2. Tuberculosis
• It primarily affects the lungs causing
pulmonary tuberculosis.
• It also affects bones, intestine, lymph glands
,skin and other tissues.
• It also affects animals, known as bovine
tuberculosis.
3. Problem statement.
• It is one of the most dangerous public health problem
discovered 100 years ago.
• Before the advent of HIV it was controlled and brought
to zero level by effective multiple drug regimens and
BCG vaccines.
• 1982 saw the resurgence of TB ,75% of this was HIV
related.
• 1/3rd of current global population has asymptomatic
TB. About 10% of this develop clinical disease.
• Most new cases and deaths occur in developing
countries.
4. Problem
• An infectious pulmonary TB case can infect about
10 people in a year.
• 2008 9,4 million cases were recorded.
• 2010,1.4m died which includes 350,000 Tb cases
with HIV co infection.
• It is the three most important cause of death
among women.(320,000).About 9.7m children
were orphaned.
• Through DOTS 85% of TB has been successfully
treated and 68 million lives have been
saved,everting 6m deaths.
5. MDR –TB.
• Defination; Multiple drug resistantstrain as
one that is at least resistant to isoliazid and
rephampicin with or without resistant to any
other anti TB drugs.
• 2010 650,000 MDR cases where recorded
which increased the TB treatment by another
46,000 of these 150,000 die every year
6. Problem continued
• Children and mothers belonging to low social
economic background between 15-49yrs
suffer from disseminated TB and Meningitis
– Carry out test of mother, if positive, treat then
BCG
• Failure of routine diagnosis results in
increased number of tuberculosis among
children born to sero-positive mothers
7. TB Definition
• A case of TB sputum positive
• AFB sputum ZNS smear
• Smear positive at least 1
• Smear negative – 2 negatives and X-ray positive
• Adherence
• New cases a new positive case never had TB treatment
• Relapse – return with TB having previously treated
• Failure case – initially smear negative is smear positive in 5
months.
• Default – returns after 2 months treatment with smear +ive
8. Natural History of TB
• Agent – M tuberculosis source of infection
• Human-sputum +ve
• Bovine = Milk infection
• Age – all ages sharp rise from childhood to
adolescents
• Source of infection both human and bovine
• Social factor- housing ,overcrowding, power
education, hetero sexuality
9. Natural History Continued
• Mode of transmission
1. Droplet infection
2. Coughing
3. Pt with extra pulmonary TB
4. Incubation period _ 3 to 6 weeks
10. TB Controlled Program
1. Case finding: tools including, x-ray and
sputum finding.
a. Target group
b. Case finding tools-sputum testing
1. Day 1 one the spot
2. Day 2 early morning 2 samples
Number of bacilli in the smear indicates
severity of the disease
