Brazil is the country in the Americas with the most reported cases of tuberculosis

On March 24th, World Tuberculosis Day is celebrated, an infectious disease that, if it is pulmonary, is transmissible. Caused by bacteria Mycobacterium tuberculosis, it mainly affects the lungs, but can extend to other organs. Brazil is the country in the Americas that records the most cases of the disease, and in 2021, just over 91 thousand cases were registered. In 2022, the number reached 103,766 thousand people, according to data from DataSus, from the Ministry of Health.

Among the main symptoms is cough, which can be dry or with secretion and last more than three weeks. Loss of weight and appetite, fever, weakness, and night sweats may also accompany it. These symptoms were the same ones that psychologist Dâmaris Cristo had 24 years ago. “It started with a fever, night sweats, a lot of tiredness and loss of appetite. When I went to the health unit, I was diagnosed with pneumonia and treated, but I soon realized that the symptoms were getting worse and I started to lose weight, in addition to my tiredness increasing significantly, as well as my fever and sweating.”

After six months, Dâmaris managed to see a specialist, when she was diagnosed with tuberculosis and referred to the Unified Health System (SUS), starting treatment with medication, which lasted a year. “Right when I was diagnosed, the doctor said that there was calcification in my left lung, which according to him is not reversible”, she remembers.

“Patients who have had tuberculosis can develop post-tuberculosis lung disease, which is characterized by varying degrees of functional and structural lung sequelae, such as bronchiectasis (distortion of the bronchi), fibrosis, pleural thickening and decreased lung function. These changes increase the risk of contracting other infectious lung diseases, including those caused by bacteria, viruses and fungi”, explains Dr. Stella Bozza Kapp, pulmonologist at the Universitário Cajuru and São Marcelino Champagnat hospitals.

The doctor also explains the chronic symptoms that can persist even after the disease is cured. “Patients may develop chronic respiratory symptoms, such as coughing and persistent shortness of breath, as well as reduced exercise capacity and quality of life.” There are people who have latent tuberculosis, where there are no symptoms or transmission, and the bacteria remains inactive for years.

Exam facilitates accurate diagnosis

Because it has symptoms similar to those of other microorganisms, the diagnosis of tuberculosis becomes more difficult. According to the pulmonologist, the disease can be confused with others, such as: silicosis (a disease caused by inhaling silica dust), fungal infections, neoplasms (mainly lung cancer), bacterial infections, other mycobacterioses, autoimmune diseases, pulmonary embolism , among others, as was the case of Dâmaris.

One of the main ways to diagnose tuberculosis is through a sputum test, which identifies the disease bacillus. Other methods available for sputum analysis are direct sputum smear microscopy, culture for mycobacteria and the rapid molecular test, in which the result can be released within a few hours. Mobius, a company that develops and sells products aimed at the diagnostic medicine segment focused on molecular biology, has tests that detect and diagnose bacteria and their resistance.

The MTB and NTB Master Kit is a Real-Time PCR assay that identifies the bacteria M. tuberculosis, MTB Complex and NTM. The GenoType MTBDRplus VER 2.0 and GenoType MTBDRsl VER 2.0 kits, from the Hain LifeScience line, identify the bacteria and their resistance to the main drugs used to treat tuberculosis.

Mobius exams have a high degree of sensitivity and precision, in addition to offering quick diagnoses. This facilitates treatment with the correct medications and can reduce hospital costs, with hospitalizations in more serious cases, and pharmaceutical costs, with ineffective medications. “These tests are requested in symptomatic respiratory patients (patients who have coughed for more than three weeks) and in cases of clinical and/or radiological suspicion of pulmonary tuberculosis, regardless of how long they have been coughing”, highlights the doctor.

Treatment lasts about six months

The treatment, which is free and offered by the SUS, can last from six months to a year. According to Dr. Stella, the regimen recommended by the Ministry of Health consists of four medications (tablets), namely rifampicin, isoniazid, pyrazinamide and ethambutol.

In addition to treatment for patients with activated bacteria, the main form of prevention is the BCG vaccine, offered free of charge by the SUS and which must be administered at birth or up to five years of age. It prevents more serious forms of the disease. The doctor also warns: it is important to evaluate family members and other people the patient has had contact with and also treat the latent infection, when diagnosed, so that the active form of tuberculosis does not develop.

*With information from the Advisory

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