Tuberculosis (TB) is one of the oldest diseases known to mankind and continues to claim a large number of lives across the world every year. India has the largest burden of any country in the world with over 2 million cases and 500,000 deaths annually. In addition to health system-related challenges, there are a number of myths about TB which prevent patients from seeking treatment or stigmatise affected populations. Here are five of the most persistent misconceptions about TB.
1. TB is a genetic condition
TB does not run in families and has nothing to do with genes. When a patient with TB of the lungs coughs, TB bacteria spread out in the air and can be inhaled by a healthy individual (for example a family member who stays in close proximity to the patient). Some people carry the TB bacteria in their body, but the bacteria are present in small numbers and kept under control by the immune system.
In fact, it is estimated that about one-third of the world's population is infected with the TB bacteria.
2. TB is highly infectious
The reality is that other conditions like chicken pox have the potential to be far more infectious than TB. In the case of TB, close, lengthy contact with a patient who while coughing emits germs into the air (sputum positive patient) in an indoor setting may lead to transmission of infection. The risk of transmission is quite low in an open or well-ventilated setting as TB bacteria are killed by sunlight and can be swept away by the wind.
3. All TB patients are infectious
Approximately one-third of TB patients, primarily those who have TB of the lungs, are infective. However, within one to two months of undergoing appropriate treatment, many sputum positive patients become non-infective. In the interim, there are effective strategies that patients can use to minimise the risk of transmission to others, including covering their nose and mouth while coughing.
Additionally, TB can occur in many other parts of the human body other than the lungs, including bones, spine, hip, brain, the bladder and the reproductive system. TB of these parts is generally non-infective.
It is, therefore, important that TB patients are not forced to leave their homes and jobs or drop out of school on account of infectiousness as this only worsens the stigma.
4. TB is incurable
TB is definitely not a death sentence. In fact, effective TB medication has been available since the 1950s. However, because of the lengthy treatment regimen (6-9 months) and side-effects associated with the medicines, patients often do not complete the full course, giving rise to the risk of relapse or drug resistance. Additionally, patients tend to feel better a few weeks after treatment and often give up their medicines at this stage. It is critical that this does not happen and patients complete their treatment. If this happens, most patients will be able to recover fully and lead normal lives.
Drug resistant forms of TB are often harder and more expensive to treat. However, even those cases are treatable if patients are diagnosed in time and put on an effective treatment regimen. It is also important to note that under the Revised National TB Control Program of the Government of India, medicines and tests are provided free of cost to Indian citizens.
5. TB is a poor man's disease, it cannot affect me
While it is true that poverty is an important risk factor for TB, the reality is that anyone can be affected no matter how socio-economically well-off they are. Transmission of TB bacteria is through the air and hence no one is immune to the disease.
Many lives are lost every day simply because of the myths and misconceptions surrounding TB which prevent people from seeking effective treatment or do not allow them to complete their treatment. It is therefore vital that we understand the facts about TB and dispel the false beliefs associated with it for the benefit of our families, friends and society.