WORLD TUBERCULOSIS DAY
24 MARCH 2022
DR.ANJALATCHI MUTHUKUMARAN
VICE PRINCIPAL
NURSING SUPERINTENDENT
ERA COLLEGE OF NURSING ,
ELMCH, ERA UNIVERSITY

Introduction
• Tuberculosis is one of the ten major causes of mortality
worldwide. The trend of increasing TB cases and drug
resistance in India is very disturbing.
• Tuberculosis (TB) is an infectious disease caused by a
bacterium, Mycobacterium tuberculosis.
• Each day, over 4000 people lose their lives to TB and close
to 30,000 people fall ill with this preventable and curable
disease. TB remains the world’s deadliest infectious killer.

theme of World TB Day 2022?
• For the first time in over a decade, TB deaths increased
in 2020. The theme of World TB Day 2022 - 'Invest to
End TB. Save Lives.' –conveys the urgent need to invest
resources to ramp up the fight against TB and achieve
the commitments to end TB made by global leaders.
• Each day, over 4000 people lose their lives to TB and
close to 30,000 people fall ill with this preventable and
curable disease. TB is one of the leading causes of
mortality in India. It kills more than 4,00,000 people in
India every year. But these deaths can be prevented.
With proper care and treatment, TB patients can be
cured and the battle against TB can be won.

Types of TB Form

Normal lungs

The Respiratory System
• When we breathe in, air flows through
the nose or mouth, down the throat,
through the voice box, and down the
windpipe (trachea).
• The air then comes to two main large
airways (the right and left bronchial
tubes).
• These large airways branch into smaller
and smaller airways (bronchioles).
Wrapped around the airways are
muscles that crisscross each other.
• We have no control over these
muscles, and their exact purpose is not
known. Air continues through these
small airways until it finally reaches the
tiny balloon-like air sacs (alveoli). It is
at these air sacs that the oxygen is
taken into the blood.

History of World TB Day
• On March 24, 1882, Dr. Robert Koch announced the discovery
of Mycobacterium tuberculosis, the bacteria that causes
tuberculosis (TB).
• During this time, TB killed one out of every seven people living in
the United States and Europe.
• Dr. Koch’s discovery was the most important step taken toward
the control and elimination of this deadly disease.
• A century later, March 24 was designated World TB Day: a day to
educate the public about the impact of TB around the world.

Problem statement
• Worldwide, TB is the 13th leading cause of death
and the second leading infectious killer after
COVID-19 (above HIV/AIDS).
• In 2020, an estimated 10 million people fell ill with
tuberculosis (TB) worldwide. 5.6 million men, 3.3
million women and 1.1 million children. TB is
present in all countries and age groups.

Transmission
• TB is spread through the air by a person suffering
from TB. A single patient can infect 10 or more
people in a year.
•

Fact about TB caused Bacteria

Symptoms
• Common symptoms of
TB are:
• Cough for three weeks
or more, sometimes
with blood-streaked
sputum
• Fever, especially at
night
• Weight loss
• Loss of appetite
•

Vulnerable population
• Those most vulnerable to falling ill with TB include
• very poor and/or malnourished/ undernourished people,
• people living with HIV/AIDS,
• children and women,
• contacts of people with TB including health workers, migrants, refugees
and internally displaced persons,
• miners and mining-affected persons,
• persons with diabetes,
• elderly,
• ethnic minorities,
• indigenous populations,
• substance users and homeless persons.
•

Strongest risk factors for TB among
adults - HIV
• The Human Immunodeficiency Virus (HIV, the virus that causes
AIDS) is the strongest risk factor for tuberculosis among adults.
• Tuberculosis is one of the earliest opportunistic diseases to develop
amongst persons infected with HIV.
• HIV debilitates the immune system increasing the vulnerability to
TB and increasing the risk of progression from TB infection to TB
disease.
• An HIV positive person is six times (50-60% life time risk) more
likely of developing TB disease once infected with TB bacilli, as
compared to an HIV negative person, who has a 10% life-time risk.
•

Pathophysiology

Tuberculosis in children
• Children account for an estimated 11 % of all TB cases in the world. TB in
children is often missed or overlooked due to non-specific symptoms and
limitation of diagnostic tools. Children at greater risk for
Tuberculosis. Some groups of children are at greater risk for tuberculosis
than others. These include:
• Children living in a household with an adult who has active tuberculosis
• Children living in a household with an adult who is at high risk for
contracting TB
• Children infected with HIV or another immuno compromising condition
• Children born in a country that has a high prevalence of tuberculosis
• Children from communities that are medically under served
•

Diagnosis
• Under Revised National
Tuberculosis Control
Programme (RNTCP) the following
methods are used to diagnose
various forms of Tuberculosis:
• Microscopy
• Culture (Solid, Liquid)
• Molecular tests Line Probe Assay
(LPA), Cartridge Based Nucleic Acid
Amplification Test (CBNAAT)
• Mantoux Test
• X-ray and other imaging techniques
• Histopathology

Tuberculosis X ray findngs

Treatment
• Today, four drugs are used to treat TB disease: isoniazid
(1951), pyrazinamide (1952), ethambutol (1961), and
rifampin (1966). This 4-drug cocktail is still the most
common treatment for drug-susceptible TB.
• Directly Observed Treatment Short-course (DOTS) is
the strategy followed for treatment of TB.
• Tuberculosis treatment requires at least 6 months of
treatment.
• TB treatment with DOTS reduces the morbidity and
mortality among people living with HIV.

