TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G....
-
Upload
constance-lane -
Category
Documents
-
view
214 -
download
0
Transcript of TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G....
![Page 1: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/1.jpg)
TUBERCULOSISTUBERCULOSIS* Prevention* Treatment, and* Challenges.
ByBy
Dr. O.S. LawalDr. O.S. LawalMatron B.G. OjelabiMatron B.G. Ojelabi
CHEST CLINIC DEPT. GHLAGOS
![Page 2: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/2.jpg)
![Page 3: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/3.jpg)
OUTLINEOUTLINEo Introductiono Classification of Tuberculosiso Mode of Transmissiono Pathogenesiso Symptoms & Signso Diagnosiso Treatmento DOTS Strategyo Stop TB Strategyo Monitoring of TB Patientso TB Preventiono Challengeso Conclusion
![Page 4: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/4.jpg)
IntroductionIntroduction
• Tuberculosis (TB) is a disease that can spread from one person to another and is caused by a bacteria called Mycobacterium tuberculosis.
![Page 5: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/5.jpg)
Introduction (Contd.)Introduction (Contd.)
• TB is curable but kills 4000 people every day, nearly 2 million every year.
• 80% of the world’s TB burden occurs in just 22 countries.
• Tuberculosis affects all ages.• TB is the No. 1 killer among HIV
positive patients
![Page 6: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/6.jpg)
LOCAL SITUATIONLOCAL SITUATION
Nigeria ranked 10th among the 22 high TB burden countries and is the 3rd most burdened country with HIV/AIDS
Estimate for all forms of cases is 199/100,000 Population
Estimated prevalence of HIV among TB patients is 27%
Lagos state carries 8.4% of Nigeria’s TB burden.
![Page 7: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/7.jpg)
CLASSIFICATIONCLASSIFICATION
• Pulmonary TB, or tuberculosis of the lungs and is the most common form (80%).
• Extra-pulmonary TB is tuberculosis affecting organs other than the lungs – kidneys, intestines, liver, womb, testes, skin, bones, joints, meninges, etc.
![Page 8: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/8.jpg)
TB transmissionTB transmission
![Page 9: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/9.jpg)
TB transmission TB transmission contd.contd.
• TB is transmitted through the air.
• When a person with TB of the lungs or throat coughs, sneezes, spits or talks loudly, the germs get into the air.
• People nearby may breathe in these bacteria and thereby become infected.
![Page 10: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/10.jpg)
1 sneeze releases millions1 sneeze releases millions
![Page 11: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/11.jpg)
Organisms LiberatedOrganisms Liberated ““Wells 1934, Duguid 1945, Wells/Riley 1953, et al.”Wells 1934, Duguid 1945, Wells/Riley 1953, et al.”
Number of Organisms Liberated::
Talking 0 – 200
Coughing 0 – 3 500
Sneezing 4500 – 1 000 000
![Page 12: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/12.jpg)
PATHOGENESISPATHOGENESIS
EXPOSURE
INFECTION
LATENT ACTIVE DISEASE
![Page 13: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/13.jpg)
SIGNS AND SYMPTOMS OF TUBERCULOSIS
![Page 14: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/14.jpg)
![Page 15: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/15.jpg)
SIGNS AND SYMPTOMSSIGNS AND SYMPTOMS
• The most important symptom of TB is prolonged, persistent cough.
• Anyone with cough of 2 weeks or more should be tested for Tuberculosis.
![Page 16: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/16.jpg)
SIGNS AND SYMPTOMSSIGNS AND SYMPTOMS
Other symptoms and signs are• Chest pain• Difficulty in breathing• Coughing out of blood• Fever• Weight loss• Night sweats• Palor• Easy tiredness.
![Page 17: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/17.jpg)
DIAGNOSISDIAGNOSIS• This is mainly through examination of the
sputum (Sputum Microscopy).
• Suspect is asked to produce 2 samples of sputum and these are examined in the laboratory.
• Other methods include Sputum Culture, Chest X-ray, Mantoux and lately the GeneXpert.
