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Epidemiologic Basis of Tuberculosis Control Slides from the web site http://www.tbrieder.org Compiled by: Hans L Rieder. The five core modules of The Union’s International Tuberculosis Courses. The DOTS Strategy of the national tuberculosis program. Intervention strategies. Etiologic
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Epidemiologic Basis of Tuberculosis Control Slides from the web site http://www.tbrieder.org Compiled by: Hans L Rieder
The five core modules of The Union’s International Tuberculosis Courses The DOTS Strategy of the national tuberculosis program Intervention strategies Etiologic agent Individual Community Bacteriologic basis Clinical presentation Epidemiologic basis
A Model for the Epidemiology of Tuberculosis Risk Risk Risk Risk factors factors factors factors Infectious tuberculosis Subclinical Death Exposure infection Non-infectious tuberculosis Rieder HL. Infection 1995;23:1-4
Exposure to M. tuberculosis o Etiologic epidemiology o Descriptive epidemiology o Predictive epidemiology
Infection with M. tuberculosis o Etiologic epidemiology o Descriptive epidemiology o Predictive epidemiology
Risk of Infection Given Exposure: Largely Exogenous Factors Particles Volume x Exposure time Particles: Volume: Exposure time: Production of infectious droplet nuclei Volume of air and ventilation Time of inhaling air with droplet nuclei
Production of Infectious Droplets and Droplet Nuclei o Aerosolization o Site and form of disease
Clearance of Air o Dispersion of bacilli o Survival of bacilli
Risk of Infection Among Contacts as a Function of Exposure Duration
Infection with M. tuberculosis o Etiologic epidemiology o Descriptive epidemiology o Predictive epidemiology
Descriptive epidemiology of tuberculous infection o Methodological issues in determining prevalence of tuberculous infection o Prevalence of tuberculous infection
Standardization of the Tuberculin Skin Test o Standardization of tuberculin o Standardization of administration o Standardization of reading
Original PPD-S Produced by Florence Seibert No. 23 No. 24 Picture courtesy: Brennan MJ, Anderson C, Quander J. United States Food and Drug Administration, November 29, 2001
Sensitivity to M. intracellulare in the United States Edwards LB, et al. Am Rev Respir Dis 1969;(No 4, part 2):13