1. Tropical and Communicable Diseases
Prepared by:
Abdul Rahman
Lecturer in IUNC
MBA in Health, BSN
Unit I
Lecture I
Disorders of
Spread by
Droplet
Infections

2. Objectives
At the end of this unit, Students will be able to:
Define Tuberculosis.
Discuss the factors/causes for Tuberculosis.
Share clinical manifestations of Tuberculosis.
Discuss management of Tuberculosis.
Explain the role of nurse in prevention and control of Tuberculosis
in hospital and Community setting.

3. Tuberculosis (TB)
Tuberculosis is one of the most prevalent infections of human beings
and contributes considerably to illness and death around the world.
It is spread by inhaling tiny droplets of saliva from the coughs or
sneezes of an infected person.
It is a slowly spreading, chronic, granulomatous bacterial infection,
characterized by gradual weight loss.
TB is the world’s second most common cause of death from
infectious disease after HIV/AIDS.

4. Cont.…
Tuberculosis is the
infectious disease primarily
affecting lung parenchyma is
most often caused by
Mycobacterium Tuberculosis.
It may spread to any part of
the body including meninges,
kidney, bones and lymph-
nodes.
https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.cdc.gov%2Ftb%2Ftopic%2Fbasics%2Fhowtbspreads.htm&psig=AOvVaw1Uap76
mUCHq6p0oquWvSoq&ust=1676366995543000&source=images&cd=vfe&ved=2ahUKEwiC5MPrl5L9AhUZmycCHcLWBUAQr4kDegUIARDUAQ

5. Pulmonary tuberculosis (TB)
Pulmonary tuberculosis (TB) is a serious infection caused by the
Mycobacterium tuberculosis (MTB) that involves the lungs but may
spread to other organs. TB is a contagious disease that can infect
anyone exposed to MTB.
https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.frontiersin.org%2Farticles%2F10.3389%2Ffcimb.2020.618414%2Ffull&psig=AOvVaw06D9N1HAHYn
CvBPsbAiXRA&ust=1676367046429000&source=images&cd=vfe&ved=2ahUKEwiG0OWDmJL9AhVwpycCHdzIBMoQr4kDegQIARA5

6. Types of
Tuberculosis
in Human
Body
https://www.google.com/url?sa=i&url=https%3A%2F%2Ftbfacts.org%2Ftypes-of-
tb%2F&psig=AOvVaw1FiG0NkLvIwV4lvtOIQWx2&ust=1676535568300000&source=images&cd=vfe&ved=2ahUKEwiRrKTpi5f9AhUTmycCHUBiD
OMQr4kDegUIARDtAQ
Active

7. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.physio-
pedia.com%2FInfection_Prevention_and_Control&psig=AOvVaw1qzoUZcx6s5xNpX3ZmTH9Y&ust=1676536496056000&source=images&cd=vfe&ved=0CBEQjhxqFwoTCOi99NOPl_0CFQAAAAAdAAAAABAH

8. Pathophysiology
Tuberculosis (TB) is caused by a type of bacterium called
Mycobacterium tuberculosis.
It's spread when a person with active TB disease in their lungs
coughs or sneezes and someone else inhales the expelled droplets,
which contain TB bacteria.

9. Cont.….
(Initial infection or primary infection)
Entry of micro organism through droplet nuclei
Bacteria is transmitted to alveoli through airways
Deposition and multiplication of bacteria
Bacilli are also transported to other parts of the body via blood
stream and phagocytosis by neutrophils and macrophages

10. Cont.….
Mycobacterium
Pulmonary alveoli
Immune system has lodged in (Alveolar Macrophages)
Detects presence of pathogen and engulf the bacteria
Mycobacterium bacteria inhibits the Macrophages (phagosome+
Lysosome) to forms phagolysosome and remains protected inside
the macrophages.

11. Cont.….
Starts replication inside macrophages.
Primary infection occurs.
Cell mediated immunity gets activated, surrounds the cell to forms
granuloma (3weeks)
Leads to necrosis of tissues at infection site
Calcification of cone complex (Latent TB or Active T.B.)

12. https://www.google.com/url?sa=i&url=https%3A%2F%2Fradiopaedia.org%2Fcases%2Fnormal-chest-x-
ray&psig=AOvVaw1XE4L5G4CT1o-
nxc7Xks0U&ust=1680235005395000&source=images&cd=vfe&ved=0CBEQjhxqFwoTCJCc2dnhgv4CFQAAAAAd
https://www.google.com/url?sa=i&url=https%3A%2F%2Fradiopaedia.org%2Fcases%2Fpulmonary-tuberculosis-
59%3Flang%3Dus&psig=AOvVaw2exl4rwnaZbzawfoWDAj3b&ust=1680235064043000&source=images&cd=vfe&ve
d=0CBEQjhxqFwoTCMCb_fXhgv4CFQAAAAAdAAAAABAD
Normal Chest X Ray Active TB Chest X Ray

13. How to spread Tb Viruses
Video Link
https://www.youtube.com/watch?v=UKV8Zn7x0wM

14. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.apollodiagnostics.in%2Fblog%2Ftogether-we-can-put-an-end-to-tb&psig=AOvVaw3uc5jf-
omAW3NyPx2BGulC&ust=1676434671122000&source=images&cd=vfe&ved=2ahUKEwj2ruH5k5T9AhWZuCcCHcZQBhEQr4kDegUIARDPAQ

