By Deepak singh Naraina Nursing College Kanpur

1. B Sc Nursing 2nd Year

2. TUBERCULOSIS

3. Introduction
TB is a specific infectious
disease caused by M.
Tuberculosis.
It primarily affected lungs and
meanings, bones and joints,
lymph glands, skin and other
tissue of the body.
TB also affects animals like
cattle, this is known as “bovine
TB”. Which may sometimes be

4. Definition
It is a chronic granulomates
disease condition caused by
mycobacterium tuberculin

5. Problem Statement
World-:TB remain a world-wide public
health problem.
 It is discovered more than 100 year ago.
 In 2009 report of WHO estimates
notification is 4.9 million new patient is
effected.
 Approximately 21.5 million patient is
affected to this disease.

6.  India-:India is the highest TB
burden country in the world and
20% of the total in world cases.
 Every year, approximately 1.8
million person is positive in the
test.
 In India two person die for TB
every minutes, more than 1000
people die every day and 0.4
million die every year.

7. Epidemiological Indices
 Indices or parameters are needed to
measure the TB problem in a
community.
 Prevalence of infection
 It is the percentage of individuals who
show as positive reaction to the
tuberculin test.
 Incidence of infection
(Annual infection rate)
 It reflect the annual. Risk of being
infected or re-infected in a given
community

8. Prevalence of disease of case rate
It is the percentage of individuals whose
sputum is positive in microscopic
examination
Incidence of new cases
It is the percentage of new TB cases
per 1,000 population occurring during
one year.

9.  Prevalence of suspect cases
 It is based on X-Ray examination of
chest.
 Mortality rate
 It is the number of death due to TB
every year per 1,000 of population.

10. Natural History of TB
 Agent Factors:-
(a)Agent:-M. TB is a facultative
intracellular parasite.
(b)Source of infection:-
(i)Human Source:-Positive but no
treatment
(ii)Bovine:- It is usually by milk.

11.  Host factors
(a)Age:- 1% in the under 5 age
group 30% in the at 15 year age
group
(b)Sex:- more then male as compare
to female
(c)Nutrition:- malnutrition is widely.
(d)Immunity:- it is acquired as a result
of natural infection or BCG
vaccination.

12.  Social factor
 It is a social disease with medical
aspect. It is a barrier for social welfare.

13. Tuberculosis

14. Tuberculin Test

15. It is discovered by Von parquet in 1907.
A positive reaction to the test is
evidence of post or present infection by
M.TB.
There are two major antigens the old
tuberculin(OT) and purified protein
derivative(PPT).
It gives fever non-specific reaction.

16. Tuberculin Test

17. Monteux Test
 It is carried out by ID injection surface
forearm.
 1 TV + 0.1ml P.P.D.
 Results is read after 72 hours.
 It results erythematic and indurations.

18. Incubation Period
 It is positive tuberculin test ranges
from 3-6 weeks.

19. Control Of TB
 Case Finding
(A)THE CASE:-It is the 1st step in TB
control programme. In this step detection
of sputum positive cases
(B)TARGET GROUP:-In have carried one
or more symptoms refer to chest pain,
cough and fever.
(C)CASE FINDING TOOLS:-
(i)Sputum examination:-it is examine
microscopically it is the cheapness and
no. One method in overall world.

20.  Collection of sputum samples
 Early morning sputum sample is
more likely to contain TB calculi
than one taken later in the day.
 Slide Reporting
 No of calculi seen in a smear
reflects disease severity.

21.  Sputum culture
 Culture of sputum is necessary for
carrying out sensitivity test and
monitoring drug treatment.

22. Chemotherapy
Anti tubercular drugs.
(i)Refampicin [R]
(ii)Isoniazide [H]
(iii)Pyarazinamide [Z]
(4)Ethambutol [E]
(iv)Streptomycin sulphate [S]

23. Directly observed treatment short
(i)Total duration 6 month
(a)Intensive phase 2 month
- R+H+Z+E
(b)Continuation phase 4 month
 R+H
(ii) Total duration 9 month
(a)Intensive phase 2 month
- H+R+E
(b)Continuation phase 7 month
- R+H
- (iii)Total duration 12 month (twice weekly)
- S+H

24. DOSES OF ANTITUBERCULAR
DRUG
REFAMPICIN-CHILDREN-
10-20 mg/kg bogy weight
ADULT<50- 450 “ “ “
ADULT>50- 600 “ “ “
ISONIAZIDE-CHILDREN-
10 Mg/kg body weight
ADULT - 200-300 “ “
PYRAZINAMIDE-CHILDREN-
20-30 Mg/kg body weight.
ADULT - 30-40 “ “ “ “

25. ETHAMBYTOL-
 25 Mg/kg body weight
STREPTOMYCIN SULTHATE-
 CHILDREN- 30 Mg/kg body weight.
 ADULT>45- 0.75 gm/kg “ “ “.
 ADULT>45- 1gm/kg “ “ “.

26. Treatment During pregnancy
 During pregnancy, streptomycin can
cause permanent deafness in the
body, so ethambutol should be used
instead of streptomycin. Isoniazide,
rifampicin. Pyarazinamide and
ethambutol are safe to use.

27. BCG VACCINATION
 BCG vaccination is a fundamental
component of a national TB Control
programme.
 AIM- The aim of BCG vaccination is to
induce a benign, artificial acquired
resistance,
 VACCINE-it is only widely used live
bacteria.
 TYPES:-
(i)Liquid vaccine
(ii)Freeze dried vaccine

28.  DOSES:- 0.1 Mg in 0.1 ml volume.
Newborn- below 4 week is 0.05 ml.
ADMINISTRATION:- Intradermally by TB
syringe.

29. BIBLIOGRAPHY
(1) Text book of community medicine
Third addition.
Jaypee publication
Peg. 149-163
(ii) Winkipiedia. Source.

30. Complication
 Bronchiactasis
 Emphysema
 Pulmonary Fibrosis
 Plural Calcification
 Haemoptysis