Chronic Ailments Patient Awareness

Breaking the Social Stigma of Tuberculosis

Breaking the Social Stigma of Tuberculosis
Reading Time: 3 minutes

 
Tuberculosis (TB) is an infectious disease that spreads through the air and has been associated with physical weakness and death. It is also been associated with urban poverty; particularly overcrowded housing conditions and certain other groups like migrants and miners for over a hundred years.  TB can be either Inactive or Active.

Inactive TB or latent TB is when the person is infected by the TB bacteria but does not have the disease. He/ She may not feel sick or show any symptoms. A positive reaction to the tuberculin skin test or TB blood test indicate that a person has been infected with TB bacteria

If TB bacteria becomes active in the body and multiplies, the person will go from having latent TB infection to being sick with TB disease. It usually occurs when the body’s immune system is unable to fight off the bacteria.

Signs and symptoms of Active TB include:

  • Cough lasting for three or more weeks.
  • Coughing up blood and pain on coughing.
  • Chest pain.
  • Weight loss.
  • Tiredness
  • Fever.
  • Night Sweats.
  • Chills.

Diagnosis of TB:

The Mantoux tuberculin skin test (TST) or the TB blood test is indicative of TB infection. The confirmatory tests for TB disease include X-ray chest and Sputum smear test.

Prevention:

Prevention is important to stop the transmission of TB. It includes prophylactic treatment and vaccination. The standard regimen for treatment of latent TB infection is nine months Isoniazid, also known as Isoniazid Prophylaxis Therapy (IPT). The Bacillus Calmette-Guerin (BCG) is the only vaccine that is currently available and used worldwide.

Precautions:

These include

  • Early recognition of patients with suspected or confirmed TB disease.
  • Educating the persons identified in cough hygiene without delay. This should include covering their mouth and noses on coughing, sneezing
  • Good infection control
  • Isoniazid preventive therapy
  • Other factors better housing, nutrition, alcohol reduction…

Treatment of TB:

Treatment usually involves the patient taking a combination of different TB drugs

The first line drugs are:

  • Isoniazid
  • Rifampicin
  • Pyrazinamide
  • Ethambutol

These drugs generally have the greatest activity against TB bacteria. With the availability of drugs, surgery is rarely used as a treatment option for TB.

Self-stigma has added the potential harm in the context of people coping with TB which may be because they require consistent engagement with health services and social support to maintain good health and wellbeing. Self-stigma for tuberculosis can lead to social withdrawal, disengagement from health services, reduced treatment compliance, and more.

While the impact of TB on physical health can be plainly seen, its immediate effects on other areas of a person’s life and well-being should also be considered when formulating strategies for coping and resilience. Addressing self-stigma among people treated for TB is part of the evolving landscape of TB care, where an increased focus on social and behavioral factors acts as a necessary complement to specific health system improvements, such as access to medications, health facilities, and the provision of services.

In recent years, TB programmes are creating meaningful change in the practice of TB care with potential effects on stigma reduction. The hard-line DOT approach is gradually ceding to patient-centered approaches that emphasize community engagement, patient counseling and structural aid in adherence promotion. Global health ambassadors including TB survivors are raising awareness about TB on a societal level through messages that affirm the dignity of people with TB rather than amplify the fear of TB. But this gradual advocacy movement of awareness raising, while necessary, is insufficient to tackle the structural drivers of stigma.

The TB community needs consciousness raising, a form of activism that connects disparate experiences of discrimination and disenfranchisement, and the systems and structures that abet them, across time and space. Knowledge of TB transmission most often used to isolate—and at times incriminate—patients can be harnessed to emphasize the stage at which patients become non-infectious.

Destigmatising TB is well aligned with ‘zero suffering’, a prominent goal of the WHO’s new End TB Strategy which is distinct from the goal of zero infections and zero deaths. One step towards alleviating patient suffering is to revisit policies and practices that fuel social stigma of tuberculosis and raise global consciousness for an inclusive and non-stigmatising approach to TB care. It is time we combated stagnant policies and complacency that diminish the social value of people with TB and indeed feed into derogation of the epidemic itself in the hierarchy of global health challenges.

Disclaimer: The above information has been prepared by a qualified medical professional and may not represent the practices followed universally. The suggestions listed in this article constitute relatively common advice given to patients, and since every patient is different, you are advised to consult your physician, if in doubt, before acting upon this information. Lupin Limited has only facilitated the distribution of this information to you in the interest of patient education and welfare.

 

Leave a Comment