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Tuberculosi s

Tuberculosis is a disease of the lungs. It is considered as the worlds deadliest disease and remains as a major public health problem in the Philippines. It is a highly infectious chronic disease caused by tubercle bacilli. TB is most common in areas where poverty, malnutrition, poor general health and disruption are present. Alcoholics, HIV-positive, recent immigrants and health workers are at increased risk of developing TB. This is most commonly found in places such as hostels for the homeless, prisons and centers for immigrants arriving from areas with high rates of HIV infection or inadequate health provision. In 1993, TB was declared as a global emergency by the World Health Organization because of its rapid increase in cases of mortality. In the year 2002, TB ranks 6th in the leading cause of morbidity and mortality in the Philippines. Signs and Symptoms: cough for 2 weeks or more fever chest or back pains hemoptysis or recurrent blood-streaked sputum significant weight loss sweating, fatigue, body malaise, and shortness of breath

Mode of transmission: - airborne - direct invasion though mucus membranes Period of Communicability - The degree of communicability depends on the number of bacilli discharged, the virulence of the bacilli, and adequacy of ventilation, exposure of the bacilli to sun or UV light and opportunities for their aerosolization by coughing, sneezing, talking or singing. Susceptibility and Resistance - Most hazardous period is the first 6-12 months after infection. - Reactivation of long latent infections account for a large proportion of cases of clinical disease in older persons. Preventive Measures - prompt diagnosis and treatment of infectious cases - BCG vaccination of newborn, infants and school entrants - Educate the public in mode of transmission and methods of control and the importance of early diagnosis - Improve social conditions, which increase the risk of becoming infected, such as overcrowding

Make available medical laboratory and x-ray facilities for examination of patients, contacts and suspects and facilitates for early treatment of cases and persons at high risk of infection Provide public health nursing and outreach services

NTP (National Tuberculosis Program) Goal: To reduce prevalence and mortality from TB by half by the year 2015 Targets: - 85% of the sputum smear-positive TB patient discovered - Detect 70% of the estimated new sputum smear-positive TB cases 4 Pronged Objectives of NTP - Improve access to and quality of services provided to TB patients, TB symptomatic and communities by health care institutions and providers - Enhance health seeking-behavior on TB communities, especially TB symptomatic - Increase and sustain support and financing for TB control activities - Strengthen management (technical and operational) of TB control services at all levels DOTS Strategy 5 Elements 1. Sustained political commitment 2. Access to quality assured sputum microscopy 3. Standardized short-course chemotherapy for all cases of TB under proper case management conditions 4. Uninterrupted supply of quality-assured drugs 5. Recording and reporting system Management: - Prevention - Case finding - Case holding and treatment Treatment: 1. Pulmonary TB a. Intensive Phase i. Isoniazid ii. Rifampicin iii. Pyrazinamide b. Continuation Phase i. Isoniazid

ii. Rifampicin 2. Extra-Pulmonary TB a. Intensive Phase i. Isoniazid ii. Rifampicin iii. Pyrazinamide b. Plus i. Ethambutol or Streptomycin c. Continuation Phase i. Isoniazid ii. Rifampicin Reference: Cuevas, et al., (2007). Public health nursing in the Philippines (10th ed.) (2011). Tuberculosis: Netdoctor, retrieved July 22, 2011 from http://www.netdoctor.co.uk/diseases/facts/tuberculosis.htm (2011). Tuberculosis (TB), Symptoms, Cause, Transmission, Diagnosis and Treatment. MedicineNet.com: We Bring Doctors Knowledge to You, retrieved July 22, 2011 from http://www.medicinenet.com/tuberculosis/article.htm