air born communicablediseas for nursing

1. Air born Diseases
(Disease transmitted by inhalation)
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2. Introduction
• Air-borne diseases are diseases transmitted
through dissemination of microbial agent by air
to a suitable portal of entry, usually the
respiratory tract.
• The organisms causing the diseases in the air-
borne group enter the body via the respiratory
tract.
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3. Introduction...
• When a patient or carrier of pathogens talks,
coughs, laughs, or sneezes, he/she discharges
fluid droplet nuclei.
• The smallest of these remain up in the air for
sometime and may be inhaled by a new host.
• Droplets with a size of 1-5 microns are quite
easily drawn in to the lungs and retained there.
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4. Introduction...
• Droplets that are bigger in size will not
remain air-borne for long but will fall to the
ground.
• Here however, they dry and mix with dust.
• When they contain pathogens that are able
to survive drying, these may become air-
borne again by wind or something stirring up
the dust, and they can then be inhaled.
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5. Introduction...
• Air-borne diseases, obviously, will spread
more easily when there is overcrowding, as
in over crowded class rooms, Public
transport, canteens, dance halls, and
cinemas.
• Good ventilation can do much to
counteract the effects of overcrowding.
• Air borne diseases are mostly acquired
through the respiratory tract.
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6. common airborne diseases
1.Common cold (Acute Viral Rhinitis or coryza)
Definition: an acute catarrhal infection of the
nasal mucus membrane.
Infections agent:
• Rhino viruses (100 serotypes) are the major
causes in adults.
• Para influenza viruses,
• Respiratory syncytial viruses (RSV),
• Influenza, and adenoviruses are additional
causes of common cold.
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7. Common cold...
EPI: it occurs world wide both in endemic and
epidemic forms.
• Many people averagely have one to six colds
per year.
• Greater incidence in the highlands.
• Incidence is high in children under 5 years
and gradually declines with increasing age.
Reservoir: Humans
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8. Common cold...
• Mode of transmission: inhalation of air-
borne droplets; and articles freshly soiled
(contaminated) by discharges of nose and
throat of an infected person.
• I/P: usually 48 hrs, varying with the agent
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9. Common cold...
POC: 24 hrs before on set and for 5 days
after onset
S&R:
• Susceptibility is universal.
• Repeated infections (attacks) are most
likely due to multiplicity of agents.
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10. Common cold...
Clinical features: -
• Coryza ( nasal congestion)
• Sneezing,
• lacrimation,
• pharyngeal or nasal irritation,
• chills and malaise.
• Dry or painful throat
Diagnosis: Based on clinical grounds
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11. Common cold...
• Treatment: No effective Rx but supportive
measures like:
1. Bed rest
2. Steam inhalation
3. High fluid in take
4. Anti pain
5. Balanced diet intake
6. Nasal Decongesant
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12. Common cold...
Prevention & control
1. Educate the public about the importance of
hand washing, covering the mouth when
coughing and sneezing,
2. Sanitary disposal of nasal and oral
discharges.
3. Avoid crowding in living and sleeping
quarters esp. in institution.
4. Provide adequate ventilation
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13. 2. Influenza
Definition: An acute viral disease of the
respiratory tract (especially trachea).
Infections agent: Three types of influenza virus (A,
B & C)
EPI: Occurs in pandemics, epidemics and localized
outbreaks
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14. Influenza...
• Reservoir: Humans are the primary reservoirs
for human infection
• Mode of transmission: Air-borne spread
predominates among crowded populations in
closed places such as school buses
• I/P: short, usually 1-3 days.
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15. Influenza...
• POC: 3-5 days from clinical onset in adults; up
to 7 days in young children
• S/R: when a new subtype appears, all children
and adults are equally susceptible.
• Infection produces immunity to the specific
infecting agent.
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16. Influenza...
