Tuberculosis (TB) is an infection caused by the bacterium Mycobacterium tuberculosis. It most often affects the lungs but can attack almost any part of the body. TB spreads through the air when a person with active lung TB coughs, sneezes or talks. It is preventable and curable, yet it remains one of the world’s deadliest infectious diseases, and Nigeria has one of the highest numbers of cases in the world.
Key facts
- A cough lasting two weeks or more should always be tested for TB.
- About a quarter of the world’s population is thought to carry TB bacteria in an inactive (latent) form.
- TB is cured with a course of antibiotics, usually taken for six months.
- In Nigeria, TB testing and treatment are free at designated DOTS centres.
- People living with HIV are at much higher risk of developing active TB.
Latent TB and active TB
- Latent TB infection: the bacteria are in the body but inactive. The person has no symptoms and cannot spread TB. Latent TB can become active later, especially if the immune system is weakened.
- Active TB disease: the bacteria are multiplying and causing illness. People with active lung TB can spread it to others.
Who is at higher risk
- People living with HIV
- People with diabetes or who are malnourished
- Smokers and people who drink heavily
- Household contacts of someone with TB, especially children
- People in crowded, poorly ventilated housing, prisons or camps
- Health workers
Symptoms
Lung TB
- Cough lasting two weeks or longer, sometimes with blood
- Fever, especially in the evening
- Night sweats
- Weight loss and loss of appetite
- Chest pain and tiredness
TB outside the lungs
TB can affect the lymph nodes (causing swollen glands in the neck), spine, bones, joints, kidneys, brain and abdomen. Symptoms depend on the part affected. Children often have non-specific signs such as poor weight gain and ongoing fever.
Diagnosis
- Sputum tests: a rapid molecular test such as GeneXpert detects TB and resistance to rifampicin, a key TB medicine, within hours.
- Chest X-ray to look for lung changes
- Other samples, such as fluid or tissue, when TB outside the lungs is suspected
- Tests for latent TB, such as a skin test or blood test, for contacts and people at high risk
- HIV test, which is offered to everyone diagnosed with TB
Treatment
Drug-sensitive TB
The standard treatment for most adults is a combination of four antibiotics (isoniazid, rifampicin, pyrazinamide and ethambutol) for two months, followed by two medicines for four more months. Shorter regimens are now used for some children and adolescents. Treatment is supported by health workers or family members to help people take every dose.
Drug-resistant TB
If TB bacteria are resistant to key medicines, different combinations are used. Newer all-oral regimens can cure most people in six to nine months.
Why finishing treatment matters
People usually feel better within a few weeks, but stopping early can cause TB to return and become drug-resistant, which is harder to treat. Take every dose for the full course, and tell your health worker about side effects such as yellow eyes, rash, numbness or vision changes.
Rifampicin can turn urine, sweat and tears orange-red. This is harmless. It also makes hormonal contraception less effective, so discuss contraception with your health worker.
Prevention
- Find and treat people with active TB early, which stops spread.
- Cover coughs and sneezes, and open windows to improve ventilation.
- BCG vaccine, given to babies at birth in Nigeria, protects young children from severe forms of TB.
- Preventive treatment is offered to household contacts and people living with HIV.
- Stop smoking and manage diabetes and HIV well.
When to see a doctor
Get tested at a health facility if you have a cough for two weeks or more, coughing up blood, night sweats, fever or unexplained weight loss, or if someone in your household has TB. Seek urgent care for coughing up large amounts of blood or severe breathlessness.
Frequently asked questions
Is TB a curse or caused by witchcraft?
No. TB is caused by bacteria and is cured with medicine. Believing otherwise delays treatment and allows it to spread.
Am I still infectious once I start treatment?
Most people with drug-sensitive TB become much less infectious after about two weeks of effective treatment. Follow your health worker’s advice.
