World Tb Day

WORLD WORLD TBTB DAY DAY2424thth March March

Dr.T.V.Rao MDDr.T.V.Rao MD

A tribute to Robert KochA tribute to Robert Koch

World TB Day is World TB Day is March 24. This annual March 24. This annual event commemorates event commemorates the date in 1882 when the date in 1882 when Dr. Robert Koch Dr. Robert Koch announced his announced his discovery of discovery of Mycobacterium Mycobacterium tuberculosistuberculosis, the , the bacteria that cause bacteria that cause tuberculosis (TB) tuberculosis (TB)

Beginning of World TB DayBeginning of World TB Day

In 1982, on the one-In 1982, on the one-hundredth anniversary of hundredth anniversary of Dr Koch's presentation, Dr Koch's presentation, the International Union the International Union against Tuberculosis and against Tuberculosis and Lung Disease (IUATLD) Lung Disease (IUATLD) proposed that March 24 proposed that March 24 be proclaimed as an be proclaimed as an official World TB Day. official World TB Day.

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TuberculosisTuberculosis

““TB" is short for tuberculosis. TB disease TB" is short for tuberculosis. TB disease is caused by a bacterium called is caused by a bacterium called Mycobacterium tuberculosisMycobacterium tuberculosis. The bacteria . The bacteria usually attack the lungs, but TB bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as can attack any part of the body such as the kidney, spine, and brain. If not treated the kidney, spine, and brain. If not treated properly, TB disease can be fatal. properly, TB disease can be fatal.


Tuberculosis can infect any oneTuberculosis can infect any one ? ?

Worldwide Distribution of New TB Cases, Worldwide Distribution of New TB Cases, 20062006

Some key facts about Some key facts about TuberculosisTuberculosis

One-third of the 33 million people worldwide who One-third of the 33 million people worldwide who are living with HIV/AIDS are co-infected with TB. are living with HIV/AIDS are co-infected with TB.

TB in HIV-positive people is almost certain to be TB in HIV-positive people is almost certain to be fatal if undiagnosed or left untreated. fatal if undiagnosed or left untreated.

People who are infected with HIV are highly People who are infected with HIV are highly susceptible to TB infection due to their immune susceptible to TB infection due to their immune system’s inability to fight off disease. system’s inability to fight off disease.

In general, while approximately 10 percent of In general, while approximately 10 percent of those who become infected will develop active those who become infected will develop active TB, HIV-positive people are 50 times more likely TB, HIV-positive people are 50 times more likely than HIV-negative people of developing the than HIV-negative people of developing the active form of the disease. active form of the disease.


Tuberculosis A Historical Tuberculosis A Historical Disease Progress to FutureDisease Progress to Future

Some key facts about Some key facts about TuberculosisTuberculosis

Just as HIV heightens the risk of developing active TB, Just as HIV heightens the risk of developing active TB, so does TB accelerate the progression of HIV into AIDS. so does TB accelerate the progression of HIV into AIDS. Without proper treatment, approximately 90 percent of Without proper treatment, approximately 90 percent of HIV-positive people die of TB within months of infection. HIV-positive people die of TB within months of infection.

TB and poverty come together to perpetuate a vicious TB and poverty come together to perpetuate a vicious cycle. Poverty contributes to the spread of tuberculosis cycle. Poverty contributes to the spread of tuberculosis as people are forced to share close living quarters and as people are forced to share close living quarters and are often in overall poor health. Simultaneously, costs are often in overall poor health. Simultaneously, costs associated with diagnosis and treatment create further associated with diagnosis and treatment create further hardship, both for patients and their families – including hardship, both for patients and their families – including their children. their children.

World TB Day is about … World TB Day is about … concern for infectedconcern for infected

World TB Day is about World TB Day is about commemorating the lives commemorating the lives and stories of people that and stories of people that are affected by TB and are affected by TB and has taken a treatment for has taken a treatment for it; nurses; doctors; it; nurses; doctors; researchers; community researchers; community workers who has put in workers who has put in global fight against TB. global fight against TB.