Clinical picture:
• Fever
• headache,
• myalgia, prostration
• sore throat and cough.
• Cough is often severe and protracted, but
• other manifestations are self limited & last
long with recovery in 2-7 days
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17. Influenza...
Diagnosis: based on clinical ground
Treatment: same as common cold, namely
• Antipain and antipyretic
• High fluid intake
• Bed rest
• Balanced diet
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18. Influenza...
Prevention:
1. Educate the public in basic personal hygiene, esp. the
danger of unprotected coughs and sneezes and
hand to mucus membrane transmission
2. Immunization (with available killed virus vaccines for
(A & B types) may provide 70-80 % protection)
3. Amantadine hydrochloride is effective in the chemo
prophylaxis of type A virus but not others.
• It is used both for Rx (4-5days) and
• prophylaxis (as long as epidemics lasts) 100mg PO
BID
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19. 3. Measles (Rubella)
• Definition: An acute highly communicable viral
disease.
• Etiology: measles virus
• EPI: Prior to wide spread immunization, measles
was common in child hood so that more than 90%
of people had been infected up to age 20; few
went through life without any attack.
• The maximum incidence is b/n 6 months and 5
years.
• Reservoir: Humans
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20. Measles...
Mode of transmission:
• Airborne droplets released when an infected
person sneezes or coughs
• Contact with nose and throat secretions of
infected people
• Cases can infect others for several days before
and after they develop symptoms
• Spreads easily in over crowded areas (schools,
military barracks, health facilities etc)
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21. Measles...
• I/P: 7-18 days from exposure to onset of fever
• POC: slightly before the s/s appear to four days
after the appearance of the rash.
• S and R: All those who are non-vaccinated or
have not had the disease are susceptible.
• Permanent immunity is acquired after natural
infection or immunization.
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22. Measles manifestation
• Have 3 phase
1. Catarrhal phase
• Coryza
• Persiostant and progressive Cogh
2. Paroxysmal phase
• Fever
• Headache
• Conjunctivitis
• Photophobia
• Maculopapular rash after 3 to 5 days
• Koplik's spots (bluish-grey lesions on buccal mucosa, opposite second
molars) often precede rash
• Encephalitis or viral pneumonia occasionally encountered.
3. Convalescence Phase
- persist with in 2-3 week and gradually subside and stablize
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23. DIAGNOSIS
• Clinical manifestations
(All suspect cases should be confirmed by laboratory)
• Laboratory findings: (naso pharyax mucosa secretions)
• Culture
– Antibody titer
– WBC is relative low
• WHO Case definition for surveillance
– Any person with fever, and maculopapular (i.e. non-
vesicular) rash, and cough, coryza (i.e. runny nose) or
conjunctivitis (i.e. red eyes). or
– Any person in whom a clinician suspects measles
infection
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24. Measles...
Treatment
• No specific Rx
• General nutritional support and Rx of
Dehydration
• Antibiotics are given only to ear and severe
respiratory infection
• Vitamin A two doses in 24 hours.
• Rx of complication
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25. Vitamin A doses
• 50,000 IU for infants younger than 6 months
of age
• 100,000 IU for infants 6–11 months of age
• 200,000 IU for children 12 months of age and
older
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26. Measles...
Nursing care
• Advise pt to have bed rest
• Relief of fever
• Provision of non- irritant small frequent diet
• Shorten the finger nails
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27. Measles...
• Complications are due to:
1. Bacterial infection
2. Measles virus which damages respiration and
intestinal tracts
3. Vitamin A deficiency.
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28. COMPLICATIONS
• Pneumonia
• Diarrhea
• Malnutrition
• Myocarditis
• Otitis
• Encephalitis
• Laryngitis/croup
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29. Prevention and Control
• Public education
• Control source of infection (isolation)
• Interruption of transmissions
• Protection of the susceptible person:
– Active immunization (Lived attenuated measles vaccine)
• Routine
• Campaign
• Supplementary
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30. Pertusis (whooping cough)
