1. Intro

TUBERCULOSIS

HISTORYDiscovered about 18000 years agoTubercular decays found in the spine of

mummiesPHTHISIS Greek word for TB Describes by HIPPOCRATES as a fatal

disease

OTHER NAMESPHTHISISCONSUMPTIONSCROFULAWHITE PLAGUELUPUS VULGARISKINGS EVILKOCH’S DISEASE

FAMOUS SCIENTISTSIBN SINA- First to identify TB as

communicable diseaseRICHARD MORTON- Described the

association of pulmonary form with tuberclesSCHONLEIN- Coined term tuberculosisROBERT KOCH- Discovered

MYCOBACTERIUMALBERT CALMETTE and GUIRREIN-

Developed BCG vaccine

MARCH 24th

EPIDEMIOLOGYAccording to WHO one third of the world

population is exposed to risk of TB Annually 8 million affected 2 million deaths every year Most important cause of death in people with

HIV infectionGreatest infectious killer in women of

reproductive age group.

PROBLEM STATEMENT-WORLDARI% ANNUAL DECLINE

%GROUP

0.1-0.01 >10 GROUP I (Industrialized countries eg. Norway)

0.5-1.5 5-10 GROUP II (Middle income countries eg. Latin America)

1-2.5 <5 GROUP III ( Middle income countries eg. SEA)

1-2.5 0-3 GROUP IV ( Sub saharan Africa, INDIA)

GLOBAL TRENDS IN TB

PROBLEM STATEMENT- INDIA PARAMETER STATISTICS

POPULATION AFFECTED 1151 MILLION

INCIDENCE 168

PREVALANCE 299

TB MORTALITY / 100000 POPULATION

28

% OF NEW TB CASES HIV POSITIVE

1.2%

% OF NEW CASES MULTIDRUG RESISTANT

2.8%

GLOBAL RANK 1

PATTERN OF TB IN INDIA 2 out of every 5 Indians are affected with TBA patient with infectious TB can infect 15

people. More prevalent in adults in INDIA 15-54 age group is the most affected MSSore than 3 billion us $ is spent on TB

each year.

EPIDEMIOLOGICAL INDICES PREVALANCE OF INFECTION - % of

individuals who show positive response to the standard TUBERCULIN test.

INCIDENCE OF INFECTION - % of population under study which becomes newly infected among the non infected of the preceding survey during the course of one year.

PREVALANCE OF DISEASE- % of people whose sputum is positive for TUBERCLE bacilli on microscopic examination.

INCIDENCE OF NEW CASES- % of new TB cases / 1000 population occurring during one year.

PREVALANCE OF SUSPECT CASES – Based on X ray examination of chest.

PREVALANCE OF DRUG RESISTANT CASES – It is the prevalence of people excreting tubercle bacilli resistant to ATT. It is directly related to chemotherapy

MORTALITY RATE – Number of deaths from TB every year / 1000 population . This index is not used now.

EPIDEMIOLOGICAL FACTORS

AGENT

HOST ENVIRONMENT

AGENT FACTORS

AGENT - MYCOBACTERIUM TUBERCULOSIS. Recently atypical mycobacterium . It is of four types.

photochromogens Scotochromogens Non photochromogens Rapid growers SOURCE OF INFECTION- Human and

Bovine COMMUNICABILITY- Infective till untreated

HOST FACTORSAGE – All ages affectedSEX – MalesHERIDITARY- No roleNUTRITION- Malnutrition is a predisposing

factor.IMMUNITY- As a result of infection or BCG

immunization.

ENVIROMENTAL FACTORS Poor quality of lifePoor housingOvercrowdingUnder nutritionLack of educationEarly marriagesLarge familiesLack of awareness