Concern for TB patients is the Concern for TB patients is the Backbone of the Control Backbone of the Control

ProgrammeProgramme

Government Programme organizesGovernment Programme organizes

The government organizes Health The government organizes Health education campaigns to inform on the education campaigns to inform on the importance of early diagnosis and Regular importance of early diagnosis and Regular treatment for the patients. A screening treatment for the patients. A screening programme to early detect the disease is programme to early detect the disease is also organized. Various other events like also organized. Various other events like seminar and exhibition on tuberculosis are seminar and exhibition on tuberculosis are held with an aim to impart knowledge on held with an aim to impart knowledge on all aspects of TB. all aspects of TB.


How TB is spreadHow TB is spread

TB is spread through the TB is spread through the air from one person to air from one person to another. The TB bacteria another. The TB bacteria are put into the air when are put into the air when a person with active TB a person with active TB disease of the lungs or disease of the lungs or throat coughs, sneezes, throat coughs, sneezes, speaks, or sings. People speaks, or sings. People nearby may breathe in nearby may breathe in these bacteria and these bacteria and become infected. become infected.

Difficulat to diagnose by Difficulat to diagnose by Conventional MethodsConventional Methods

The two conventional techniques used to detect The two conventional techniques used to detect TB are acid-fast smearing and culturing. All TB are acid-fast smearing and culturing. All detection techniques use sputum samples. Acid-detection techniques use sputum samples. Acid-fast smearing has very low sensitivity and fast smearing has very low sensitivity and specificity, and cannot distinguish between specificity, and cannot distinguish between Mycobacterium TuberculosisMycobacterium Tuberculosis (the bacterium (the bacterium that causes TB) and other types of bacilli. that causes TB) and other types of bacilli.

The culture technique, on the other hand, has The culture technique, on the other hand, has good specificity and sensitivity but typically takes good specificity and sensitivity but typically takes about three to six weeks to completeabout three to six weeks to complete

Global Plan – Stop TBGlobal Plan – Stop TB

The Global Plan to Stop TB, 2006-2015 sets out the strategic directions of the Stop TB Partnership for the decade 2006–2015.

Why Sputum MicroscopyWhy Sputum Microscopy

Sputum smear microscopy is an essential tool of case-finding in Tuberculosis control. Tuberculosis control, aiming at the prevention of the transmission of infection, imparts a clear priority to the sputum positives which are the sources of infection in the community. Hence the need to detect as many sputum positives as possible

WHO WHO - Working - Working

WHO is working to WHO is working to dramatically reduce dramatically reduce the burden of TB, and the burden of TB, and halve TB deaths and halve TB deaths and prevalence by 2015, prevalence by 2015, through its Stop TB through its Stop TB Strategy and Strategy and supporting the Global supporting the Global Plan to Stop TB. Plan to Stop TB.

WHO aims to reduce the burden WHO aims to reduce the burden of TB by 2015of TB by 2015

WHO has developed a new six point Stop TB WHO has developed a new six point Stop TB Strategy which builds on the successes of DOTS Strategy which builds on the successes of DOTS while also explicitly addressing the key while also explicitly addressing the key challenges facing TB. Its goal is to dramatically challenges facing TB. Its goal is to dramatically reduce the global burden of tuberculosis by reduce the global burden of tuberculosis by 2015 by ensuring all TB patients, including for 2015 by ensuring all TB patients, including for example, those co-infected with HIV and those example, those co-infected with HIV and those with drug-resistant TB, benefit from universal with drug-resistant TB, benefit from universal access to high-quality diagnosis and patient-access to high-quality diagnosis and patient-cantered treatment cantered treatment

Early Detection is the Major Early Detection is the Major CriteriaCriteria

The strategy also The strategy also supports the development supports the development of new and effective tools of new and effective tools to prevent, detect and to prevent, detect and treat TB. The Stop TB treat TB. The Stop TB Strategy underpins the Strategy underpins the Stop TB Partnership's Stop TB Partnership's Global Plan to Stop TB Global Plan to Stop TB 2006-2015.2006-2015.

Up gradation of Laboratory Up gradation of Laboratory servicesservices

Bacteriology is one of the Bacteriology is one of the fundamental aspects of fundamental aspects of national tuberculosis (TB) national tuberculosis (TB) control programmes control programmes (NTP's).. Improving (NTP's).. Improving sputum smear sputum smear microscopy, the need to microscopy, the need to upgrade existing upgrade existing laboratory services and laboratory services and strengthen and build strengthen and build capacity to perform capacity to perform culture and drug culture and drug susceptibility testing susceptibility testing (DST) are essential. (DST) are essential.