Treatment schedule
• New cases :
• IP: (2)HRZE for 8 weeks 2months
• CP:(4)HRE 16 weeks for 4 months

Medical management

Diet plan for TB patients

To keep your lungs healthy, do the
following:
• Stop smoking, and avoid secondhand smoke
or environmental irritants.
• Eat foods rich in antioxidants.
• Get vaccinations like the flu vaccine and the
pneumonia vaccine. ...
• Exercise more frequently, which can help your
lungs function properly.
• Improve indoor air quality.

Your health in your hands

Hand hygiene practices

Respiratory hygiene

Physical exercises

Continued

Continued

Continued

Healthy food for lungs

Antibacterial therapy food

Best food for improve breathing

Natural pain killers

Recent changes in RNTCP

Gaps in TB treatment
• “Missed” is the gap between the estimated
number of people who became ill with TB in a
year and the number of people who were
notified to national TB programmes. In 2018, in
India 2.69 million people fell ill with TB and about
0.449 million people died. Only 1.99 million
people with TB were notified. Every year 7 lakh
people with TB are missing out on quality care.
The vast majority of people dying of TB are
missed

Vaccine BCG
• Albert Calmette and Jean-Marie Camille Guerin
developed the Bacille Calmette-Guérin (BCG)
vaccine in 1921. Prior to developing the BCG
vaccine, Calmette developed the first
antivenom to treat snake venom.
• The BCG vaccine is not widely used in the
United States, but it is often given to infants
and small children to prevent TB meningitis in
countries where TB is common. BCG does not
always protect people from getting TB. TB
blood tests are the preferred TB test for people
who have received the BCG vaccine.
• Vaccination - The TB vaccine, BCG, addresses
the tuberculosis problem in children to some
extent.

NATIONAL STRATEGIC PLAN FOR TUBERCULOSIS
ELIMINATION 2017–2025
• In 2020 the RNTCP was renamed the National
Treatment Elimination Program (NTEP) to
emphasize the aim of the Government of
India to eliminate TB in India by 2025.

Delamanid
• Delamanid is one of two drugs developed specifically
for the treatment of TB in the last 40 years. It is the
first approved drug in the class of nitro-dihydro-
imidazo-oxazoles for the treatment of MDR-TB.
• It has been developed by Otsuka Pharmaceutical Ltd.
for the treatment of MDR-TB.
• Delamanid was first approved by the European
Medicines Agency (EMA) in November 2014 and
subsequently by regulatory authorities in Japan,
Republic of Korea, Hong Kong, Turkey and Philippines
(4-6,8-21).

CONTINUED
• The approval dated 14 June 2017 reads as
follows: “
• Drug name: Delamanid (50 mg);
• Indication: Indicated in adults aged 18 or over
18 years as part of combination therapy of
pulmonary tuberculosis (TB) due to multi-drug
tuberculosis (MDR) Mycobacterium
tuberculosis;

THANK YOU

What is DOTS?
• DOTS stands for directly observed treatment short
course, the curative treatment for tuberculosis. It is the
name for a comprehensive strategy which primary
health services around the world are using to detect
and cure TB patients

It combines five elements:
• Political commitment to a National Tuberculosis Control
Programme.
• Microscopy services to detect the infectious cases among those
people attending health care facilities with symptoms of pulmonary
tuberculosis, most importantly cough of 3 weeks duration or more.
• Regular uninterrupted supply of anti-TB drugs. The establishment of
a dependable, high quality supply of anti-TB drugs throughout the
health system is an essential part of the DOTS strategy to ensure
that the treatment of TB patients is never interrupted.
• Direct observation of the treatment for at least initial intensive
phase. As a part of DOTS strategy health workers counsel and
observe their patients swallowing each dose of powerful
combination of medicines.
• Monitoring and accountability system for programme supervision
and evaluation of treatment of each patient diagnosed.

What are the advantages of DOTS
• DOTS produces cure rate high as 95 percent.
• DOTS guarantees quicker and surer relief from the disease.
• DOTS has changed the lives of 17 lakh patients in India.
• DOTS is a strategy for alleviating poverty. Saving lives, reducing the
duration of illness, and preventing new infectious cases would
mean fewer years of employment lost.
• DOTS prolongs survival of HIV-Infected TB patients.
• DOTS prevents treatment failure and the emergence of multi-drug
resistant tuberculosis by ensuring patient compliance and
uninterrupted supply of anti-TB drug.
• DOTS increases the reach of health services. The DOTS strategy has
been remarkably successful in promoting the development of
peripheral health services.
• DOTS is available for free at all Health Centres.

Tuberculosis Dos and Don’t’s
• Do’s
• Have 2 sputum examinations
done if you have cough of three
weeks or more. These tests are
done free of cost at Government
sputum microscopy centers.
• Take all the medicines for the full
prescribed period on regular
basis.
• Understand that TB can be
cured.
• Use handkerchief when coughing
or sneezing.
• Spilt in spittoons containing
house-hold germicides.
Don’ts
Don't avoid medical care if you have
cough of three weeks or more.
Don't rely only on X-ray for diagnosis
of TB.
Don't stop medicines before your
physician discontinues them.
Don't discriminate against TB
patients.
Don't spit indiscriminately

Important information
• Not everyone gets side effects.
• If you get side effects, inform and consult your doctor/nurse
• Early action prevents side effects
• Some symptoms may be experienced due to other causes
and need investigation
• Don't stop your drugs or restart them on your own.
• Don't share your drugs or advice treatment to others.
• Don't smoke or drink alcohol as it can worsen side effects
• Main Adverse Reactions
•