Pulmonary
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Pulmonary. Tuberculosis. 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.

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Pulmonary

Pulmonary

Tuberculosis


Tuberculosis

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.


Symptoms

Symptoms

  • coughing,

  • tiredness,

  • loss of appetite

  • and weight loss.

  • http://www.youtube.com/watch?v=05pbSjkfIyE

  • later fever and coughing up blood may occur..


Causes

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.


Tuberculosis bacterium dyed red in sputum

Tuberculosis bacterium (dyed red) in sputum


Transmission

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.


Who is most at risk

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.


Course of infection

Course of Infection

First…..

  • 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.


Pulmonary

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………


Years later

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.


X ray showing tb damage

X–ray showing TB damage


Case study china

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.


Intervention programme

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?


Impact

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.


Cost and cost effectiveness

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.


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