Check Your EmailTB FAQ
- What is tuberculosis?
- Who gets tuberculosis?
- How is tuberculosis spread?
- What is the difference between latent tuberculosis infection and tuberculosis disease?
- What are the symptoms of tuberculosis?
- How soon do symptoms appear?
- When and for how long is a person able to spread tuberculosis?
- What is the treatment for tuberculosis?
- What can be the effect of not being treated for tuberculosis?
- What can be done to prevent the spread of tuberculosis?
- What is multidrug-resistant tuberculosis (MDR-TB)?
- What is extensively drug-resistant tuberculosis (XDR-TB)?
- Who gets MDR-TB?
- What is the treatment for multidrug-resistant tuberculosis?
- What can be done to prevent the spread of MDR-TB?
What is tuberculosis?
Tuberculosis is a bacterial disease usually affecting the lungs (pulmonary TB). Other parts of the body can also be affected, for example lymph nodes, kidneys, bones, joints, etc. (extrapulmonary TB). Approximately 1,300 cases are reported each year in New York State.
Who gets tuberculosis?
Tuberculosis can affect anyone of any age. People with weakened immune systems are at increased risk.
How is tuberculosis spread?
Tuberculosis is spread through the air when a person with untreated pulmonary TB coughs or sneezes. Prolonged exposure to a person with untreated TB usually is necessary for infection to occur.
What is the difference between latent tuberculosis infection and tuberculosis disease?
Latent tuberculosis infection (LTBI) means the person has the TB germ in their body (usually lungs), but has yet to develop obvious symptoms. In latent TB, the person has a significant reaction to the Mantoux skin test with no symptoms of tuberculosis, and no TB organisms found in the sputum. Tuberculosis disease indicates the person has symptoms, a significant reaction to a Mantoux skin test and organisms found in the sputum. In order to spread the TB germs, a person must have TB disease. Having latent TB infection is not enough to spread the germ. Tuberculosis may last for a lifetime as an infection, never developing into disease.
What are the symptoms of tuberculosis?
The symptoms of TB include a low-grade fever, night sweats, fatigue, weight loss and a persistent cough. Some people may not have obvious symptoms.
How soon do symptoms appear?
Most people infected with the germ that causes TB never develop active TB. If active TB does develop, it can occur two to three months after infection or years later. The risk of active disease lessens as time passes.
When and for how long is a person able to spread tuberculosis?
A person with TB disease may remain contagious until he/she has been on appropriate treatment for several weeks. However, a person with latent TB infection, but not disease, cannot spread the infection to others, since there are no TB germs in the sputum.
What is the treatment for tuberculosis?
People with latent TB infection should be evaluated for a course of preventive therapy, which usually includes taking antituberculosis medication for several months. People with active TB disease must complete a course of treatment for six months or more. Initial treatment includes at least four anti-TB drugs, and medications may be altered based on laboratory test results. The exact medication plan must be determined by a physician. Directly observed therapy (DOT) programs are recommended for all TB patients to help them complete their therapy.
What can be the effect of not being treated for tuberculosis?
In addition to spreading the disease to others, an untreated person may become severely ill or die.
What can be done to prevent the spread of tuberculosis?
The most important way to stop the spread of tuberculosis is for TB patients to cover the mouth and nose when coughing, and to take all the TB medicine exactly as prescribed by the physician.
This refers to the ability of some strains of TB to grow and multiply even in the presence of certain drugs which would normally kill them.
What is extensively drug-resistant tuberculosis (XDR-TB)?
Extensively drug-resistant TB (XDR-TB) is a subset of MDR-TB in which the strains of TB bacteria are resistant to several of the best second-line drugs for TB. These strains are very difficult to treat. XDR-TB cases make up approximately 10 percent of MDR-TB cases.
Who gets MDR-TB?
TB patients with drug sensitive disease may develop drug resistant tuberculosis if they fail to take antituberculosis medications as prescribed, as well as TB patients who have been prescribed an ineffective treatment plan. TB cases diseased with MDR-TB can transmit the drug resistant infection to other individuals.
What is the treatment for multidrug-resistant tuberculosis?
For patients with disease due to drug resistant organisms, expert consultation from a specialist in treating drug resistant TB should be obtained. Patients with drug resistant disease should be treated with drugs to which their organisms are susceptible. The effectiveness of treatment for latent infection with MDR-TB is uncertain.
What can be done to prevent the spread of MDR-TB?
Ensuring people with MDR-TB take all their medication and teaching patients to cover their mouth and nose when coughing and sneezing can reduce the risk of spread of MDR-TB. In addition, directly observed therapy should be used to ensure patients complete the recommended course of therapy.
Leprosy Frequently Asked Questions
- What is the cause of leprosy?
- What are the symptoms of Leprosy?
- What is the Treatment for leprosy?
- Why is the elimination of leprosy as a public health problem feasible?
- What does eliminating leprosy as a public health problem mean?
- Why has the prevalence rate been selected as the yardstick for elimination?
- Why not aim for the eradication of leprosy rather than elimination?
- Will new cases of leprosy continue to occur beyond the year 2005? If so, how can they be explained?
- Why is it crucial to integrate leprosy within the general health services?
- What was the guiding principle in the development of MDT
- What are the recommended standard treatment regimens for leprosy?
- What is the evidence that MDT is effective in MB and PB leprosy?
- Leprosy is a chronic disease caused by a bacillus, Mycobacterium leprae.
