Connecting the dots with science: Latent TB, active TB disease, and integrated health and development responses

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"The scientific evidence to link latent TB, active TB disease, and multi sectoral response towards ending latent TB and TB" presentation is of senior researcher, epidemiologist, and public health expert Dr Artawan Eka Putra, made at the National Media Workshop on "Reporting using #OneHealth approach on health and development issues" hosted by CNS (Citizen News Service), Asia Pacific Media Alliance for Health and Development (APCAT Media), Asia Pacific Cities Alliance for Health and Development (APCAT), and partners in Bali, Indonesia. For more details, check out www.citizen-news.org or email editor@citizen-news.org Thanks CNS team

Science

The Scientific Link Between TB
(latent TB and active TB disease)
IWG Artawan Eka Putra
gedeartawan@unud.ac.id

TB in Indonesia (based on global TB report 2022)
969.000 new cases
per year

Tuberculosis Natural History and The Risk Factors
Agent concentration
Closeness
Contact duration
Environment factors
(ventilation, density,
UV, humidity)
Behavior (mobility)
Characteristic (age, sex, occupation
Immune system status
Comorbidity
(HIV, DM, immunocompromised)
Undernourish
Behavior (Smoking, alcohol c)
Characteristic (age, sex, occupation
Immune system status
Comorbidity
(HIV, DM, immunocompromised)
Undernourish
Behavior (Smoking, alcohol c)
Diagnosis and treatment delay
Treatment adherence
Under treatment
Behavior (Smoking, alcohol c)
Treatment adherence
Under treatment
Behavior (Smoking, alcohol c)
DR TB

Spectrum of tuberculosis infection and disease

The Concept of Prevention
• Risk Factors Elimination
• TOSS TBC
• Temukan (Case findings)
• Obati sampai sembuh (Adequate treatment)

Challenges
• Reaching high-risk populations
• Treatment adherence
• Stigma and discrimination of people with TB
“We cannot effectively fight TB without reaching all the people who
need to hear messages about TB prevention, symptoms, and treatment
and action them.”

www.slideshare.ne www.slideshare.ne Tuberculosis (TB) is fatal contagious disease that affects the lungs and other part of body which is a public health problem but curable and preventable disease . Caused organism : bacteria (Mycobacterium tuberculosis Human : Mycobacterium tuberculosis Pulmonary TB Extra pulmonary TB Animals : Mycobacterium Bovis Bovine tuberculosis (TB) is a chronic disease of animals caused by a bacteria called Mycobacterium bovis, (M.bovis) which is closely related to the bacteria that cause human

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Interest in the epidemiology of TB was triggered by the re-emergence of tuberculosis in the early 1990’s with the advent of HIV and falling economic status of many people which subjected them to poverty. The dual lethal combination of HIV and poverty triggered an unprecedented TB epidemic. In this study, we focused on the period 2000-2013 and all the notified data in Kenya was included. Data on estimates of TB incidence, prevalence and mortality was extracted from the WHO global Tuberculosis database. Data was analysed to produce trends for each of the years and descriptive statistics were calculated. The results showed that there was an average decline of 5% over the last 8 years with the highest decline being reported in the year 2012/13. TB continues to disproportionately affect the male gender with 58% being male and 42% being female. Kenya has made significant efforts to address the burden of HIV among TB patients with cotrimoxazole preventive therapy (CPT) uptake reaching 98% AND ART at 74% by the end of 2013. Kenya’s TB epidemic has evolved over time and it has been characterised by a period where there was increase in the TB cases reaching a peak in the year 2007 after which there was a decline which began to accelerate in the year 2011. The gains in the decline of TB could be attributed in part to the outcomes of integrating TB and HIV services and these gains should be sustained. What is equally notable is the clear epidemiologic shift in age indicating reduced transmission in the younger age groups.

