PPT on Tuberculosis

1. WORLD TB DAY
2019
DR. SHERIFF . M. A

2. WHY ARE WE STILL FIGHTING TUBERCULOSIS?
CALL TO ACTION FOR A TB FREE UAE
P R E PA R E D
B Y
D R . S H E R I F F M U I D E E N
( M B B S , M N I M , M P H , F R S P H )
C O M M U N I T Y / P U B L I C H E A LT H S P E C I A L I S T
R A K - P M D .

3. TUBERCULOSIS: OBSTACLES AND CHALLENGES, CALL TO ACTION

4. LEARNING OBJECTIVES
To discus the history of
Tuberculosis
To highlight the key issues why
we are still fighting Tuberculosis
Epidemiology of TB and at Risk
Individual’s
Identify the obstacles and
challenges of TB disease
Doing things Differently in fighting
TB: Who is going to do it?

5. INTRODUCTION
 Tuberculosis (TB) is one of the most
ancient diseases of mankind, with
molecular evidence going back to over
12,000 years.
 It’s a disease that has plagued
human since the Paleolithic era (Old
Stone age – 2.5 million to 10,000
years ago)

6. INTRODUCTION
 According to World Health
Organization (WHO), TB is a
worldwide pandemic. It is a leading
cause of death among HIV-infected
people.
 In spite of newer modalities for
diagnosis and treatment of TB,
unfortunately, people are still
suffering, and worldwide it is among
the top 10 killer infectious diseases,
second only to HIV.

7. .

8. TB HISTORY ….

9. TB HISTORY….
ONE DISEASE ………… MANY NAMES
 Consumption Disease
 Phthisis
 Pott’s Disease
 White Death/ White Plague
 King’s Evil
 The Robber of youths
 Graveyard Cough
These are all terms used to describe Tuberculosis
throughout history

10. TB HISTORY…
 Consumption Disease ..Because of the severe weight loss that is
associated with the disease and the way the infection appear to
“Consume the patient”
 Phthisis Pulmonalis … Phthisis (Φθισις) is a Greek word for
consumption, an old term for pulmonary tuberculosis coined by
Hipocrate around 460 BCE, Hippocrates described phthisis as a
disease of dry seasons.
 Pott’s Disease … is a form of tuberculosis that occurs outside the
lungs whereby disease is seen in the vertebrae. A kind of
tuberculous arthritis of the intervertebral joints. (Spinal TB).
 White Death (or White Plague)… Because of the extreme pallor
seen among those infected
Synonyms:Phthisis
, Phthisis Pulmonalis,
consumption

11. TB HISTORY….
Robber of the youths… Because it’s a fatal disease for
the young
King’s Evil …… In the 16th century, the illness was
known in England and France as "king's evil", and it
was widely believed that persons affected could heal
after a royal touch
Graveyard Cough… Because of its death related
chances.

12. OTHER NAMES OR NICKNAMES THAT ARE USED, OR USED TO BE USED, FOR
TUBERCULOSIS!
Consumption disease Lungers Rapid Consumption Emphysema Tisica
Miner’s consumption White Plague Rock on the chest Coughing Sickness One way trip to
Arizona
Phtisis Bowgalosha Silicosis Croup Decline
Slow Consumption Been dusted Rock in the lung Cattarrh of the head Tuberculosis
Hasty Consumption Graveyard Cough Spitting Cough Galloping Catarrh
Lingering
Consumption
Grippe Walking
Consumption
Galloping Fever
Lung Disease Inflamation of the
Lungs
Wasting away
disease
Galloping TB
Lung Trouble Miner’s Puff White Death The Con
Miner’s Con Quick Pneumonia Two Bugs in a locust Came West too late
The Bugs Rale The Hickey Consumption of the
Lung

13. TB HISTORY…
TUBERCULOSIS…..
The greatest killer of all time….
The Captain of all the men of
death (Death merchant)
Over the last 100 years, TB has
killed more than 100 million
people

14. TB HISTORY…
 One in 4 died of the disease in 1800,
and by the late 1890s, it was still one
in 7
 Until the early twentieth century, TB
was the greatest killer of all time
 Among the communicable diseases,
TB is the second leading cause of
death worldwide after HIV
 TB is one of the top 3 killer diseases
world wide along side HIV and Malaria

