Explore the intricate world of Tuberculosis with this comprehensive PowerPoint presentation. Uncover its origins, transmission, symptoms, diagnosis, treatment, and preventive measures. Engage your audience with informative visuals and charts, shedding light on the global impact of TB. Equip your audience with knowledge to raise awareness and foster a proactive approach towards combating this infectious disease.

1. Seminar on
Tuberculosis(TB)
PRESENTED BY:
ELANGOVAN. R,
I YEAR M. SC. ZOOLOGY,
KANCHI MAMUNIVAR GOVERNMENT
INSTITUTE FOR POST GRADUATE
STUDIES AND RESEARCH,
PUDUCHERRY.

2. Objectives
• INTRODUCTION
• HISTORY
• ETIOLOGY
• PATHOGENESIS
• SYMPTOMS
• DIAGNOSIS
• TREATMENT
• PREVENTION
• CONCLUSION

3. INTRODUCTION
• TUBERCULOSIS(TB) is an airborne
infectious disease caused by bacteria
whose scientific name is Mycobacterium
tuberculosis was first isolated in 1882 by a
German physician named Robert Koch who
received the Nobel prize for this discovery.

4. HISTORY OF TUBERCULOSIS
 TB in humans can be traced back to 9,000 years ago in Atlit Yam, a
city now under the Mediterranean Sea.
 Mummies from ancient Egypt, dating back over 2,600 years, have
provided evidence of TB. These findings suggest that TB had an
impact on the health of ancient Egyptians.
 The “Ebers Papyrus,” an Egyptian medical document from around
1550 BC, described symptoms consistent with tuberculosis.
 The earliest written mentions of TB were in India (3,300 years ago)
and China (2,300 years ago).

5.  Tuberculosis (TB) was called “phthisis” in ancient Greece,
“tabes” in ancient Rome, and “schachepheth” in ancient Hebrew.
 1600-1800s in Europe, TB caused 25% of all deaths.
 In the 1700s, TB was called “the white plague” due to the paleness of the
patients.
 TB was commonly called “consumption” in the 1800s.
 Johann Schonlein coined the term “tuberculosis” in the 1834.
 On March 24, 1882, Dr. Robert Koch announced the discovery of
Mycobacterium tuberculosis, the bacteria that causes tuberculosis (TB).
 In 1889, Dr. Hermann Biggs convinced to report TB cases in health
department, leading to the first published report on TB in 1893.
 WHO declared TB a global emergency in the 1990s.

6. Etiology of Mycobacterium tuberculosis
 TB is caused by M
tuberculosis, a slow-growing
obligate aerobe and a facultative
intracellular parasite.
 M. tuberculosis, are aerobic,
non–spore-forming, non-motile
and measuring about 0.2-0.5 μm
by 2-4 μm. Their cell walls
contain mycolic acid.

7. Transmission and Pathogenesis
 M. Tuberculosis is carried in
airborne particles, called
droplet nuclei, of 1–
5microns in diameter.
Infectious droplet nuclei are
generated when persons
who have pulmonary or
laryngeal TB disease cough,
sneeze, shout, or sing.

8. Pathogenesis
1. Droplet nuclei containing tubercle bacilli are inhaled, enter the lungs, and
travel to the alveoli then multiply.
2. A small number of tubercle bacilli enter the bloodstream and spread
throughout the body.
3. Within 2 to 8 weeks, special immune cells called macrophages ingest and
surround the tubercle bacilli. The cells form a barrier shell, called a
granuloma, that keeps the bacilli contained and under control (LTBI).
4. If the immune system cannot keep the tubercle bacilli under control, the bacilli
begin to multiply rapidly. This process can occur in different areas in the body.

9. Latent TB and Active TB
Latent TB
 Persons with LTBI have M.
Tuberculosis in their bodies,
but do not have TB disease
and cannot spread the infection
to other people.
Active TB
 Persons who have TB disease
may spread the bacteria to
other people.

