TUBERCULOSIS (TB) has yet to be eradicated, with thousands diagnosed with this infectious disease every year.

Yet, many people assume that TB is rare, and therefore, they ignore the symptoms, says Institute of Respiratory Medicine (IPR) director Datin Dr Aziah Ahmad Mahayiddin.

She warns that TB is still one of the deadly infectious diseases in Malaysia.

It was the number one killer in this country in the 50s and 60s.
Instead of doing the sputum test - a simple test to determine if one has TB - doctors continue to prescribe cough medicine, she laments.

Others keep changing doctors, making it difficult to keep track of their condition.

"Some immediately think of cancer when they exhibit certain symptoms. They go through a CT scan and other expensive tests only to find out later that it is TB. This can be avoided if the patients know more about this disease," say Dr Aziah.

She says the influx of illegal immigrants into the country is also making it difficult to control TB effectively.

Many of these illegal immigrants have been identified as the main carriers of the TB germs. Unfortunately, they cannot be detected since they do not go to hospitals when they are sick, making it difficult for the government to monitor the spread of the disease.

"Those who are HIV positive are also at risk of TB because of their low immune system. TB is the leading cause of deaths for HIV/AIDS patients. Almost 11 per cent of HIV/AIDS patients have TB," she adds.

Dr Aziah was speaking at the World TB Day 2008 celebration at IPR. World TB Day is celebrated on March 24 every year. This year's theme is "I Am Stopping TB".

With the advent of anti-tuberculosis antibiotics in the 1940s, the battle against tuberculosis seemed to have been won.

However, because of factors such as inadequate public health resources, reduced immune response due to AIDS, the development of drug resistance, and extreme poverty in many parts of the world, TB continues to rear its ugly head.

Dr Aziah says that since the government introduced the National TB Control Programme in 1961, the number of new cases has declined to 100 per 100,000 population.

Last year, there were 16,825 TB cases, with 1,472 deaths nationwide compared to 16,665 cases and 1,431 deaths in 2006.

Dr Aziah says TB patients need to stay committed to the treatment to ensure they are cured.

"Patients must stay on the full course of treatment for at least six months. If they stop half-way, the bacteria may become resistant to some of the drugs. It can become very serious and may take longer to cure."

It is estimated that the largest number of new TB cases in 2005 occurred in the Southeast Asia region, which accounted for 34 per cent of the global outbreak. The largest number of patients in the world, in any single country, is in India, followed by China, Indonesia, Pakistan, Bangladesh and African countries.

Worldwide, there are eight million new cases of symptomatic tuberculosis and three million deaths from the disease every year.

It is believed that one- third of all the people in the world have a dormant tuberculosis infection, although only about five to 10 per cent progress to the active stage.

Killer air-borne disease

TUBERCULOSIS is a contagious disease. It is caused by a mycobacteria called Mycobacterium tuberculosis. Like the common cold, it spreads through the air. When infectious people cough, sneeze, talk or spit, they propel the germs into the air.

Difference between TB infection and TB disease (active TB)

Most people who are infected are able to fight the TB bacteria and stop it from multiplying.

The bacteria is not killed, but it becomes inactive and is stored harmlessly in the body. This is called a TB infection.

People with TB infection have no symptoms and cannot spread the infection to others. However, the bacteria can become active again later.

If an infected person's immune system cannot stop the bacteria from multiplying, the bacteria eventually cause TB. Those with a weak immune systems, patients with lung disease, babies and children should be careful as they are more prone to contract TB.

When left untreated, a TB patient can infect on an average between 10 and 15 people every year.

Symptoms

TB mainly affects your lungs (pulmonary tuberculosis), and coughing is often the only indication of infection initially. Signs and symptoms of active pulmonary TB include:

- A cough lasting three or more weeks that may produce discoloured or bloody sputum
- Unintended weight loss
- Fatigue
- Slight fever
- Night sweats
- Chills
- Loss of appetite
- Pain with breathing or coughing (pleurisy)

TB also can target almost any part of your body, including your joints, bones, urinary tract, central nervous system, muscles, bone marrow and lymphatic system.

Diagnosis

TB infection is diagnosed by a skin test. A small needle is used to put some fluid, called tuberculin, under the skin.

After two to three days, the amount of skin swelling around the test area is measured. A positive reaction usually means that the person has TB infection. TB disease is diagnosed by a chest x-ray or a test of a sputum sample.