Tuberculosis: Tuberculosis Program Principles 2025
Tuberculosis history
- Poverty in poor and industrially marginalized nations.
- Demographic growth in tuberculosis affected countries.
- The acquired immunodeficiency (AIDS) epidemic in tuberculosis affected countries.
·
Carelessness on part of health ministries of
tuberculosis affected nation, that didn’t give tuberculosis control needed priority. According to W.H.O., there were already 8.4 million cases
which could have led to 2 million deaths, so if it didn’t 80 million more cases
might rise which consequently will lead to 20 million deaths— this death wave
might take economy running youth (age 20–49-year-old citizen).
The countries like Benin, China, Gunia, Nicaragua, Peru and
United Republic of Tanzania which were supported by W.H.O. and T. A.T. L. D
(treatment against Tuberculosis and lung disease) have shown improvement. Tuberculosis is contagious
disease caused by bacteria belonging to genus Mycobacterium, the bacterium manifest in form of different disease when it occurs in different parts of the body. When
carefully examined in radiography, it shows cavity in pulmonary region; In such
cases sputum sample must be taken two different days in two different time of
day, if nothing comes out the next will be culture method. TB which happens outside the pulmonary region is called
extrapulmonary tuberculosis which effect different parts of the organ of the
body how to this diagnose the simulating tuberculosis there is an acute your
classes that to the blood means that is source of the primary part affected
they are factor and need immediate treatment and diagnosis the lunch of the liver or sometimes brain
abnormalities.. In this condition the nodes enlarge leading to chronic fistulation
within 7 months several dark scars appear. Tuberculin tests a
usually positive or a serious indicator of culture purr if the node. If node is firm, then it's advice to surgically remove and let culture happen in
it. Tuberculosis in abdomen results collection of fluid leading
to bloating-like structure with no science of hypertension aspiration of fluid
will be found containing proteins, side pain exists but liver and spleen will
be normal when the ultrasound. When laparoscope will be done caseation in the walls of
liver or mucous in abdominal wall will be found accompanying with, swelling of mass of abdomen and
obstruction on the way till mouth. In spine tuberculosis create posture deformity, chronic
pains and in some cases paralysis. Lumber vertebra or lower back pains, lower back deforms, inguinal Canal swells and disc
gets damaged. In joints tuberculosis cause monoarticular arthritis,
imitation in movement or the large joint redness and functional deformities of
joints It creates obstruction poses kidney failure and enlarging
seminal vesicles in 50% of cases. In women obstruction in fallopian tube swells abdomen, irregular mental cycle and uterus deformation happen. In men prostate enlarges and so does seminal vesicles; there
is swelling painless but thetical becomes sensitive. Pericardium
tuberculosis occurs in heart region at the twice heart shape and heart can be
seen in form of a shadow in radiography there is also irrigation of arteries
and there is a reduction in the heart sound. Usually, sputum is
not present and only way to detect the in only way to detect is loss of weight
in the child and the person who was in direct contact with the child. Therefore, type of
tuberculosis in child is primary pulmonary, it is a symptom of attack producing
generalizes symptoms like our cold fever and other normal symptom they
excessive flow of mucus and formation of caseation in shin. Eyes also waters and is lot irritated by lights; person also
develops photophobia, on radiological examination you will find formation of cavity and tuberculosis meningitis
causing laziness irritation complaint about headache and vomiting and eyes
there are photophobia, irritation in eyes when exposed to the light. In radiography you may find lumbar puncture that is CSF is
clear, and pressure is elevated, presence of lymphocytes, glucose level is low,
and protein is elevated indicating alarming situation. Post-pulmonary tuberculosis Material examination is potential enough to detect
tuberculosis post pulmonary tuberculosis occurs when person is reinfected which
is mostly due to Malnutrition or suffering from HIV due to history of the contacts with the pulmonary
tuberculous effects WBC come in blood. A person is HIV
positive because he has, he is following characteristics: In case of tuberculosis the HIV patient is at the risk come
becoming drug dependent. All exudes on serenas membrane must be taken seriously. in case of
tuberculosis meningitis your she maybe suspected immediately after cryptococcal meningitis is disapproved. The process of tuberculosis is same as a saving negative
person. appropriate treatment or tuberculosis is chemotherapy with anti-tuberculosis
drug they are five prominent tuberculosis drugs: drug metabolically
active replicating bacteria are blocked by lack of oxygen and I said pH of
macrophages cytoplasm but some of bacilli remain dormant do metabolically
inactive have ability to multiply most effective on bacteria is and rifampicin that are the games
metabolically active metabolically and antibacterial both Isoniazid and rifampicin—it act faster so it's better, but
they can't go intercellular wall , so to attack on intercellular bacteria Pyrazinamide is
recommended and streptomycin is capable of killing extracellular bacteria. All the four
medicines recommended to be taken with chemotherapy. No drug should be given alone, it risks resistant immunity
of TB bacteria against anti-tuberculosis drug; according to National
tuberculosis program standard practice is recommended according to which some cases
are recommend different regime. Women receiving chemotherapy who are breastfeeding is allowed to receive chemotherapy, but the child
has to be given to rifampicin and vaccinated BCG. The pregnant Women are not given streptomycin and women using contraceptive asked to use higher dose of rifampicin else would be infective in the case of Kidney failure Paradoxcyne must be prescribe and patient. Prevention of tuberculosis main risk group case is family in which tuberculosis patient
is held institutes citizen a marginalization refuges Nd infected marginalization
or from infected marginalized nation and person whose untreated prevention
measures for to be taken it immediate detection and reporting out the same
positive case preventive prevent infections or tuberculosis caused by good
ventilation of Laboratories and I see you so that it allows the sunlight to
come and kill bacteria. For BCG, bacteria pass through glyceride potato making it
lose its potential to cause illness this is affection should be given after the
birth, and injecting vaccine should be from injection after applying antiseptic on skin. It is instructed that