10. Sites of TB Disease
Pulmonary
 TB disease most commonly affects the lungs; this is referred to as pulmonary
TB. Patients with pulmonary TB usually have a cough and may be infectious.
Although the majority of TB cases are pulmonary TB.
Extra pulmonary
 Extra pulmonary TB disease occurs in places other than the lungs, including
larynx, lymph nodes, pleura, brain, kidneys, or bones and joints.
Miliary TB
 Miliary TB occurs when tubercle bacilli, where they grow and cause disease in
multiple sites. This condition is rare but serious. It is most common in infants and
children younger than 5 years of age.

11. Drug-Resistant TB (MDR and XDR)
 Drug-resistant TB is caused by M. tuberculosis organisms that are resistant to
the drugs normally used to treat the disease.
Multidrug-Resistant TB
 Multidrug-resistant TB (MDR TB) is caused by organisms resistant to the most
effective anti-TB drugs, isoniazid and rifampin.
Extensively Drug-Resistant TB
 Extensively drug-resistant TB (XDR TB) is a relatively rare type of drug-
resistant TB. XDR TB is resistant to isoniazid and rifampin, plus any
fluoroquinolone and at least one of three injectable second-line drugs.

12. Symptoms
Pulmonary TB symptoms:
 Weight loss/anorexia
 Fever
 Cough
 Night sweats
 Hemoptysis
 Chest pain
 Fatigue.

13. Extra Pulmonary TB symptoms:
• TB of the kidney may cause
blood in the urine.
• TB meningitis may cause
headache or confusion.
• TB of the spine may cause back
pain
• TB of the larynx can cause
hoarseness
• Loss of appetite
• Unexplained weight loss
• Night sweats
• Fever
• Fatigue

14. Diagnosis of tuberculosis
1. Medical history
2. Physical examination
3. Test for M. tuberculosis
infection
4. Chest radiograph
5. Bacteriologic examination
of clinical specimens.

15. Medical History
 Clinicians should determine if the patient has underlying
medical conditions, especially HIV infection and diabetes,
that increase the risk for progression to TB disease in
those latently infected with M. tuberculosis.
 Both pulmonary and extra pulmonary TB disease
symptoms can be caused by other diseases; however, they
should prompt the clinician to consider TB disease.

16. Physical Examination
 A physical examination is an essential
part of the evaluation of any patient. It
cannot be used to confirm or rule out
TB disease, but it can provide
valuable information about the
patient’s overall condition, inform the
method of diagnosis, and reveal other
factors that may affect TB disease
treatment, if diagnosed.

17. Test for M. Tuberculosis infection
Currently, there are two methods available for the detection of M. Tuberculosis
infection.
 Mantoux tuberculin skin test (TST)
 Interferon-gamma release assays (IGRAs)*
» QuantiFERON-TB Gold In-Tube test (QFT-GIT)
» T-SPOT®.TB test
However, a negative reaction to any of the tests does NOT exclude the diagnosis
of TB disease or LTBI.

18. Chest Radiograph
 Abnormalities seen on chest
radiographs may be suggestive of,
but are never diagnostic of, TB
disease. Chest radiographs may be
used to exclude pulmonary TB
disease in a person with a normal
immune system who has a positive
TST reaction or IGRA and who has
no symptoms or signs of TB
disease.

19. Bacteriologic Examination of Clinical
Specimens
The bacteriologic examination has five
parts:
 Specimen collection, processing, and review
 AFB smear classification and results
 Direct detection of M. tuberculosis in clinical
specimen using nucleic acid amplification
(NAA)
 Specimen culturing and identification
 Drug-susceptibility testing

20. Specimen Collection, Processing, and
Review
Specimen Collection Methods for Pulmonary TB Disease
 Coughing
 Induced sputum
 Bronchoscopy
 Gastric aspiration
Specimen Collection Methods for Extra pulmonary TB
TB disease can occur in almost any anatomical site; thus, a variety of
clinical specimens other than sputum (e.g., urine, cerebrospinal fluid,
pleural fluid, pus, or biopsy specimens) may be submitted for examination
when extra pulmonary TB disease is suspected.

21. AFB Smear Classification and Results
 Detection of acid-fast bacilli in
stained and acid-washed
smears examined
microscopically may provide
the first bacteriologic evidence
of the presence of
mycobacteria in a clinical
specimen.