• An acute bacterial infection of the upper respiratory
tract caused by bordetella pertusis
• Disease is highly communicable (highly infectious)
• Occurs every where as endemic disease
• Common among younger's than adult
• Significantly reduced with DPT vaccine
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31. Pertusis (whooping cough)
• Reservoir- Human being is only reservoir
• Incubation period: 7-10 days (range of 5-21 days)
• Mode of transmission: air born (droplet spread) or
direct contact
• Period of communicability: early catarrhal stage to
3 weeks.
• Susceptibility: non immunized individuals
• Resistance- One attack usually confers prolonged
immunity but may not be lifelong.
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32. Pertusis clinical manifestation
• Catarrhal phase (1-2 weeks )
– Cough and rhinorrhea
– catarrhal state may be indistinguishable from a viral upper
respiratory tract infection
• Paroxysmal phase
– Explosive, repetitive and prolonged cough
– Child usually vomits at the end of paroxysm
– There may be mild fever
– Epistaxis and sub conjunctival haemorrhage often noted
• Convalescent phase
– The cough may diminish slowly or may last long
– ƒ
After improvement the disease may recur.
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33. Pertusis diagnosis
• Clinical background
– Paroxysmal phase is the most differentiating one
• Culture & direct fluorescence (nasopharynx)
• Serology
– Nucleic acid amplification test (Not available but
effective and sensitive test
– Detection of IgG and IgA can confirms clinical
back ground
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34. Pertusis treatment
• Most of the time antibiotics have little effect on the
clinical course of disease but can reduce the risk of
transmission
• Erythromycin 500 mg QID X 10d.
• Alternatives:
– Azithromycin,
– Clarithromycin
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35. Pertusis Complications
– Pneumonia
– Seizures
– Encephalopathy
– Hospitalization
– Death
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36. Prevention and Control
• Public education
• Early management of cases
• Chemoprophylaxis of erythromycin if contact Hx
• Immunization
– Combined with Diphtheria and tetanus toxoids
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37. MENINGITIS
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38. Anatomy
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39. Providing care for a child with MENINGITIS
Definition : Meningitis is defined as inflammation of the
membranes that surround the brain and spinal cord.
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40. Etiology
There are a number of causative organisms include:
bacteria, viruses, fungi and parasites.
Bacteria.
• Infants aged 0 -2months old: most common
organisms are Escherichia coli ,group B strep.and
Listeria monocytogenes
• Children 2 months -12 years: most common
organisms are Haemophilus influenzae type b,
Streptococcus pneumoniae and Neisseria
meningitides
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41. Etiology…
• In children over 12yrs of age;- Neisseria meningitides
and Streptococcus pneumonia.
Viruses
• many agents, including mumps and enteroviruses.
• Viral meningitis is usually much less serious than the
bacterial form.
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42. Types of meningitis
1. Bacterial meningitis: bacterial infection.
2. Viral meningitis: caused by viruses (enterovirus)
3. Tuberculosis meningitis: Tuberculosis infection due to M.
tuberculosis.
4.Cryptococcal meningitis: Infection from a yeast called
Cryptococcus. Often associated with AIDS.
5. Neoplastic meningitis: spread of solid tumors to the brain
or spinal cord.
6. Syphilitic meningitis: due to infection with the bacterium
that causes syphilis.
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43. Risk factors
• Major risk factor -lack of immunity to specific
pathogens associated with young age.
• Additional risk factors –
• Recent colonization with pathogenic bacteria
• Close contact with patient having invasive
disease by N. meningitides & HIB
• Crowded living conditions
• Poverty
• Lack of breast feeding for infants.
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44. • Mode of transmission- The mode of transmission is
probably person to person contact through respiratory
tract secretions or droplets.
 Route of infection
 Via the blood stream is the most frequent
 Traumatic breakage of the anatomic barriers
 Direct spread from infections in the contagious tissue
like ear, sinuses , mastoiditis.
