Doc, what’s the link between HIV and tuberculosis?
In Kenya, there are more people who have TB who are HIV negative than those who are HIV positive.
What you need to know:
- In Kenya, there are more people who have TB who are HIV negative than those who are HIV positive.
- While it is true that TB is a big health problem among persons living with HIV and is a leading cause of death for this population, there are several measures that are taken to prevent illness and death, including intensive screening at every clinic visit and use of TB preventive treatment.
Dear doctor,
I have been coughing for the past three weeks and a colleague mentioned that I should be tested for tuberculosis. How can I know if I have it? Where could I have gotten it from? Is it possible that I have it even though I am HIV negative?
Donald
Dear Donald,
Tuberculosis (TB) is an infectious disease caused by bacteria called Myocobacterium tuberculosis. TB is spread by airborne transmission, that is, it spreads when someone inhales droplets produced when an infected person coughs, sneezes, or sings. It can spread easily in areas where there is close contact and there is poor ventilation.
TB can affect anyone regardless of HIV status, age, gender, occupation or education level. In Kenya, there are more people who have TB who are HIV negative than those who are HIV positive. While it is true that TB is a big health problem among persons living with HIV and is a leading cause of death for this population, there are several measures that are taken to prevent illness and death, including intensive screening at every clinic visit and use of TB preventive treatment.
TB can affect any organ in the body, but most people who get infected get pulmonary TB, which affects the lungs. The symptoms of pulmonary TB are cough, fever, night sweats and weight loss. The person may also feel constantly weak and fatigued, and there may be chest pain, bloody sputum and swelling of the lymph nodes. Diagnosis is made from clinical examination, examination of sputum and a chest x-ray. There are additional tests that may be done in sputum, urine or blood to screen for TB. Other tests depend on which parts of the body are affected such as taking a biopsy of a swollen lymph node.
There are antibiotics available for TB treatment and they are effective when taken as prescribed. The treatment is easily accessible in most health facilities. Additional treatments that may be given include nutritional support and medication to manage fever.
If you have TB, the best way to manage it and prevent spread to others is to get it diagnosed early and treatment started. Another benefit of getting an early and thorough medical review is to find out if the persistent cough may be due to other diseases like asthma, other lung conditions, heart disease among others.
Dear Doc,
The body is prone to many diseases. How does one develop a strong immune system to combat the infections that we are so vulnerable to? What is the impact of lifestyle behaviours on health? How many of these diseases have vaccines?
Alnashir D Walji
Dear Alnashir,
The human body is prone to many illnesses, with the causes ranging from infectious agents, genetic conditions, exposure to toxins, environmental triggers, to lifestyle behaviours. Sometimes ill health may be due to a specific cause, or due to interaction between different factors, or there may be no identifiable cause. Since we are constantly exposed to factors internally and externally that can cause diseases, the best approach is to maintain the body in the best possible condition possible and to take measures to prevent or reduce exposure to external disease-causing factors. Adopting a healthy lifestyle helps prevent or delay lifestyle diseases and maintains a good immunity. A healthy lifestyle includes having a good diet – regular and adequate meals that have whole grains, complex starches, lean proteins, a lot of vegetables and fruits, and limiting saturated fats, salt and processed sugars. Another measure is having regular physical activity, about 30 to 60 minutes of moderate activity per day. The diet and physical exercise also assist in maintaining a healthy weight, which is a contributor to health outcomes. Other measures to maintain good health and boost immunity are stress management, getting adequate sleep, having good hygiene, including regular handwashing and proper food handling. Having regular, healthy and supportive social interactions and adopting a positive mindset also help to support stress management, mental health and general health. Things to avoid include smoking, excessive alcohol consumption, and risk behaviours, including sexual risk taking.
There are also vaccines that have been developed against different diseases, to either prevent them or reduce the severity of their impact. These include:
HPV vaccine to prevent cervical cancer, Cholera, Covid-19, Diphtheria, Hepatitis B, Influenza, Japanese encephalitis, Malaria, Measles, Meningitis, Mumps, Pertussis (whooping cough), Pneumonia, Polio, Rabies, Rotavirus, Rubella (German measles), Tetanus, Typhoid, Varicella (chicken pox), Yellow fever
The vaccines in different stages of development include Malaria, Ebola and HIV vaccines.
Dear doctor,
After being treated for UTIs many times over several months, my elderly aunt was told that she had TB in her urinary bladder and was started on TB treatment. Is this even possible?
Dear reader,
Tuberculosis is disease caused by a bacterial infection that can affect any organ in the body. This includes the lungs, the lymph nodes, the spine, the brain, the kidneys, the skin, the adrenal glands, the urinary system, the heart, and any other organ in the body, including spreading through the blood stream. While the most common type of TB disease is pulmonary TB (affecting the lungs), the other forms of TB (extra-pulmonary TB) can also occur. Extra-pulmonary TB can affect anyone, but there’s a higher chance of occurrence in persons who have weakened immunity like the elderly, diabetics, cancer patients, those on treatments that lower immunity, those living with HIV, among others.
The process of diagnosis is dependent on the specific area of the body that is affected, for example, for TB of the urinary bladder, analysis of the urine and scans of the abdomen/pelvis may be used in addition to other tests. Treatment of pulmonary and extra-pulmonary TB is usually similar, except for TB of the brain and of the spine which take longer. Other supportive treatments are given depending on the affected area and the symptoms such as unblocking of the ureters (the tubes that drain urine from the kidney to the bladder) in case bladder TB leads to their blockage.
