which is unable to fight the organisms or germs. This defect may be qualitative or quantitative. Not only this, but individuals who have a highly compromised immune system would even go on to have a disseminated (spread throughout the body) form of the infection.
To prevent infection with tuberculosis and other contagious diseases, it is very important to maintain and boost the immune system. This can be done by
1. Following a healthy lifestyle
2. Ensuring good nutrition and intake of vitamins
3. Timely meals
4. Exercising regularly
5. Avoiding excessive alcohol and completely avoiding smoking
6. Keeping diabetes in control
7. Taking the minimum possible dose of steroids, in consultation with the physician, etc