Epidemiology of tuberculosis... 98754328
- 2. INTRODUCTION 🞇 Tuberculosis (TB) - Infectious bacterial disease caused by Mycobacterium tuberculosis - most commonly affects the lungs. 🞇 Transmitted from person to person via droplets from the throat & lungs of people with the active respiratory disease. 3 9/12/2015
- 3. BURDEN GLOBALLY: 🞇 In 2013, mortality of TB including HIV was 16 per lakh cases 🞇 Mortality of TB excluding HIV was 5 per lakh cases 🞇 Prevalence of TB was 159 per lakh 🞇 Incidence of TB was 80 per lakh 8 9/12/2015
- 4. INDIA 🞇 India is the highest TB burden country in the world & accounts for nearly 1/5th (20 per cent) of global burden of tuberculosis, 2/3rd of cases in SEAR. 🞇 Every year approximately 1.8 million persons develop tuberculosis, of which about 0.8 million are new smear positive highly'- infectious cases. 🞇 Annual risk of becoming infected with TB is 1.5 % and once infected there is 10 % life-time risk of developing TB disease 9/12/2015 9
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- 7. AGENT FA1 4 CTORS 9/12/2015 Agent Mycobacterium tuberculosis - facultative intracellular parasite, ingested by phagocytes & resistant to intracellular killing Source of infection Human - human case positive for tubercle bacilli& who has either received no treatment or has not been fully treated Bovine - infected milk Communicability Patients are infective as long as they remain untreated
- 9. HOST FACTO 15 RS 1. AGE: Affects all ages. In India, 0-14 age group – 2%, 15-24 age group - 20% 2. SEX: More prevalent in males 3. HEREDITY: Tuberculosis is not a hereditary disease, but through studies found that inherited susceptibility is an important risk factor. 4. NUTRITION: Malnutrition – predisposes to TB 5. Immunity: Man has no inherited immunity againstTB 9/12/2015
- 10. SOCIAL FACTORS 🞇 TB is a social disease with medical aspects, also known as barometer of social welfare 🞇 Social factors include poor quality of life, poor housing, overcrowding, population explosion, undernutrition, lack of education, large families, & lack of awareness of causes of illness 🞇 All these factors are interrelated & contribute to the occurrence & spread of TB 9/12/2015 16
- 11. MODE OF TRANSMIS1 S 7 ION 9/12/2015 🞇 Transmitted mainly by droplet infection and droplet nuclei – by sputum-positive patients with pulmonary TB 🞇 Coughing generates the largest number of droplets of all sizes 🞇 Frequency & vigour of cough & the ventilation of the enviroment influence transmission of infection
- 13. INCUBATION PERIOD Time from receipt of infection to the development of a positive tuberculin test ranges from 3 to 6 weeks. Development of disease depends upon the closeness of contact, extent of disease & sputum positivity of the source. Incubation period may be weeks, months or years RESERVOIR: Human case is the chief reservoir.
- 14. TYPES OF T1 B 9 1. Pulmonary : In active cases – most commonly involves the lungs (90% cases) Symptoms – Chest pain & a prolonged cough producing sputum About 25% of people - asymptomatic 2. Extra pulmonary : In 15–20% of active cases, the infection spreads outside the lungs, causing other kinds of TB More commonly in immunosuppressed persons and young children 9/12/2015
- 15. Common sites are Meninges Lymph nodes Bones & joints Intestine Genitourinary tract 20 9/12/2015
- 16. 21 9/12/2015 A potentially more serious, widespread form of TB - "disseminated" TB - commonly known as Miliary Tuberculosis. Miliary TB -10% of extrapulmonary cases
- 17. CLINICAL FEA 26 TURES •Coughing that lasts two or more weeks •Coughing up blood •Chest pain, or pain with breathing or coughing •Unexplained weight loss •Fatigue •Fever •Night sweats •Chills •Loss of appetite 9/12/2015
- 33. PREVENTION & CONTROL OF TUBERCULOSIS 9/12/2015 37
- 34. PREVENTION & 3 8 CONTRO 9 L /12/2015 Primary prevention- 1. health education & specific protection. 2. Population strategy & high risk strategy Secondary prevention- early diagnosis & specific treatment Tertiary prevention- rehabilitation & disability limitation
- 35. BCG-VACCINE 🞇 The first human was vaccinated by the intradermal technique in 1927 🞇 BCG is the only widely used live bacterial vaccine. It consists of living bacteria derived from an attenuated bovine strain of tubercle bacilli 🞇 The WHO has recommended the "Danish 1331" strain for the production of BCG vaccine 🞇 Since January 1967, the BCG Laboratory at Guindy, Chennai, has been using the "Danish 1331" strain for the production of BCG vaccine 9/12/2015 40
- 36. CONT.. 🞇 There are two types of BCG vaccine - the liquid (fresh) vaccine and the freeze dried vaccine. 🞇 For vaccination. the usual strength is 0.1 mg 0.1 ml volume. The dose to newborn aged below 4 weeks is 0.05 ml. 9/12/2015 41
- 38. RNTCP Need for a Revised Strategy. India has had an on-going National TB Program, NTP since 1962. Program reviews showed that only 30% of estimated tuberculosis patients were diagnosed & treated successfully. Based on the findings & recommendations of the review in 1992, the GOI evolved a revised strategy and launched the Revised National TB Control Programme (RNTCP)in the country. 42 9/12/2015
- 39. COMPONENTS OF RNTCP 1. The directly observed treatment short-course (DOTS) strategy. 2. 'Stop TB Partnership ‘. both are implemented as a comprehensive package for TB control. 9/12/2015 43
- 49. SUMMARY 🞇 Despite all these national programmes & efforts from govt. of India , TB still continues to be a major socio- economic burden of the country 🞇 Still there is need to create awareness among health care professionals, and the community. 49 9/12/2015
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