Tuberculosis, caused by Mycobacterium tuberculosis, is one of the most lethal infectious diseases caused by a single infectious agent, primarily affecting the lungs (pulmonary) and other organs of the body. In 2022, it ranked as the world’s second leading cause of death, following closely behind COVID-19. According to the World Health Organisation Report 2023 and the India TB report 2023, it has impacted close to one-quarter of the world’s population (1.3 billion people), with over 25 lakh cases notified in India alone in 2023.
Moreover, certain underlying health conditions, such as diabetes, HIV, or hepatitis, can increase the likelihood of developing active TB disease due to certain external and internal factors. Additionally, it can also trigger the disease and create various challenges or complications in the treatment outcomes. These factors include:
Impact on Immune System
“Health conditions like HIV or Diabetes can affect the immune system that prevents the body from responding effectively to the infections or treatments/ medications which are used to treat tuberculosis or safeguard the body against it. For instance, diabetes can impair the immune system’s ability to respond effectively to infections,” said Dr Chaitali Nikam, Director (infexnTM), HaystackAnalytics. Also, elevated blood sugar levels associated with diabetes can impact the immune function, and further increase the risk of TB.
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Defective Granuloma Formation
Dr Nikam stated, “Granulomas is a tiny cluster of white blood cells and other tissues which is formed by the immune system to prevent the spread of acute infections like Tuberculosis. When the immunity of the body is impacted by the infection, it also disrupts the granuloma formulation and maintenance, leading to uncontrolled bacterial growth and triggers infection in the body”.
Delayed Diagnosis and Treatment
“Another crucial challenge for patients with chronic diseases, especially HIV, Hepatitis or Diabetes, is delayed diagnosis and increased transmission rate. For instance, if a patient has been diagnosed with HIV, they can also have TB symptoms which might be obscure due to the symptoms of HIV,” Dr Nikam said. As per him this leads to growth of advanced TB in the body with higher bacterial loads, which are more likely to be transmitted through the respiratory tract. On the other hand, diabetes can complicate TB treatment by affecting drug metabolism and increase the risk of medication-related complications. And, poorly controlled diabetes may also delay TB treatment response and increase the risk of treatment failure.
Moreover, lifestyle factors play a crucial role in determining the body's response to treatment, especially nutritional intake of the individual, which impacts the healing processes and medication efficacy. Thus, it is important to understand the significance of maintaining a well-nutritious diet which includes essential nutrients like vitamins A, C, and D, zinc, lean proteins, fruits, vegetables, and whole grains. Furthermore, it is important to abstain from smoking and alcohol consumption to support treatment effectiveness and outcome. Apart from this, it is crucial to sustain a healthy sleep routine and incorporate activities like meditation, yoga, or walking for effective stress management and positive mindset.
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Mycobacterium tuberculosis continues to rank among the leading causes of death worldwide, and a major threat for the individuals living with underlying conditions such as HIV, diabetes or Hepatitis. Though factors such as weak immune system, alongside challenges in granuloma formation and delayed diagnosis contribute to the complexity of managing the disease, it is important to opt for healthy lifestyle choices, emphasizing on nutrition, sleep and stress management activities. Furthermore, delayed diagnosis and increased transmission reflects the need for early screening and detection of chronic diseases and drug resistance to effectively manage the overall health and wellbeing of the patient.