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

1. Tuberculosis (TB)
public health prospective
Surya Narayan chaudhary
lecture
public health department
koshi health and science campus Biratnagar
MPH , MA (Sociology and anthropology )
1SNC

2. Tuberculosis (TB)
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)
2SNC

3. Types
1 Human : Mycobacterium tuberculosis
 Pulmonary TB
 Extra pulmonary TB
2 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
3SNC

4. Pulmonary tuberculosis
Pulmonary
tuberculosis (TB)
is a contagious
bacterial infection
that involves the
lungs.
4SNC

5. common extrapulmonary TB
1. Lymph node TB
2. TB of the bone and
the joint
3. TB of the central
nervous system
5SNC

6. Mode of disease transmission
Airborne: TB is spread
from person to person
through the air. When
people with lung TB
cough, sneeze or spit, they
propel the TB germs into
the air. A person needs to
inhale only a few of these
germs to become infected.
6SNC

7. Tuberculosis Symptoms and signs
1. Prolonged cough
2. Chest pain
3. Fatigue
4. Coughing up blood
5. Feeling tired all the
time
6. Night sweats
7. Chills
8. Fever
9. Loss of appetite
10.Weight loss
7SNC

8. 8SNC

9. Epidemiology
• A total of 1.5 million people died from TB in 2018 (including 251
000 people with HIV). Worldwide.
• TB is one of the top 10 causes of death and the leading cause from a
single infectious agent (above HIV/AIDS).
• In 2018, an estimated 10 million people fell ill with
tuberculosis(TB) worldwide. 5.7 million men, 3.2 million women
and 1.1 million children. There were cases in all countries and age
groups.
• In 2018, 1.1 million children fell ill with TB globally, and there were
205 000 child deaths due to TB.
• In 2018, the 30 high TB burden countries accounted for 87% of new
TB cases. Eight countries account for two thirds of the total, with
India leading the count, followed by, China, Indonesia, the
Philippines, Pakistan, Nigeria, Bangladesh and South Africa.
9SNC

10. • Globally, TB incidence is falling at about 2%
per year. This needs to accelerate to a 4–5%
annual decline to reach the 2020 milestones of
the End TB Strategy.
• An estimated 58 million lives were saved
through TB diagnosis and treatment between
2000 and 2018.
• Ending the TB epidemic by 2030 is among the
health targets of the Sustainable Development
Goals.
10SNC

11. Who is most at risk
Tuberculosis mostly affects adults in their most
productive years. However, all age groups are at risk.
Over 95% of cases and death are in developing country .
.
1. People who are infected with HIV
2. Low immune system.
3. People with under nutrition are 3 times more at risk.
4. Alcohol user
5. Tobacco smoking increase the risk of TB disease
11SNC

12. History of World TB Day
On March 24, 1882, Dr. Robert
Koch announced the discovery
of Mycobacterium tuberculosis, the
bacteria that causes tuberculosis
(TB). During this time, TB killed
one out of every seven people
living in the United States and
Europe.
A century later, March 24 was
designated World TB Day: a day to
educate the public about the impact
of TB around the world.
it is a valuable opportunity to
educate the public and how it can
be stopped. 12SNC

13. What is in a name?
Johann Schonlein coined the term
“tuberculosis” in the 1834.
Tuberculosis (TB) was called
“phthisis” in ancient Greece,
“tabes” in ancient Rome, and
“schachepheth” in ancient Hebrew.
In the 1700s, TB was called “the
white plague” due to the paleness of
the patients.
13SNC

14. How is TB diagnosed?
• tuberculin skin test (TST)
• or a blood test called an interferon gamma
release assay (IGRA).
• The TB skin test is also called a Mantoux test
• chest x-ray.
• sputum test
14SNC

15. World Tuberculosis Day 2020
Slogans : It's time to End TB!
15SNC

16. In Nepal
• Tuberculosis (TB) is a public health problem in
Nepal that affects thousands of people each year
and is one of the leading cause of death in the
country.
• WHO estimates that around 45,000 people
develop active TB every year in Nepal. Nearly
fifty percentage of them are estimated to have
infectious pulmonary disease and can spread the
disease to others.
16SNC

17. Vision, goal, objectives of the National
TB Programme
• Vision: TB Free Nepal
• Goal
• To reduce the TB incidence by 20% by the year
2021 compared to 2015 and increase case
notifications by a cumulative total of 20,000
from July 2016 to July 2021, compared to the
year 2015.
17SNC

18. Objective
• 1:Increase case notification through improved
health facility-based diagnosis; increase
diagnosis among children
2: Maintain the treatment success rate at 90% of
patients (all forms of TB) through to 2021.
4: Further expand case finding by engaging
providers.
18SNC

19. 5:Strengthen community systems for
management, advocacy, support and rights.
6: Contribute to health system strengthening
through HR management and capacity.
7: Develop a comprehensive TB Surveillance,
Monitoring, and Evaluation system.
• 8: To develop a plan for continuation of NTP
services in the event of natural disaster or public
health emergency
19SNC

20. The End TB Strategy
• VISION: A world free of TB
Zero deaths, disease and suffering due to TB
• GOAL: End the Global TB Epidemic
• MILESTONES FOR 2025:
1. 75% reduction in TB deaths (compared with 2015)
2. 50% reduction in TB incidence rate (less than 55 TB
cases per 100,000 population)
3. No affected families facing catastrophic costs due to TB
• TARGETS FOR 2035:
1. 95% reduction in TB deaths (compared with 2015)
2. 90% reduction in TB incidence rate (less than 10 TB
cases per 100,000 population)
20SNC

21. 21SNC

22. Province wise TB treatment out come
2074/75
22SNC

23. National vaccination coverage by
vaccine FY 2074/75
23SNC

24. National Routine Immunization Administrative Coverage (%),
Nepal, FY 2072/73 to 2074/75
24SNC

25. Preventive measures
 BCG Vaccine
 Personal hygiene
 Environment sanitation
 Mask
 Regular medical followup
 Isolation of Patient
 Ventilation
 Natural sunlight
 UV germicidal irradiation
 Promote for breast feeding
 Case Finding
25SNC

26. Cont
 Always cover your mouth with a tissue when
you cough or sneeze. Seal the tissue in a plastic bag,
then throw it away.
 Wash your hands after coughing or sneezing.
 Don’t visit other people and don’t invite them to visit
you.
 Stay home from work, school, or other public places.
 Use a fan or open windows to move around fresh air.
 Don’t use public transportation.
26SNC

27. 27SNC

28. BCG vaccine
Bacille Calmette Guerin (BCG).
First used in 1921.
Only vaccine available today for protection against tuberculosis.
It is most effective in protecting children from the disease.
Given 0.1 ml intradermally.
Duration of Protection 15to 20years
Efficacy 0 to 80%.
Should be given to all healthy infants as soon as possible after birth
unless the child presented with symptomatic HIV infection.
28SNC

29. REFERENCE
1 Annual report . government of Nepal ministry of heath and
population . Department of heath service 2074-2075
2 World heath organization . Accessed April 21, 2020
3 Central for disease control and prevention Accessed April
21 , 2020
4 Am J Respir. American Thoracic Society . 2017
5 Dr Nikhil oza , BVDUMC PPT presentation
29SNC

30. 30SNC