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TUBERCULOSIS

 

SYMPTOMS

TB is an infectious disease caused by Mycobacterium Tuberculosis that primarily affects the lung causing pulmonary tuberculosis. However, the bacteria may spread through the bloodstream and infect the brain, skin, bones, stomach, lymph gland or other organs; known as extrapulmonary tuberculosis.

TB is not a genetic disease and is not caused by supernatural forces or curse. Tuberculosis infects any gender, at any age and from any socioeconomic class. TB is curable if patients receive the appropriate regimen and complete the treatment.
 

The main symptom is coughing for 2-3 weeks or more and usually accompanied by:

  • Pain the chest

  • Coughing up blood or sputum 

  • Weakness and fatigue

  • Lack of appetite and weight loss

  • Sweating at night

  • Fever

  • Chills

MEANS OF INFECTION

Mycobacterium Tuberculosis are spread through the air when particles from sputum of pulmonary TB patients are expelled when they cough, sneeze, sing and speak. Droplets of the sputum contains the bacteria and people nearby may breathe it and become infected. Smear-positive pulmonary TB patients may infect 10-15 people in their surroundings every year. However, if the person infected has a strong immune system, he/she will not immediately get sick, it is estimated that 5-10% out of those infected will develop active tuberculosis. 

Notes : Smear-positive means that the TB bacteria is found in the suspect's sputum sample using microscopy testingThe more bacteria are found in the sputum during testing, (+1/+2/+3), the person's likelihood to infect others nearby is also higher.

DIAGNOSIS

a) Microscopic Testing
A suspect is confirmed with  TB when Mycobaterium Tuberculosis is found in his/her sputum sample through a microscope.

Two sputum samples are required and collected in two separate pots from two different times (i.e. in Indonesian - SP/SS):

  1. Collected during the suspect's first visit to the facility or 'Dahak Sewaktu pertama' (S).

  2. Collected in the morning after the suspect's wake up in the morning and then the sample is transported to the facility for lab examination or 'Dahak Pagi' (P).

  3. Collected when the patient visit the healthcare facility to bring back 'P' sputum sample in the morning or 'Dahak Sewaktu kedua' (S).

 

b) Chest X-ray

If the suspect still show clinical symptoms but his/her result from microscopic testing is negative, diagnosis can be supported with result from chest x-ray.

TREATING DRUG-SUSCEPTIBLE TB

TB treatment completion requires 2 phases: Intensive phase (may take 2-3 months depending on sputum conversion result) and continuation phase (for min. 4 months). For at least 6 months, TB patients must comply to the treatment regimen until the doctor declare that the patient's cured or have completed the treatment.

 

During the treatment, there will be 3 other microscopic testing required to examine treatment progress:
1) At the end of the intensive phase
2) One month prior to the last month of treatment
3) After treatment completion

 

How do we know a person is 'cured'?

A person can be declared 'cured' if at least one of their sputum examination result during the treatment is negative and their last (after completion) sputum examination result is negative.

LOCATIONS FOR TREATMENT

Primary Health Centers, Lung Health Centers, Hospitals, Clinics and Private General Practitioners. In public facilities, patients can receive free treatment.*

Clinics owned by Indonesian Association Against Tuberculosis:

  •  JRC-PPTI Clinic: Jalan Sultan Iskandar Muda No.66A Kebayoran Lama Utara Jakarta Selatan – 12240.
     

*Note: Registered Hospitals, Clinics and Private General Practitioners that coordinates their work with NTP also provide the standardized treatment regimen for free.

CONSEQUENCES FROM NOT COMPLETING TREATMENT

  • The patients is not cured and symptoms may worsen

  • Patients will continue to infect other people

  • The disease will be harder to treat if the bacteria become resistant which requires a different and more expensive treatment regimen with adverse side effects. Medications to treat drug-resistant TB are not available at every health centers and hospitals in Indonesia

  • Requires more time to get cured

  • Increases infection of drug-resistant TB 

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