![Page 18: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/18.jpg)
TB germsTB germs
![Page 19: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/19.jpg)
![Page 20: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/20.jpg)
TREATMENTTREATMENT
• Is through the use of a combination of drugs.
• These are taken orally except one of them which is given as injection.
• The treatments have been standardized and the drugs and injections made available free of charge.
• A complete course lasts 6 to 8 months.
![Page 21: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/21.jpg)
Standardized short-course Standardized short-course chemotherapychemotherapy
• 2 regimens in use:CATEGORY 1 for new cases.CATEGORY 2 for re-treatment cases.
• CAT 1 means 2 months of 4FDC (Rifampicin – 150mg, Isoniazid – 75mg,Pyrazinamide – 400mg and Ethambutol – 275mg) and 4 months of Rifampicim and Isoniazid [2RHZE/4RH]
• CAT 2 – 2 months of Streptomycin injection with 3 months of 4FDC, then 5 months of Rifampicin, INH and Ethambutol. [2SRHZE/1RHZE/5RHE]
• All treatment is expected to be directly observed (DOT)
![Page 22: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/22.jpg)
DOTS STRATEGYDOTS STRATEGYIt is the combination of best practises in different countries of the world where TB disease was a challenge. It consists of the following
•Political commitment with sustained financing.•Case detection through quality-assured bacteriology.•Standardized treatment with supervision and patient support.•An effective drug supply and management system.•Monitoring and evaluation system, and impact measurement.
NOTE: TB control Targets:1.Case finding 70%2.Cure rate 85%
![Page 23: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/23.jpg)
STOP TB STRATEGYSTOP TB STRATEGY
• High quality DOTS
• TB/HIV
• MDR-TB
• Health system strengthening.
• Public-Private Mix (PPM).
• Promote Research on TB.
• Empower people with TB.
![Page 24: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/24.jpg)
MONITORING OF MONITORING OF TBTB PATIENT PATIENT
Body Weight. [Monthly]
Assessment for ADR
Sputum Test 2/3,4,6/7 months.
CXR
![Page 25: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/25.jpg)
PREVENTION OF TB
• BCG Vaccination: 40-80% effective (up to 15 years of age)
• Chemoprophylaxis- eg IPT• Cough Hygiene: cover the mouth and nose
when coughing or sneezing.• Good nutrition: to prevent or reduce
progression from infection to disease. This is by boosting host immunity.
![Page 26: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/26.jpg)
PREVENTION OF TB
• Good housing : that prevents over-crowding and affords good ventilation reduces the risk of exposure to the bacilli.
• Screening of contacts of TB patients
• Control of HIV/AIDS
![Page 27: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/27.jpg)
CHALLENGESCHALLENGES1. Difficulty in Diagnosis2. Limitation of Lab. Investigation-
GeneXpert, FNAC.3. Clinical delay – when surgery is
required4. Delay at home, before presentation.
• Inappropriate therapy of Private hospital
• Reduce case finding5. TB/HIV
![Page 28: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/28.jpg)
6. MDR TB7. EP8. IPACAdministrative controls to reduce risk of exposure,
infection, and disease through policy and practice;
Environmental (engineering) controls to reduce concentration of infectious bacilli in air in areas where contamination of air is likely; and
Respiratory protection to protect personnel who must work in environments with contaminated air
9. Admission in the hospital wards10. DM Screening.
![Page 29: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/29.jpg)
CONCLUSIONCONCLUSION• TB is preventable and curable• TB treatment is available at Chest Clinic• TB treatment is free• Wherever you are, support TB control because
“TB ANYWHERE IS TB EVERYWHERE.”
• The most important symptom of TB is prolonged, persistent cough. Anyone with prolonged, persistent cough of 2 weeks or more is a TB suspect and should be tested for Tuberculosis.
![Page 30: TUBERCULOSIS TUBERCULOSIS * Prevention * Treatment, and * Challenges. By Dr. O.S. Lawal Matron B.G. Ojelabi CHEST CLINIC DEPT. GHLAGOS.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e1a5503460f94b07d4e/html5/thumbnails/30.jpg)
EKO O NI BAJE OEKO O NI BAJE O
TB O NI WOLE WA O!
THANK YOU.