Dr Nguyễn Thu Thủy from the National Lung Hospital’s Department of Pulmonary Tuberculosis. — VNA/VNS Photos

Việt Nam ranks 11th among the top 30 countries with the highest multi-drug resistant tuberculosis rates in the world. It is estimated that Việt Nam sees around 169,000 new tuberculosis cases each year, with approximately 8,900 cases of multi-drug resistance and around 14,200 deaths. Notably, tuberculosis is shifting towards younger patients. Dr Nguyễn Thu Thủy from the National Lung Hospital’s Department of Pulmonary Tuberculosis discussed this issue with Vietnamplus online newspaper.

Previously, tuberculosis primarily affected older patients, but now young people are also among those affected. How has this trend been observed in the hospital?

Tuberculosis is a rapidly spreading and challenging disease to control. The cause of tuberculosis always originates from the tuberculosis bacteria, with favourable conditions for the disease to develop.

Although tuberculosis can be prevented and treated, over 4,100 people worldwide still die from it, and nearly 30,000 people contract the disease every day.

People of all ages are at risk of contracting tuberculosis. According to statistics, the highest tuberculosis infection is among the working-age population, accounting for nearly 40 per cent, with those aged 21-30 and 31-40 making up around 16 per cent each.

At the National Lung Hospital, tuberculosis patients range from infants a few months old to the oldest individuals aged 90-95.

In the Department of Pulmonary Tuberculosis, doctors are currently treating six patients in the student age group. A typical case is a 20-year-old patient with prolonged cough symptoms starting in early February 2023.

Could you explain further why many young people still contract tuberculosis despite improvements in living conditions?

The cause of tuberculosis is the Mycobacterium tuberculosis bacteria, which is a respiratory transmitted infectious disease. When normal individuals inhale the tuberculosis bacteria from a patient, they can become infected with the disease, but not everyone infected develops active tuberculosis. The tuberculosis bacteria inside the body cannot grow because the immune system protects the body. In fact, there are individuals who remain infected with tuberculosis throughout their lives but never develop active tuberculosis.

There are two risk factors that lead to tuberculosis developing from infection: the quantity of bacteria and the individual's immune response. When there is a large quantity of bacteria, and the body's immune system is unable to control them, the infection can progress to active tuberculosis. Therefore, individuals with high-risk factors for developing tuberculosis due to a weakened immune system include malnourished individuals, heavy smokers, those with chronic diseases, weakened immunity due to HIV infection, children. If there's a positive tuberculosis source within the family, this is also a factor that increases the risk of transmission to children.

Doctors at the National Lung Hospital conduct lung surgery on a patient.

For students, academic stress, lack of proper lifestyle habits, and inadequate rest are among the factors that weaken their immune systems. When immunity is compromised, the risk of transitioning from tuberculosis infection to active tuberculosis disease increases.

Additionally, living and working conditions that are not adequately controlled provide favourable conditions for the growth and transmission of tuberculosis bacteria.

Could you share how effective the current tuberculosis treatment measures are?

Tuberculosis is highly contagious during the period before a patient receives a diagnosis. Once diagnosed and treated, the bacterial activity decreases significantly, and the ability to transmit the disease decreases within about two-four weeks. However, in cases where the disease hasn't been detected, being in close proximity in a confined living environment can result in direct transmission from an infected person, making those around them vulnerable to infection and disease.

Because a single tuberculosis patient's cough can release bacteria that can be transmitted to 10-15 other people, especially in small community settings like families, classrooms, or crowded areas. Moreover, in natural conditions, tuberculosis bacteria can survive for three to four months, and the phlegm of a patient in a humid room can retain its infectious potential for three months.

Although the initial dispersal of bacteria during a single cough may not be extensive, in confined and poorly ventilated spaces, the accumulation of tuberculosis bacteria in the air increases the likelihood of infection. Under sunlight, tuberculosis bacteria are destroyed within one hour and a half. Tuberculosis bacteria stop growing at 42 degree Celsius and are destroyed within ten minutes at 100 degree Celsius. Therefore, we can disinfect instruments at 100 degree Celsius to eliminate the bacteria.

What recommendations do you have to detect and treat tuberculosis early, especially for young people?

Young individuals with good health and immune systems often overlook the initial symptoms of the disease. However, tuberculosis is a silent disease with delayed detection. If not treated in a timely and effective manner, it can lead to severe complications that threaten lives.

Complications can include localised damage leaving calcified nodules or fibrosis, more severe damage where the lungs form mottled scar tissue, damage to lung tissues and bronchi leading to lung collapse, reactivation tuberculosis with potential secondary infections, occasional coughing with blood.

When lung damage is extensive, it undoubtedly leads to complications, and when the lungs leave such scars, breathing capacity diminishes, slight exertion leads to breathlessness.

Tuberculosis is one of the leading causes of death in infectious diseases. To prevent the disease, patients who have contracted it should limit contact with others and wear masks. Additionally, family members should undergo screening examinations to check for infection.

For those who haven't contracted the disease, they should focus on proper nutrition, adequate consumption of essential nutrients, regular physical exercise to strengthen their immune systems, maintain personal hygiene, ensure a well-ventilated living environment to minimise bacteria, and avoid contact with individuals showing cough or sneezing symptoms. Children should receive the tuberculosis vaccine within the first month after birth. Most importantly, regular health check-ups are essential for early detection and timely treatment. — VNS