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Respiratory Health

Tuberculosis: Recognising It Early and Completing Treatment

TB is curable and treated free of cost in India. The two things that turn a curable illness into a dangerous one are late diagnosis and stopping treatment early.

When to suspect TB

  • Cough lasting more than two weeks
  • Fever, particularly in the evenings, with night sweats
  • Unexplained weight loss and loss of appetite
  • Blood in the sputum
  • Chest pain and breathlessness
  • Persistent fatigue
  • For TB outside the lungs: a painless neck swelling, back pain with fever, abdominal swelling, or persistent headache with fever
Worth knowing

Any cough lasting more than two weeks should be evaluated for TB, regardless of your background, income or living conditions. TB is not confined to any one section of society.

Diagnosis

Sputum testing with a molecular test such as CBNAAT is the primary investigation, and it identifies both the bacterium and resistance to rifampicin within hours. Chest X-ray supports the diagnosis. For TB outside the lungs, a biopsy or fluid sample from the affected site is usually needed.

All of this is available free of charge under the National TB Elimination Programme, at government facilities and through notified private providers. Nutritional support payments are also available to registered patients.

Completing treatment

Standard drug-sensitive TB is treated for six months. Symptoms improve substantially within the first two to four weeks — and that improvement is exactly when patients stop, believing they are cured. They are not; the bacteria that remain are the hardiest ones.

Stopping early causes relapse and, more seriously, drug-resistant TB, which requires much longer treatment with more toxic drugs and has considerably lower cure rates. Completing the full course is the single most important thing a TB patient does.

During treatment

  • Take all tablets together, usually on an empty stomach, at the same time daily
  • Expect orange-red urine and tears from rifampicin — this is harmless
  • Report jaundice, persistent vomiting, visual changes, numbness in the feet or a rash immediately
  • Eat a high-protein, high-calorie diet; weight gain is a good sign of response
  • Stop alcohol and tobacco completely
  • Attend all follow-up sputum tests

Protecting the household

  • Cover the mouth when coughing and dispose of sputum safely
  • Keep rooms well ventilated with open windows — ventilation matters more than disinfectant
  • After two to four weeks of effective treatment, infectiousness falls dramatically
  • All household contacts, especially children under five, should be screened
  • Preventive treatment is offered to eligible close contacts
  • Screen household members for diabetes and HIV, which increase susceptibility

Key takeaways

  • Cough for more than two weeks needs TB evaluation, whatever your circumstances.
  • Diagnosis and treatment are free under the national programme.
  • Feeling better after a few weeks does not mean cured — stopping early causes drug resistance.
  • All household contacts, particularly young children, should be screened.
A note on medical advice

This article is general health education written and reviewed by the Department of Pulmonology at SIMS. It is not a substitute for an examination, a diagnosis or the advice of your own treating doctor, and it cannot account for your history, medicines or reports. If a symptom is sudden or severe — chest pain, stroke symptoms, breathing difficulty, serious injury, seizures or heavy bleeding — call 9281862028 or come straight to the emergency department instead of reading further.

TuberculosisCoughPublic healthPulmonology

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