Dedicated Laboratory Services a Dedicated Laboratory Services a Must to control TuberculosisMust to control Tuberculosis

Global Laboratory Initiative (GLI)Global Laboratory Initiative (GLI)

Global policy guidance on appropriate laboratory Global policy guidance on appropriate laboratory technology and best practices technology and best practices

Laboratory advocacy and resource mobilization Laboratory advocacy and resource mobilization Laboratory capacity development and coordination Laboratory capacity development and coordination Interface design with other laboratory networks to ensure Interface design with other laboratory networks to ensure

appropriate integration appropriate integration Standardized laboratory quality assurance Standardized laboratory quality assurance Coordination of technical assistance Coordination of technical assistance Effective knowledge sharing Effective knowledge sharing


Do You KnowDo You Know

That someone in the world is newly That someone in the world is newly infected with TB bacilli every second? infected with TB bacilli every second? • That one-third of the world population is • That one-third of the world population is currently infected by TB?currently infected by TB?• That there are two deaths per three • That there are two deaths per three minutes in minutes in IndiaIndia due to TB? due to TB? • That over six lakh Indians are unaware • That over six lakh Indians are unaware that they suffer from TB? that they suffer from TB? • That every TB patient infects 10-15 new • That every TB patient infects 10-15 new persons on an average every year? persons on an average every year?


History Of TB control in IndiaHistory Of TB control in India

The first open air sanatorium for treatment and The first open air sanatorium for treatment and isolation of TB patients in India was founded in isolation of TB patients in India was founded in 1906 in Tiluania, near Ajmer, and then at Almora 1906 in Tiluania, near Ajmer, and then at Almora two years later. two years later.

Dr Frimodt Moller a medical superintendent, Dr Frimodt Moller a medical superintendent, played a prominent role in TB control in India. played a prominent role in TB control in India. This included training health workers, This included training health workers, conducting surveys and introducing Bacillus conducting surveys and introducing Bacillus Calmette Guerin (BCG) vaccination Calmette Guerin (BCG) vaccination


Imitation to Imitation to Revised National TB Revised National TB ControlControl

India had switched over to the Revised India had switched over to the Revised National TB Control (RNTBC) Programme, National TB Control (RNTBC) Programme, which concentrates on the personal which concentrates on the personal attention of the health staff on each TB attention of the health staff on each TB patient. Thus, India hopes to cut down TB patient. Thus, India hopes to cut down TB prevalence and death rate by half, by the prevalence and death rate by half, by the year 2015. year 2015.

Tuberculosis – A major cause of Tuberculosis – A major cause of Morbidity and Mortality in IndiaMorbidity and Mortality in India

In India today, two In India today, two deaths occur every deaths occur every three minutes from three minutes from tuberculosis (TB). But tuberculosis (TB). But these deaths can be these deaths can be prevented. With prevented. With proper care and proper care and treatment, TB patients treatment, TB patients can be cured and the can be cured and the battle against TB can battle against TB can be won be won

WHO - DOTSWHO - DOTS

The WHO-recommended The WHO-recommended Directly Observed Directly Observed Treatment, Short Course Treatment, Short Course (DOTS) strategy was (DOTS) strategy was launched formally as launched formally as Revised National TB Revised National TB Control programme in Control programme in India in 1997 after pilot India in 1997 after pilot testing from 1993-1996. testing from 1993-1996. Since then DOTS has Since then DOTS has been widely advocated been widely advocated and successfully and successfully applied. .... applied. ....


