L24. Social and Economic Determinants of Health: TB

Question 1

What is a major driving factor for the incidence of TB?

Answer 1

Poverty and malnutrition

Question 2

Why does TB in children often go undiagnosed?

Answer 2

Because they don’t have access to health services and even if they do, they are often ill equipped or not trained enough to diagnose
Children count for 6% of the diagnosis of TB

Question 3

There is a 20-37% increased risk of contracting TB and a 13% of dying from TB as a result of which risk factor?

Answer 3

HIV AIDS

Question 4

What is the incidence of TB in Australia?

Answer 4

4 per 100,000 people

Question 5

How is TB spread?

Answer 5

By droplets (sneezing, coughing, spitting)

Question 6

Where do up to 80% of the worldwide cases of TB occur?

Answer 6

In poverty stricken nations

Question 7

The epidemiological impact is far less than predicted. What is an important need as a result of this?

Answer 7

To target additional interventions including social and economical: peoples vulnerability to TB

Question 8

What were the millennium development goals?

Answer 8

An attempt to bring focus to key aspects of health and disease and set targets and timelines to achieve them

Question 9

Have there been decreases in TB incidence since 1990? (has the MDG for TB been achieved?)

Answer 9

Yes.
2.2% decrease in incidence and a decrease in about 41% in mortality
But this is not enough

Question 10

What is an emerging problem in TB?

Answer 10

Drug resistance

Question 11

What are reasons for the steady decline in TB incidence?

Answer 11

Bettering health and social environments
Development
Germ era and antimicrobial therapy

Question 12

What are DOTS?

Answer 12

Directly Observed Treatment Short course: ensuring people taking TB medication do so and are observed. (6 month course, daily)

Question 13

Why are biomedical approaches not showing the benefit they are expected to?

Answer 13

Little regard for reducing the VULNERABILITY to disease

Question 14

Even when biomedial approaches (DOTS) are successfully implemented, the decrease in TB incidence is less than expected.

Answer 14

There is a need to address UNDERLYING factors making people vulnerable to disease

Question 15

Describe the Socio-economic gradient in terms of TB risk

Answer 15

Linear relationship, the richer the socio-economic status the less risk of TB of the community/country

Question 16

What are proximate risk factors to TB?

Answer 16

• Exposure to infectious droplets (related to the underlying burden of disease in the community)
• Host defences (HIV)
• malnutrition
• indoor air pollution
• smoking and alcohol abuse
• other diseases
• depression and stress

Question 17

What are some common features of low socioeconomic status (SES) groups?

Answer 17

More frequent contact with active TB disease including crowding
Limited access to safe cooking facilities and food insecurity
Low levels of awareness and less power to act
Limited access to high quality health services

Question 18

What is the Poverty-ill health cycle?

Answer 18

Poverty predisposes people to risk factors like malnutrition, poor sanitation, illiteracy which leads to disease. Then disease increases health care costs and reduces labour and work. This leads to poverty and the cycle starts again.

Question 19

What are the 6 goals of the WHO “Stop TB” Stragery?

Answer 19

1. pursue high quality DOTS
2. TB-HIV and MRD-TB addressal and the needs of poor and vulnerable
3. Contribute to strengthening primary health care
4. Engage all care providers
5. Empower people with TB and communities
6. Enable and promote research

Question 20

What are some ways to achieve goals?

Answer 20

High quality medical technologies
Collaboration
Multi-sectoral approaches

Question 21

What is a major and common goal of the upcoming targets and milestones for TB?

Answer 21

Reduce the cyclic nature of TB and poverty