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Tuberculosis and It’s Control in India and Uttarakhand

Tuberculosis and It’s Control in India and Uttarakhand. What is Tuberculosis?. An infectious disease caused by Mycobacterium tuberculosis. Who discovered the Tubercle bacilli?. Robert Koch. AFB. A cid F ast B acilli. How TB spreads ?.

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Tuberculosis and It’s Control in India and Uttarakhand

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  1. Tuberculosisand It’s Control in India and Uttarakhand

  2. What is Tuberculosis? An infectious disease caused by Mycobacterium tuberculosis

  3. Who discovered the Tubercle bacilli? Robert Koch

  4. AFB Acid Fast Bacilli

  5. How TB spreads ? Inhalation of droplets containing AFB in air

  6. Most common Symptom of PT cough > 2 weeks

  7. symptom of PT Loss of appetite

  8. another symptom of PT loss of weight

  9. Another Symptom of PT Rise of Temperature in the evening

  10. another Symptom of PT chest pain

  11. What are the symptoms of PT? Cough > 2 weeks Loss of appetite Loss of weight Rise in temp. in the evening Chest pain Haemoptosis

  12. India Accounts for Nearly One Third of the Global TB Burden • India has more cases of tuberculosis than any other country in the world & twice as many cases as China • Although exact and current information on TB incidence and prevalence is not available, studies show an incidence rate of more than 200 per lakh, among the highest in the world

  13. TB - Disease Burden • > 40% of country’s population is infected • 2 million new cases each year • 450,000 deaths each year • > 5,000 people develop TB every day • > 1,000 people die every day • TB kills more women than all causes of maternal mortality put together All this despite TB being nearly 100% curable

  14. TB is the leading single infectious cause of death in India Number of deaths (1000s) Deaths from infectious agents in India Source: World Health Report, 1999

  15. How many die in India in 2 minutes due to TB? Three

  16. Status of TB Control in India • 1950s-60s: Important TB research(TRC/NTI) • 1962: National TB Programme • 1992: Programme Review- only a third of patients diagnosed and only a third of those treated successfully • 1993: DOTS pilots (RNTCP) • 1998: DOTS scale-up begins • 2000: > 30% of country covered by DOTS • Beginning of 2002: almost 50% of country covered by DOTS (460 million population) • 2006 – Whole India covered by DOTS

  17. DOTS Directly Observed Treatment Short Course

  18. RNTCP : Revised National Tuberculosis Control Programme

  19. Aims of RNTCP 1.To achieve 85 % Cure Rate 2. To diagnose 70 % of estimated new Sp. Sm. Pos. cases after achieving the above.

  20. TB Register Directly Observed Treatment, Short-course (DOTS) • Political commitment • Diagnosis by microscopy • Adequate supply of SCC drugs • Directly observed treatment • Accountability

  21. How TB is diagnosed ? By the examination of Sputum for AFB X-ray examination

  22. What is the specific method for the diagnosis of PT? sputum exam.

  23. Advantages of Sputum Microscopy Simple Less expensive More reliable Rapid

  24. Take Home Messages 1. Anybody who is having Cough for more than 3 weeks with or without other symptoms should get their sputum examined at the nearest Health Facility 2. TB Diagnosis and treatment are available free of cost in all the govt. hospitals

  25. Fight against TB

  26. How many sputum samples are examined for diagnosis? spot morning Two

  27. CATEGORYI • New sp.pos. • New sp.neg. but seriously ill • New extra-pulmonary but seriously ill

  28. CATEGORY II • Sm. pos. relapse • Sm.pos. failure • Sm.pos treatment after default

  29. CATEGORY-III • New sp.neg. not seriously ill • New extra-pulmonary not seriously ill

  30. TB Alternative treatment regimens (if smear + at end of initial phase of Cat I or Cat II, treatment one more month of initial phase is given) category Continuation Phase Initial phase 2 HRZE(2 HRZS) 6 HE I 2 H R Z E (2 H R Z S ) 4 HR 3 3 3 3 3 3 3 3 4 H R 3 3 2 SHRZE/1 HRZE 5 HRE II (2 S H R Z E /1 H R Z E 5 H R E ) 3 3 3 3 3 3 3 3 3 3 3 3 2 HRZ 6 HE III 2 H R Z 4 HR 3 3 3 4 H R 3 3 Recommended treatment regimens Direct observation is recommended for all patients and is particularly essential when intermittent regimens are used

  31. How many specimens are examined during follow up examination? morning spot two

  32. During treatment, when do you examine the sputum for Cat-I patients ? Month 2 4 6

  33. Month 3 5 8 During treatment, when do you examine sputum for Cat-II patients ?

  34. During treatment, when do you examine sputum for Cat-IIIPatients? Month 2 6

  35. What is to be done when the sp. sm. is pos. at the end of IP ? IP to be continued for one more month.

  36. What is to be done when the patients default in the CP ? Action to be taken within a week of default.

  37. DOTS triples treatment success in India

  38. Anti TB drugs are available free of cost in all the govt. hospitals. true

  39. Fight against TB

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