15. TB HISTORY….
Egyptian mummies, dating back to 2400 BC, reveal skeletal deformities typical of tuberculosis

16. TB HISTORY …..
460BC
Hippocrates identifies phtisis
(greek word meaning
"consumption") as the most
widespread disease of the
times and notes that is almost
always fatal

17. TB HISTORY…

18. TB HISTORY….

19. TB HISTORY….
Ibn Sina, was the first to write
that Pulmonary TB was a
contagious disease thereby
requiring a method called
quarantine to limit its spread

20. TB HISTORY…

21. TB HISTORY….

22. TB HISTORY….

23. TB HISTORY….

24. ISSUES IN FIGHTING TB.
 KEY ISSUES why we are still fighting TB
 Only 132 000 people with drug-resistant TB (DR-TB) diagnosed (out
of an estimated 580 000 new DR TB cases), and only 50% of those
that started the life-saving DR-TB regimens are cured.
(WHO Global TB Report 2016)
TB epidemiology is closely connected with social and economic
conditions which makes TB prevention, care and control even
more challenging.

25. TB AND ASSOCIATED SOCIAL ECONOMIC RISK FACTORS
HIV, PRISON, WOMEN, DIABETES, ALCOHOL, DRUG ABUSE,
AND SMOKING SSSMSMOKING

26. Epidemiology of TB ….
TB is a global disease….It’s found in all countries of the world
It affect all age groups…. but fatal in elderly and the young
It is found in all gender …. but about 2 times common in men
Roughly One-Quarter (2 Billion people ) of the world's population
has been infected with MTB.

27. EPIDEMIOLOGY….
 At every second somewhere, someone is being
infected with TB.
 It kills more than 3 million people annually
 In 2017, an estimated 10 million people fell ill
with tuberculosis(TB) worldwide. 5.8 million
men, 3.2 million women and 1.0 million children

28. EPIDEMIOLOGY….

29. EPIDEMIOLOGY….

30. EPIDEMIOLOGY…

31. EPIDEMIOLOGY….

32. EPIDEMIOLOGY

33. EPIDEMIOLOGY
In 2018, there were an estimated 8.5 million incidence cases of TB
globally
It’s equivalent to 125 cases in 100,000 population
Asian……………59%
Africa ………….. 26%
Eastern Mediterranean Region ……….. 7.7%
European Region …………. 4.3%
American Region ………….. 3%

34. EPIDEMIOLOGY….
Reactivation of LTBI … People who are infected with both
TB and HIV are 25 to 30 times more likely to develop
TB again than people only infected with T.B
Primary Infection …. New Tubercular infection in people
with HIV can progress to active disease very quickly
Recurring Infection… In people who were initially cured of
TB

36. AT RISK INDIVIDUAL FOR TB.

37. AT RISK INDIVIDUAL’S FOR TB

38. TB RISK FACTORS

39. OBSTACLES AND CHALLENGES IN FIGHTING TB
Financial Obstacles in Fighting TB.

40. WHY ARE WE STILL FIGHTING TB?
After centuries of deaths and decades of research,
why are we still fighting this deadly disease?

41. CHALLENGES & OBSTACLES
Challenges contd….
The public health challenge of TB has been managed by a
number of drugs and treatment strategies over the years, but
this challenge has always been much bigger in certain parts of
the world.
 One of the numerous reasons we are still fighting TB is due
to the spread of HIV infection which has been a major
factor in managing the TB challenge.

42. OBSTACLES AND CHALLENGES IN FIGHTING TB…
 The increasing resistance of MTB strains to the high efficacy first
line anti-TB drugs (WHO, 2009) which leads to the growing
incidences of drug resistant strains, multiple drug resistant
(MDR) and extensively drug resistant (XDR) is also a strong
factor we are still fighting TB today.

43. WHY WE ARE STILL FIGHTING TB TODAY.
Challenges to control TB in many parts of the world;
 poor primary health-care infrastructure in rural areas
 Unregulated private health care leading to widespread irrational use of
first-line and second-line anti-TB drugs
 Lack of political will
 corrupt administration.