15. Assessment
History collection
Physical examination
Clubbing of the fingers or toes (in people with advanced disease)
Fluid around a lung (pleural effusion)
Unusual breath sounds (crackles)

16. Diagnosis Findings
Biopsy of the affected tissue (rare)
Bronchoscopy
Chest CT scan
Chest x-ray
Acid- Fast Bacilli (AFB) tests are most often used to diagnose an
active tuberculosis (TB) infection
Sputum examination and cultures
Thoracentesis
Tuberculin skin test (also called a PPD test)

17. Nursing Diagnosis
Assessment
Obtain history of exposure to TB
Assess for symptoms of active disease
Auscultate lungs for crackles
During drug therapy assess for liver function

18. Risk factors
Close contact with some one who have active TB.
Immuno compromised status (elderly, cancer).
Drug abuse and alcoholism.
People lacking adequate health care.
Pre existing medical conditions (diabetes mellitus, chronic renal
failure).
Immigrants from countries with higher incidence of TB.
Institutionalization (long term care facilities)
Living in substandard conditions.
Occupation (health care workers)

19. Medical Management
The usual treatment is: 2 antibiotics (isoniazid and rifampicin) for 6
months.
2 additional antibiotics (pyrazinamide and ethambutol) for the first 2
months of the 6-month treatment period.

20. Nursing Management
Ineffective breathing pattern related to pulmonary infection and
potential for long term scarring with decreased lung capacity.
Interventions.
Administer and teach self administration of medications ordered.
Encourage rest and avoidance of exertion.
Monitor breath sounds respiratory rates , sputum production and
dyspnea.
Provide supplemental oxygen as ordered.
Encourage increased fluid intake.
Educate patient about etiology transmission and effects of TB.

21. Cont.…
Be aware that TB is transmitted by respiratory droplets.
Use high efficiency particulate masks for high risk procedures
including endoscopy.
Educate patient to control the spread of infection by covering
mouth and nose while coughing and sneezing.
Isolation of patient.
Instruct about risk of drug resistance if drug regimen is not strictly
and continuously followed.
Carefully monitor vital signs and observe for temperature changes.
Explain that TB is a communicable disease and that taking
medications is most effective way of preventing transmission
Instruct about medications schedule and side effects

22. Prevention
Isolation
Ventilate the room
Cover the mouth
Wear mask
Finish entire course of medication
 Vaccinations
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.

23. References
https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.cdc.gov%2Ftb%2Ftopic%2Fbasics%2Fhowtbspreads.htm&psig=AOvVaw1Uap76m
UCHq6p0oquWvSoq&ust=1676366995543000&source=images&cd=vfe&ved=2ahUKEwiC5MPrl5L9AhUZmycCHcLWBUAQr4kDegUIARDUAQ
https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.frontiersin.org%2Farticles%2F10.3389%2Ffcimb.2020.618414%2Ffull&psig=AOv
Vaw06D9N1HAHYnCvBPsbAiXRA&ust=1676367046429000&source=images&cd=vfe&ved=2ahUKEwiG0OWDmJL9AhVwpycCHdzIBMoQr4k
DegQIARA5
https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.apollodiagnostics.in%2Fblog%2Ftogether-we-can-put-an-end-to-
tb&psig=AOvVaw3uc5jf-
omAW3NyPx2BGulC&ust=1676434671122000&source=images&cd=vfe&ved=2ahUKEwj2ruH5k5T9AhWZuCcCHcZQBhEQr4kDegUIARDPAQ
https://www.google.com/url?sa=i&url=https%3A%2F%2Ftbfacts.org%2Ftypes-of-
tb%2F&psig=AOvVaw1FiG0NkLvIwV4lvtOIQWx2&ust=1676535568300000&source=images&cd=vfe&ved=2ahUKEwiRrKTpi5f9AhUTmycCHU
BiDOMQr4kDegUIARDtAQ
https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.physio-
pedia.com%2FInfection_Prevention_and_Control&psig=AOvVaw1qzoUZcx6s5xNpX3ZmTH9Y&ust=1676536496056000&source=images&cd=vfe
&ved=0CBEQjhxqFwoTCOi99NOPl_0CFQAAAAAdAAAAABAH
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Control of diphtheria, pertusis, tetanus, Heaemophilus influenza type b and Hepatitis C: Field guide. (2005). American Health organization. Retrieved
on October 8, 2006 from www.paho.org.
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Report from WHO Expert Consultation on Rabies, Geneva, Switzerland. (5-8 October 2004) Retrieved from http://www.who.int/rabies/trs931.
Sack, D. A., Sack, R. B., Nair, G. B., & Siddique, A. K. (2004) Cholera: Seminar. The Lancent, 363, 223-232
Werner, D. (1998). Where there is no doctor A village health care hand book New Delhi: Voluntary association of India.
Yasinzai, M. I., kakarsulemankel, J. (2003). Incidence of malaria infection in rural areas of district. Online journal of biological science, 9, 766-772.