- M. leprae multiplies very slowly and the incubation period of the disease is about five years. Symptoms can take as long as 20 years to appear.
- Leprosy is not highly infectious. It is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated, infected persons.
What are the symptoms of Leprosy?
Skin patch or patches with a definite loss of sensation; the patches can be pale or reddish or copper coloured, can be flat or raised. The patch usually can appear anywhere, do not itch, do not hurt and usually lack sensation to heat, touch or pain.
Leprosy mainly affects the skin and nerves.
If untreated, there can be progressive and permanent damage to the skin, nerves, limbs and eyes.
What is the Treatment for leprosy?
- Leprosy is a curable disease and treatment provided in the early stages averts disability.
- The treatment for leprosy requires combination of different drugs. This drugs are taken once a day for six months to one year .
- World Health Organization (WHO) recommended multidrug therapy (MDT) in 1984. MDT consists of three drugs: dapsone, rifampicin and clofazimine. This drug combination kills the pathogen and cures the patient.
- MDT is safe, effective and easily administered under field conditions.
Why is the elimination of leprosy as a public health problem feasible?
Leprosy is one of the few infectious diseases to meet the strict criteria for elimination:
- There is only one source of infection: untreated, infected human beings.
- Practical and simple diagnostic tools are available: leprosy can be diagnosed on clinical signs alone.
- The availability of an effective intervention to interrupt its transmission: multidrug therapy (MDT).
- Under natural conditions, “incident’ cases” (new cases in which the disease has recently developed) make up only a small fraction of the prevalence pool. Below a certain level of prevalence, any resurgence of the disease is very unlikely.
- Unlike tuberculosis, the leprosy situation does not appear to be adversely affected by HIV infection.
What does eliminating leprosy as a public health problem mean?
In 1991, the World Health Assembly passed a resolution to eliminate leprosy as a public health problem by the year 2000. Elimination was defined as a prevalence rate of less than 1 case per 10 000 population. Although this was achieved at the global level and in 108 countries at the national level, by the end of 2000, extra efforts are still needed to achieve the goal at the national level in a few countries.
The elimination strategy is based on detecting and treating all cases with MDT and thereby reducing the disease burden to a very low level. The key will be to ensure that all new cases continue to have access to MDT services.
Why has the prevalence rate been selected as the yardstick for elimination?
Prevalence at the end of the year is a simple and easily understandable indicator, which gives the balance of the patients under active treatment,
WHO is fully aware of the limitations of using registered prevalence as an indicator of progress towards elimination. However, in the absence of practicable alternatives, prevalence is considered the best indicator available. After excluding those cured during the year. The main thrust of the elimination strategy is to reduce the burden of the disease to very low levels. In view of the long incubation period of leprosy, it is difficult to differentiate new or incident cases, i.e., those who developed the disease within one year from those who developed earlier (backlog cases). Hence it was decided to use prevalence rate as the yardstick for elimination.
Why not aim for the eradication of leprosy rather than elimination?
Eradication would mean the complete absence of the disease and the organism that causes it throughout the world. At present, we lack the tools both to protect people from developing leprosy and to diagnose and treat the disease in its sub clinical form. Significant resources would be required to develop and deploy the necessary tools, and hence, it was decided to aim at elimination of the disease as a public health problem, as the first step.
Will new cases of leprosy continue to occur beyond the year 2005? If so, how can they be explained?
Since the goal is elimination of leprosy as a public health problem by reducing the disease burden, new cases will continue to occur in small numbers beyond the year 2005. The disease will appear in individuals who acquired their infection several years earlier as a result of the long incubation period of the disease.
Why is it crucial to integrate leprosy within the general health services?
Integration improves the coverage, equitable accessibility of leprosy services and availability of MDT to all sections of the community, and makes it an integral part of the basic health services provided to communities, thus ensuring that leprosy is considered like any other disease.
What was the guiding principle in the development of MDT?
MDT was developed against a background of growing primary and secondary resistance to dapsone. It is based on two or three drugs (rifampicin, clofazimine, and
dapsone), used in combination to prevent the development of resistance. Leprosy should never be treated with any single antileprosy drug.
What are the recommended standard treatment regimens for leprosy?
MDT treatment is provided in blister packs, each containing four weeks’ treatment. Specific blister packs are available for multibacillary (MB) and paucibacillary (PB) leprosy as well as adult and children.
PB treatment
Regimen |
0 – 5 Years |
6 – 13 Years |
More than 14 Years |
Dapsone daily |
25mg |
50mg |
100mg |
Rifampicin |
150mg |
300mg |
600mg |
MB treatment
Regimen |
0 -5 years |
6- 14years |
More that 14years |
Dapsone daily |
25mg |
50mg |
100mg |
Clofazimine4 weekly supervised |
100mg |
200mg |
300mg |
Clofazimine unsuoervised |
50mg alternate days |
50mg daily |
50mg daily |
Rifampicine4 weekly supervised |
150mg |
300mg |
600mg |
What is the evidence that MDT is effective in MB and PB leprosy?
Clinical trials have established the efficacy of the individual drugs within MDT for the treatment of leprosy. The efficacy of MDT has been clearly demonstrated by the extremely low relapse rate (average 0.1% per year for PB and 0.06% per year for MB) following successful completion of treatment; these figures are based on reports from a number of countries and information available at WHO. In addition, the low frequency of side-effects has made MDT highly acceptable to patients.