One Health is an initiative that looks at how people, animals and the environment interact, and the health impacts that each has on the others. Researcher Dr. Baljit Singh provides a deeper insight into how One Health could improve our understanding of complex problems such as food safety, water safety, infection and disease transmission through a cross-disciplinary approach. Co-presenter Dr. Susan Cork looks at three different case studies on vector borne diseases in Canada to illustrate the need to take a One Health approach in the face of climate change and other factors affecting in how diseases are distributed. To watch the webinar recording, go to http://www.ucalgary.ca/explore/interconnections-between-human-animal-and-environmental-health

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Incidence of Tuberculosis in HIV Sero-positive Patients at HIV Clinic at Kampala International University Teaching Hospital, Bushenyi District Okello, Andrew School of Allied Health Sciences Kampala International University-Western Campus ________________________________________ ABSTRACT This study on the prevalence of TB among HIV sero-positive was carried at the HIV CLINIC of Kampala International University Teaching Hospital (KIUTH), Ishaka Bushenyi district. A retrospective cross-sectional study design was used to conduct this research. The study targeted all patients attending KIUTH HIV/TB clinic. A standard structured and semi-structured questionnaires were designed and pre-tested for validity and reliability at Kampala International University Teaching Hospital HIV/Tuberculosis clinic before being used for data collection. Data collection started by recruitment of qualified research assistants, appropriate training and orientation of the interviewers before the survey for example when reading the questions. Quantitative methods of data analysis was used in which data was presented in form of bar charts, graphs and tables. The prevalence of TB among HIV sero-positive patients attending HIV clinic at KIUTH stands at 8.06 per 100 participants. The study found that generally, people are aware about the modes of transmission of TB but there is still need for more awareness. Many patients are still not certain whether TB is curable in HIV patients. As seen from the above study, most of the people are not yet aware whether HIV goes hand in hand with tuberculosis. The prevalence of TB in HIV sero-positive attending HIV clinic at KIUTH is high. Generally, TB is affecting patients of all ages and most patients are still not aware if TB in HIV is curable. Most patients have a perception that all TB patients have HIV. Health workers in HIV clinic of KIU-TH should teach patients the modes of transmission and prevention of TB. KIUTH also need to provide easy access to TB screening services to patients. There is need for financial support by the government to the unemployed patients and low-income earners in order to curb TB infections. Keywords: Tuberculosis, HIV, Sero-positive, Bushenyi District ________________________________________

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Chapter 4 Communicable and Noncommunicable Diseases: Prevention and Control of Diseases and Health Conditions Chapter Objectives (1 of 2) After studying this chapter, you will be able to: Explain the differences between communicable (infectious) and noncommunicable (noninfectious) diseases and between acute and chronic diseases and provide examples of each. Describe and explain communicable and multicausation disease models. Explain how communicable diseases are transmitted in a community using the “chain of infection” model and use a specific communicable disease to illustrate your explanation. Explain why noncommunicable diseases are a community and public health concern and provide some examples of important noncommunicable diseases. Explain the difference between primary, secondary, and tertiary prevention of disease and provide examples of each. Chapter Objectives (2 of 2) List and explain the various criteria that communities might use to prioritize their health problems in preparation for the allocation of prevention and control resources. List and discuss important measures for preventing and controlling the spread of communicable diseases in a community. List and discuss approaches to noncommunicable disease control in the community. Define and explain the purpose and importance of health screenings. Outline a chronic, noncommunicable disease control program that includes primary, secondary, and tertiary disease prevention components. Introduction Diseases and other health conditions are classified in several meaningful ways Classification can lead to prevention and control strategies Classification of Diseases and Health Problems In community health, diseases are usually classified as: Acute or chronic (<3 or >3 months) Communicable or noncommunicable Communicable versus Noncommunicable Diseases Communicable (infectious) diseases – those diseases for which biological agents or their products are the cause and that are transmissible from one individual to another Noncommunicable (noninfectious) diseases – those illnesses that cannot be transmitted from one person to another Identifying cause is difficult because many factors can contribute Acute versus Chronic Diseases and Illnesses Diseases classified by duration of symptoms Acute – diseases in which peak severity of symptoms occurs and subsides within 3 months Can be communicable or noncommunicable Chronic – diseases or conditions in which symptoms continue longer than 3 months Can be communicable or noncommunicable Communicable Diseases Infectivity: ability of a biological agent to enter and grow in the host Agent: cause of disease or health problem Host: susceptible person or organism invaded by an infectious agent Environment: factors that inhibit or promote disease transmission Pathogenicity: capability of a communicable agent to cause disease in a susceptible host Biological Agents of Disease Communicable Disease Model Chain of Infectio.

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