DOTS - IndiaDOTS - India

CControlling TB in India is a tremendous ontrolling TB in India is a tremendous challenge. The TB burden in India is still challenge. The TB burden in India is still staggering. Every year, 1.8 million persons staggering. Every year, 1.8 million persons develop the disease, of which about 800,000 are develop the disease, of which about 800,000 are infectious; and, until recently, 370,000 died of it infectious; and, until recently, 370,000 died of it annually —1,000 every day. The disease is a annually —1,000 every day. The disease is a major barrier to social and economic major barrier to social and economic development. An estimated 100 million development. An estimated 100 million workdays are lost due to illness. Society and the workdays are lost due to illness. Society and the country also incur a huge cost due to TB—nearly country also incur a huge cost due to TB—nearly US$ 3 billion in indirect costs and US$ 300 US$ 3 billion in indirect costs and US$ 300 million in direct costs. million in direct costs.

India – DOTS largestIndia – DOTS largest

India now has the second largest DOTS India now has the second largest DOTS (Directly Observed Treatment, Short (Directly Observed Treatment, Short course) programme in the world. However, course) programme in the world. However, India's DOTS programme is the fastest India's DOTS programme is the fastest expanding programme, and the largest in expanding programme, and the largest in the world in terms of patients initiated on the world in terms of patients initiated on treatment, placing more than 100,000 treatment, placing more than 100,000 patients on treatment every month. patients on treatment every month.


DOTS is a systematic strategy DOTS is a systematic strategy which has five componentswhich has five components

Political and administrative Political and administrative commitment.commitment.

Good quality diagnosis.Good quality diagnosis. Good quality drugs. An uninterrupted Good quality drugs. An uninterrupted

supply of good quality anti-TB drugs supply of good quality anti-TB drugs

monitoring and accountabilitymonitoring and accountability

Sputum Microscopy – Major Sputum Microscopy – Major strategy in strategy in DOTSDOTS

The quality assurance in sputum microscopy under RNTCP had been given a prime place. Microscopy has been an essential tool both for the diagnosis and follow up of the TB patients particularly in the RNTCP areas where declaring a patient cured is dependent on laboratory results

DOTS – A massive Disease DOTS – A massive Disease Control ProgrammeControl Programme

Every day in India, under the RNTCP, more than 15,000 Every day in India, under the RNTCP, more than 15,000 suspects are being examined for TB, free of charge. The suspects are being examined for TB, free of charge. The diagnosis of these patients and the follow-up of patients diagnosis of these patients and the follow-up of patients on treatment is achieved through the examination of on treatment is achieved through the examination of more than 50,000 laboratory specimens. As a result of more than 50,000 laboratory specimens. As a result of these examinations, each day, about 3,500 patients are these examinations, each day, about 3,500 patients are started on treatment, stopping the spread of TB in the started on treatment, stopping the spread of TB in the community. In order to achieve this, more than 600,000 community. In order to achieve this, more than 600,000 health care workers have been trained and more than health care workers have been trained and more than 11,500 designated laboratory Microscopy Centres have 11,500 designated laboratory Microscopy Centres have been upgraded and supplied with binocular microscopes been upgraded and supplied with binocular microscopes since the inception of the RNTCP since the inception of the RNTCP

DOTS A successful Programme DOTS A successful Programme to control Tuberculosisto control Tuberculosis

Revised National TB Control Programme and its Revised National TB Control Programme and its recent progress in DOTS expansion has been recent progress in DOTS expansion has been encouraging. As per Global TB Report 2003, encouraging. As per Global TB Report 2003, 2/3rd of the additional sputum positive cases 2/3rd of the additional sputum positive cases reported under DOTS in 2001, were found in reported under DOTS in 2001, were found in India. In 2002, over 620,000 cases were placed India. In 2002, over 620,000 cases were placed on treatment of which nearly 250,000 were new on treatment of which nearly 250,000 were new smear positive cases. In the year 2003, more smear positive cases. In the year 2003, more than 900,000 cases were placed on treatment. than 900,000 cases were placed on treatment.

Dr.T.V.Rao Dr.T.V.Rao MDMD

DOTS in 2009DOTS in 2009

By June 2009, more than 10.2 million By June 2009, more than 10.2 million patients have been initiated on treatment, patients have been initiated on treatment, saving more than 1.9 million additional saving more than 1.9 million additional lives. The success of DOTS in India has lives. The success of DOTS in India has contributed substantially to the success of contributed substantially to the success of TB control in the world. TB control in the world.