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45. Clinical features
• Regardless of etiology, most patients with CNS
infection have similar clinical manifestations.
• dependent on the age of the child.
Infants and young children:
• Usually exhibit non specific symptoms like
hyperthermia or hypothermia, poor feeding,
irritability, nausea and vomiting, and seizures.
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46. Infants and young children…
• signs and symptoms of increased ICP in
infants Such as
Headache
 Emesis
Bulging fontanel or widening of sutures
cranial nerve palsy
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47. Older children exhibit
• Nausea and vomiting
• Irritability, confusion
• Anorexia
• Headache, back pain, nuchal rigidity
• Photophobia
signs of meningeal irritation.
a. Kernig sign: Flexion of the leg 90° at hip and Pain on
extension of leg.
b. Brudzinski sign: involuntary flexion of legs when neck
is flexed
c. Late signs: seizures and behavioral changes
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48. • The Kernig sign is +ve
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49. • BRUDZINSKI SIGN is +ve
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50. Diagnosis
Suggestive.
• Clinical picture: see signs and symptoms.
• Positive bacterial throat and nose cultures: the
bacteria often enter the body via the respiratory
tract.
• Positive bacterial blood cultures: bacteria may
enter the CNS via the vascular system.
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51. Definitive diagnosis is made by lumbar puncture(LP).
• LP - A thin needle is inserted between L3/L4 or L4/L5 to
withdraw a sample of CSF.
• It will help to distinguish between the different type of
meningitis.
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52. lumbar puncture..
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53. CSF ANALYSIS
If bacterial meningitis, CSF findings:
• Cloudy fluid.
• WBC count: more than 100 cells/mm3 (normal is < 5).
• Glucose: Below 45 mg/dL (normal is 50 to 80 mg/dL).
• Increased protein ( >150 mg/dL)
• CSF pressure: Above 15 mm Hg (normal is 8 to 15 mm
Hg).usually 200-300 mm Hg
• Positive bacterial culture.
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54. CSF ANALYSIS…
If viral meningitis, CSF findings.
• Clear fluid.
• WBC count: normal.
• Glucose: normal.
• Protein: normal but may be slightly elevated
• Elevated CSF pressure. Usually 90-200
• Culture negative.
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55. Nursing Alert
Contraindications to a Lumbar Puncture:
• Increased intracranial pressure
• Infection on the lumbar space
• Severely ill infant if the lumbar puncture will
further compromise the respiratory status.
• Immunocompromised state
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56. Complications of meningitis
Acute :
Increased ICP
Hydrocephalus
Hypoglycemia
Brain damage
Severe diarrhea and vomiting
Internal bleeding
Low blood pressure
Shock
Death
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57. Late compications:
• Developmental delay
• Cerebral palsy
• Microcephaly
• Hemiparesis
• Hearing loss
• Blindness
• Seizure disorder
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58. Management/Treatment
• Suspected bacterial meningitis is a medical emergency,
and immediate diagnostic steps must be taken to
establish the specific cause so that appropriate
antimicrobial therapy can be initiated.
• Initiate antibiotic therapy once diagnosis is confirmed
by clinical findings while awaiting specific CSF and
blood culture results.
• Treat all suspected patient intravenously
• The choice of antibiotics depends on the probability of
the causative organism in that age group, and the
antibiotics susceptibility of the organism.
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59. Empiric treatment
• Ceftriaxone 50-100 mg/kg/day IV every12 hr.
• Vancomycin 60 mg/kg/day IV every 6 hr.
• Dexamethasone, 0.6mg/kg/day divided QID for four
days in cases of suspected H. influenza meningitis
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60. Therapy for specific pathogens
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61. Therapy for specific pathogens….
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62. Supportive care
• Restrict fluid intake to one half to two thirds
of calculated maintenance
• Monitor urine output and daily weight
• Support feeding
• Monitor vital signs and neurologic assessment
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63. Nursing Management
• Before entering the room, the nurse caring for the
