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2. Introduction:
 Tuberculosis (TB) is the world’s
leading cause of death from a single
infectious agent next to coronavirus
(COVID-19)
 TB remains the leading cause of
death in the country, particularly to
people living with HIV.
 The Global TB report of 2021 quoted
61 000 who had died of TB

4.  Low immunity is regarded as one of the
common reasons why TB infection
breaks into TB disease
 People suffering from HIV, stress,
diabetes, damaged lung condition;
alcoholics and smokers whose general
health condition is poor also have the
possibility of getting the disease

6. TB Statistics:
 31 000 of those were people living
with HIV during the year 2020 &
167 deaths per day.
 We need to work hard to reverse
these in order to improve favourable
treatment outcomes among our TB
patients.

7.  More than 40% of the population in
India carry Tuberculosis infection in
their body but only 10% get TB
disease
 Incidence of TB is quite high across
the world. Out of the total cases,
more than 26% are from India. This
includes both multidrug-resistant TB
and HIV TB cases.

8. Survey report:
 There is high TB among men than
women, indicating the need for
interventions targeting men.
 The TB Prevalence Survey also
highlighted that the youth and the
elderly are also among the hardest
hit.

9. 7th SA TB Conference:
 Durban International Convention
Centre (ICC) 16 Sept 2022
 7th SA TB Conference: Working
together to get TB control back on
track

10. Aims of the conference :
1. Re-energise the TB community
through in-person interaction of
academic, governmental, non-
governmental and civil society
stakeholders.

11. 2. Understand setbacks in TB control
and research due to the Covid-19
epidemic and examine opportunities
to get back on track.

12. 3. Understand the latest advances in
TB prevention, diagnosis, and
treatment, including discovery,
development, and implementation.

13. 4. Explore optimal community
engagement and communications in
TB control and research. Social
aspects around TB
5. Learn about advances in basic
understanding of the pathogen and
host response

14. Conference tracks:
 Track 1: Pathogenesis of TB –
pathogen and host
 Track 2: Drugs/Vaccines/Diagnostics
 Track 3: Implementation/Health
systems
 Track 4: Social and Community
aspects of TB

15. Track 1: Pathogenesis of
tuberculosis – the
pathogen and the host
 Novel understanding of lung
pathology in tuberculosis.
 Research in this area will be
adequately funded so we can get
these testing methods in our
facilities.

16. Track 2:
Vaccines/drugs/diagnostics
 Reaching the WHO, End TB
Strategy targets of a 95% reduction
in TB mortality and
 90% reduction in TB incidence
worldwide, by 2035, will require a
new vaccine that is effective across
all age groups, particularly adults
and adolescents.

17.  Today, the only effective tuberculosis
vaccine in common use is the Bacillus
Calmette-Guérin (BCG) vaccine, first
used on humans in 1921
 Tuberculosis (TB) is the leading killer
among all infectious diseases
worldwide despite extensive use of
the Mycobacterium bovis bacille
Calmette-Guérin (BCG) vaccine.

18.  A safer and more effective vaccine
than BCG is urgently required. More
than a dozen TB vaccine candidates
are under active evaluation in
clinical trials aimed to prevent
infection

19. Current global clinical pipeline of TB
vaccine
 The 2019 global clinical portfolio of
TB vaccine candidates includes
mycobacterial killed, whole-cell, or
extract vaccine candidates (Vaccae,
MIP, DAR-901, and RUTI);

20. Medication / drugs
 Many drugs are in the pipeline, this is
encouraging. Shorter TB preventive
therapy regimens
 In India the three-antibiotic
combination is still under clinical trials
and the regimen could be included in
the national TB programme.
 BPaL is a combination of three newer
antibiotics: bedaquiline, pretomanid
and linezolid

21. Diagnosis:
 There are two kinds of tests used to
detect TB bacteria in the body: the TB
skin test (TST) and TB blood tests
 A positive TB skin test or TB blood test
only tells that a person has been
infected with TB bacteria. TB blood tests
(IGRAs)
 It does not tell whether the person
has latent TB infection (LTBI) or has
progressed to TB disease.

23.  Other tests, such as a chest x-ray and
a sample of sputum, are needed to see
whether the person has TB disease.
 Advances in the detection of Mtb
include LED fluorescence microscopy,
nucleic acid amplification of Mtb and
 Drug resistant strains, and more rapid
liquid culture with adjunct drug
susceptibility testing.