Revised National TB Control Revised National TB Control ProgrammeProgramme

The Revised National TB Control Programme The Revised National TB Control Programme now aims to widen the scope for providing now aims to widen the scope for providing standardized, good quality treatment and standardized, good quality treatment and diagnostic services to all TB patients in a diagnostic services to all TB patients in a patient-friendly environment, in which ever patient-friendly environment, in which ever health care facility they seek treatment from. health care facility they seek treatment from. Recognizing the need to reach to every TB Recognizing the need to reach to every TB patient in the country, the programme has made patient in the country, the programme has made special provisions to reach marginalized special provisions to reach marginalized sections of the society, including creating sections of the society, including creating demand for services through specific advocacy, demand for services through specific advocacy, communication and social mobilization activities. communication and social mobilization activities.


MDR TuberculosisMDR Tuberculosis

MMDRTB refers to strains DRTB refers to strains of the bacterium which of the bacterium which are proven in a laboratory are proven in a laboratory to be resistant to the two to be resistant to the two most active anti-TB most active anti-TB drugs, isoniazid and drugs, isoniazid and rifampicin. Treatment of rifampicin. Treatment of MDRTB is extremely MDRTB is extremely expensive, toxic, expensive, toxic, arduous, and often arduous, and often unsuccessful. unsuccessful.


DOTS Can reduce MDR DOTS Can reduce MDR TuberculosisTuberculosis

DOTS has been proven to prevent the DOTS has been proven to prevent the emergence of MDRTB, and also to emergence of MDRTB, and also to reverse the incidence of MDRTB where it reverse the incidence of MDRTB where it has emerged. MDRTB is a tragedy for has emerged. MDRTB is a tragedy for individual patients and a symptom of poor individual patients and a symptom of poor TB management. The best way to confront TB management. The best way to confront this challenge is to improve TB treatment this challenge is to improve TB treatment and implement DOTS. and implement DOTS.


What the World need to control What the World need to control TuberculosisTuberculosis

Better TB diagnosticsBetter TB diagnostics — — that are rapid, practical and that are rapid, practical and accurate in resource-poor settings — are critical to accurate in resource-poor settings — are critical to ensuring that people receive proper and timely ensuring that people receive proper and timely treatment. treatment.

New TB drugsNew TB drugs — — that will shorten treatment, be effective that will shorten treatment, be effective against susceptible and resistant strains, be compatible against susceptible and resistant strains, be compatible with antiretroviral therapies used for HIV/AIDS and that with antiretroviral therapies used for HIV/AIDS and that will improve treatment of latent infection — will will improve treatment of latent infection — will dramatically improve TB treatment and controldramatically improve TB treatment and control

A new vaccineA new vaccine — — that is both effective and safe for children, that is both effective and safe for children, adolescents and adults, including people infected with adolescents and adults, including people infected with HIV — will decrease TB incidence overall and, along with HIV — will decrease TB incidence overall and, along with an effective drug therapy, could eventually control the an effective drug therapy, could eventually control the disease. disease.

The TB Research MovementThe TB Research Movement

The development of the Research The development of the Research Movement was mandated in 2006 by the Movement was mandated in 2006 by the Stop TB Partnership Coordinating Board Stop TB Partnership Coordinating Board and WHO's TB advisory body. The and WHO's TB advisory body. The increasing recognition of the importance of increasing recognition of the importance of TB research is reflected by the TB research is reflected by the incorporation of the need to enable and incorporation of the need to enable and promote research as a key element of promote research as a key element of WHO's new WHO's new Stop TB StrategyStop TB Strategy (launched (launched in 2006). in 2006).

Control of TB is a Team WorkControl of TB is a Team Work

World TB Day celebrated with a World TB Day celebrated with a New Theme Every YearNew Theme Every Year

The 2010 World TB Day campaign, On the move against tuberculosis: Innovate to accelerate action, launched , speaks to the need for a new way forward. World TB Day is held each year on 24 March.


Stopping spread of Tuberculosis is a Stopping spread of Tuberculosis is a concern to everyone concern to everyone

Let us be united to control Let us be united to control TBTB

STOP TBSTOP TB Everyone's ConcernEveryone's Concern


Created for Dr.T.V.Rao MD’s “e” Created for Dr.T.V.Rao MD’s “e” learning Programmelearning Programme

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World Tb Day

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