child with bacterial meningitis must don appropriate
protective attire, which includes a gown, gloves, and
mask.
• The nurse should check vital signs frequently.
• A neurological evaluation should be performed.
• The infant’s fontanel must be frequently palpated
for bulging (common in meningitis) or depression (a
result of dehydration), and head circumference
measured daily as rapid enlargement may be
secondary to the development of hydrocephalus.
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64. Nursing Management….
• Antibiotics should be administered as prescribed.
• Comfort measures include keeping the environment
quiet and dark (the child may have photophobia) and
allowing the child to assume a comfortable position.
• Pain should be managed using acetaminophen or a
nonsteroidal anti-inflammatory preparation.
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65. Prevention
• Vaccination
• Antibiotic prophylaxis
 N.meningitidis- rifampin 10mg/kg/dose every 12 hr.
for 2 days for all close contacts of patients with
meningococcal meningitis.
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66. TUBERCULOSIS
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67. Introduction
67
Tuberculosis (TB) is an infectious disease that primarily
affects the lung parenchyma.
It also may be transmitted to other parts of the body,
including the meninges, kidneys, bones, and lymph
nodes
TB is caused by myco bacterium tuberculosis ,a rod-
shaped ‘acid fast’ bacillus.
Occasionally ,the disease can also be caused by
mycobacterium bovis and africanum.
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68. Introduction…
• Properly treated, tuberculosis caused by drug-susceptible
strains is curable in virtually all cases.
• Untreated, the disease may be fatal within 5 years in 50–
65% of cases.
• Transmission: airborne spread of droplet nuclei produced
by patients with infectious pulmonary tuberculosis.
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69. Routes of transmission
.
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1) By inhalation of infected droplet nuclei. This is most
common MOT.
3000 droplet nuclei can be produced during a single
cough.
Droplet nuclei are so small that they pass the defenses
of the bronchi and
multiplication and infection begin in to the terminal
alveoli of the lungs.
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70. Routes of transmission…
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2) Consumption of raw milk containing M .bovine.
It is much less frequent
The risk of infection is high with close,
prolonged, indoor, exposure to a person with
sputum smear-positive pulmonary TB.
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71. Risk Factors
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Household contact with a newly diagnosed smear
positive case
Age less than 5 years and elders
Immunosuppressive therapy
HIV infection ,Malnutrition ,Over crowding
 Poor living condition
Alcohol abuse & drug use
Co morbid condition(DM, Chronic Renal Failure, Ca).
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72. Clinical signs and symptoms
Since the predominate site of TB is the lung, commonest
symptoms are:
– Cough with or with out sputum production ,
– Chest pain, hemoptysis and mild dyspnea .
 Systemic complaints such as fever, night sweats,
anorexia, and decreased activity.
Some infants and young children with bronchial
obstruction have localized wheezing or decreased breath
sounds that may be accompanied by tachypnea or, rarely,
respiratory distress.
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73. Signs and symptoms
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Symptom of EPTB
Bone TB; localized pain ,swelling , muscle weakness,
paralyzing and stiffness of joint .
Intestinal; loss appetite ,weight, abdominal pain, diarrhea
and ascites.
TB meningitis; headache , fever, neck stiffness ,and
vomiting.
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74. Classification of TB
1. Anatomical site of disease
2. Bacteriological results (including drug resistance)
3. History of previous treatment
4. HIV status of the patient
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75. Classification of TB
1. Anatomical site of TB disease
In general recommended Rx regiments are similar,
irrespective of site.
It is important for recording a reporting purposes.
A. pulmonary tuberculosis(PTB)
Refer to a case of TB involving the lung parenchyma.
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76. Classification of TB…
B. Extra pulmonary tuberculosis(EPTB)
 Refer to a case of TB involving organ other than lung