24. Track 3: Health systems
 Communities to be part of the
solution.
 Children, adolescents are at the
greatest risk for TB and initiatives to
improve retention of adolescents on
treatment

25.  The major issues to emerge from
this track was how many people
with TB have co-morbidities
 Screening routinely at clinics for TB
and HIV, also be screening for
diabetes and hypertension at the
same time

26.  Posters and leaflets to take home to
read and understand.
 Practices for the management of
pregnant and postpartum women
with DR-TB

27. Track 4: Social aspects
 Impact of stigma on care-seeking
and outcomes.
 Stigma is real, it is a challenge, and
it has a negative impact on
treatment outcomes.
 Patient’s support was highlighted as
an important factor to improve
treatment outcomes.

28.  The role of leaders in supporting the
fight against tuberculosis was
extensively important
 Leaders and civil society need to be
fully involved in health issues
regarding their communities

29. Approaches
Our interventions should be targeted
 patient-centred and community-
centered,
 Our approaches should be
multisectoral

30. TB Infection Control in
Health Care Settings
A tuberculosis (TB) infection control
plan is part of a general infection
control program designed to ensure
the following:
 Prompt detection of infectious TB
patients,
 Airborne precautions, and
 Treatment of people who have
suspected or confirmed TB disease.

31. Three-level hierarchy of
control
The TB infection control program
should be based on a three-level
hierarchy of control measures and
include:
 Administrative measures
 Environmental controls
 Use of respiratory protective
equipment

32. Administrative measures:
 Assigning someone the responsibility
for TB infection control in the health
care setting;
 Conducting a TB risk assessment of the
setting;
 Developing and implementing a written
TB infection-control plan;
 Ensuring the availability of
recommended laboratory processing,
testing, and reporting of results;

33.  Implementing effective work
practices for managing patients who
may have TB disease;
 Ensuring proper cleaning,
sterilization, or disinfection of
equipment that might be
contaminated (e.g., endoscopes);

34.  Educating, training, and counseling
health care personnel, patients, and
visitors about TB infection and TB
disease;
 Screening, testing, and evaluating
personnel who are at risk for exposure
to TB disease;
 Applying epidemiology-based prevention
principles, including the use of setting-
related TB infection-control data;

35.  Using posters and signs to remind
patients and staff of proper
coughing technique (covering
mouth when coughing) and
respiratory hygiene; and
 Coordinating efforts between local or
state health departments and high-
risk health-care

36. Environmental control
 The second level of the hierarchy is
the use of environmental controls to
prevent the spread and reduce the
concentration of infectious droplet
nuclei. This includes two types of
environmental control.

37.  Primary environmental controls
consist of controlling the source of
infection by using local exhaust
ventilation and diluting and
removing contaminated air by using
general ventilation.

38.  Secondary environmental controls
consist of controlling the airflow to
prevent contamination of air in areas
adjacent to the source airborne
infection isolation (AII) rooms; and
 Cleaning the air by using high
efficiency particulate air (HEPA)
filtration, or ultraviolet germicidal
irradiation.

39. Respiratory protective
equipment
 The third level of the hierarchy is
the use of respiratory-protection
control.
 It consists of the use of personal
protective equipment in situations
that of high risk of exposure to TB
disease.

40.  Use of respiratory protection
equipment can further reduce risk
for exposure of health care
personnel to infectious droplet nuclei
that have been expelled into the air
from a patient with infectious TB
disease.

41. The following measures can be taken to
reduce the risk for exposure:
 Implementing a respiratory protection
program;
 Training health care personnel on
respiratory protection; and
 Educating patients on respiratory
hygiene and the importance of cough
procedures.

42. communication vehicles
 Communication vehicles – both mass media
and interpersonal communication - being
adopted by the Government of India for
effective TB control.
 “Bollywood endorsements featuring
Amitabh Bachchan have attempted to
address the challenge quite effectively
 Government’s Swachh Bharat Mission has
also contributed in fighting many such
diseases”.

43.  India’s revised strategy on National
Tuberculosis Control Programme and
its target to make the country TB-free
by 2025.
 “India is a signatory to UN Sustainable
Development Goals, making the world
TB-free by 2030; India targets to
achieve this by 2025.”

44. Conclusion:
“Achievement of this goal will be
possible only if we adopt a
comprehensive approach to ending
TB,”

45. Thank you