What is TB or tuberculosis?
TB is short for tuberculosis, a treatable infectious disease caused by the bacteria Mycobacterium tuberculosis most commonly affecting the lungs. Tuberculosis can be spread through the air when a person with active TB coughs, speaks, sings, or sneezes. Though highly infectious, TB is curable when treated with antibiotics.
Tuberculosis remains one of the world’s deadliest infectious diseases, with 1 in 4 people around the globe infected with TB. In 2020, 10 million people fell ill and 1.5 million people died from TB. Even though tuberculosis is a global epidemic, over 95% of TB deaths occur in low- and middle-income countries.
What are the symptoms of TB?
For individuals with active TB disease, the symptoms occur in a gradual progression. Symptoms of coughing, fever, night sweats, or weight loss may be mild for many months, resulting in delays in seeking care and increased infection of others. As the disease progresses, common symptoms are cough with sputum and blood at times, chest pains, weakness, and fever. If left untreated, all forms of TB can be fatal.
Source: https://www.who.int/news-room/fact-sheets/detail/tuberculosis
How do I know if I have TB?
TB requires diagnosis from a medical professional. Two tests exist to determine the presence of a TB infection: a TB skin test or a blood test. The presence of an infection does not definitively determine active TB. Chest x-rays, medical evaluation, and sputum sample collection are required to diagnose the presence of active TB disease. A key challenge in ending TB is due to barriers of access to diagnosis, whether through cost or access to healthcare. Stop TB Partnership’s TB REACH and Global Drug Facility (GDF) tackle these issues from all angles, from funding, research, and supply.
Diagnosis of TB in children is extremely difficult and is often recognized only when the child is already critically ill and the disease has spread from the lungs to the brain or other organs. In 2020, 1.1 million children fell ill with TB globally. Fortunately, new technologies are currently being developed to try to identify TB in children. Take the quiz to learn key facts about TB in children: https://hellokittyquiz.stoptb.org/
What’s the difference between a TB infection and active TB disease?
One quarter of the world’s population has a TB infection, meaning individuals carry TB bacteria but are not ill and cannot transmit the disease. While these individuals are asymptomatic, people infected with TB bacteria have a 5-10% lifetime risk of falling ill and developing active TB disease. However, those with compromised immune systems, such as people living with HIV, malnutrition or diabetes or who use tobacco have a much higher risk of becoming sick with active TB disease.
Active TB disease indicates the presence of M. tuberculosis that has progressed from infection to active disease; in other words, what is commonly meant when we say that “a person has TB”. While the most common and communicable form of TB involves the lungs (pulmonary TB), TB can affect other organ systems, bones and joints, the genitourinary tract and other sites.
Who is at risk for TB? Do I need to be tested?
Individuals with a high risk for infection should get tested for TB.
These individuals include those who spend ample time with people with active TB disease, work in high-risk environments (long-term care, homeless shelters, correctional facilities) or recently traveled to high-risk areas (Eastern Europe, Russia, Asia, Africa, the Caribbean, and Latin Americas).
The risk of active TB is greater in those with a compromised immune system such as those infected with HIV or with malnutrition. Alcohol use disorder and tobacco smoking also increase the risk of TB disease. Notably, TB vaccinations provide only limited protection from TB and still warrant frequent testing in at-risk populations.
What is drug-resistant TB?
Drug-resistant TB (DR-TB) and multidrug-resistant TB (MDR-TB) arise when a strain of the tuberculosis-causing bacteria is resistant to one or more of the medicines used to treat TB. DR-TB can occur through many ways, including but not limited to poor quality drugs, incorrect medical practices and premature termination of treatment. DR-TB is treatable, but options are limited and expensive, especially in low- and middle-income countries. Learn more here.
What are the treatment options if I test positive for TB?
TB is a treatable and curable disease.
If you test positive for a TB infection, you may be prescribed regiments of preventative medication to stop the disease from developing.
If you are diagnosed with active TB disease, you may be treated with a standard 6-month course of a combination of antimicrobial drugs, provided with information and support by a health worker or trained volunteer.
Despite TB being treatable, many high-risk places have little to no access to treatment or diagnostic options. Stop TB aims to bridge this gap through advocacy and GDF. Learn more here.
How can we prevent the spread of TB?