such as:
lymph nodes, pleura, GUT, bones and joints,
meninges, peritoneum, and pericardium.
Virtually all organ systems may be affected.
EPTB is seen more commonly in HIV-infected patient
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77. Classification of TB…
2. Bacteriological classification
refer to the smear status of pulmonary case and the
identification of MTB by culture or newer methods.
A. smear PTB+
A pt with at least two initial sputum smear +ve for AFB
By direct microscope or
 A pt with one initial smear examination +ve for AFB By
direct microscope and culture +ve or
 A pt with at one initial smear examination +ve for AFB
by direct microscope and radiographic abnormalities
consistent with active TB as determined by a clinician.
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78. Definition of TB case classification
B. Smear- Negative PTB/PTB-ve/
A pt having symptom suggestive of TB with at least 3
initial smear examination-ve for AFB by direct
microscope.
and
1. No response to a course of broad spectrum antibiotic
and
2. Again three smear examination–ve by direct microscope
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79. Definition of TB case classification …
and
3. Radiological abnormality consistent with pulmonary TB.
and
4. Decision by clinician to treat with a full course of anti
TB.
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80. Definition of TB case classification …
3. Hx of previous Rx pt registration group
• It is important to identify previously treated pt . B/c they
are high risk for drug resistance including MDR-TB
New patient: A who never had Rx or have taken anti TB
for less than 1 month. [New case (N)]
 Previously Treated patient: A patient who have received
1 month or more of anti TB drug in the past& may have
+ve or –ve bacterlogical and may be any diseases at an
anatomical site .
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81. Definition of TB case classification/
Registration group
Relapse(R): Rx completed but who report back is now
found to be AFB +ve
Rx after failure(F): pt while on Rx is smear +ve at end of
5 month.
Return after default (D): a pt record as default from Rx
and return with smear +ve.
Transfer in (T): pt transfer into continue Rx after staring
Rx in to another Rx unit for at least 4 week.
Other (O):Smear –ve PTB who retunes after default ,EPTB
return after default. 81
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82. Diagnosis of Tuberculosis
• The key to the diagnosis of tuberculosis is a high index of
suspicion.
• Diagnosis is not difficult with a high-risk patient e.g., a
Homeless, alcoholic who presents with typical
symptoms and
A classic chest radiograph showing upper-lobe
infiltrates with cavities .
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83. Diagnostic Method
A. bacteriological method
1.Direct light smear microscope/
Conventional microscope.
2. fluorescent microscope
- sensitivity by 10%.
3. culture
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84. Diagnostic Method…
B. Molecular test for TB Dx
1. Line probe Assay (LPA): show Rifampicin & INH drug
sensitivity & used for smear +ve only to check presence
or absence of a specific mutation.
2. Gene Xpert MTB/RIF :Shows Refampicin resistance
only.
C. Histo-pathological examination
D. Radiological examination
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85. Standard TB Case Definition
85
Tuberculosis suspect
cough of 2weeks or more duration with SOB, chest
pain, hemoptysis & constitutional symptoms is TB
suspect.
Case of tuberculosis
A definite case of TB or one a health worker has
diagnosed TB and has decided to Rx with a full course
of TB Rx .
A definite/proven case of tuberculosis
A pt with two sputum smears +ve (one sputum +ve is
enough for HIV +ve pt )or culture +ve for
mycobacterium tuberculosis .
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86. Treatment of TB
The aim of TB treatment
To cure the TB patient and restore QOL and productivity.
To prevent death from active TB or its late effects.
To Prevent relapse of TB.
To prevent the development and transmission of drug
resistance.
To decrease TB transmission to others.
Rapidly and substantially reduces the number of actively
multiplying bacteria.
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87. Drugs-used For The Chemotherapy of TB
The drugs used for the TB treatment are safe and effective if
properly used:
First line drugs for the treatment of TB in Ethiopia include:
Rifampicin (R)
Ethambutol (E)
Isoniazid (H)
Pyrazinamide (Z)
Streptomycin(S)
87
BY.NIGATU A
Mar-24

