RCUL
OSIS
Prepared by:
Mecor M. Riego
BSM III
Source: ww.who.int
TB Burden in the
Philippines
What is Tuberculosis?
Tuberculosis (TB) is an infection caused by bacteria that usually affect the lungs. These bacteria, called
Mycobacterium tuberculosis, can be passed on to another person through tiny droplets spread by coughing and
sneezing. Even the accidental spread of saliva through laughing, singing, and spitting can pass on the TB
bacteria.
The Tubercle Bacilli or Mycobacterium Tuberculosis is the bacteria that cause Tuberculosis. It can be seen
under the microscope as red rods. The TB germ, as it is also called, is slow growing, thus no immediate signs
and symptoms can be seen in an infected person. It is only when the TB germ multiplies in number that the TB
infection will develop into a TB disease. When this happens, signs and symptoms will be manifested. The TB
germ can easily be killed when exposed to direct sunlight.
How it is TRANSMITTED?
A person with TB can transmit the bacteria when he or she coughs and/or sneezes, laughing,
shouting. The TB germ is airborne, thus inhalation of droplets from a person with TB may cause TB
infection. Invasion may occur through mucous membranes or damaged skin.
But is should be emphasized that being TB infected does not absolutely lead to TB disease.
1. TB bacilli enters the body and lodges in the lungs (TB Infection).
2. In the lungs, they multiply and slowly eat the cells and the body begins to
experience symptoms (TB Disease)
3. If undiagnosed, lungs cells are eaten up leading that may lead death.
People who share the same breathing space with someone who has infectious TB
Health workers, especially those working in long-term facilities (prison, sanitariums, etc.)
People who are infected with HIV are 26 to 31 times more likely to become sick with TB Risk of active
TB is also greater in persons suffering from other conditions that impair the immune system.
People exposed to silica and those with jobs that compromise the respiratory system (mine workers)
People underweight and malnourished (esp. Children)
Alcoholics and IV drug users
Tuberculosis mostly affects young adults, in their most productive years. However, all age groups are at
risk. Over 95% of cases and deaths are in developing countries.
Over half a million children (0-14 years) fell ill with TB.
Tobacco use greatly increases the risk of TB disease and death. More than 20% of TB cases worldwide
are attributable to smoking.
How is TB diagnosed?
1. Sputum Microscopy
It shows the TB bacilli in the sputum.
It is the most definitive diagnostic tool of Tuberculosis.
2. Chest X-Ray
Determines extent of the lung damage
Not a very definitive diagnostic tool
How is TB cured?
TB can be cured.
DOTS (Directly-Observed Treatment Short Course) is the recommended strategy to cure TB. It ensures the right
combination and dosage of anti-TB drugs. It ensures regular and complete intake of anti-TB drugs.
Patient takes drugs every day with the help of a treatment partner.
What is DOTS?
D.O.T.S stands for Directly-Observed Treatment Short Course.
- It is a comprehensive strategy endorsed by the World Health Organization (WHO) and International Union Against
Tuberculosis and Lung Diseases (IUATLD) to detect and cure TB patients.
TB recording and reporting systems, Global TB Control Report, data and country profiles, TB planning
and budgeting tool, WHO epidemiology and surveillance online training
b. Extra-pulmonary TB (EPTB) Refers to a case of tuberculosis involving organs other than the lungs (e.g.,
larynx, pleura, lymph nodes, abdomen, genitourinary tract, skin, joints and bones, meninges). Histologicallydiagnosed EPTB through biopsy of appropriate sites will be considered clinically-diagnosed TB. Laryngeal TB,
though likely sputum smear-positive, is considered an extrapulmonary case in the absence of lung infiltrates on
CXR.
Classification based on drug-susceptibility testing
a. Monoresistant-TB Resistance to one first-line anti-TB drug only.
b. Polydrug-resistant TB Resistance to more than one first-line anti-TB drug (other than both Isoniazid and
Rifampicin).
c. Multidrug-resistant TB (MDR-TB) Resistance to at least both Isoniazid and Rifampicin.
d. Extensively drug-resistant TB (XDR-TB) Resistance to any fluoroquinolone and to at least one of three
second-line injectable drugs (Capreomycin, Kanamycin and Amikacin), in addition to multidrug resistance.
e. Rifampicin-resistant TB (RR-TB) Resistance to Rifampicin detected using phenotypic or genotypic
methods, with or without resistance to other antiTB drugs. It includes any resistance to Rifampicin, whether
monoresistance, multidrug resistance, polydrug resistance or extensive drug resistance.
Protionamide
Group 5 TB drugs: Agents with an unclear role in the treatment of drug resistant TB
Clofazimine
Linezolid
Amoxicillin/clavulanate
Thioacetazone
Imipenem/cilastatin
High dose isoniazid
Clarithromycin
Classification of Patients in Categories for Standardized Treatment Regimen