Tuberculosis (TB): Symptoms, Free Tests, Treatment and Care

7 min read · Conditions · By the Asthra Health Care team

What is tuberculosis?

Tuberculosis (TB) is an infection caused by the bacteria Mycobacterium tuberculosis. It most often affects the lungs, but can also affect lymph nodes, the spine, bones, brain, kidneys and other organs. India has the largest number of TB patients in the world, and TB elimination is a national health priority.

TB of the lungs spreads through the air when a person with active TB coughs, sneezes or talks. Not everyone who breathes in the bacteria becomes ill. Many people carry an inactive (latent) infection that does not cause symptoms and does not spread, but it can become active later if immunity becomes weak.

Symptoms of tuberculosis

TB symptoms usually develop slowly over weeks. Symptoms of TB outside the lungs depend on the part affected, such as a painless swelling in the neck, back pain or long-term headache. Some people, especially those with diabetes or HIV, have few symptoms at first.

• Cough lasting more than two weeks
• Coughing up phlegm or blood
• Fever, often in the evening
• Night sweats
• Weight loss and loss of appetite
• Tiredness and chest pain

Who is at higher risk?

Anyone can get TB, but the risk is higher for people who live with a TB patient, people with diabetes, HIV, kidney disease or undernutrition, smokers, people who use alcohol heavily, and those taking medicines that lower immunity, such as long-term steroids. Crowded, poorly ventilated homes and workplaces also increase the spread of TB. Children and elderly people can develop TB more easily after exposure, and their symptoms may be less obvious, such as poor weight gain in a child.

Tests for TB

The main test for lung TB is a sputum (phlegm) test. Rapid molecular tests such as CBNAAT (GeneXpert) or TrueNat can detect TB and check whether it is resistant to rifampicin, a key TB medicine. Sputum smear microscopy is also used. A chest X-ray helps show lung changes.

For TB outside the lungs, doctors may use scans, fluid tests or a biopsy. Tests such as the tuberculin skin test or IGRA blood test can show TB infection but cannot tell latent from active disease on their own. Under the national TB programme, testing and treatment are free at government health centres and many approved private facilities.

How tuberculosis is treated

TB is curable. Treatment uses a combination of several TB medicines taken together for many months, because TB bacteria are slow-growing and can quickly become resistant if only one medicine is used. The medicines, the combination and the duration are decided only by a doctor, and depend on the type of TB and whether it is drug-resistant.

Taking every dose and completing the full course is essential, even when you feel better after a few weeks. Stopping early or missing doses can lead to drug-resistant TB, which is much harder to treat. Tell your doctor about side effects such as yellow eyes, vomiting, skin rash, joint pain or vision changes; do not stop medicines on your own.

Support and living with TB

Under the national TB programme, patients receive free medicines, follow-up tests and nutritional support through direct benefit transfer. Health workers and treatment supporters can help you remember your medicines. Good nutrition with enough protein, from dal, eggs, milk, pulses and vegetables, supports recovery.

Avoid alcohol and smoking. People with diabetes should keep their sugar well controlled. Pregnant and breastfeeding women with TB can and should be treated; the doctor will choose medicines that are safe. TB is not a reason for shame; it is an infection that can be treated.

Protecting your family and when to see a doctor

Cover your mouth when coughing, use a mask in the early weeks of treatment, and keep windows open for fresh air. People with lung TB usually become much less infectious after a few weeks of proper treatment. Family members, especially children under five, should be checked, and the doctor may advise preventive treatment for them.

BCG vaccine given at birth protects young children from severe forms of TB. If you or someone at home has a cough for more than two weeks, fever, weight loss or night sweats, see a doctor and get tested. Your doctor or pharmacist can answer questions about TB medicines.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.