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Tuberculosis

Introduction & The Global Picture

November 3rd, 2009


Lecture Notes
Page 1 of 16 foundations of health science
What is it?

Historically TB disease known as:

• Phthisis (ancient Greeks)

• Tabes (Romans)

• Rajayakshma (India)

• Consumption (Victorian England)

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Lecture Notes foundations of health science
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TB Infection Vs. TB
Disease

Begins with latent infection = exposure to TB bacillus

Latent infection is asymptomatic

Usually affects the lungs and respiratory tract

TB can affect other organ systems in the body

• Pulmonary disease (primarily)


• Extrapulmonary disease
• Systemic infection when lymphatic dissemination spreads TB bacilli
throughout body

November 3rd, 2009


Lecture Notes foundations of health science
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Symptoms
(Pulmonary disease)

1. bad cough that lasts longer than 2 weeks


2. pain in the chest
3. coughing up blood or sputum (phlegm)
4. weakness or feeling very tired
5. weight loss
6. no appetite
7. chills
8. fever
9. night sweats.

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Lecture Notes foundations of health science
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The Organism

Tubercle bacilli (Koch, 1882)


Mycobacterium tuberculosis complex

• Group of five closely related mycobacteria


• Slender, slightly curved rod-shaped bacteria
• Slow growing; generation time (approximately 24 hours)
• High molecular weight of lipids in their cell walls

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Lecture Notes foundations of health science
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The Organism

-genetic mapping has indicated that bacteria not a mutation of M.bovis (theory that
was held until 10 years ago)

-million years ago in soil and water in Paleolithic period

-traces identified in Egyptian mummies from 3500-400 BC


-initial sporadic becoming endemic
-AD100 in Mediterranean states and Europe
-increased incidence during Industrial Revolution
-established in North America by the early 1700s
-largely unknown in Africa at the beginning of 1900s spread with European colonization

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TB – “iClicker”

1. Someone in the world is infected with TB:

a) Every week
b) Every day
c) Every minute
d) Every second

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TB – “iClicker”

2. This is the percentage of the world population


infected with the TB bacillus:

a) 5%
b) 15%
c) 35%
d) 50%

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Lecture Notes foundations of health science
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TB – “iClicker”

3. This is the percentage of people who are


infected with TB who become sick at some point
in their lifetime:

a) 5-10%
b) 15-20%
c) 50%
d) 100%

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TB – “iClicker”

4. In 2004, the largest number of new cases of


TB occurred in:

a) Africa
b) Western Pacific
c) Europe
d) South-East Asia

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Lecture Notes foundations of health science
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TB – “iClicker”

5. In 2004, the highest per capita incidence of TB


occurred in:

a) Africa
b) Western Pacific
c) Europe
d) South-East Asia

November 3rd, 2009


Lecture Notes foundations of health science
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TB – “iClicker”

6. In 2004, _______ people died from


tuberculosis around the world:

a) 700, 000
b) 1, 700,000
c) 2, 300,000
d) 3, 000, 000

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TB – “iClicker”

7. A patient with pulmonary tuberculosis can


spread the disease when:

a) coughing
b) sneezing
c) talking
d) spitting
e) all of the above

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Lecture Notes foundations of health science
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Estimated Incidence of TB (per 100,000 population), 2007

Maroon=>300
Red=100 - <300
Yellow=<10

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November 3rd, 2009
Lecture Notes foundations of health science
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25 Minute Film – Post Reflection on WebCT for ICE!

November 3rd, 2009


Lecture Notes foundations of health science
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