TUBERCULOSIS (TB)

By Deden Sura Agung

Tuberculosis (TB) is a disease that has long been recognized by humans. Mycobacterium tuberculosis causes tuberculosis germ has been discovered by Robert Koch in 1882. Although already known for so long and have long found the drug - a potent antituberculosis drugs, today TB is still a major health problem throughout the world. Last decade of the 20th century, the number of new TB cases increased throughout the world, 95% of cases occurring in developing countries. In Indonesia, tuberculosis is still a prominent problem. Even globally, Indonesia was ranked third as the world's largest contributor of cases.

Increasing the number of TB cases in many places at this time thought to be caused by many things, namely (1) incorrect diagnosis, (2) inadequate treatment, (3) prevention program is not implemented properly, (4) infection endemic human immuno - deficiency virus (HIV), (5) migration of population; (6) treat yourself (self-treatment); (7) increasing poverty; (8) inadequate health services.

Tuberculosis child has special problems that are different from adults. In tuberculosis of children, the problems faced is the problem of diagnosis, treatment, prevention, and tuberculosis in HIV infection.

The difficulty of diagnosing TB in children, often followed over diagnosis overtreatment. On the other hand, under diagnosis and under treatment was also found. This happens because the source of the spread of TB are usually adults with sputum positive acid-fast bacilli, so that TB control is emphasized in the treatment of adult tuberculosis. As a result, TB treatment of children less attention.

WHO is making efforts by making a consensus diagnosis in many countries. Given this consensus, the diagnosis of TB is expected to be enforced child the possibility of overdiagnosis or underdiagnosis sehinggan can be minimized and the exact prevalence known.

1. Symptoms of Tuberculosis (TB)

a. Main symptoms, persistent cough and phlegm for 3 (three) weeks or more

b. Additional symptoms that are common: bloody sputum, coughing up blood, shortness of breath and chest pain, body weakness, decreased appetite, weight loss, body discomfort (malaise), night sweats, although no activity, fever fever for more than a month , there is a reddish reaction immediately after injection of BCG (within 3-7 days), there are common symptoms of TB

2) Common symptoms of TB in children

- Weight down for 3 months in a row for no apparent reason and does not rise within 1 month despite treatment with good nutrition (failure to thrive).

- No appetite (anorexia) with failure to thrive and weight does not go up (failure to thrive) with adequately.

- Fever long / repetitive for no apparent reason (not typhoid, malaria or acute respiratory infection) can be accompanied by night sweats.

- Enlargement of superficial lymph nodes are not ill usually the most frequent multiple armpit and neck area groin (inguinal).

- The symptoms of respiratory tract such as cough for more than 30 days (after excluded other causes of cough), signs of chest fluid, and chest pain.

- The symptoms of recurrent gastrointestinal tract such as diarrhea that are not cured by treatment of diarrhea, lump (period) in the abdomen and signs of fluid in the abdomen.

3) Specific Symptoms

These symptoms usually depend on which body part affected for example:

- TB Skin / skrofuloderma

- Tuberculosis of bones and joints:

- Spine (spondylitis): gibbus

- Pelvis (koksitis): lame swelling in the hip

- Bone knee: a limp and / or swelling

- Foot and hand bones

- TBC Brain and Nervous: meningitis, with symptoms iritabel vomiting, stiff neck and decreased consciousness

- Symptoms of eye

- Conjunctivitis fliktenularis

- Choroid tubercles (only visible by funduscopic)

- Other