TUBERCULOSIS

BY: IFEOLUWA DEBORAH OLOPADE

OUTLINE
EPIDEMIOLOGY OF TUBERCULOSIS
• BASIC SCIENCE OF TUBERCULOSIS
• BIOLOGY OF TUBERCULOSIS
• EPIDEMIC PATTERN OF TUBERCULOSIS
• ENDEMIC PATTERN OF TUBERCULOSIS IN NIGERIA
• HISTORY OF TUBERCULOSIS
• INCIDENCE RATE OF TUBERCULOSIS
• RISK FACTORS OF TUBERCULOSIS
BASIC SCIENCE OF TUBERCULOSIS
Tuberculosis (TB) is a contagious disease caused by Mycobacterium tuberculosis. It is an airborne and contagious
disease. There are three forms of TB:
 Active TB disease: This happens when TB bacteria affects the lungs and rapidly multiplying and invading
various organs of the body. The manifestations of the disease show in patients with Active TB.
 Miliary TB disease: It is a rare and serious form of the infection.
 Latent TB disease: it is not a severe form of the infection. People with the latent form of the infections show
no symptoms and cannot spread the infection.
BIOLOGY OF TUBERCULOSIS
Tuberculosis is caused by Mycobacterium tuberculosis. The causative agent of TB is a bacterium. The bacterium
is an obligate aerobe; it requires oxygen for its survival. It is an acid fast organism. It is said to be weakly gram
positive, it does not stain well with the Gram staining procedure. Mycobacterium tuberculosis has a lot of fatty
acids known as Mycolic acid in its cell wall which makes it waxy, hydrophobic and impermeable to simple and
routine staining methods. The acid fast staining procedure also known as the Ziehl-Neelson staining technique is
employed in the laboratory diagnosis of this organism.
Mycobacterium tuberculosis
EPIDEMIC PATTERN OF TB
TB is the most ancient disease in the world and a serious disease in HIV/AIDS patients. TB is still a public health
problem in the present world. Despite the decrease in incidence, morbidity and mortality remain partially due to
co-infection with Human Immunodeficiency Virus and emergence of drug resistant bacilli. According to WHO,
annually, it is estimated that 10 million people develop TB disease and 1.6 million people die of it.
 ENDEMIC PATTERN OF TB IN NIGERIA
According to WHO, Nigeria is one of the countries with a high burden of TB worldwide. It is estimated that almost
half a million people every year in Nigeria get infected with TB. The problem of TB has been made worse by the
issues of drug resistant TB and the HIV/AIDS epidemic.
HISTORY OF TUBERCULOSIS

 On March 24, 1882, Dr. Robert Koch, a German physician discovered the causative agent responsible for TB
infection which is Mycobacterium tuberculosis. His discovery supported the Germ theory of diseases. The
theory states that ‘microorganisms are the causes of infectious diseases’. World TB day is on March 24.
INCIDENCE RATE OF TUBERCULOSIS
About one-quarter of the world’s population is infected with TB. In 2020, an estimated 10 million people fell ill
with TB worldwide. TB is present in all countries and age groups but, TB is curable and preventable. A total of
1.5 million people died from TB in 2020 worldwide, TB is the 13th leading cause of death and the second leading
infectious killer after COVID-19. TB incidence rate was 158 per 10 000 per people, while the total number of TB
mortality was
39 933 deaths. In 2020, the largest number of TB cases occurred in South-East Asian Region with 43% of new
cases, followed by the African Region with 25% and the Western Pacific with 18%
RISK FACTORS
 Apart from HIV-immunocompromised patients, it is found out that people can get infected with TB through
close-contact situations like overcrowding, taking alcohol, malnutrition and drug abuse. Certain diseases like
cancer, diabetes and also smoking can predispose to the disease.
PREVALENCE OF THE DISEASE IN AFRICA AND THE WORLD

 PREVALENCE OF THE DISEASE

 GLOBAL IMPACT OF THE DISEASE
PREVALENCE OF THE DISEASE IN AFRICA AND THE WORLD

In 2016, tuberculosis was the ninth leading cause of death worldwide, ranking above HIV/AIDS. In 2016, 2.5
million people fell ill with TB in the African region, accounting for a quarter of new TB cases worldwide. An
estimate 417 000 people died from the disease in the African region(1.7 million globally) in 2016. over 25% of TB
deaths occur in the African region. Seven countries account for 64% of the new TB cases in 2016, with India
leading the count, followed by Indonesia, China, Philippines, Pakistan, Nigeria and South Africa. In 2016, an
estimated 1 million children became ill with TB and 250 000 died of TB. IN 2016, 40% OF HIV deaths were due
to TB.
GLOBAL IMPACT OF TUBERCULOSIS
Globally, TB incidence is falling about 2% per year and between 2015 and 2020. The cumulative reduction was
11%. This was over the halfway to the end TB strategy milestone of 20% reduction between 2015 and 2020. An
estimated 66 million lives were saved through TB diagnosis and treatment between 2000 and 2020. By 2022, US
$billion is needed for TB prevention, treatment and care to achieve the global target agreed at the UN high level
meeting on TB in 2018.
TYPE OF ORGANISM

