As a medical student at Hospital Tuanku Ja'afar (HTJ) Seremban, I was first introduced to the world of tuberculosis patients. Circa 2010, from my recollection, we had a small number or maybe 1😂 dedicated Infectious Diseases Physician who was caring for tuberculosis patients and patients with contagious infectious diseases in a small corner cubicle right at the back of the medical wards.
It was a humbling experience to witness the struggle and burden faced by these patients who were battling a disease that had plagued mankind for thousands of years. Over the years, my journey with tuberculosis patients has been a long and rewarding one, with very many stories about the disease, patients and reflections on my management.
Challenges...
Having spent a fair amount of time in the infectious diseases department in the country's Infectious Diseases Centre - I must admit managing tuberculosis patients is not an easy task.
The biggest challenge is the lengthy treatment duration, which can last for up to 6 months or longer. Patients have to take multiple medications every day, and many of them suffer from unpleasant side effects such as nausea and fatigue. Worst-case scenario, some may end up with liver problems and nerve or vision issues too.
Compliance with treatment is also a major issue, as some patients may stop taking their medication once they start feeling better, which can lead to drug-resistant TB.
Above all, I must say the biggest challenge is the social stigma associated with TB. Many patients are afraid to disclose their diagnosis to their family and friends, which can lead to isolation and depression. In addition, some communities may view TB as a "dirty" disease and may discriminate against those who have it.
Burden Faced by Tuberculosis Patients
The burden faced by tuberculosis patients cannot be overstated. Not only do they have to deal with the physical symptoms of the disease, but they also have to cope with the emotional and social impact of the diagnosis. Many patients have to take time off work or school, which can lead to financial difficulties. In addition, they may face discrimination or social isolation, which can have a negative impact on their mental health.
Hopes for the Future
Despite the challenges faced with managing tuberculosis, there is hope for the future. Advances in medical science have led to the development of new drugs and treatment regimens, which are easier to practise and reduce pill burden with better patient outcomes. In addition, efforts to raise awareness about the disease and reduce the stigma associated with it are helping to improve patient care and support. We have also leveraged technology by utilising digital notification systems and DOTS - Directly Observed Therapy for the treatment of TB (still largely done manually at the moment).
Here are some commonly asked questions on tuberculosis:
☘️ Is TB curable?
Yes, TB is curable with proper treatment.
☘️ What is drug-resistant TB?
Drug-resistant TB occurs when the bacteria that causes TB becomes resistant to the drugs used to treat it. This can occur when patients do not complete their full course of treatment or when they receive inadequate treatment.
☘️ How is TB diagnosed?
TB can be diagnosed through a combination of tests, including a chest X-ray, a sputum test, and a TB skin test.
☘️ Can TB be prevented?
Yes, TB can be prevented through vaccination, good hygiene practices, and early diagnosis and treatment.
☘️ What is the biggest challenge faced with managing TB?
The biggest challenge is the lengthy treatment duration and ensuring compliance with medication.