Overview of tuberculosis Know

Tuberculosis is an infectious disease directly caused by the TB germ (Mycobacterium tuberculosis). Most of the TB germs assault the lungs, but can also on other organs.

Tuberculosis Germs

Modes of Transmission

Rod-shaped bacteria, have special properties that is resistant to acid staining. Therefore, also often called Basil Acid Resistant (BTA). TB germs die quickly in direct sunlight, but can survive several hours in a dark and damp. In this germ tissue to dormant, sleeping for a few years elderly.

Source of infection is sputum smear positive TB patients. At the time of coughing or sneezing, people spread germs in to the air in the type of droplets (splashing sputum). Droplets containing the bacteria can survive in air at room temperature for several hours. People can become infected if the droplets are inhaled in to the respiratory tract.
After TB germs enter the human body through breathing, these TB germs can spread from the lungs to other body parts, through the circulatory technique, lymphatic drainage technique, respiratory tract, or spread directly to other body parts.

Power transmission from a patient is determined by the number of bacteria released from the lungs. The higher the degree of positive results of sputum examination, the patient is contagious. When the results of sputum examination is negative (no visible germ), then the patient is thought about not contagious. The chance of somebody infected with TB is determined by the concentration of droplets in the air and the length of breathing air.

Transmission Risk

The risk of infection every year (Annual Risk of Tuberculosis Infection = ARTI) in Indonesia is thought about high and varied between 1-3%. In regions with ARTI of 1%, means that every year between 1000 population, ten 0) people will be infected. Most individuals who won't become infected with TB, only about 10% of which will become infected with TB.

From the information above, can be estimated that in areas with ARTI of 1%, then among the 100,000 people on average 100 (hundred) people with tuberculosis every year, in which 50 patients were smear positive. Factors affecting the likelihood a person with TB is a low immune technique, such as malnutrition or HIV / AIDS.


The occurrence of tuberculosis Method

The presence of infection can be proved by the tuberculin reaction changes from negative to positive.

Primary Infection
Primary infection occurs when a person was first exposed to TB germs. Are inhaled tiny droplet size, so it can pass defense technique mukosilier bronchus, and kept jogging, so until the alveolus and remained there. Infection begins when the TB germs to breed successfully by splitting themselves in the lungs, causing inflammation in the lung. Lymph channel will over TB germs in to the lymph nodes around the lung hilum, and is called primary complex. The time between the occurrence of infection to primary complex formation is about 4-6 weeks.

Continuation after primary infection depends on the number of germs that enter and magnitude of immune responses (cellular immunity). In general, immune reactions can cease the progression of TB germs. Nevertheless, there's some germs will stay as germ persister or dormant (sleeping). Sometimes the immune technique is unable to cease the growth of germs, leading to a few months, the concerned will wait and see with TB.

The incubation period, the time needed from infected to become ill, it is estimated about 6 months.

Post-primary tuberculosis usually occurs after several months or years after primary infection, such as decreased immune technique due to HIV infection or poor nutritional status. Characteristic of the post-primary tuberculosis is extensive lung destroy with the cavity or pleural effusion.


Post-Primary Tuberculosis (Post Primary TB)

The main signs
Persistent cough and phlegm for six ) weeks or more.

Signs of tuberculosis

Additional signs, which are often encountered:

  * Sputum mixed with blood.
  * Coughing blood
  * Shortness of breath and chest pain.
  * Body weakness, decreased appetite, weight loss, body discomfort (malaise), night sweats, although without any activity, fever, fever over a month.


Complications in Patients with TB

The signs mentioned above are found also in lung diseases other than tuberculosis. Therefore, every that came to the DMU with the signs mentioned above, the flow is regarded as a "suspected tuberculosis" or suspect TB patients, and needs to be done by microscopic examination of sputum directly.

  * Extreme hemoptysis (bleeding from the lower respiratory tract), which may finish up in death due to hypovolemic shock or blockage of the airway.
  * Collapse of the lobe due to bronchial retraction.
  * Bronkiectasis (local bronchial dilation) and fibrosis (formation of fibrous tissue in the recovery method or reactive) in the lung.
  * Pneumotorak (presence of air within the pleural cavity) spontaneous: spontaneous collapse because of destroy to lung tissue.
  * The spread of infection to other organs such as brain, bones, joints, kidneys and so forth.
  * Cardio pulmonary insufficiency (Cardio Pulmonary insufficiency).

The following complications often occur in patients with advanced stage:


Without treatment, 50% of TB Patient Dies After two Years


Patients who experience extreme complications ought to be hospitalized in the hospital. Pulmonary TB patients with extensive tissue destroy that has been cured (smear negative) can still be experienced coughing up blood. This situation is often confused with cases of relapse. In such cases, treatment with OAT is not necessary, but adequate given symptomatic treatment. If heavy bleeding, patients ought to be referred to specialist units.

Without treatment, after years, 50% of TB patients will die, 25% will heal itself with high endurance, and 25% as "chronic cases" ang stay infectious (WHO, 1996).


Effect of HIV Infection

HIV infection resulted in extensive destroy to the immune technique of mobile (Cellular Immunity), so if there is an opportunistic infection, like tuberculosis, then the ersangkutan will become seriously ill and even lead to death. When the number of people infected with HIV increases, the number of TB patients will increase, thus the transmission of TB in the community will increase as well.