Senin, 13 Juni 2011

TB Disease


TB disease can affect anyone (old, young, male, female, poor, or rich), and anywhere. Each year, Indonesia increased by a quarter million new TB cases and approximately 140,000 deaths occur each year are caused by TB. In fact, Indonesia is the third largest country with the problem of TB in the world.
TB prevalence surveys conducted in six provinces in 1983-1993 showed that the prevalence of TB in Indonesia ranges from 0.2 to 0.65%. Meanwhile, according to the Global Tuberculosis Control report issued by WHO in 2004, TB incidence rate in 2002 reached 555 000 cases (256 kasus/100.000 population), and 46% of them are thought to be new cases.Causes of TB Disease
Tuberculosis is an infectious disease caused by bacteria Mikobakterium tuberculosis. These bacteria are rod-shaped acid-resistant and so is also known as Batang Resistant Acid (BTA). The bacteria was first discovered by Robert Koch on March 24, 1882, so to commemorate his services was given the name of the bacterium bacillus Koch. In fact, TB disease of the lungs is sometimes referred to as Koch Pulmonum (KP).

Bacterium tuberculosis MikobakteriumMode of transmission of TB Disease
TB disease usually transmitted through contaminated air with Mikobakterium tuberculosis bacteria that are released at the time of TB patient coughs, and in children the source of infection is generally derived from adult TB patients. These bacteria when frequently enter and accumulate in the lungs will breed a lot (especially in people with low immunity), and can be spread through blood vessels or lymph nodes. That's why infectious TB can infect virtually all body organs such as lung, brain, kidney, gastrointestinal tract, bone, lymph nodes, etc., though the organs most often affected are the lungs.
When Mikobakterium tuberculosis successfully infect the lungs, it will soon grow colonies of bacteria that form globular (round). Usually through a series of immunological reactions TB bacteria will endeavor is hampered by forming a wall around the bacteria by lung cells. The mechanism of formation of the wall it makes the surrounding tissue into scar tissue and will become dormant TB bacteria (resting). These dormant forms that actually appear as tubercles on the x-ray examination.
In some people with good immune systems, this form will remain dormant throughout his life. Whereas in people with immune systems that are less, these bacteria will have breeding tubercles grow so much. That many of these tubercles form a space inside the lungs. This space will be a source of production of sputum (phlegm). Someone who has been producing sputum can be estimated is experiencing positive growth and excessive tubercles infected with TB.
Increased transmission of infection have been reported at this time, many associated with several conditions, including worsening socio-economic conditions, not optimal public health service facilities, the increasing number of people who do not have a place to live and an epidemic of HIV infection. Besides, a weak immune system / decrease, virulence and the number of germs is a factor that plays an important role in the occurrence of TB infection.Symptoms of TB Disease
Symptoms of TB disease can be divided into general symptoms and specific symptoms that arise according to the organ involved. Clinical picture is not too typical, especially in the new case, so it is quite difficult to diagnose clinically.Symptoms of systemic / general

    
* Fever is not too high that lasted a long time, usually felt at night accompanied by night sweats. Sometimes such as influenza and fever attacks are intermittent.
    
* Decrease in appetite and weight loss.
    
* Cough-cough for more than 3 weeks (can be accompanied by blood).
    
* Feeling bad (malaise), weakness.
Specific symptom

    
* Depending on which organs are affected, in case of partial bronchial obstruction (the channel leading to the lungs) due to suppression of enlarged lymph nodes, will cause the sound of "wheezing" sound accompanied by shortness of breath weakened.
    
* If there is fluid dirongga pleura (covering the lungs), can be accompanied by chest pains.
    
* If the bone, there will be symptoms such as bone infection at some point to form a channel and empties into the skin above it, in this estuary will discharge pus.
    
* In children to the brain (brain wrapper layer) and referred to as meningitis (inflammation of the lining of the brain), the symptoms are high fever, an impairment of consciousness and convulsions.
In pediatric patients who do not cause symptoms, tuberculosis can be detected if there are known contacts with adult TB patients. Approximately 30-50% of children in contact with adult pulmonary TB patients gave a positive tuberculin test results. In children ages 3 months - 5 years old who live with adult pulmonary TB patients with sputum smear positive, 30% reported infected based on serological examination / blood.Enforcement Diagnosis
If a person suspected of contracting tuberculosis, then a few things that need to be done to make the diagnosis are:

    
* Diagnose both the patient and his family.
    
* Physical examination.
    
* Laboratory tests (blood, sputum, cerebrospinal fluid).
    
* Examination of anatomical pathology (PA).
    
* X-ray chest (thorax photo).
    
* Test tuberculin.

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