What is TB?

• Tuberculosis is an airborne infectious disease,

caused by bacilli called the Mycobacterium
tuberculosis
 Is an infectious disease caused by –
Mycobacterium Tuberculosis
 Primarily effects lungs and causes – Pulmonary TB
 Also effects- intestine, meninges, bones, joints,
lymph glands, skin.(Extra pulmonary)

 Also Effects animals- known as bovine TB

 Incubation period- 3-6 wks
TB INFECTION
 TB DISEASE
• the bacteria may grow and cause active TB
disease. TB symptoms may include a constant
cough that lasts two or more weeks, chest
pain, weakness, and loss of appetite. When a
person has active TB disease, the individual
may be contagious and cause infection in
other people, particularly those with whom
they spend the most time.
 Agent-
• Mycobacterium Tuberculosis
• Bovine
• Atypical-
 Source of infection
There are two sources
Human source- sputum positive case
Bovine source- infected milk

Communicability- patients are infective as long

as they are untreated
 Host factors
• Age- all ages
• Sex- more in male
• Heredity- no
• Nutrition-malnutrition
• Immunity- by natural infection or BCG
vaccination.
 Social factors
• Poor housing
• Poor quality of life
• Overcrowding
• Under nutrition
• Smoking
• Lack of education
• Lack of awareness
 Mode of transmission

• Droplet infection
• Droplet nuclei
 Examination of Sputum Specimens

• Sputum microscopy should be performed in all presumptive

TB cases on two sputum specimens, as follows:
• For Laboratory:
• Spot specimen
• Early morning specimen (on the following morning)
• For Out reach:
• Early morning specimen
• Spot specimen
 Control of TB
• CURATIVE- case finding and treatment
• PREVENTIVE- BCG vaccination
• Drugs
• First line tuberculosis drugs
Ethambutol
Isoniazid INH H
Pyrazinamide PZA Z
Rifampicin RMP R
Streptomycin STM S Second line tuberculosis
drugs
• Streptomycin STM S Second line tuberculosis drugs
aminoglycosides : e.g., amikacin (AMK), kanamycin
(KM);
• polypeptides e.g., capreomycin, viomycin,
enviomycin;
• fluoroquinolones : e.g., ciprofloxacin (CIP),
levofloxacin, moxifloxacin (MXF);
• thioamides : e.g. ethionamide, prothionamide
• cycloserine
• terizidone
 MDR TB
• Multi-drug-resistant tuberculosis (MDR-TB) is
a form of tuberculosis (TB) infection caused by
bacteria that are resistant to treatment with at
least two of the most powerful first-line
anti-TB medications (drugs), isoniazid and
rifampin. Although its causes are microbial,
clinical and programmatic, MDR-TB is
essentially a man-made phenomenon
 XDR TB
• Some forms of TB are also resistant to
second-line medications, and are called
extensively drug-resistant TB (XDR-TB)
• Extensive drug-resistance (XDR): MDR TB Plus
resistance to at least one of the
fluoroquinolones, and at least one of three
injectable second line drugs (Capreomycin,
Kanamycin and Amikacin).