Chapter 1 understanding tb

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Gesundheit & Medizin

How does TB infection spread? Coughing Sneezing Singing

A TB patient can infect……….. A TB patient can infect 10-15 persons/year

How does PTB end? 90 – 95% Immunity ↑ Immunity ↓ 5 – 10% Containment Healing Spread

How does TB spread in a body? 85% Pulmonary TB 15% Extrapulmonary TB

Can TB be cured? Why can’t we control TB infection?

Although TB is infectious and lethal, it can be cured and controlled.

TB situation in Myanmar One of 22 high TB burden countries One of 27 high MDR countries One of 41 high TB-HIV burden countries All TB: 612/100,000 Infectious: 240/100,000 80% Urban>Rural National Prevalence study, 2009/10 Global TB control, 2010

National TB Control Strategy Case detection D O T S DOTS Directly Observed Treatment Short Course

How people seek for their health? To relieve their illness, where people go to? Who are the private health services providers? (both formal and informal) ? ? ?

How do private health care providers take part in TB control?

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The asymptomatic infectious case is a “silent client,” one of the most complex and damaging types of client: It is someone who does not provide information; of which we have no information. The silent client, as in the asymptomatic infection, can undermine the business by apparently not being able to address the problem. So how do you manage silent clients, asymptomatic cases? Identifying the points where asymptomatic (silent) cases occur and addressing the situation from a comprehensive perspective. This includes: (1) Preventing contagion and interrupting the transmission process immediately after contact with the virus: Test system, trace, and public health measures: Polymerase chain reaction testing on as many people as possible who have been in contact with infected people which allows the isolation of infected and the tracking and quarantine of their contacts; (2) universal public health measures: Wear a mask in public, wash your hands regularly, stay home when sick, keep a physical distance, and avoid meeting people outside of your home; (3) being so strict with negative cases as with positive ones: The consequences of high rates of false negatives are serious because they allow asymptomatic – and symptomatic – people to transmit diseases; follow-up is recommended, from a clinical point of view – epidemiological, as strict to negative cases as to positive ones; (4) trace back the contacts of the positive cases: search the source of a new case, together with the contacts of that person; and (5) massive and opportunistic tests for the detection of general and specific populations: Rapid response tests for coronavirus disease-19 available to everyone, especially those without symptoms, carried out as mass population screening, to certain groups such as health workers and students, as detection opportunistic in the general practitioner’s consultation, and even self-administered by anyone.

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India is the highest TB burden country in the world & accounts for nearly 1/5th (20 per cent) of global burden of tuberculosis, 2/3rd of cases in SEAR. Every year approximately 1.8 million persons develop tuberculosis, of which about 0.8 million are new smear positive highly'- infectious cases.Annual risk of becoming infected with TB is 1.5 % and once infected there is 10 % life-time risk of developing TB disease

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