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25 Epidemiology of Tuberculosis by DR - Faryal Shaikh (22nd Feb 2023)

The document provides an overview of the epidemiology of Tuberculosis (TB), detailing its determinants, transmission, and global and local statistics, particularly in Pakistan. It outlines the National Tuberculosis Control Program's objectives and the WHO's global strategies for TB control, including the DOTS, STOP TB, and END TB strategies. The Xpert MTB/RIF assay is highlighted as a significant advancement in TB diagnosis, contributing to rapid detection and treatment efforts.

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Awais Irshad
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14 views20 pages

25 Epidemiology of Tuberculosis by DR - Faryal Shaikh (22nd Feb 2023)

The document provides an overview of the epidemiology of Tuberculosis (TB), detailing its determinants, transmission, and global and local statistics, particularly in Pakistan. It outlines the National Tuberculosis Control Program's objectives and the WHO's global strategies for TB control, including the DOTS, STOP TB, and END TB strategies. The Xpert MTB/RIF assay is highlighted as a significant advancement in TB diagnosis, contributing to rapid detection and treatment efforts.

Uploaded by

Awais Irshad
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Epidemiology of Tuberculosis

BY
DR. FARYAL SHAIKH
MBBS,MPH
SENIOR LECTURER, FRPMC
Learning Objectives :

By the end of session, students will be able to:


 Delineate epidemiological determinants of
Tuberculosis (TB)
 Discuss epidemiology of Tuberculosis globally and
locally
 Describe key objectives of National program for TB
control and prevention
 Discuss the WHO Global TB Strategies
Tuberculosis :

 Myocobacterium Tuberculosis
 It affects primarily lungs
 Also affect
- Intestine
- Meninges
- Bones & Joint
-Lymph gland, skin & other tissues
 TB is curable and preventable
Epidemiological Determinants of TB:
 Agent :
 Source of infection:
- Human case whose sputum is positive for tubercle bacilli
- Bovine source
 Host Factors :
- Age: Affects all ages. Sharp rise in infection rates from
childhood to adolescence
- Sex: More prevalent in males than in females
- Immunity :
Mode of Transmission :

 TB is transmitted mainly by droplet infection


and droplet nuclei
 Incubation Period : 3 to 6 weeks
Tuberculosis- Epidemiology
 TB is the 13th leading cause of death and the second leading
infectious killer globally
 In 2021, an estimated 10.6 million people fell ill with TB worldwide.
- Six million men, 3.4 million women and 1.2 million children
 Multidrug- resistance TB ( MDR-TB) remains a public health crisis
and health security threat
 An estimated 66 million lives were saved through TB diagnosis
and treatment between 2000 and 2020
 Ending the TB epidemic by 2030 is among the health targets of UN
SDGs
Ref: World Health
Organization
Situation Analysis of TB in Pakistan :
 Pakistan ranks 5th amongst the high burden countries
in the world.
 The prevalence and mortality per 100,000 population
per year from TB in Pakistan are 348, 276 and 34
respectively.
Control of Tuberculosis (TB):

The control measures consists of :


 Curative component

- Case finding
- Intensified TB Case finding :
- Case-finding Tools :
(a) Sputum examination (b) Ziehl-Neelsen acid-fast stain
(c) Fluorescence microscopy (d) Radiography (e) Sputum culture
(f) Genotypic methods : 1) PCR 2) NAAT 3) GeneXpert MTB/RIF
(g) Skin sensitivity test: 1) Tuberculin test 2) Mantoux test
- Treatment
 Preventive component

- BCG vaccination
A New Tool to Diagnose Tuberculosis: The Xpert
MTB/RIF Assay
 The Xpert MTB/RIF assay is a new test that is revolutionizing
tuberculosis (TB) control by contributing to the rapid diagnosis of TB
disease and drug resistance.

Advantages of The Xpert MTB/RIF Assay:


 Results are available quickly
 Minimal technical training is required to run the test.

Ref CDC
National Tuberculosis Control Program (NTP)
NTP revived under Ministry of Health subsequent to
declaration of TB as national emergency in Pakistan in
2001 and is currently working along with National Institutes
of Health, Pakistan
Vision:
Universal access to quality TB care and achieving Zero TB
death
Goal :
TB free Pakistan by reducing 50 % prevalence of TB in
general population by 2025
Key Objectives of NTP :

 To increase the number of notified TB cases and


maintaining the treatment success rate at 91%
 To reduce the prevalence of MDR-TB by atleast 5% per
year by 2020
 Strengthen programmatic and operational
management capacity of TB Control program while
enhancing public sector support by 2020
WHO Global TB Strategies :

 The DOTS Strategy (1994)


 The STOP TB Strategy (2006)
 The END TB Strategy (2015)
The DOTS Strategy :
 To ensure cure by providing the most effective medicine
and confirming that it is taken
Components of DOTS strategy:
1. Government commitment
2. Case detection through passive case finding
3. Standardized short-course chemotherapy to atleast all
confirmed sputum smear positive cases of TB
4. Establishment of system for regular drug supply of all
essential anti-TB drugs
5. Maintenance of a monitoring system for program
supervision and evaluation
The Stop TB Strategy :
Objectives:
1. Universal access to high quality care for TB
2. Protect vulnerable population
3. Support new tools

Goal :
To reduce global burden of TB by 2015
Components of Stop TB Strategy :

 Pursue high quality DOTS expansion and


enhancement
 Address TB/HIV,MDR-TB and other challenges
 Contribute to health system strengthening
 Engage all care providers
 Empower people with TB and communities
 Enable and promote research
The END TB Strategy (2016-2035):

Vision: A world free of TB-zero deaths ;disease and


suffering
due to TB

Goal : To end the global TB epidemic


The END TB Strategy (2016-2035):

To facilitate the adoption of the End TB Strategy, a


framework of three pillars was established:

1) integrated, patient-centered care and prevention


2) bold policies and supportive systems
3) intensified research and innovation
References :

 Park’s Textbook of Preventive and Social Medicine 25th edition


 World Health Organization
 National Tuberculosis Control Program- National Institutes of
Health
Available at : of https://www.nih.org.pk/national-tb-control-
program
Thank you

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