TB clubs Flashcards
importance of TB
Was single biggest infectious disease killer - until covid but coming back
Up for all of the ratings of disease importance
Poverty is driving the epidemic
TB RFs
Think that 1/5 of cases are due to malnourishment
Smoking,
HIV,
dm,
harmful use of alcohol
TB health goals
changing TB epidemiology
Looks like Tb cases are going down - but diagnosis is hard
So we don’t really know
Notification of cases has increased
But vague feeling that numbers have reduced
Increasing because finding more people, strengthening health system
TB diagnosis rates are increasing - getting treated so we assume cases are coming down
why is compliance to TB treatment hard
have to go to clinic every day to take medicine - directly observed therapy
for 6mo (more for MDRTB)
long time where cant work
stigma - worried about friends, reject from family, lose job, people dont want to buy food for them
56-85% of patients finish treatment
Gold standard is 90% - if over 90% then transmission comes down
MDRTB - used to be IM and then mo to yrs tablets - obvious completion rate is low
what is the best technique to reduce TB rates
improve socioecomonic status
Correlation between reducing TB rates - increased development, better sanitation and public health
NOT TB control programs - averts death but effect on transmission is not detectable
relationship between TB and poverty
When have TB it makes you poor again - so much TB might be the reason that there is low development
Bidirectional relationship between GDP and TB
Most of cost lost is that cant go to work
Most is in young people - the ones earning - how is everyone else meant to earn
Want to eat and be healthy - more money on food, supplementary meds
Money on transport
Health inequity
Difference in TB rates in white vs african americans - not reducing at the same rate
relationship between TB and crowding
more likely to breathe in TB if there
TB rates increase with people per room
Guinae pigs - If increase window and ventilation in room and UV light - can reduce risk of infectious disease
relationship between TB and nutrition
As have increased BMI - less likely to have TB
effectiveness of TB Rx
If on right treatment - transmission rate reduces 3x in 9 days
Within days TB in lungs is reduced - to transmit have to have TB in sputum and have to be coughing
Cough also reduces quickly
Probably feel better in days to weeks
commonest reason why TB treatment is not completed
Loss to follow up
impact of TB on mental health
effects every domain - negative
Low QOL scores
Reduce minimally when on rx
When finish treatment - QOL similar but slightly lower than control ]
Care giver look after persona dn try and gain more mobey etc
consequences of TB
When completed TB have high rate of dying
Sequalae
Chronic inflammation
Social determinants
Poorer
QOL lowe r
Lower QOL = more early death
CRESIPT trial
Cash transfer - conditional
Every mo that you finish rx - get money
Every time get screened - get money
Every time HIV test etc
Improve knowledge
Less marginalisation
Train TB survivor - sponser another family - bring pills to patiens etc
TB clubs
How to work through negative emotions
Masks not stigmatising - but responsible
After a couple of weeks don’t have to be isolated - not infectious
improved compliance
communities thought social help was more important than financial - financial just got them through the door