Tuberculosis is a chronic contagious infection caused by an airborne bacteria known as Mycobacterium

tuberculosis which usually affects the lungs. Mycobacterium are acid fast organisms. Mycobacterium
tuberculosis contain mycolic acid. Pathogenic mycobacteria include the organism that causes tuberculosis;
Mycobacterium tuberculosis and the organism that causes leprosy; Mycobacterium leprae.
 MICROORGANISMS RESPONSIBLE FOR THE
DISEASE
Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into
the air. This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes,
spits, laughs or sings.
Although tuberculosis is contagious, it’s not easy to catch. You’re much likely to get tuberculosis from someone
you live or work with than from a stranger. Most people with active TB who’ve had appropriate drug treatment
for at least two weeks are no longer contagious.
SIGNS AND SYMPTOMS OF THE DISEASE

 SYMPTOMS OF TB
 SIGNS OF TB
SYMPTOMS OF TB

Most people with tuberculosis don’t have symptoms but when they occur, the victim will experience a cough
with blood droplets, emaciation, night sweats and fellers.
Latent TB: This is when you have TB infection, but the bacteria in your body are inactive and cause no
symptoms. Although, latent TB can turn into active TB so treatment is important.
Active TB: This condition makes you sick and in most cases, can spread to others. It can occur weeks or years
after infection with TB bacteria. Beyond the lungs, symptoms include: persistently swollen lymph nodes,
abdominal pain, joint or bone pains, a persistent headache, seizures.
SIGNS OF TUBERCULOSIS

Signs of tuberculosis include:

 Coughing for three or more weeks
 Coughing of blood or mucus(phlegm)
 Chest pain or pain with breathing or coughing
 Unintentional weight loss and loss of appetite
 Fatigue
 Fever
 Night sweats
 Chills, swollen lymph nodes
MODE OF TRANSMISSION

Tuberculosis is transmitted through the air not by surface contact. Transmission occurs when a person inhales
droplet nuclei containing Mycobacterium tuberculosis. The source of infection is usually a patient with pulmonary
or laryngeal TB. During coughing, speaking or sneezing, the patient produces tiny infectious droplets. The droplet
nuclei are about 1 to 5 microns in diameter. The droplet nuclei transverse the mouth or nasal passages, upper
respiratory tract and bronchi to reach the alveoli of the lungs. Transmission may occur when these infectious
droplets are inhaled. UV light and ventilation reduce the probability of transmission. Children are generally much
less infectious than adults. This may be due to weaker cough mechanics, less sputum production and lower
bacillary load.
INCUBATION PERIOD

The incubation period for TB is measured from the time of exposure to the time of development of a positive
tuberculin skin test. In most individuals, the incubation period varies from appropriate 2 to 12 weeks. However,
the risk for developing active TB is highest in the first 2 years of infection and development of a positive TB skin
test. TB has a long incubation period. Some people develop TB disease rapidly, others may get sick later, when
their immune system becomes weak for another reason.
DIAGNOSIS

Diagnosing TB can be a complex process. Doctors will first consider a person’s history and the likelihood they
were exposed to someone with active TB.
TB infection is often diagnosed with a skin or blood test, a chest x-ray and examination and culture of a sputum
sample. Ziehl-Neelsen staining is carried out to detect the acid-fast bacilli in samples.
A positive TB skin or blood test only tell that a person has been infected with the bacteria. The most commonly
used is a skin test. A small amount of a substance called TUBERCULIN, which is injected just below your skin
on the inside of your forearm.
Mycobacterium tuberculosis (Acid-fast bacilli)
TREATMENT
With early detection and appropriate antibiotics, TB is treatable. The right type of antibiotic and length of
treatment will depend on;
 The person’s age and overall health
 The location of the infection
 Whether the strain of TB is drug resistant
Treatment for latent TB can vary. It may involve taking an antibiotic once a week for 12 weeks or every day for
9 months.
Treatment for active TB may be severe. The patient may be treated with a combination of antibacterial
medications for a period of 6-12 months. It is essential for people to complete the full course of treatment, even
if symptoms go away.
PREVENTION OF TUBERCULOSIS
 A good ventilation
 Good hygiene
 Constant use of medication
 Regular check ups
 Use of UV lamps to kill airborne bacteria
 Use of prophylaxis for infected individuals
CONTROL OF TUBERCULOSIS
• Availability of recommended laboratory processing, testing and reporting of results.
• Effective work practices for managing patients.
• Proper disinfection of equipment.
• Enlightenment of the public about the disease.
• Use of posters and signs to ensure proper respiratory hygiene.
• Screening and testing of people who are at risk for exposure to TB disease.
CONCLUSION

Tuberculosis is a highly infectious disease that affects people with reduced immunity. TB is preventable and
curable. Wherever you are support TB control because Tuberculosis is a disease without boundaries. ‘TB
ANYWHERE IS TB EVERYWHERE’.
References

 WHO TB Report
 WHO Tuberculosis fact sheet