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Tuberculosis (TB) Basics: Treatment Action Group TB/HIV Advocacy Toolkit January 2021
Tuberculosis (TB) Basics: Treatment Action Group TB/HIV Advocacy Toolkit January 2021
With thanks to Adam Almeida, Andolyn Medina, and Dr. Jennifer Furin
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•Fundamentals of TB
•Transmission of TB
•Immune Response to TB
Overview •TB Infection vs. TB Disease
•Drug Sensitive vs. Resistant TB
•Global Statistics
•TB and COVID-19
•Key Takeaways
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FUNDAMENTALS OF TB
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FUNDAMENTALS
What is
Tuberculosis?
• Tuberculosis, commonly known as TB, is a disease that most commonly affects the lungs
• TB infection is caused by bacteria, called Mycobacterium tuberculosis (MTB)
• Under a microscope, MTB is identified by its long, rod-like shape and its waxy
appearance
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FUNDAMENTALS
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TRANSMISSION OF TB
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TRANSMISSION
How is TB Transmitted?
• TB is passed (transmitted) through the air
when someone who is infected coughs,
sneezes, shouts, or sings
• Droplets of saliva contain thousands of
TB bacilli
• Once inhaled, the droplets push their way
into the lungs, settling in tiny air sacs
(alveoli)
• TB is NOT spread through touch, blood,
sperm, vaginal fluids, food or liquids,
sharing utensils, dust, dirt, or vehicle
fumes
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TRANSMISSION
Factors related to the person with TB (index case):
• Bacillary count/load (amount of MTB in the body)
• Presence of TB in lungs (pulmonary TB) and a cough
• Being on effective TB medication
After 2-3 weeks on an effective treatment regimen,
people are usually not infectious anymore, though
What Affects must continue treatment through cure
• Wearing a mask
Transmission?
Factors related to the person being exposed to TB
(contact):
• Closeness and frequency of contact with index case
• Age of contact (children and older persons are more likely to
develop TB)
• Wearing an N-95 respirator (special kind of mask)
Environmental factors:
• ventilation
• size of room or space
• duration of exposure
• sunlight or ultraviolet (UV) light (sunlight/UV light kills TB
bacteria)
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1.TB is a virus.
a) True
b) False
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THE IMMUNE RESPONSE TO TB
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IMMUNE RESPONSE
The Immune
Response To TB
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IMMUNE RESPONSE
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IMMUNE RESPONSE
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TB INFECTION VS. TB DISEASE
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INFECTION VS DISEASE
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INFECTION VS DISEASE
(Latent)TB
Infection
vs.
(Active) TB
Disease
Latent TB TB Disease
TB lives but doesn’t grow in the body TB is active and grown in the body
Doesn’t make a person feel sick or Makes a person feel sick and have
have symptoms symptoms
Can’t spread from person to person Can spread from person to person
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INFECTION VS DISEASE
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INFECTION VS DISEASE
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INFECTION VS DISEASE
A functional immune
system takes many years to As children age Adolescents (ages
develop in a child. and their 10 to 18 years)
immune systems are more likely
develop, they to develop TB.
can better This may be due
control TB when to the impact of
exposed. If they get hormones/ puberty on
sick, they tend to have the immune response
a disease that is more to TB and increased
like adults. social activity.
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INFECTION VS DISEASE
TB meningitis (TB in
the brain/nervous
system)
70-80% of children with
TB in Miliary or
disseminated TB (TB
TB have TB in the chest
and lungs (pulmonary
Children throughout the body) TB)
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1. It is possible to be infected with TB but to not have
symptoms or disease.
a) True
b) False
2. Which of the following can affect an individual’s risk
of TB infection progressing to active disease?
a) HIV
b) Malnutrition
c) Age
d) All of the above
3. Miliary TB is in what part(s) of the body?
a) Brain and nervous system
b) Bones and spine
c) Disseminated throughout the body
d) Lungs
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DRUG-SENSITIVE VS. DRUG-RESISTANT TB
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DRUG-SENSITIVE
VS. RESISTANT TB
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DRUG-SENSITIVE
VS. RESISTANT TB
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DRUG-SENSITIVE
VS. RESISTANT TB
TB Treatment Regimens
DRUG-SENSITIVE TB DRUG-RESISTANT TB
(DS-TB) (DR-TB)
4–6 months 6–20 months
4 drugs 3–8 drugs
first-line medicines second-line, new /
repurposed medicines
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1. Drug-resistant TB is less likely to be transmitted
between people.
a) True
b) False
2. How does drug resistance develop?
a) Inadequate drug exposures
b) Prescription for inappropriate/weak regimen
c) Inconsistent adherence to treatment
d) Naturally occurring mutations
3. XDR-TB is resistant to which of the following
medicines?
a) rifampicin
b) isoniazid
c) moxifloxacin
d) bedaquiline
e) All of the above
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GLOBAL STATISTICS
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STATISTICS
Global Estimates of TB
It is There were An estimated There were an Geographically,
estimated an estimated 1.2 million estimated most people who
that one- 10.0 million children 1.2 million deaths from developed TB in
fourth of new cases of became sick TB in 2019 (nearly 5,000 2019 were in
the world TB in 2019 with TB in deaths per day) South-East Asia
is infected (active TB 2019 TB is the number one (44%), Africa
with TB disease), (children killer of people living (25%), and the
(latent TB among which account for with HIV, accounting for Western Pacific
infection) 500,000 had 12% of the an additional 208,000 regions (18%)
drug- global deaths in 2019
resistant TB disease
Until recently overtaken
burden)
by COVID-19, TB was
the leading infectious
cause of death
worldwide
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STATISTICS
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STATISTICS
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TB AND COVID-19
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TB AND COVID-19
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TB AND COVID-19
Resources
2020 UNSG Report on TB:
https://www.who.int/news/item/21-10-2020-un-secretar
y-general-outlines-priority-recommendations-to-acceler
ate-the-tb-response-and-reach-targets
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KEY TAKEAWAYS
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KEY TAKEAWAYS
1 3 4 5
Tuberculosis (TB) Drug TB is a common
There is a resistance,
is a disease
spectrum of
caused a result of co-infection
TB disease,
by the bacteria, inadequate among, and the
including:
Mycobacterium or irregular number one
tuberculosis (Active) TB TB drug killer of, people
Disease: when exposures, living with HIV
the presence is on the rise
2 of MTB causes and evolving 6
TB is spread Coordinated
disease with
through saliva efforts are
(Latent) TB increased use
droplets in the air needed to
Infection: when of new and
when a person sick address TB
MTB is present repurposed
with pulmonary TB in the era of
without disease TB medicines
coughs, sneezes, COVID-19
shouts, or sings
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