TB and DOTS肺结核与点.pptVIP

TB: A Global Emergency 1/3 of the world (2 billion people) infected 1 person infected/second resulting in 30 million new infections, 8 million new cases Left untreated 1/3 die, 1/3 self-cure, 1/3 remain infectious TB kills 1 person every 10 seconds = 5000/day = 2-3 million each year 22 High Burden Countries India China Indonesia Bangladesh Pakistan Nigeria Philippines South Africa Ethiopia Vietnam Russian Federation Congo Brazil Tanzania Kenya Thailand Myanmar Afghanistan Uganda Peru Zimbabwe Cambodia TB: Clinical Features TB is caused by Mycobacterium tuberculosis TB can affect any organ system: bone, kidney, CNS; 80% are pulmonary Classic pulmonary systems of active disease: cough 3 weeks duration, chest pain, bloody sputum Classic systemic symptoms: fever, night sweats, weight loss, malaise Treated for many years with long hospitalization, surgery, myriad of drugs leading to belief that TB is not treatable or treatment worse than disease. TB Infection vs TB Disease TB infection – organism is present, but dormant, cannot infect others TB disease – person is sick and can transmit disease to others if in lungs 10% of individuals with TB infection will develop TB disease Each individual with active TB can infect 10-15 people/year When does TB infectionbecome disease? Most likely to occur in first two years after infection If person becomes immunocompromised HIV Cancer Chemotherapy Poorly controlled diabetes malnutrition The 5 Essential Components of the DOTS Strategy Government commitment to a National TB Program Priority to detect infectious cases by sputum smear microscopy Standardized regimens of short-course chemotherapy, given under direct observation for , at least, the intensive phase Regular, uninterrupted supply of anti-TB meds Monitoring system for program supervision and evaluation 1. Political/Administrative Commitment Perception of TB as a priority problem with real solution Government acknowledges importance of disease Public commitment to Nat