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ERADICATING TUBERCULOSIS
IS FEASIBLE
PRESENTED BY:
JERRY SELASE SIFA
OUTLINE
• TUBERCULOSIS
• Brief History
• Burden of TB
• Global Trend
• Determinants of Disease
TUBERCULOSIS
• Agent: Mycobacterium tuberculosis
• Reservoir: Human beings
• Mode of transmission: Airborne
• Often affects the lungs (P.TB)
• Signs: Fever, fatigue, long cough, chest
pains etc
BRIEF HISTORY OF TB
• Evolved and acquired about 15,000 years
• Once endemic in Europe
• First described by Hippocrates
• Rober Koch (1882) established the mode of transmission
Burden of TB
• Top 10 causes of death worldwide
• In 2016:
 10.4 million people fell ill with TB
1.7 million died from the disease
 About 1 million children became ill with TB, and 250 000 children
died of TB
40% of HIV deaths were due to TB
BURDEN OF TB
• India, Indonesia, China, Philippines, Pakistan, Nigeria, and South Africa
bears 64% of the burden
• About 53 million lives were saved through TB diagnosis and treatment
between 2000 and 2015
• Multidrug-resistant TB (MDR-TB) remains a threat to global health
• Ending the TB epidemic by 2030 is among the health targets of the newly
adopted Sustainable Development Goals
GLOBAL TREND
DETERMINANTS OF DISEASE ERADICABILITY
Known etiology and epidemiology
Vaccine & Other tools
Human reservoir only
Political will/commitment
KNOWN ETIOLOGY & EPIDEMIOLOGY
• Etiology
• Person, Place, Time
Inform interventions
(e.g Interrupt transmission)
Saves resources
TOOLS- VACCINE
Currently:
Bacillus Calmette-Guerin (BCG)
 For Children
 Up to 80% protection
18% -99% coverage @ 2016
Ghana=94% @2016
Way Forward:
≥98% protection
100% coverage
Adults vaccine
TOOLS- DIAGNOSTIC
Currently
Microscopy
• 1/3 cases are missed
Equipment for LTBI
Way Forward
Observer bias immune tool
• PCR
TOOLS-TREATMENT
Current and way forward
1st: Rifampicin, Isonianzid,
Pyrizinamide, Ethambutol
• DOTS is still long
• MDR-8 months to 2years is long
• Adverse effects
HUMAN RESEVOIR
• Presence of other reservoirs
create room for reemergence
POLITICAL & HEALTH WORKER COMMITMENT
$162 billion needed (2017-2035)
Currently:
$2 billion deficit every year
Apathy in accepting vaccine
Unreached Communities
Way Forward
Step Up: Education, Screening,
Case finding
THANK YOU

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Eradicating Tuberculosis is Feasible

  • 2. OUTLINE • TUBERCULOSIS • Brief History • Burden of TB • Global Trend • Determinants of Disease
  • 3. TUBERCULOSIS • Agent: Mycobacterium tuberculosis • Reservoir: Human beings • Mode of transmission: Airborne • Often affects the lungs (P.TB) • Signs: Fever, fatigue, long cough, chest pains etc
  • 4. BRIEF HISTORY OF TB • Evolved and acquired about 15,000 years • Once endemic in Europe • First described by Hippocrates • Rober Koch (1882) established the mode of transmission
  • 5. Burden of TB • Top 10 causes of death worldwide • In 2016:  10.4 million people fell ill with TB 1.7 million died from the disease  About 1 million children became ill with TB, and 250 000 children died of TB 40% of HIV deaths were due to TB
  • 6. BURDEN OF TB • India, Indonesia, China, Philippines, Pakistan, Nigeria, and South Africa bears 64% of the burden • About 53 million lives were saved through TB diagnosis and treatment between 2000 and 2015 • Multidrug-resistant TB (MDR-TB) remains a threat to global health • Ending the TB epidemic by 2030 is among the health targets of the newly adopted Sustainable Development Goals
  • 8. DETERMINANTS OF DISEASE ERADICABILITY Known etiology and epidemiology Vaccine & Other tools Human reservoir only Political will/commitment
  • 9. KNOWN ETIOLOGY & EPIDEMIOLOGY • Etiology • Person, Place, Time Inform interventions (e.g Interrupt transmission) Saves resources
  • 10. TOOLS- VACCINE Currently: Bacillus Calmette-Guerin (BCG)  For Children  Up to 80% protection 18% -99% coverage @ 2016 Ghana=94% @2016 Way Forward: ≥98% protection 100% coverage Adults vaccine
  • 11. TOOLS- DIAGNOSTIC Currently Microscopy • 1/3 cases are missed Equipment for LTBI Way Forward Observer bias immune tool • PCR
  • 12. TOOLS-TREATMENT Current and way forward 1st: Rifampicin, Isonianzid, Pyrizinamide, Ethambutol • DOTS is still long • MDR-8 months to 2years is long • Adverse effects
  • 13. HUMAN RESEVOIR • Presence of other reservoirs create room for reemergence
  • 14. POLITICAL & HEALTH WORKER COMMITMENT $162 billion needed (2017-2035) Currently: $2 billion deficit every year Apathy in accepting vaccine Unreached Communities Way Forward Step Up: Education, Screening, Case finding

Editor's Notes

  1. TB is a caused by Mycobacterium TB. Most affect that most often affect the lung.
  2. Currently TB programmes us Microscopy
  3. Recommendations improve adherence leading to no treatment default
  4. 8.3 billion needed every year