TB symptoms, diagnosis and treatment

Being diagnosed with tuberculosis (TB) can be scary. We’re here to help you make sense of it and stick to your treatment plan.

How is TB diagnosed?

What are the symptoms of TB?

Your doctor, nurse, or clinic sister will suggest a TB test if you have any of the following TB symptoms:

  • Night sweats
  • Persistent coughing for at least a week
  • Coughing up blood/phlegm constantly
  • Chest pain
  • Breathing problems
  • Unexplained weight loss
  • High temperature or fever
  • Fatigue and weakness
  • Loss of appetite
  • Swollen lymph nodes

Tuberculosis can affect almost any organ in your body, but it is most commonly found in your lungs.

How is TB diagnosed?

If you present any of the above symptoms, your doctor, nurse or clinic team will encourage you to undergo a TB test. It’s always important to listen to your medical practitioners, so rather get tested as soon as you can, once you receive their recommendations.

What can you expect from a TB test?

TB tests are simple. The most common one in South Africa is the sputum test. Various countries will use different tests but sputum tests are preferred in regions where there’s a high prevalence of latent TB.

You’ll be asked to cough and spit onto a medical slide, or into a container. This sample is laboratory tested for the presence of a bacteria known as mycobacterium tuberculosis. Your results should arrive within a few days.

There’s also the rapid sputum test. This provides your results within 24 hours. If you’re uncertain about your TB test results, you can request further tests. This may include having an x-ray, or similar scan.

What do you do if you’re diagnosed with TB?

If diagnosed with TB, your doctor, nurse or clinic team will place you on a TB treatment plan and tell you everything you need to know. Take your medication as directed and make sure you attend every scheduled medical appointment. Remember: TB is fully treatable and you can recover from it, as long as you stick to your treatment regime.

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TB treatment

Treatment for regular TB

Ordinary TB can be quite severe, especially for people also coping with HIV. Depending on how severe your status is, treatment can last between six to nine months. HIV-positive people who get diagnosed with TB will need to follow something called a co-infection treatment plan, but you can read more about the link between HIV and TB.

How does normal TB become drug-resistant or XDR-TB?

The bacteria can develop a mutation very quickly so taking medication at the right times every day for the full duration of the treatment plan is critical. If even a single dose is taken a few hours later than prescribed, it’s possible for the TB to mutate into Extensively Drug-Resistant TB (XDR-TB), meaning any of the medication you continue to take will have no impact on treating the strain of TB evolving inside the body.

How is drug-resistant TB treated?

If you delay or skip even a single dose of your TB treatment, speak to your doctor, nurse or clinic team immediately. You may need to restart treatment, but this time for XDR-TB. The XDR-TB treatment timeline can extend to more than 18 months from start to finish.

It involves a different and much stronger dosage of antibiotics, which is even more important to follow. As long as you’re disciplined, you have nothing to worry about.

Can you stop taking your TB medicine if you feel better?

No. Even if you start feeling better, and you think you’ve sufficiently recovered, don’t ever stop taking your TB medication. Until your doctor, nurse or clinic team confirms that you can stop your doses, your body is still fighting TB at a molecular level.

Halting your medicine will result in the bacteria mutating, becoming XDR-TB and resisting your medication. Your condition could quickly degenerate to a state far worse than when you were first diagnosed.

What’s the treatment plan for people with both HIV and TB?

For people coping with HIV, being diagnosed with TB presents more danger than it does for HIV negative patients. A co-infection programme is prescribed, which combines antiretrovirals (ARVs) with antibiotics in very specific doses. This helps your body cope with and conquer both conditions simultaneously. Because every patient’s body is different, it’s most critical that you remain committed to treatment adherence in this situation. Don’t share medicine with anyone even if you know that they also have to cope with HIV and TB together. Sharing medication is extremely risky and can make both your conditions worse.

Do you have more questions about TB?

If you have more, or different, questions, we strongly encourage you to speak directly with your doctor, nurse or clinic team. Experienced medical staff at clinics and hospitals know what they’re talking about. Listen carefully to their explanations and ask them any questions that might appear in your mind while you’re with them.

Make notes on exactly when you should be taking your medication (before or after meals); what substances to avoid and what other medication may cause negative reactions with your TB medication. You can further develop your understanding by asking what kinds of physical activity you should do more of, or avoid, during treatment.

Sources:

Bronze, MS, and Herchline, TE. 2018. Tuberculosis (TB) treatment and management. Medscape. 1 October. Available at: https://emedicine.medscape.com/article/230802-treatment [Accessed 22 July 2019].

