TUBERCULOSIS
lt is an air borne disease due to tubercular bacilli which causes 2-4 lakhs deaths annually, in spite of the fact, large number of
people, get cured after the complete treatment.
It is the diseases which is
present throughout the world which is more common in developing
countries.
It is of two types:
1)Pulmonary
Tuberculosis which affects lungs in about 60-70% cases.
2)Bovine
Source which is usually due to infected milk. It is extra pulmonary
tuberculosis which affects glands,
bones, intestine, brain etc.
AGENT
Tubercular bacili (Mycobacterium tuberculosis), they are acid fast bacilli,rod shaped, non motile (no movement)
Tubercular bacili (Mycobacterium tuberculosis), they are acid fast bacilli,rod shaped, non motile (no movement)
HOST
Any age, sex,individual having H.I.V(+ve)/AIDS, Diabetics not taking treatment, kidney disease, smokers, low income group etc.
ENVIRONMENT
Overcrowding,low-socio economic conditions, illiterates, ignorance, poor housing conditions having low ventilation. It is obsèrved that a person who is susceptible is having chances of getting infection who is in contact with indoor exposure moreover in close contact to a person who is AFB (+ve) in his sputum
Overcrowding,low-socio economic conditions, illiterates, ignorance, poor housing conditions having low ventilation. It is obsèrved that a person who is susceptible is having chances of getting infection who is in contact with indoor exposure moreover in close contact to a person who is AFB (+ve) in his sputum
HOW TUBERCULOSIS IS SPREAD
This disease spreads through air. If a patient of tuberculosis coughs, he will
spread lot of bacterias (Tubercular bacilli) in
air and if a healthy person hese
bacterias along with breathing, these Tubercular bacilli will go into lungs and will cause the infection.
Extra-pulmonarytuberculosis which is
common in glands, bones, kidneys, brain, intestine etc. is never infectious.
when healthy person inhales
yubercular bacilli go to his from infected person tubercular bacilli go to his
lungs alveoli and cause infection and further spread of infection is through
blood which will cause primary infection which mostily
common in children.
We may see following findings
1) Positive tuberculin skin test
2) We may not get clinical findings
3) Cervical Lymphadenopathy
4) Pericarditis i.e. inflammation of covering of heart
POST PRIMARY INFECTION
It is quite common in adults and follwing findings are usually available:
1) Fibrosis of lungs,
2) Cavities in lungs
3) Pulmonary effusion i.e. presence of fluid in pleura
4) Lymphadenopathy
5) Meningitis which is inflammation of covering of brairn
6) Pericarditis
INCUBATION PERIOD (I.P.)
Usually 3 - 6 weeks which may be even longer in some cases depends upon dose of infection patient has inhaled
SIGN SYMPTOMS (S.S.)
3) Cervical Lymphadenopathy
4) Pericarditis i.e. inflammation of covering of heart
POST PRIMARY INFECTION
It is quite common in adults and follwing findings are usually available:
1) Fibrosis of lungs,
2) Cavities in lungs
3) Pulmonary effusion i.e. presence of fluid in pleura
4) Lymphadenopathy
5) Meningitis which is inflammation of covering of brairn
6) Pericarditis
INCUBATION PERIOD (I.P.)
Usually 3 - 6 weeks which may be even longer in some cases depends upon dose of infection patient has inhaled
SIGN SYMPTOMS (S.S.)
1)Chronic cough of more than
3 weeks usually with sputum.
2) Evening rise of low grade fever.
3) Chest pain and blood comes out with sputum (Haemoptysis)
4) Weakness and weight loss
2) Evening rise of low grade fever.