it is to be applied after birth and after 2 months vaccine can be applied polio
vaccination s and after 9 months can be applied with measles reaction on the
body after BCG vaccine is a small rate after 2- or 3-weeks car is form with the
last diameter light and protection from BCG vaccine is out 10 to 15 years and
effective a long term not for instant action. According to the classes mortality of death definition or
tuberculosis number by unit per time the information is not reliable collected most countries of
the world in 1997 who is the mated more than 1.9 million due to triple classes
the more than 1 million in southeast countries in 2000 cause that in
individual countries other in different countries tuberculous estimated 2.8
caused that's in the world in all is groups 26% of avoidable these Individual countries Motability has two
main indices The disease presence number of diseases present in the
community at a given time in the pre unit of population it can be determine
only by survey conducted on the representative sample of general Population on
the representative sample of general population survey are costly difficult and
conductors in some part of the country of the world. Disease incidence the new cases are to be not a file and to
be put against the population in 1 million multiples to get how many numbers of
people infected the in high income country is the disease notification date I
was more than case in in the poor countries and the notification rate and was
30 per 100000 and 1980 tuberculosis was considered natural after that measure
after every natural vaccine and number was 3 million in South west Asia which
amount to 40 percent of world population. Infectious percentage was as follows 25% in South West Asia 22% in China 10% in best Pacific 7%
in Latin America and rep person and Eastern Mediterranean effector the
treatment in rich countries the improvement was 5 to 10% which after medication
increase to 4 to 5% and after the full treatment was done it increase to 14 to
18% in poor country also recover but not HIV patients affected with
tuberculosis in African Saharanpur The
main objective of global tuberculosis control is to reduce of Transmission of
disease and hence lower the death rate due to disease. The specific objective
for tuberculosis control established by WHO under "National Tuberculosis Program
(NTP) are: This
main objective of NTP should be reached before expanding case-finding. New WHO strategy It
is based on new absolute priority: ensure all sputum complete full course of
standardization by observation during treatment. As the cure of currently cases
is the best mean to prevent furthermore case-finding of tuberculosis. Overall
are five public health principles where success of program depends: Number
of activities are needed to be implemented for success of program which
includes: 1. The
Peripheral Level: The basic management unit the part of minimum package of health activities is
applied at the level and on an average population of 1 00 000 is served
includes basis activities performed targeted identifying tuberculosis patients,
providing treatment; BCG vaccination is arranged by team of Expanded Program of
Immunization and NTP activities are carried out by basic management unit. Organization of the basic management unit includes: The
health staff of health service institutions participating for tuberculosis
control serve At Community Level, Village Level, First Level of Health
Centre depending on the covering of
population. 2. The
Intermediate Level: It includes 8 to 10 basic management units. The clinical responsibilities for
Tuberculosis control program at Intermediate Level are to Supervising the
control activities to the basic management units; Intermediate Level Laboratory
for providing training to Microscopists with general region as well as
coordinating with reference laboratory as well as Coordination with other national programs
like leprosy, acute respiratory infection
and AIDS. 3. The
Central Level: It is National Level scale for control tuberculosis. Its structure involves
Central Unit; works under ministry of health ensuring responsibilities of
delivering of medical reagents, laboratory reagents; receiving reports as well as provide training
to basic management units. The National reference Laboratory include diagnosis and susceptibility testing for epidemiological surveillance as well The
University hospital treat patients referred by Intermediate Level. The
specialist development develops and applies technical guidance and supervising
health personnel. 4. Organization
of Treatment: -The
basic management unit is responsible for organizing the treatment for
tuberculosis generally located in the main center of district. 5. During
Initial Phase: Patient needed to take drug daily during the
initial stage of treatment, which contains rifampicin. The regular and
systematic visit must be made to the heath post by the unit coordinator.
Out-Patient should be hospitalized during the whole of initial phase of
treatment, if patient requires it. However, Systematic Hospitalization of the
patient during initial phase of treatment is difficult due to lack of hospital beds
and even not reasonable furthermore extremely costly. Thats
why tuberculosis patients only hospitalized only in following situations: The
period often less than 2 weeks all varies depending upon the causes: 1. During
the Continuation Phase: In
continual phase of treatment, a supply
of fixed dose combinations is given to the patient at regular intervals every
day and the interval jointly set by patient and health worker depends on ease
of access of health center. The patients who are drug alcoholic or behavioral problems; the
organization of follow-up aims for supervised intermittent treatment and health
staff should try to make more available to these patients. 2. to improve treatment compliances: How
to diagnose other cases of pulmonary tuberculosis. While diagnosing if a smear negative case is to be recommended treatment, then his at least six smears should come positive else a positive culture should be found. A proper radiological x-ray should be done to find existence of disease, and
radiological examination should be done i96n
proper health institute
Types of tuberculosis found
1. Pulmonary tuberculosis:
2. Extrapulmonary tuberculosis
3. Tuberculosis lymphadenitis
4, Abdominal Tuberculosis
5. Spinal Tuberculosis
6. Genital tuberculosis
7. Pericardium tuberculosis
Tuberculosis in children
Tuberculosis in HIV patient
Treatment of Tuberculosis
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Action of first
line anti-tuberculosis
Tuberculosis affecting community
Tuberculosis Program Principles launched
The components of Effective Tuberculosis control
Implement of the program
The
program must be integrated with prioritizing task as per level of intervention:
3. Communicate
with the patient:
Fact about tuberculosis
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