Centers for Disease Control and Prevention. 2016. Treatment for TB disease. 5 April. Available at: https://www.cdc.gov/tb/topic/treatment/tbdisease.htm [Accessed 22 July 2019].

Centers for Disease Control and Prevention. 2016. Extensively drug-resistant tuberculosis (XDR TB). 4 May. Available at: https://www.cdc.gov/tb/publications/factsheets/drtb/xdrtb.htm [Accessed 22 July 2019].

Centers for Disease Control and Prevention. 2016. Signs & symptoms. 17 March. Available at: https://www.cdc.gov/tb/topic/basics/signsandsymptoms.htm [Accessed 22 July 2019].

Centers for Disease Control and Prevention. 2019. Tuberculosis (TB) disease: symptoms and risk factors. 24 January. Available at: https://www.cdc.gov/features/tbsymptoms/index.html [Accessed 22 July 2019].

Mayo Clinic. 2019. Tuberculosis. Available at: https://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250 [Accessed 22 July 2019].

McIntosh, J. 2018. All you need to know about tuberculosis. Medical news today. 16 November. Available at: https://www.medicalnewstoday.com/articles/8856.php [Accessed 22 July 2019].

TB Alert. n.d.. Do I have TB. Available at: https://www.thetruthabouttb.org/do-i-have-tb/ [Accessed 22 July 2019].

TB Facts. 2019. Symptoms of TB – tiredness, losing weight, fever, cough. Available at: https://www.tbfacts.org/symptoms-of-tb/ [Accessed 22 July 2019].

TB Facts. 2019. TB treatment – TB drugs, failure, duration, relapse. Available at: https://www.tbfacts.org/tb-treatment/ [Accessed 22 July 2019].

TB Facts. 2019. TB Tests – Tests for diagnosis of TB, sputum test, blood test. Available at: https://www.tbfacts.org/tb-tests/ [Accessed 22 July 2019].

United Kingdom National Health Service. 2016. Treatment – tuberculosis (TB). 15 November. Available at: https://www.nhs.uk/conditions/tuberculosis-tb/treatment/ [Accessed 22 July].

Western Cape Government. 2017. TB and you. 3 March. Available at: https://www.westerncape.gov.za/tb [Accessed 22 July 2019].

World Health Organisation. 2010. Treatment of Tuberculosis: Guidelines. 4th edition. Geneva: World Health Organization, cited in National Center for BioTechnology Information, n.d.. Available at: https://www.ncbi.nlm.nih.gov/books/NBK138748/ [Accessed 22 July 2019].

We all have questions.

Below are some of the answers to the most common questions that you need to know.

What is usually the first sign of HIV?

After getting infected with HIV, most patients only experience moderate flu-like symptoms. Typically, the illness is sudden in onset and is characterised by fever, swelling of the lymph glands, a measles-like rash all over the body and ulcers in the mouth and sometimes on the genitalia.

What are the 4 stages of HIV?

  • Stage 1: Infection – Exposure to infected bodily fluids.
  • Stage 2: Asymptomatic – HIV quickly spreads and the patient becomes seropositive for HIV antibodies.
  • Stage 3: Symptomatic – The immune system is now engaged in a constant battle with the rapidly replicating virus.
  • Stage 4: AIDS – At this stage, the patient’s CD4+ count is 200 cells per mm3 or less.

How soon can HIV be detected by a blood test?

No test can detect HIV immediately after infection. The time between initial infection and a detectable viral load is called the window period. It can take anywhere from 2-12 weeks to after exposure detect whether you are HIV-positive or not, depending on which testing method is used.

How long does it take to show symptoms of HIV?

Following initial infection, there is a period of intense, unchecked viral replication that occurs. It usually takes two to four weeks after infection and can last about one to two weeks, after which there tends to be a slight recovery, and the infected individual is considered to be seropositive for HIV antibodies.

How is HIV transmitted?

HIV is transmitted from one person to another through the exchange of body fluids. The main method of transmission in South Africa is through unprotected sexual activity.

Does HIV test affect life insurance?

Being HIV-positive can affect standard life insurance policies, particularly if your status changes from HIV-negative to HIV-positive within a particular age range. That’s why AllLife covers all lives. Your HIV status doesn’t prevent you from getting cover with us.

Can HIV-positive women have children?

Yes, HIV-positive women can enjoy healthy pregnancies and give birth to healthy HIV-negative babies. Through the Prevention of Mother to Child Transmission (PMTCT) programme has been highly effective in reducing transmission risk to under 1%.

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