As a person with TB, there are several precautions you can take to reduce the probability of infecting others. Like COVID-19, physical distancing and covering one’s mouth and nose is necessary to prevent the spread of airborne disease. Additionally, ensuring effective air circulation can eliminate active bacteria in confined rooms.
Beyond taking these precautions, completing the course of treatment is vital to kill all TB bacteria in the body. Though symptoms may be alleviated after only a few weeks of treatment, one is still infectious as TB bacteria can be active for at least six months.
Who are "missing" people with TB?
Of the approximately 10 million people who infected with TB in 2018, around two-thirds were detected and officially reported. Around three to four million people are missed by health systems every year because they were not diagnosed, treated, or reported. Although TB is an entirely preventable and curable disease, it will continue to spread while the missing four million people remain undiagnosed and untreated. Finding them is essential if we are to end TB.
What is the Declaration on Human Rights in TB?
The promotion and protection of human rights is central to ending TB. A human-rights-based approach to TB is grounded in international, regional, and domestic law. These laws establish rights to health, non-discrimination, privacy, confidentiality, participation, freedom of movement, and enjoyment of the benefits of scientific progress, among others. Human rights law also establishes the legal obligations of governments and private actors. Read the Declaration of the Rights of People Affected by Tuberculosis here.
The Stop TB Partnership, TB-affected communities and civil society are working to build evidence and operationalize a human-rights-based TB response, engaging in Communities, Rights and Gender (CRG) TB plans to promote equity and human rights at all levels through the Country and Community Support for Impact team.
How can we combat stigma and empower people affected by TB?
National governments have explicitly recognized and articulated a commitment to combating TB stigma. To support these efforts, the Stop TB partnership developed the TB Stigma Assessment tool through a collective effort. The tool aims to assess the extent to which and how TB stigma acts as a barrier to accessing services, and to support the development of recommendations to address stigma so that quality TB services are available, accessible, and acceptable to all.
Beyond combating stigma, we can empower those affected by TB by prioritizing meaningful engagement with affected communities, including TB survivors and TB key and vulnerable populations (KVP). These groups must receive the investment and capacity to strengthen community systems, particularly locally and nationally, but also at the regional and global level. Read more about how Stop TB supports these initiatives here.
How do we talk about TB? What language should I use?
On an individual level, using appropriate language and word choice when discussing TB helps combat stigma, but also empowers those with TB. The Stop TB Partnership’s Words Matter Language Guide serves as a resource for both conversational language as well as technical/medical language to equip those with TB with the tools to speak and advocate for themselves.
What kinds of new tools and innovations have we seen for TB?
To ensure quality TB care for all, it is critical to accelerate the roll-out (i.e., introduction and scale-up) of TB innovations to improve diagnosis, treatment and care. Sputum Smear Microscopy (SSM) is the preferred method of diagnosis of pulmonary TB and often the only option in low- and middle-income countries. Though cost-effective, this traditional method lacks sensitivity and has a high false negative rate, which can result misdiagnosis in patients. More accurate, affordable, and rapid diagnostic tools are crucial to the detection of TB in the 21st century.
Stop TB partners with innovators from TB affected countries who are developing pioneering solutions in the areas of artificial intelligence (AI), cloud computing, nano-sensor, telehealth, and other digital solutions so that all TB affected people will have access to affordable, quality, and people-centered care wherever they are. Read more about our funding initiative TB REACH, the Introducing New Tools Project (INTP), and the Digital Health Technology Hub.
Which countries have the highest levels of TB?
To provide focus for global action on Tuberculosis (TB), HIV-associated TB (TB/HIV) and drug-resistant TB (DR-TB) WHO publishes and updates a list of 51 High Burden Countries (HBC) for TB, available here. These countries represent 86-90% of the global TB burden. Inclusion of countries in this list enhances political commitment and funding at national level.
An interactive map is also available here.
Where does Stop TB fit in?
Founded in 2001, the Stop TB Partnership is a United Nations hosted organization that takes bold and smart risks to serve the needs and amplify the voices of the people, communities, and countries affected by TB.
We work to advocate, catalyze, and facilitate sustained coordination and collaboration among partners; to support the development, replication, and scale-up of innovative approaches and tools; and to facilitate equitable access to TB diagnostics, treatment, and care for all in need.