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