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    TUBERCULOSIS (Lec Community Medicine)

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    wanderer_1010
    This document discusses tuberculosis (TB), including its epidemiology in Pakistan and globally. It notes that TB accounts for 5.1% of Pakistan's total disease burden, with most cases occurring in the productive age group. Key points made include that Mycobacterium tuberculosis is the causative agent; infected persons and animals are reservoirs of infection; and control relies on case finding, treatment with bactericidal and bacteriostatic drugs, and BCG vaccination. The take home message is that TB is highly communicable but curable, and early case finding, treatment, and BCG vaccination are important for control.

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    TUBERCULOSIS (Lec Community Medicine)

    Uploaded by

    wanderer_1010
    324 views24 pages
    This document discusses tuberculosis (TB), including its epidemiology in Pakistan and globally. It notes that TB accounts for 5.1% of Pakistan's total disease burden, with most cases occurring in the productive age group. Key points made include that Mycobacterium tuberculosis is the causative agent; infected persons and animals are reservoirs of infection; and control relies on case finding, treatment with bactericidal and bacteriostatic drugs, and BCG vaccination. The take home message is that TB is highly communicable but curable, and early case finding, treatment, and BCG vaccination are important for control.

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    TUBERCULOSIS

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    This document discusses tuberculosis (TB), including its epidemiology in Pakistan and globally. It notes that TB accounts for 5.1% of Pakistan's total disease burden, with most cases occurring in the productive age group. Key points made include that Mycobacterium tuberculosis is the causative agent; infected persons and animals are reservoirs of infection; and control relies on case finding, treatment with bactericidal and bacteriostatic drugs, and BCG vaccination. The take home message is that TB is highly communicable but curable, and early case finding, treatment, and BCG vaccination are important for control.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    324 views24 pages

    TUBERCULOSIS (Lec Community Medicine)

    Uploaded by

    wanderer_1010
    This document discusses tuberculosis (TB), including its epidemiology in Pakistan and globally. It notes that TB accounts for 5.1% of Pakistan's total disease burden, with most cases occurring in the productive age group. Key points made include that Mycobacterium tuberculosis is the causative agent; infected persons and animals are reservoirs of infection; and control relies on case finding, treatment with bactericidal and bacteriostatic drugs, and BCG vaccination. The take home message is that TB is highly communicable but curable, and early case finding, treatment, and BCG vaccination are important for control.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 24

    Dr.

    Komel Zulfiqar
    Assistant professor
    Community Medicine
    22 HIGH DISEASE BURDEN COUNTRIES
    India Russia Combodia
    China Kenya Myanmar
    Indonesia Vietnam
    Nigeria Ur Tanzania
    Bangladesh Brazil
    Ethiopia Uganda
    Philippines Zimbabwe
    Pakistan Mozambique
    South Africa Thailand
    Congo Afghanistan
    At the end of lecture students are able to
    Describe Epidemiology of T.B
    Discuss control of T.B
    Discuss prevention of T.B
    LETS RECALL:
    What do you know about communicable diseases?
    What do you mean by Epidemiology?

    EPIDEMIOLOGY
    MAGNITUDE OF THE PROBLEM
    A world-wide public health problem
    Estimated number of infectious cases in the world 15
    20 million
    About 8 million people develop tuberculosis every year
    2 million people die of this disease every year
    The problem is acute in developing countries which
    account for about 95 per cent of tuberculosis cases
    South-East Asia, Western Pacific and Africa are the worst
    affected regions (38 %)
    PAKISTAN
    TB accounts for 5.1% of the total national disease burden

    Two-third of TB cases are in productive age group

    Incidence of all form of TB per year 177/100,000


    Incidence of sputum-positive cases per year 80/100,000
    Open cases per year 120,000
    AGENT FACTORS

    Mycobacterium Tuberculosis
    Human Variety

    Bovine Variety

    Murine Variety

    Avian Variety

    Last two types rarely pathogenic to man


    RESERVOIR OF INFECTION
    Infected persons (Cases)

    Infected animals
    SOURCE OF INFECTION
    Human Source
    Sputum
    Excreta
    Bovine Source
    Milk
    Tuberculous Material
    Operation Theatre
    Laboratories
    Slaughtered animals
    HOST FACTORS
    Age:
    Male 25-45 years
    Female 15-35 years
    Sex: more in males
    Heredity : not a hereditary disease
    Immunity : natural infection & BCG vaccination
    Intercurrent infection & concomitant
    diseases: measles, pneumonia, whooping ,cough,
    influenza etc.
    ENVIRONMENTAL FACTORS
    Social factors:
    Housing, nutrition, education, early marriages, family
    size & overcrowding etc

    Occupation:
    Industrial workers having Silicosis & Anthracosis
    Bus Conductors, Counter Clerks at rush offices
    Health care workers
    THE CONTROL OF TUBERCULOSIS
    Tuberculosis control means reduction in the prevalence
    and incidence of disease in the community
    As per WHO criteria, tuberculosis control is said to be
    achieved when the prevalence of natural infection in the
    age group 0 14 years is 1% or less
    CONTROL MEASURES
    Curative component: Case Finding and
    Treatment

    The most powerful weapon in the control of


    tuberculosis is case finding and treatment
    TARGET GROUP
    Patients who attend hospitals and health
    centers with the following symptoms
    Persistent cough for 3 weeks or more
    Continuous fever
    Chest pain
    Haemoptysis
    Household contacts (especially children &
    young adults) of all smear-positive patients
    CASE FINDING TOOLS
    Sputum Smear Examination
    By direct microscopy
    Examination of two consecutive specimens is sufficient
    Method of choice is Sputum Culture
    For patients with chest symptoms and negative sputum
    smear
    TREATMENT
    BACTERICIDAL DRUGS:
    Rifampicin (R) Daily Dose 450-600 mg
    The only drug active against the dormant bacilli
    INH (H) Daily Dose 300 mg
    Action is most marked on rapidly multiplying bacilli
    Streptomycin (S) Daily Dose 0.75 to 1 g in a single injection
    Acts entirely on rapidly multiplying bacilli
    Pyrazinamide (Z) Daily Dose 1.5-2 g
    Particularly active against slow-multiplying IC bacilli
    TREATMENT
    BACTERIOSTATIC DRUGS:

    Ethambutol (E) Daily Dose 800 mg

    Prevents emergence of resistance to other drugs

    Thioacetazone Daily Dose 150 mg


    PREVENTION
    BCG VACCINATION) (Live-attenuated bacilli)
    Chalmette & Guerin 1906, 230 Subcultures in 13 years

    Universal recognition by 1948, In Pakistan 1950

    Dosage: Below 4 weeks 0.05 ml, Above that 0.1 ml

    Administration: I/D with Tuberculin syringe, just above the insertion


    of Deltoid Muscle

    Age: At birth, then at 6 weeks with DPT

    Protective Value: For 15 20 years (80%)


    FOR FURTHER READING
    K Park Text book of social and preventive Medicine
    21st edition

    M Ilyas Ansari Text book 20th edition


    ANY QUESTION
    TAKE HOME MESSAGE
    T.B is highly communicable disease but 100% curable.
    Most important step in control of T.B is early case
    finding & treatment.
    BCG vaccination is live attenuated vaccine given to
    children to elicit immune response and protects
    against T.B up to 80%.

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