88. Drugs-used For The Chemotherapy of TB
The fixed dose combination(FDC) drugs available for
adult and adolescent:
RHZE 150/75/400/275mg
RHZ 150/75/400mg
RH 150/75mg
EH 400/150mg
88
BY.NIGATU A
Mar-24

89. Chemotherapy of TB
TB drugs available as loose form:
Ethambutol 400mg
Isoniazid 300mg
Streptomycin sulphate vials 1 gm
NB: streptomycin is administered by injection and the other
anti TB drugs are to be taken orally
 All drugs should be taken together as a single ,daily dose,
preferably on an empty stomach.
89
BY.NIGATU A
Mar-24

90. Phases of chemotherapy
.
90
1. Intensive phase:
 This phase consists of combination of four drugs for
the first 8 weeks for new cases.
 with combination of five drugs for the first 8 weeks
followed by four drugs for the next four weeks for re-
treatment cases.
BY.NIGATU A
Mar-24

91. Phases of chemotherapy …
91
2.Continuation phase
 This phase immediately follows the intensive phase
and is important to ensure cure or completion of
treatment.
 Necessary to avoid relapse after completion of
treatment.
 Requires treatment with a combination of two drugs, to
be taken for 4 months for new cases and treatment with
a combination of three drugs for retreatment cases
for 5 months.
BY.NIGATU A
Mar-24

92. TB patient categories and how to select the
correct treatment regimen
92
Before putting patients on anti TB drugs
Determine the type of TB:PTB+,PTB- and EPTB
Determine previous treatment history: new patient,
previously treated
Select based on the three standard treatment regimen
i. New patient regimen
ii. Previously treated patient regimen
iii. MDR-TB regimen BY.NIGATU A
Mar-24

93. • New TB patients will be treated with
2RHZE/4RH.
• Previously treated TB cases will be re-treated
with 2S(RHZE)/1(RHZE)/5(RH)E .
BY.NIGATU A 93
Mar-24

94. Anti TB Drugs Dosage of New TB cases
94
Patient’s Weight in
Kgs
Treatment regimen and dose
Intensive phase
2RHZE
Continuation phase
4RH
20-29 1½ 1½
30-39 2 2
40-54 3 3
≥55 4 4
BY.NIGATU A
Mar-24

95. Anti TB Drugs dosage for previously treated cases
95
Patients'
weights in
kgs
Treatment regimen and dose
Intensive phase
2SRHZE/1RHZE
Continuation phase
5(RH)E
s* RHZE RH E
20-29 ½(0.5g) 1½ 1½ 1½
30-39 ½(0.5g) 2 2 1½
40-54 ¾(0.75g) 3 3 2
≥55 1g 4 4 3
BY.NIGATU A
Mar-24

96. Pediatrics FDC dosing regimens for New cases
Weight
(kg)
Intensive phase(2months) Continuation phase
(4months)
RHZ
(60,30,150)
RHZE
(150,75,40
0,275)
E
(100)
RH
(150,75)
RH
(60,30)
RH
(60,60)
5 -7 1 1 1 1
8-14 2 2 2 1
15-20 3 3 3 2
21-30* 2 2 2
96
BY.NIGATU A
Mar-24

97. FDC dosing regimen for retreatment cases
Wt
(kg)
Intensive
phase(3months)
Continuation phase (5months)
RHZ
(60,30,1
50)
RHZE
(150,75,400,
275)
E
(100
)
RH
(60,30
)
RH
(150,75)
RH
(60,60
)
E
(100)
E
(400
)
5 -7 1 1 1 1 1
8-14 2 2 2 1 2
15-20 3 3 3 2 3
21-
30*
2 2 2 1
97
BY.NIGATU A
Mar-24

98. Prevention
• Immunization of infants with BCG
• Educate the public about the modes of disease
transmission and methods of control
• - Improved standard of living
• - Adequate nutrition
• - Healthy housing, ventilation and sunlight
exposure (windows open and
• transparent)
• - Environmental sanitation
• - Personal hygiene & Active case finding and Rx.
• Isolation of PTB +ve case = decreases infectivity
BY.NIGATU A 98
Mar-24

99. 99
BY.NIGATU A
Thank u
Mar-24