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Tuberculosis: History, Epidemiology, Pathogenesis, Immunity
Tuberculosis: History, Epidemiology, Pathogenesis, Immunity
Tuberculosis: History, Epidemiology, Pathogenesis, Immunity
history, epidemiology,
pathogenesis, immunity
Lecturer: Ph.D
M.G.Dolynska
The magnitude of the problem
Tuberculosis kills more than 3 million people per
year
Tuberculosis produces 25% of all avoidable
deaths in developing countries
Tuberculosis produces more death than any
other single infectious disease , so its the
deadliest one
About the 1/3 of the world population are
infected by tuberculosis
Tuberculosis uniqueness
the most ancient among known infection
the most ubiquitous infection
infection which can coexist with the
human being without producing the
disease
infection from which human being isn’t
able to deliver
Main reasons for tuberculosis
reappearance as a global
challenge
Drug-resistance
HIV
Social disturbances
Types of Approaches to the
Epidemiology of Tuberculosis
o Descriptive epidemiology
o Etiologic epidemiology
o Predictive epidemiology
Tuberculosis prevalence
Low (less than 30 cases per 100000) −
Western Europe, USA
Moderate (30-90 cases per 100000) −
Central Europe
High (more than 90 cases per 100000) −
Southeast Asia
Western Pacific
Africa
Eastern Mediterranean
Europe
Americas
0 1 2 3 4
Number of cases (in million)
Dye C, et al. J Am Med Assoc 1999;282:677-86
Afg
h
a
n
istan
Annual Risk of Tuberculous Infection in
Low Income Countries of Five WHO Regions
T
h
a i
l n
d
4
G
a
m
biaP a
kistC
a
n L
e
so
Bth
o
to
s
w
a
nPK
h
i
l
po
r
i
ne
a
e
s
Risk of infection (%)
3 Africa
h
i
n a Tza
n
i
a
Americas
A
rge iyaS
n
tLb am
oa
South-East Asia
M
lKy
ius
a A lg
er
i
a
2
atBahran
Eastern Mediterranean
w Y
e
a
r
Western Pacific
1
0
70 75 80 85
o Descriptive epidemiology
o Etiologic epidemiology
o Predictive epidemiology
Mycobacteria types
1. M. causing tuberculosis
M. tuberculosis (human)
M. bovis.
M. Africans.
2. Non-patogenous M.
M.avium-intracellulare.
M.smegmaticus.
M. xenopi
M. scrofulaceum.
3. M. causing leprosy
M. leprae
Mycobacteria important properties
o Droplet
Alimentary
Contact
Vertical
Risk of Infection Among Contacts as
a Function of the Proximity of Contact
Number of Droplets produced by Different
Aerosol Producing Maneuvers
50000
40000
Number of droplets
C
oughingT
alkingS
inging
30000
20000
10000
o Descriptive epidemiology
o Etiologic epidemiology
o Predictive epidemiology
A
M
o
isk R
R de
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f
or
t
he
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p
i
d
isk Re
m
i
olgy
o
f
Tu
b
e
rc
u
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o
s
isk Ri isk
factors factorsS f
a
ct
o
r
s I
t
u n
bf
erct
i
o lu si f
a
c
to
r
s
Exposure iu
b c
lnfeitnocalN o n
-tube
irfe
c
tulisous D
e
at
h
R
iedrH
L.Infection195;23:1-4
Risk groups
Medical
HIV-positive people
Social
Any kind of marginal population