What you should know about

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What you should know about TB
Ghana TB Control Program Telephone (233 21
660023) Dr. Frank Bonsu
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THE AFRICAN

• EMERGENCY

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• The growing tuberculosis epidemic is no longer
  an emergency only for those who care about
  health, but for those who care about justice
• World Health Organization. TB - A global
  emergency. Geneva WHO 1994

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Tuberculosis
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Epidemiological summary

• TB coming under control everywhere except Africa
  (and Eastern Europe)
• HIV is the proximal cause in Africa
• East and Southern Africa worst hit
• Women more affected than men by TB/HIV
• Mortality from TB rising with HIV
• Most TB in Africa in HIV uninfected
• Notwithstanding, TB control nearing 2005 targets
• MDGs likely to be met, except in Africa and
  Eastern Europe
• Battleground for TB MDGs shifts towards Africa

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TB incidence rate
1990
2005
Stop TB Department
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Millennium Development Goals
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MDGs

• Eradicate extreme poverty and hunger
• Achieve universal primary education
• Promote gender equality and empower women
• Reduce child mortality
• Improve maternal health
• Combat HIV/AIDS, malaria and other diseases(
  including TB)
• Ensure environmental sustainability
• Develop a global partnership for development

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Goal 6Statistics
(Continued)

• Tuberculosis is the leading infectious killer of
  adults and kills almost 2 million people a year
  malaria kills more than 1 million people a year.
• People with HIV/AIDS are seven times more likely
  to develop tuberculosis.
• In 2000, 17 million people in Africa were
  affected with both HIV and tuberculosis
  simultaneously.

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What is TB (Tuberculosis)?

• a disease caused by BACTERIA
• usually affects the LUNGS
• spread in the AIR
• can be cured with MEDICINE

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There are 2 types of TB
1. Latent TB Infection
2. TB Disease
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Latent TB infection

• A PERSON WITH LATENT TB INFECTION
• Has a POSITIVE skin test.
• Has a NORMAL chest x-ray.

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Latent TB infection

• Has breathed in TB germs.
• Feels fine, is not sick.
• Cannot spread TB germs to others.

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TB infection / positive skin test is very common

• About 1 out of every 3 people in the world is
  infected with TB germs.

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TB disease

• A PERSON WITH TB DISEASE
• Has a POSITIVE Sputum test.
• Has a BAD chest x-ray.
• Has positive Skin Test

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TB disease

• Feels sick
• Can spread TB germs to others.
• - TB disease can be cured with medicine!!

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How is TB spread ?
TB germs can be spread when a person with TB
disease

• Coughs
• Sneezes
• Shouts
• Sings
• Talks

sending TB germs into the air.
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• You get TB from being in VERY CLOSE CONTACT with
  someone who is sick with TB disease.

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Risk Factors for T.B.

• Close contact exposure to active case patient
• Person to person passing of TB microdroplets
  (1-5mm)
• Close contact 30 hours per week
• Immune status
• Renal failure, Cancer, Immunosuppressing drugs
  (4-16 fold)
• HIV 100 fold more likely to acquire disease
• Has significantly contributed to rising TB

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Government warning smoking may seriously damage
your health
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Remember !
You CANNOT get TB from someone with latent TB
infection!!
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TB germs are NOT spread by sharing

• Spoons and forks
• Drinking glasses
• Bathrooms

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TB germs are NOT spread by handling

• Bedding
• Rubbish
• Clothes or towels
• Food

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TB Prevention Protection-
6 tips for you and your family
TB
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1. Know the signs and symptoms of TB disease

• Constant tiredness
• Fever
• Weight loss
• Night sweats

• Cough
• Loss of appetite
• Spit up blood
• Chest pain

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2. Know the Medical risk factors for TB disease

• HIV infection
• Recent TB infection
• Substance abuse

• Diabetes
• Cancer of head and neck
• Low body weight

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3. TB chest X-ray
If you have a positive skin test (TB infection),
get a chest x-ray and make sure you do not have
TB disease.
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4. TB preventive medicine
If you have a positive skin test (TB infection),
a doctor can give you medicine to get rid of TB
germs in some special situations eg HIV
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5. Keep windows open

• TB cannot spread outside or in fresh air.

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6. Live healthy

• Eat right.
• Get enough sleep.
• Keep your immune system strong.

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Remember !

• Only people who are sick with TB disease can
  spread TB.
• TB is a disease that can be prevented and cured.
• TB treatment is Free

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" We cant fight AIDS unless we do much more to
fight TB as well " Nelson Mandela Bangkok,
July 2004
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Two Diseases, One Patient
Another Challenge TB/HIV
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Comprehensive HIV treatment including DOT- TB/ART
is feasible even in the poorest of settings (PIH
Haiti)
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Essential DOTS Process
commitment
detect
treat
report
screen
record
detect
record
treat
report
management
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Essential QCM Elements
Technical ii. Case holding Address
verification Directly Observed
Treatment Default retrieval Follow-up
microscopy
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Essential QCM Elements
Managerial i. Software Social commitment,
Genuine willingness, Quality consciousness ii.
Hardware Resources - human and financial,
Space and facilities, Equipment, Drugs and
supplies, Stationary
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SUMMARY

• TB is a devastating disease It is the Worlds
  No. 1 killer among curable, infectious diseases.
• However, we have a proven method to STOP TB
  DOTS.
• To fight TB with DOTS, we have two measurable
  targets
• 70 detection. 85 cure.
• Case detection is our main challenge.
• For accelerating case detection we have thousands
  of allies People who have been CURED.
• If you know people who have been cured of TB or
  you have been cured yourself, you can help by
• Coming forward or encouraging others to come
  forward.
• Becoming an ambassador for TB.
• Becoming a treatment partner.
• REMEMBER...
• If we achieve our target rates of detection and
  cure, 5.000.000 lives will be saved by 2010!!!

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Two Diseases, One Patient
Another Challenge TB/HIV
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HIV and Tuberculosis, GHANA

• In 1989 whilst about 14 cases could be
  attributed to AIDS
• By the year 2009, about 59 of the projected TB
  cases will be due to the HIV/AIDS epidemic

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ROLE OF THE CHIEFS

• Accept whatever is done in community TB / HIV
  control as their own and get involved
• Mobilize resources from within and without their
  communities to support TB / HIV activities
• Spend few minutes to talk about TB /HIV whenever
  their speaking to their community members
  (Education Counseling- Public patients)
• Work assiduously to remove outmoded traditional
  and cultural practices that hinder the fight
  against TB in their various communities ( Remove
  Stigma)
• Monitor TB / HIV activities in their various
  communities

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JOIN THE FIGHT AGAINST TB
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Thank YOU!