Frequently Asked Questions

Who is most at risk from Tuberculosis?

Certain factors increase your risk of contracting Tuberculosis. An individual in an immuno-compromised state is at risk of developing Tuberculosis. A number of factors can cause the immune system to be in a weakened state. Some diseases can suppress the immunity such as diabetes, HIV/AIDS, and silicosis.

Certain medications can affect the body’s immune system which includes chemotherapy drugs and corticosteroids. An increased risk of reactivated Tuberculosis has been associated with the use of arthritis medications Enbrel® and Remicade.

Individuals within close proximity of those infected with Tuberculosis are at an increased risk of developing disease. Individuals in areas of high rates of Tuberculosis (Asia, Africa, Latin America, former Soviet Union) have an increased risk of developing Tuberculosis. Certain races (Hispanics, American Indians, Asian Americans, African Americans) in the U.S. are at risk of developing Tuberculosis.

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What other factors may increase your risk of developing Tuberculosis?

The older adult is at an increased risk of developing Tuberculosis due to a weakened immune system. Individuals who are malnourished, lack adequate medical care, or who suffer from long term drug or alcohol abuse are at increased risk of developing Tuberculosis. Health care workers are at increased risk of developing Tuberculosis also.

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What are the obvious symptoms of Tuberculosis?

Typical signs of Tuberculosis are:

• chronic or persistent cough and sputum production. If the disease is at an advanced stage the sputum will contain blood.
• fatigue.
• lack of appetite.
• weight loss.
• fever.
• night sweats.

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What is a latent Tuberculosis infection?
Is it possible for people to have Tuberculosis but not show it?

In most people who breathe in Tuberculosis bacteria and become infected, the body is able to fight the bacteria successfully. The bacteria become inactive, remains alive in the body and can become active later. This is called a latent Tuberculosis infection.

People with latent Tuberculosis infection:

• have no symptoms.
• don't feel sick.
• can't spread Tuberculosis to others.
• usually have a positive skin test reaction.
• can develop active Tuberculosis disease, at a later date, if they do not receive treatment for latent Tuberculosis infection.

Many people who have latent Tuberculosis infection never develop active Tuberculosis disease. In these people, the Tuberculosis bacteria remain inactive for a lifetime without causing disease. But in other people, especially people who have weak immune systems, the bacteria become active and cause Tuberculosis disease.

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Is it true that some Tuberculosis bacteria are resistant to drugs?

Most typically, drug-resistance arises in areas with poor Tuberculosis control programmes.

Drug resistance can develop due to the improper use of antibiotics during chemotherapy of drug-susceptible Tuberculosis patients. This improper use is a result of a number of actions, including administration of improper treatment regimens by health care workers and failure to ensure that patients complete the whole course of treatment.

Drug resistant strains of Tuberculosis are a serious problem. Tuberculosis bacteria have developed strains of the bacteria that are resistant to each of the major Tuberculosis medications. There are also strains of Tuberculosis that are resistant to at least two Tuberculosis medications. This multi-drug resistant Tuberculosis (MDR-TB) poses an even deadlier threat to those affected. Individuals affected with MDR-TB are much more difficult to treat requiring a long term therapy of up to two years.

Multiple medicines are necessary to prevent the emergence of resistance, which would lead to treatment failure.

The "essential top four" medicines used in various combinations for the treatment of Tuberculosis are Isoniazid*, Rifampicin*, Pyrazinamide* and Ethambutol*.

* Key suppliers of Tuberculosis treatment products include:

• Isoniazid - Glaxo
• Rifampicin - Sanofi-Aventis
• Pyrazinamide - Genus Pharmaceuticals (From Q3 2008)
• Ethambutol - Genus Pharmaceuticals

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Why are so many people infected with Tuberculosis in less-developed areas of the world?

There are many reasons for this situation.

The spread of Tuberculosis is more common in poorer areas of the world. Overcrowding, poor sanitation and poor housing increase the risk. Also, there are economic reasons. Medicines are expensive and sufficient stocks of the right medicines may not be affordable.

In addition, there is an education and awareness problem. Not only are people not alert to the risk of infection but also they are not able to understand the best ways to reduce those risks. Sadly, avoiding overcrowded living accommodation is not possible for many poor families in areas where the disease is prevalent.

The treatment regime for Tuberculosis is complicated. The patient has to understand which drugs to take, and when and what dose. If a programme of medicines is not taken completely, there is a strong likelihood that the Tuberculosis infection will regain a strong hold.

Incomplete programmes increase the risk of drug-resistant Tuberculosis infections. In such cases, the treatment is more prolonged and the medicines can cause serious side effects. Combination therapies offer the most effective treatment of Tuberculosis.

The "essential top four" medicines used in various combinations for the treatment of Tuberculosis are Isoniazid*, Rifampicin*, Pyrazinamide* and Ethambutol*.

* Key suppliers of Tuberculosis treatment products include:

• Isoniazid - Glaxo
• Rifampicin - Sanofi-Aventis
• Pyrazinamide - Genus Pharmaceuticals (From Q3 2008)
• Ethambutol - Genus Pharmaceuticals

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