3) Chest pain and blood comes out with sputum (Haemoptysis)
4) Weakness and weight loss
DIAGNOSIS
It is done by sputum examination for three days by Ziele-Nelson Staining (AFB Staining)
1)Make smear of sputum
2) Fix it over flame
3) Put hot carbol fuchsin on it and keep it for 5 minutes
4) Wash with tap water
5) Decolourise with dilute acid
6) Counter stain with Methylene blue for 30 seconds
7) Wash with tap water
8) Observe under microscopror rod shaped pink bacilli if the case is AFB+ve)
It is done by sputum examination for three days by Ziele-Nelson Staining (AFB Staining)
1)Make smear of sputum
2) Fix it over flame
3) Put hot carbol fuchsin on it and keep it for 5 minutes
4) Wash with tap water
5) Decolourise with dilute acid
6) Counter stain with Methylene blue for 30 seconds
7) Wash with tap water
8) Observe under microscopror rod shaped pink bacilli if the case is AFB+ve)
TREATMENT
Tuberculosis is a curable disease. Patients with t. b. having sputum for acid fast bacilli (AFB) need to be isolated because these are infectious cases. T.B. can be completely cured in case patient takes anti-tubercular medicine for complete duration. Most of antitubercular drugs are rifampicin, isoniazid, thiacetazone, ethambutol and pyrazinamide, are taken orally but Streptomycin is to be given by injection (intra-muscular) Patients can take treatment at home but few patients with complications requires hospitalization. In cases of tuberculosis in females breast feeding to babies should be allowed in case mother is AFB(+ve). Baby should get treatment as well as BCG immunization
Tuberculosis is a curable disease. Patients with t. b. having sputum for acid fast bacilli (AFB) need to be isolated because these are infectious cases. T.B. can be completely cured in case patient takes anti-tubercular medicine for complete duration. Most of antitubercular drugs are rifampicin, isoniazid, thiacetazone, ethambutol and pyrazinamide, are taken orally but Streptomycin is to be given by injection (intra-muscular) Patients can take treatment at home but few patients with complications requires hospitalization. In cases of tuberculosis in females breast feeding to babies should be allowed in case mother is AFB(+ve). Baby should get treatment as well as BCG immunization
(DOTS) DIRECTLY OBSERVED
TREATMENT SHORT COURSE
Now-a-days we treat the patients by DOTS. Patient is to take medicines in correct dose for 6 to 8 months under the supervision
of health worker.
Patient swallows the drugs in presence of health worker in
intensive period.
In continuation
phase patients gets medicine for 1 week and takes 1st dose in presence of health worker. Patient can take any of
these drugs: Patient Pyrazinamide, Ethambutol, Streptomycin
If patients does not take treatment regularly he may develop resistance against drugs.
If patients does not take treatment regularly he may develop resistance against drugs.
PREVENTION AND CONTROL
1) By B.C.G. vaccine at birth
2) Patients should keep handkerchief on mouth while coughing and sneezing.
3) Proper screening by sputum by examination for 3 days if sign symptoms of tuberculosis are observed.
4) He/she should take complete treatment
2) Patients should keep handkerchief on mouth while coughing and sneezing.
3) Proper screening by sputum by examination for 3 days if sign symptoms of tuberculosis are observed.
4) He/she should take complete treatment
5) DOTS medicine are taken
in front of health worker
6) An unintenupted supply of anti-tubercular medicines
7) Monitoring and supervision of outcome of every patient as far as treat-ment is concerned
8) Screening of AIDS/HIV patients should be done in all tuberculosis cases Tuberculin test is not reliable for diagnosis of T.B. as +ve test indicates
9) that individual is infected by T.B. On the other hand, negative test does not rule out tuberculosis lt is most important control of tuberculosis that following points should be observed by health workers:
6) An unintenupted supply of anti-tubercular medicines
7) Monitoring and supervision of outcome of every patient as far as treat-ment is concerned
8) Screening of AIDS/HIV patients should be done in all tuberculosis cases Tuberculin test is not reliable for diagnosis of T.B. as +ve test indicates
9) that individual is infected by T.B. On the other hand, negative test does not rule out tuberculosis lt is most important control of tuberculosis that following points should be observed by health workers:
1) Screen for tuberculosis, all patients of H.I. V./AIDS
2) Offer HIVtesting and councelling of all patients of tuberculosis
3) HIV surveillance amongst tuberculosis patient
4) Our aim is to increase DOTS treatment in tuberculosis patients and also HiV care
5) Screen for diagnosis HIV and AIDS in all tuberculosis patients
6) We should establish at national level T.B. and HIV/AIDS co-ordination committee
In T.B. control i.e.
Selt-help groups are playing important role for help of the
2) Offer HIVtesting and councelling of all patients of tuberculosis
3) HIV surveillance amongst tuberculosis patient
4) Our aim is to increase DOTS treatment in tuberculosis patients and also HiV care
5) Screen for diagnosis HIV and AIDS in all tuberculosis patients
6) We should establish at national level T.B. and HIV/AIDS co-ordination committee
people suffering from either tuberculosis and HIV/AIDS in T.B. control programmes by giving
1) Health education to patients and their families
2) Individuals should be informed about the risk to themselves and their families about early signs of T.B., they should know about DOTS, and T.B. patients should ensure to take every precaution to rule out TB of their family members.
3) Media is playing important role about AlDS and TB programmes.
4) The NGO's are also quite helpful in control of TB/AIDS in the community
1) Health education to patients and their families
2) Individuals should be informed about the risk to themselves and their families about early signs of T.B., they should know about DOTS, and T.B. patients should ensure to take every precaution to rule out TB of their family members.
3) Media is playing important role about AlDS and TB programmes.
4) The NGO's are also quite helpful in control of TB/AIDS in the community
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