22. Direct Detection of M. Tuberculosis in
Clinical Specimen
Nucleic Acid Amplification (NAA)
 NAA tests are used to amplify DNA and
RNA segments to rapidly identify the
microorganisms in a specimen.
 Culture remains the gold standard for
laboratory confirmation of TB disease,
and growing bacteria are required to
perform drug-susceptibility testing and
genotyping.

23. Specimen Culture and Identification
 Positive cultures for M.
tuberculosis confirm the
diagnosis of TB disease;
however, in the absence of
a positive culture, TB
disease may also be
diagnosed on the basis of
clinical signs and
symptoms alone.

24. Drug-Susceptibility Testing
 For all patients, the initial M.
tuberculosis isolate should be
tested for resistance to the first-line
anti-TB drugs, Then the patients
should be tested for resistance to
the second-line anti-TB drugs.
 To find whether the patients is
MDR-TB or XDR-TB.

25. Treatment For Tuberculosis
LTBI Treatment Regimens.
For persons who are at especially high risk for TB disease and are either suspected of
nonadherence or are given an intermittent dosing regimen, directly observed therapy (DOT) for
LTBI should be considered.
Intermittent dosing regimen
 Isoniazid (INH) Dosage
 Isoniazid (INH) and Rifapentine (RPT) Regimen
 Rifampin (RIF) Regimen
Directly observed therapy (DOT)
Drug-resistant TB disease should always be treated with a daily regimen and under direct
observation. There are no intermittent regimens for treatment of multidrug-resistant (MDR) TB.

26. TB Disease Treatment Regimens
First-line drugs
 Isoniazid (INH)
 Rifampin (RIF)
 Pyrazinamide (PZA)
 Ethambutol (EMB)
 Rifabutin* (RBT)
 Rifapentine (RPT)
Second-line drugs
 Streptomycin (SM)
 Cycloserine
 Capreomycin
 ρ-Aminosalicylic acid
 Levofloxacin*
 Moxifloxacin*
 Gatifloxacin*
 Amikacin/Kanamycin*
 Ethionamide

27. Prevention of tuberculosis
 Vaccination: The Bacillus Calmette-Guérin (BCG) vaccine can be given to protect against
severe forms of TB, particularly in children. However, it is not always effective in preventing
all forms of TB.
 Infection Control: TB is primarily spread through the air when an infected person coughs or
sneezes. To prevent its spread, infected individuals should be isolated and treated promptly.
Good ventilation in indoor spaces and the use of masks can help reduce transmission.
 Screening and Testing: Regular testing and early detection of TB cases are essential for
preventing its spread. High-risk individuals, such as those with HIV or close contacts of TB
patients, should be screened.
 Treatment: TB can be cured with antibiotics, but it's crucial that the full course of antibiotics is
completed to prevent drug-resistant TB. Directly Observed Therapy (DOT) is often used to
ensure patients take their medications as prescribed.
 Contact Tracing: Identifying and testing people who have been in close contact with TB
patients can help catch and treat new cases early.

28. Cont...
 Health Education: Public health campaigns and education can help raise awareness about
TB, its symptoms, and how to prevent it.
 Good Hygiene and Nutrition: Maintaining a healthy lifestyle, including good nutrition, can help
boost the immune system, making it easier to resist TB infection.
 Treatment of Latent TB Infection: People with latent TB infection, where the bacteria are
dormant and not causing symptoms, can be treated to prevent them from developing active
TB in the future.
 Reducing Risk Factors: Managing other health conditions like HIV, diabetes, and smoking can
reduce the risk of developing active TB.
 Preventive Therapy: High-risk individuals, such as those with HIV, may be prescribed
preventive therapy to reduce the risk of developing active TB.

30. Conclusion
tuberculosis (TB) is a persistent global
health issue, with approximately 10 million
new cases reported annually. Although
progress has been made, TB remains a
significant cause of illness and death
worldwide. Efforts to combat TB through
improved diagnosis, treatment, and
prevention strategies are ongoing, but
there is still much work to be done to reach
the goal of eradicating this disease.

32. Thank you !