Tuberculosis
When any part of the body gets infected with Mycobacterium tubercle, it is called tuberculosis.Most of the infections caused by this bacterium occur in the lungs of humans. This is called pulmonary tuberculosis. Apart from the lungs, this disease also occurs in the intestines, meninges, bones, joints, lymph glands, skin, etc.
Source of Infection.
Human Source Bovine SourceMode of transmission(a) Droplet infection Most of the TB disease spreads through this method. Droplets containing germs spread in the air through the sputum, sneeze, spit, cough etc. of the TB patient. These droplets enter the lungs of a healthy person with the breath and cause pulmonary tuberculosis.(b) Other waysLiving in densely populated and dark places.Using immunosuppressive drugs for a long time.Being a victim of malnutrition for a long time.Working for a long time in a dusty environment. Incubation periodIt can last from weeks to months.Clinical featuresThe most common symptoms of tuberculosis are as follows:.Chronic coughChest pain. HaemoptysisLoss of weightContinuous low grade fever.Night sweatsCervical lymphadenitisInvestigations.Chest X-ray.Blood test
TLCDLCESRHaemoglobin (Hb%)ELISA-IgM, IgG. Tuberculin test- This skin test is also called mantoux test..Sputum test- For AFB.Prevention of Tuberculosis.Get BCG vaccine at the time of birth.To solve the problem of malnutrition and starvation.. To improve the dirty and slum settlements.To improve the socio-economic condition of the people. Identify tuberculosis in its early stages and treat it promptly. Complete cure of this disease is possible.Spread necessary knowledge about TB among the people of the community.TB ChemotherapyH – Isoniazid (INH) 600 mg (300mg – 2 tablets)R-Rifampicin 450 mg (450 mg-1 capsule)Z-Pyrazinamide 1500 mg (750 mg – 2 tablets)E-Ethambutol 1200 mg (600 mg-2 Tablets)S-Streptomycin 0.75 gone injection.Control of TuberculosisThere are four basic principles of tuberculosis control-(a) Early case finding(b) Chemotherapy
(c) B.C.G. Vaccination(d) Health educationOn the basis of the above basic principles, the National Tuberculosis Control Programme was started in India in 1962. The objective of this programme was to reduce tuberculosis in a stipulated time using the resources available in the country. Its functions are -1. To diagnose and treat tuberculosis patients near their residence.2. To administer BCG vaccine to newborns and infants.3. To prevent suffering, disability and death of tuberculosis patients.This programme is run by the District Tuberculosis Programme. 600 TB hospitals were built in the country, out of which 390 were upgraded as District TB Centres. Health institutions of District Tuberculosis Program (DTP)Government general hospitalsCommunity Health Centres (CHC)Primary Health Centres (PHC)Tuberculosis clinicsOPD of TB sanitorium and Hospitals.DispensariesA TB trained team works in DTC, which has the following members-District tuberculosis officer number-1Medical Officer number-1 Laboratory technician No.-2Treatment organiser No.-3X-ray technician No.-1Non-medical team leader No.-1
Statistical assistant number- IPharmacist number-1NTCP (National Tuberculosis Control Programme) is sponsored by the Central Government. Medicines are available free of cost in this.Revised National Tuberculosis Control Programme(Revised National Tuberculosis Control Programme-RNTCP)For effective control over tuberculosis, the Indian Government re-evaluated the National Tuberculosis Control Programme (NTCP) in the year 1992 and decided a new policy. In its implementation, the help of World Health Organization (WHO) and World Bank was taken. RNTCP is as follows-. To increase the cure rate of infectious patients to 85% by supervised short course chemotherapy.. Introduction of sputum microscopy in case finding activities so that the disease could be isolated in up to 70% of the population.Involvement of NGOs in the programme.Improved operational research.Standardisation of treatment regimens.Introduction of peripheral level supervision by creating subdistrict supervisory unit.Regular, uninterrupted supply of medicines in remote areas.Introduction of organisational support for meaningful coordination at the centre and state levels.Increase in budget.Until 1998, RNTCP could reach only 9% of the population of the country. Hence, it was expanded. At the request of the Indian government, the World Health Organization reviewed the RNTCP during 4-6 February 2000 and declared it a success. Under RNTCP, tuberculosis is confirmed by examining the sputum of patients suspected of having tuberculosis. In this, the patient’s sputum is examined three times under a microscope.
DOTS System DOTS
(Directly Observed Treatment Short Course) is an internationally recognized method of tuberculosis control. It was started in 1997.It has five major components-. Sustained Political and Financial Commitment.Diagnosis by quality ensured sputum smear microscopyStandardized short course antituberculosis treatmentRegular, uninterrupted supply of high quality TB drugsStandardized recording and reporting |World Tuberculosis Day 24 March, 2003. Stop TB Strategy-2006Aim: To free the world from tuberculosis.Target: To reduce the world’s tuberculosis burden to a remarkable level by 2015.Components..Expansion of high quality DOTS (Directly Observed Therapy Short Term).Identification of TB-HIV, MDR-TB.Contribute to strengthening health systems.. Involve all health providers.Empower TB patients and the community.. Promote research.