TUBERCULOSIS

Tuberculosis (TB) is an infectious disease caused by a Bacterium, Mycobacterium

tuberculosis. It is spread through the air by a person suffering from TB.. It makes someone
cough, get weak and become thinner and thinner for a long time. It is contagious (passes from
person to person easily.) It usually attacks the lungs, but may also affect any other organ of the
body.

Among infectious diseases, tuberculosis is the single most common killer of adults in the world
today.

Causative agent:- Bacterium Mycobacterium

 TB bacilli was first discovered by Robert Koch in 1882.

 It is also known as Gohn’s lesion or Koch’s disease.

Incidence:-

India has more cases of tuberculosis than any other country in the world and twice as
many cases as China, which has the next highest number ,Prevalence Rate is 1.6/1000. In India
per day 1000 people die/day 40% of the Indian population is infected with the TB bacillus. Every
day, more than 20,000 people become infected with the TB bacillus and about 5000 develop the
disease. Every year 18 lakh (or 1.8 million) people inIndia develop TB, of which nearly 8 lakh
(0.8 million) are infectious (sputum+). Untreated pulmonary TB cases spread infection to others
in the community—each infectious patient can infect 10-15 persons in a year unless effectively
treated.5 lack death /year.
China
15%
India
30%

Indonesia
10%

Bangladesh
4%
Russia
1%
South Africa
Other
2%
coutries
Phillippines Pakistan Nigeria 28%
3% 4% 3%
TB: A Global Emergency

 5 lack people die from TB /Year

 Annual incidence of new cases of all forms of Tb word wide is approx 8 million (95% in
Developing countries)

 Number of do not completed their treatment 16-20 million.(sputom +)

 8-10 million are highly infectious (sputum +)

 2 billion people infected

 1 person infected/second resulting in >30 million new infections, 8 million new cases

 Left untreated 1/3 die, 1/3 self-cure, 1/3 remain infectious

 TB kills 1 person every 10 seconds = 8000/day = 2- 5 million each year

Pathogenesis

Someone can get lung tuberculosis if he breathes in the germs which another person who has the
disease has coughed out into the air. It happens this way: When the sick person coughs out, he
releases into the air thousands of germs which can cause the disease. ii. People around him then
breathe in the air with the germs. iii. Those of them whose bodies cannot fight off and kill the
germs then get the disease when the germs grow in them.

Sign and symptoms of TB

 Fever
 Night sweating
 Weight loss
 Anorexia
 Cough more than two weeks
 Chest pain
 Weakness
 Fatigue
 Restlessness
 Breathing difficulty

Diagnosis

 Physical assessment

 Sputum culture
  Mass miniature radiograph

 Tuberculin Test

 Chest x-ray

 Montoux Test

 Haef Test

 Tine multiple puncture test

Management

- Provide antipyretic drug

- Bronchodilator
- Dots therapy ( Streptomycin, Rifampicine, Pyrazinamid, Salbutamol)

2H3R3Z3E3 (24 doses) + 4H3R3 (54 doses)

Prevention of TB

I. People who have tuberculosis must be treated promptly. Curing them is the best way of
preventing the disease from spreading. This eliminates the source of infection.
II. Give BCG vaccination to all babies at birth or soon after birth, and to other children
before tuberculosis strikes them.
III. As soon as any person shows signs of having tuberculosis, report to the medical workers
so he can be examined and treated. (This is in the interest of both the sick person and the
 people he lives and works with. If he receives treatment, he will be cured; and a few
weeks after he starts receiving treatment, he can no more pass the disease to others.)
IV. Treatment should be fully supervised by a health care provider.
V. At least during the first 2 months of treatment, patients should receive their daily
medication under the supervision of a health care provider.
VI. During the next 4 - 6 months, they must visit the health centre every month to receive a
supply of drugs.
VII. Cover your mouth when coughing and nose when sneezing to prevent the spread of the
germs which causes the disease.
VIII. Don't spit on the ground.
IX. Avoid sleeping in overcrowded rooms.
X. Observe the rules of hygiene.
XI. Prophylactic vaccine against Tuberculosis –BCG