TB continues to be the top infectious killer worldwide. Each year WHO commemorate World TB Day on March 24 to raise public awareness about tuberculosis (TB). Last year, WHO reported that 10.4 million people fell ill with TB and there were 1.8 million TB deaths in 2016, making it the top infectious killer worldwide.

The theme of World TB Day 2018 - “Wanted: Leaders for a TB-free world”

Let’s take this opportunity to spared awareness about the devastating health, social and economic consequences of tuberculosis (TB) 

Prevalence:      

  • One-third of the nation’s population is infected with TB.·      
  • Each year, about 9 million people worldwide are infected with TB· 
  • There are approximately 2 million worldwide deaths each year from TB.·      
  • TB is the most prevalent killer of people who are infected with HIV.

Clinical Presentation/Signs and Symptoms:

There are usually no symptoms of tuberculosis during the first year of exposure. This is when the disease would be the most curable. Symptoms suggestive of TB include:·      

  • A productive cough lasts longer than 3 weeks.
  • Sudden/ unexplained Weight Loss 
    • Fever
    • Night Sweats 
    • Blood stained sputum
    • Fatigue- Weakness, a feeling of tiredness, exhaustion.
  • Malaise- general feeling of discomfort, illness, or unease whose exact cause is difficult to identify.
    • Anorexia- loss of appetite.
    • Dull chest pain, tightness, or discomfort·

    • Dyspnoea- difficult breathing.
    • Haemoptysis (late stage symptom)- the coughing up of blood.

    Medications

    There commended time for taking the meds is 6-9 months.  Unfortunately, many people fail to take their medicine daily for 9 months. Because when people begin to feel better, they decide to stop administering the medicine.Compliance is also a problem with homeless people, alcoholics, and drug users. 

    If treatment is not completed, multidrug-resistant TB can form which means the person will now be resistant to the medication taken previously.

    Multi-drug resistant TB has an even more complicated treatment than before. Some people require a pneumonectomy (surgical removal of a lung or part of a lung) or chemotherapy along with two or more drugs that are used at the same time.

    Systemic Involvement

    10%-15% of tuberculosis is extra pulmonary (situated or occurring outside the lungs).  It can spread from organ to organ through the blood vessels. Extrapulmonary TB can involve the Kidneys, Bone Growth Plates, Lymph Nodes, Meninges (the three membranes that line the skull and vertebral canal and enclose the brain and spinal cord), Hip Joints - can cause avascular necrosis (the death of bone tissue due to a lack of blood supply) of the hip and Vertebrae(Pott's Disease).

    Pott's disease

    Infection usually begins in the body of the vertebrae and then spread to the inter-vertebral discs and to the adjacent vertebrae. As the infection continues to spread throughout the spine, the following problems can occur: ·       

    • Irritation of the nerve roots- causes radiating pain, numbness, paralysis, etc.·       
    • Pressure from an abscess – e.g. produce hip pain if the abscess goes to the muscle·       
    • The collapse of the vertebral body - can cause cord compression and possible paraplegia 

    Physical Therapy Management 

    • Pulmonary Tuberculosis 

    Physiotherapists are able to provide percussion and postural drainage to clear secretions out of the lung.

    • Extra pulmonary 

    Tuberculosis Patients may present in clinic with musculoskeletal problems with unknown causes or arthritic pain.  A patient could also be seen in physical therapy if they have had surgery on their back, in which case the normal rehabilitation protocols would be followed.