TB can recur, this is characteristic

Tuberculosis (TB) is not only difficult to treat, it is also at risk of reappearing at any time. Even TB patients who have recovered are not completely free from the risk of relapse. In fact, once someone is re-infected, treatment will be more difficult than before. Therefore, it is important for you to recognize the characteristics of recurrent TB disease, causes, and ways to prevent the disease from returning.

Recurrence of TB disease

TB disease is said to recur when the patient feels sick again or experiences symptoms or features of active TB after being declared cured and the body has been cleared of TB bacterial infection.

Symptoms of tuberculosis that are experienced when the disease recurs, among others, are generally similar to the symptoms when first infected with TB, namely:

• Chronic cough for several weeks
• Cough accompanied by blood
• Shortness of breath and chest pain
• Night sweats
• Fever

Clinically, the characteristics of recurrent tuberculosis are characterized by the appearance of tuberculosis-causing bacteria on sputum test results (BTA) and the presence of signs of bacterial infection on lung X-rays.

The smear came back positive and there were also a number of nodules or lesions on the chest X-ray that indicated damage to the lungs due to tuberculosis bacterial infection.

No one can say for sure when TB disease can recur. Patients may experience symptoms that characterize tuberculosis recur within months to years of recovery.

But one thing is certain, The possibility of TB recurrence will be very small if the patient is successfully treated for TB.

The cause of recurrence of TB disease

Based on one of the studies in the journal PLos One , TB disease relapse is more at risk in patients who have recovered for several months. The study states that the increased risk of TB recurrence is due to the reinfection (reinfection) of tuberculosis bacteria.

However, relapsing TB disease can actually be caused by several things, such as:

1. TB treatment failure

The bacteria that cause tuberculosis can be resistant or resistant to TB antibiotics due to inadequate treatment or the patient's lack of discipline to take all the drugs as directed.

This often occurs when the patient's condition improves after undergoing treatment in the first few weeks. In this phase, many patients who think that they are cured stop treatment.

When the body's resistance decreases, the symptoms of tuberculosis return. At this stage, actually TB cannot be called a relapse because what actually happens is that the TB bacterial infection has not disappeared or has stopped completely, because treatment has not been completed or has failed.

Antibiotic-resistant effects of this kind can cause patients to enter MDR TB conditions and need to take second-line TB drugs with a longer duration of treatment.

2. Resistance of bacteria to antibiotics

In normal cells, cell division will produce two cells with the same properties. Two cells divide into four equal cells, four divide into eight, and so on.

However, this does not apply to Mycobacterium tuberculosis, the bacteria that cause tuberculosis. M. tuberculosis splitting asymmetrically. This means that the resulting new bacterial population grows at different rates, has different sizes, and has different resistance to antibiotics.

TB treatment can kill most of these bacteria, but there is a possibility that the bacteria will survive in the body due to the nature of division. Without prevention efforts, the bacteria that survive can become resistant and cause TB to recur.

3. Re-infection of TB bacteria with different strains

Not all cases of TB recurrence are caused by resistant bacteria. Recurrence of tuberculosis can occur because the patient is infected with bacteria M. tuberculosis from strains different. This means that the new TB bacteria have a different gene arrangement from the bacteria that previously infected them.

In these conditions of bacterial re-infection, the antibiotics previously used cannot kill strains new bacteria. As a result, patients who have recovered actually come back and experience the signs or symptoms of active tuberculosis.

HIV patients who recover from tuberculosis but are reinfected also have a greater risk of relapse than those who are not infected with HIV.

How to prevent TB from returning

TB disease can not always be prevented, whether it appears for the first time or when it comes back. However, there are steps you can take to reduce the risk.

The most important step that a patient must take is to undergo a complete treatment. TB treatment can last for 6-12 months, or even more if the infected bacteria have become resistant to various antibiotics.

Patients must be obedient and disciplined in taking various types of drugs given. TB medicine must be taken according to the rules recommended by the doctor. If not, the TB bacteria can mutate and become immune. If so, TB treatment must be repeated.

In addition to completing treatment, other efforts you can take to prevent TB from recurring include:

• Installing adequate air vents that facilitate air circulation in the house. The reason is, the TB bacteria are easier to spread in a closed room.
• Limiting contact with TB patients to avoid transmitting TB so that it is not re-infected. If you have to interact, try to limit the time.
• Use a mask when around a crowd.
• Do not visit TB patients while you are on treatment or when your new treatment is finished.
• Wash your hands regularly using running water and soap.

Treating recurrent tuberculosis is much more difficult than dealing with the disease when it is first infected. This is because the bacteria that cause tuberculosis are very easy to become resistant to various antibiotics that are given.

Therefore, TB patients must undergo proper treatment to prevent the disease from recurring. Patients also need to make various efforts that can reduce the risk of recurrent TB disease.