44. Other factors that may contribute in disease progression include;
 poverty,
 population expansion,
 active transmission in overcrowded places (hospitals, prisons,
labor camp, and other public places),
 migration of individuals from high-incidence countries due to
wars or famine, drug abuse, social decay,

45. homelessness
 Technical problems like poor quality of detection
 Health status (old age, malnutrition, and medical
conditions that compromise the immune system)

46. CALL TO ACTION FOR TB FREE UAE

47. CALL TO ACTION FOR TB FREE UAE
o THE global battle to end tb will not be possible
without the proper involvement of its most
important stakeholder, the people and
communities affected by this disease
o Engagement of TB affected communities at
national, regional and global level remains
superficial and limited .

48. CALL TO ACTION FOR TB FREE UAE

49. CALL TO ACTION FOR TB FREE UAE

50. CALL TO ACTION FOR TB FREE UAE
CONTD.
Recent statistics showed that the UAE still holds the
lowest rank in terms of TB cases
- The country, in the year 2002, registered around 90
cases out of 168,7000 cases reported in the 22 countries
of the region, including the Arab Gulf Cooperation Council
(AGCC) countries.
- Saudi Arabia registered 3,374 TB cases during the same
year while Qatar recorded 278 cases, Bahrain 193 cases,
Kuwait 341cases, Oman 290 cases and Yemen 7,231
cases.

51. CALL TO ACTION FOR A TB FREE UAE
The incidence of TB in UAE had since been
dropping consecutively due largely to
concerted effort by the government to raise
awareness on the disease and its screening
as well as prompt diagnosis and treatment.

52. CALL TO ACTION FOR TB FREE UAE
Nationality
Distribution of TB cases by
Nationality
Emirati 6
Non Emirati 22
Total 28
21%
79%
Emarati
Non Emarati

53. CALL TO ACTION FOR TB FREE UAE.
We need to do things differently to achieve a UAE free
TB
There is need to intensify awareness, health
education and stigmatization of TB
Raise screening awareness, diagnosis and prompt
treatment where needed.

55. END…

56. END

57. REFERENCES
W h o , 2 0 0 9 . w h o n e w s r e l e a s e , 2 0 0 9
. o b s t a c l e s a n d c h a l l e n g e s a g a i n s t t b … ( f r i e d e n e t a l . , 2 0 0 3 ; h i l l e t a l . , 2 0 0 4 ;
m a t h e m a e t a l . , 2 0 0 8 )
( C o r b e t t e t a l . , 2 0 0 3 ; f r i e d e n e t a l . , 2 0 0 3 ; w e l l s e t a l . , 2 0 0 7 ; d o o l e y a n d
c h a i s s o n , 2 0 0 9 ) .
. W o r l d h e a l t h o r g a n i z a t i o n . g l o b a l t u b e r c u l o s i s r e p o r t 2 0 1 5 . a v a i l a b l e
f r o m : h t t p : / / a p p s . w h o . i n t / i r i s / b i t s t r e a m / 1 0 6 6 5 / 1 9 1 1 0 2 / 1 / 9 7 8 9 2 4 1 5 6 5 0 5 9 _ e n g . p d f ? u
a = 1 .
. W o r l d h e a l t h o r g a n i z a t i o n . r e s o l u t i o n w h a 6 7 / 1 1 : g l o b a l s t r a t e g y a n d t a r g e t s f o r
t u b e r c u l o s i s p r e v e n t i o n , c a r e a n d c o n t r o l a f t e r 2 0 1 5 . 2 0 1 4 . a v a i l a b l e
f r o m : h t t p : / / a p p s . w h o . i n t / g b / e b w h a / p d f _ f i l e s / w h a 6 7 / a 6 7 _ 1 1 - e n . p d f .
I . B a r b e r i s ( 2 0 1 7 ) . T h e h i s t o r y o f t u b e r c u l o s i s : f r o m t h e f i r s t h i s t o r i c a l r e c o r d s t o
t h e i s o l a t i o n o f k o c h ' s b a c i l l u s .
h t t p s : / / w w w . n c b i . n l m . n i h . g o v / p m c / a r t i c l e s / P M C 5 4 3 2 7 8 3 /