1.
TUBERCULOSIS
PRESENTED BY
ABHAY RAJPOOT

2.
DEFINITION
It is infectious disease caused by Mycobacterium tuberculosis and
characterized by the formation of tubercles (round nodules) or
granulomas in lungs.
It may be transmitted to other body parts such as meningitis, bones,
kidneys, lymph nodes.

3.
Latent TB - the bacteria
remain in the body in an
inactive state. They cause
no symptoms and are not
contagious, but they can
become active.
Active TB - the bacteria
do cause symptoms and
can be transmitted to
others.

4.
Global India
Incidence 1,04,00,000
(140/lakh)
27,90,000
(211/lakh)
Deaths 16,74,000
(22/lakh)
4,35,000
(33/lakh)
HIV TB
cases
10,30,000
(14/lakh)
87,000
(6.6/lakh)
HIV TB
deaths
3,74,000
(5.0/lakh)
12,000
(0.9/lakh)
Estimated
MDR/RR
cases
6,01,000
(8.1/lakh
population)
1,47,000
(11/ lakh
population)
Global TB Burden -2017

5.
INCIDENCE
Tuberculosis (TB) remains the world's deadliest infectious disease
although global efforts have averted an estimated 54 million
tuberculosis (TB) deaths since 2000, the World Health
Organization (WHO) warned on Tuesday. WHO, in its latest 2018
Global TB Report, says countries are still not doing enough to end
TB by 2030 and calls for an unprecedented mobilization of
national and international commitments.

6.
TRANSMISSION

7.
PATHOPHYSIOLOGY

8.
DIAGNOSTIC EVALUATION
 History collection
 Physical examination
 Sputum test
 Blood test

9.
Mantoux test

10.
CHEST X-RAY

11.
COMPLICATIONS
• Meningitis
• Spinal pain.
• Joint damage.
• Damage to the liver or
kidneys
• Heart disorders

12.
MANAGEMENT

13.
Directly
Observation
Treatment
Shortcourse
 Why? Many patient don’t take medicine
regularly ,even if excellent health
education provided.
 Who? All patient…impossible to
predict which patient will take
medicine(1/3 not adherent).
 What? Observer watches and helps
patient swallow tablets.
 Where? Anywhere (home, clinic, work,
school etc).
 Who does it? HCW, community
workers , teacher.
 Direct observation ensure treatment for
entire course with the right drugs, in the
right dose, at the right intervals.

14.
ANTI
TUBERCULAR
DRUGS
FIRST LINE DRUGS
 Isoniazid (H)
 Rifampicin(R)
 Pyrazinamide(Z)
 Ethambutol(E)
 Streptomycin(S)

15.
SECOND LINE
DRUGS
 Thioacetazone
 PASA
 Ethionamide
 Cycloserine
 Kanamycin
 Capreomycin
 Amikacin

16.
NEWER
DRUGS
Ciprofloxacin
Ofloxacin
Clarithromycin
Azithromycin
Rifabutin

17.
`
Category Type of patient Regimen Duration in
months
Test at month
Category I
COLOR OF
BOX: RED
New sputum
smear positive
New sputum
smear negative
New extra
pulmonary
New others
2(HRZE)3
4(HR)3
6 2
Category II
COLOR OF
BOX:BLUE
Sputum positive
relapse
Sputum positive
failure
After default
2(HRZES)3
1(HRZE)3
5(HRE)3
8 3
Category III
COLOR OF
BOX:GREEN
Sputum negative,
Extra pulmonary
not seriously ill
2(HRZ)3
4(HR)3
6

18.
Adverse reactions to anti-T.B
drugsDrugs Adverse effects
•Isoniazid Peripheral neuropathy
Hepatitis
•Rifampicin Vomiting, abdominal pain
hepatitis
•Pyrazinamide Joint pain, hepatitis
•Ethambutol Optic neuritis
•Streptomycin Renal damage
Auditory & vestibular nerve
damage

19.
OTHER
MANAGEMENT
STRATEGIES
Nutritional therapy
Lifestyle modification
Cough hygiene
Regular follow up
Prevention of complications

20.
ROLE OF NURSE
 NURSES ARE THE BACKBONE OF TB CONTROL
 NURSES EXIST GLOBALLY AND SHARE COMMON IDEAS AND
VALUES

21.
KEY
ACTIVITIES
OF NURSES
PATIENT CARE
HEALTH EDUCATION
TREATMENT OBSERVATION
SPUTUM COLLECTION
MANAGEMENT/ COORDINATION
CONTACT TRACING/ SCREENING
RESEARCH
TEACHING

22.
NURSES AND
CASE
DETECTION:
• First point to call in
primary care services
• Health education
• Holding patient from
presentation to
registration
• Reporting and
recording
70% CASE
DETECTION-

23.
Nurses and
treatment
success
85 % treatment success
• Patient care
• Health education
• Treatment monitoring
• Reporting and recording

24.
Challenges
Lack of nursing
guidelines
Lack of research
evidence
Lack of an
international voice
Large variety of
circumstances

25.
NURSING
DIAGNOSIS
 Ineffective airway clearance related to
copious tracheobronchial secretions
 Deficient knowledge about treatment regimen
and preventive health measures and related
ineffective individual management of the
therapeutic regimen (noncompliance)
 Activity intolerance related to fatigue, altered
nutritional status, and fever

26.
PREVENTION
 Wash your hands after sneezing, coughing or holding your hands near
your mouth or nose.
 Cover your mouth with a tissue when you cough, sneeze or laugh.
Discard used tissues in a plastic bag, then seal and throw it away.
 Do not attend work or school.
 Avoid close contact with others.
 Sleep in a room away from other family members.
 Ventilate your room regularly. TB spreads in small closed spaces. Put a
fan in your window to blow out air that may contain bacteria
 Vaccination (BCG)

27.
RESEARCH STUDY
Aspirin could be the new target for treating drug-resistant
tuberculosis, as tuberculosis bacterium was found to hijack
platelets from the blood clotting system to weaken body's
immune system, according to the research led by the Centenary
Institute in Sydney

28.
SUMMARY

29.
CONCLUSION
Urine testing of people with HIV for tuberculosis can save lives and be
cost-effective, stated findings from an international team of
investigators published in The Lancet Global Health and could
influence international guidelines on TB testing. Screening all
hospitalized patients with HIV for tuberculosis (TB) using urine tests
would improve life expectancy and be cost-effective in Malawi and
South Africa

30.
BIBLIOGRAPHY
 https://doi.org/10.1016/j.tube.2018.04.006
 www.nsgmed.com/respiratory/pulmonary-tuberculosis-drugs-medical
 www.health24.com/Medical/Tuberculosis/About-
tuberculosis/Tuberculosis-TB-20120721
 https://emedicine.medscape.com/article/230802-treatment
 https://www.health.gov.au/.../Content/cdna-song-tuberculosis
 icmr.nic.in/ijmr/2008/september/0913.pdf?origin=publication_detail ·
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