pulmonary tuberculosis. tuberculosis tuberculosis ranks as the third leading cause of disease and...
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PulmonaryPulmonary
TuberculosisTuberculosis
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Tuberculosis• Tuberculosis ranks as the third leading cause of
disease and disability among adults in the world, and nearly one-third of the world's population is infected with the tuberculosis bacillus.
• Of these cases, more than 9 million people become sick with TB when their immune system is weakened and 1.76 million die each year.
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Symptoms
• coughing, • tiredness, • loss of appetite • and weight loss.• http://www.youtube.com/watch?v=05pbSjkfIyE
• later fever and coughing up blood may occur..
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Causes
• Caused by one of two species of rod-shaped bacteria;
• Mycobacterium tuberculosis or Mycobacterium bovis.
• Estimated that up to 30% of the world’s population has one of these bacteria in their body.
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Tuberculosis bacterium (dyed red) in sputum
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Transmission• Spread through droplets released by coughs,
sneezes, laughing or even talking.
• M. tuberculosis is very resistant and can survive for several weeks once the droplets have dried.
• TB can be spread from cows to humans as M.bovis infects cattle and can be passed on in milk.
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Who is most “at risk” ?
• Those living or working together for longer periods, especially in over crowded and poorly ventilated rooms.
• Those working or living in long term care facilities like hospitals, prisons and old people’s homes.
• Those from countries where TB is common.• Those with reduced immune systems.
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Course of InfectionFirst…..
• 1. The bacteria grow and divide within the upper region of the lungs where there is plenty of oxygen.
• 2. The body’s immune system responds and white blood cells accumulate at the infection site to ingest the bacteria.
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Then……..
• 3. This leads to inflammation and enlargement of lymph notes that drain the lungs – primary infection (usually in children).
• 4. In a healthy person there are few symptoms and recovery occurs within a few weeks.
• But some bacteria usually remain………
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Years later…..• 5. Many years later these bacteria re-emerge to cause a
second TB infection. This is post-primary tuberculosis and occurs usually in adults.
• 6. This also occurs in the upper lungs but this time destroys lung tissue, lung cavities and scar tissue.
• 7. It is difficult to control and the sufferer coughs up blood and lung tissue. It can then spread to the rest of the body and becomes fatal.
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X–ray showing TB damage
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Case Study: China• In China, tuberculosis is the leading cause of death
from infectious disease among adults.
• Every year, 1.4 million people develop active TB.
• In 1990, 360,000 people in China died from the disease.
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Intervention programme• In 1991, China revitalized its ineffective tuberculosis program.
• The program adopted the WHO-recommended TB control strategy, DOTS, through which trained health workers watched patients take their treatment at local TB county dispensaries.
• Why do you think this was done?
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Impact• China achieved a 95 percent cure rate for new cases within
two years of adopting DOTS.
• The number of people with TB declined by over 37 percent in project areas between 1990 and 2000, and 30,000 TB deaths have been prevented each year.
• More than 1.5 million patients have been treated, leading to the elimination of 836,000 cases of pulmonary TB.
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Cost and cost effectiveness• The program cost $130 million in total. The World Bank and
the WHO estimated that successful treatment was achieved at less than $100 per person.
• One healthy life was saved for an estimated $15 to $20.
• The World Bank ranks DOTS as one of the most cost-effective of all health interventions.