TUBERCULOSIS
BOQUIA, REYES, SEMILLA, ZITA
TUBERCULOSIS (TB)
• It is a bacterial infection
caused by Mycobacterium
tuberculosis, which most
commonly affects the lungs.
• It is infectious disease.
Categories of Tuberculosis
Latent TB
•
People with latent TB show no
symptoms and cannot spread the
disease.
Active TB
•
People with active TB show
symptoms and can spread the
disease.
Symptoms of Tuberculosis
• A cough that lasts more than three weeks.
• Loss of appetite and unintentional weight loss.
• Fever.
• Chills.
• Night sweats.
• Back pain.
• Abdominal pain.
• Can even harm the brain function.
Pathophysiology
Infection occurs when a
person inhales droplet
nuclei containing
tubercle bacilli that
reach the alveoli of the
lungs.
Pathophysiology
Droplet nuclei containing tubercle bacilli
are inhaled, enter the lungs, and travel
to the alveoli.
Pathophysiology
•
Tubercle
bacilli
multiply in
the alveoli.
Pathophysiology
•
A small number of
tubercle bacilli enter
the bloodstream and
spread
throughout
the
body.
The
tubercle bacilli may
reach any part of the
body, including areas
where TB disease is
more likely to develop
(such as the brain,
larynx, lymph node,
lung, spine, bone, or
kidney).
Pathophysiology
•
Within 2 to 8 weeks,
special immune cells
called
macrophages
ingest and surround the
tubercle bacilli. The cells
form a barrier shell,
called a granuloma, that
keeps
the
bacilli
contained and under
control (LTBI).
Pathophysiology
•
If
the
immune
system cannot keep
the tubercle bacilli
under control, the
bacilli
begin
to
multiply rapidly (TB
disease).
This
process can occur in
different areas in the
body, such as the
lungs, kidneys, brain,
or bone.
Drug of Choice
✓ Rifampicin and isoniazid are active
bactericidal anti-TB drugs which are
particularly active against the rapidly
growing extracellular organisms and
also
have
bactericidal
activity
intracellularly.
✓ For active tuberculosis, you must take
antibiotics for at least six to nine
months. The exact drugs and length
of treatment depend on your age,
overall
health,
possible
drug
resistance and the infection's location
in the body.
Mortality Rate
- 6th leading cause of death
- 200,000 to 600,000 active cases of TB
Primary Prevention
1. BCG VACCINATION
✓ BCG vaccine stands for Bacillus
Calmette-Guérin, it gives protection
against tuberculosis (TB) infection.
✓ It is 70-80% effective against the
most severe forms of TB.
BCG
vaccine contains live bacteria that
have been weakened (attenuated),
so that they stimulate the immune
system but do not cause disease in
healthy people.
✓ Recommended for patients who are
at high risk of exposure to TB.
✓ Should not to be given to women
who are pregnant.
Primary Prevention
2. Housing with good ventilation and proper hygiene
- As TB is an airborne infection, TB
bacteria are released into the air
when someone with infectious TB
coughs or sneezes.
✓ good ventilation: as TB can
remain suspended in the air for
several hours with no ventilation.
✓ good hygiene: covering the
mouth and nose when coughing
or sneezing reduces the spread of
TB bacteria.
Primary Prevention
3. Early diagnosis and treatment
✓ is the most effective way to prevent the
spread of tuberculosis.
✓ A person with infectious tuberculosis can
infect up to 10–15 other people per year.
But once diagnosed with TB, and started on
treatment, the majority of patients are no
longer infectious after just two weeks of
taking the medication.
Secondary Prevention
- it aims to block progression of an infection to active disease.
1. Detection of Latent TB Infection
(LTBI)
- apply chemotherapy to prevent the
latent infection from progressing to
active TB disease.
Secondary Prevention
2 TEST TO DETECT THE LTBI
a. The Tuberculin Skin Test (TST)
b. QuantiFERON-TB Gold (QFT-G)
✓ Secondary control methods for TB are
greatly hindered by the BCG vaccine.
Secondary Prevention
2. Identification and Testing of people with greater
likelihood of being infected
✓ Some of these high risk groups are:
• Health care workers who work with patients at risk of TB
• Those who have lived or traveled extensively in areas
where TB is endemic
• Immunocompromised individuals
• Those who have had a recent positive conversion of a skin
test
• Persons who live in a congregant setting (e.g. jails and
nursing homes)
• Homeless persons
Secondary Prevention
3. Contact investigation
✓ Identify the contacts or people who may
have been exposed to the person who
has TB.
Secondary Prevention
4. Treatment of LTBI
Patients who are identified as
being infected with TB should
be evaluated for active TB
disease, by receiving a chest Xray, and a focused clinical
evaluation
Conclusion
TB remains a worldwide public health problem despite
the fact that the causative organism was discovered
over 100 years ago and highly effective drugs and
vaccine are available making TB a preventable and
curable disease. However, the perpetuation of
‘nonspecific’ determinants of disease in third world
countries has impeded a rapid conquest of this
disease.