TB prevention

Question 1

What are the general preventive measures?

Answer 1

• socioeconomic development
• sanitary living conditions
• health promotion
• health education

Question 2

What are the specific preventive measures?

Answer 2

• vaccination by BCG
• chemoprophylaxis by INH
• combined vaccination and chemoprophylaxis

Question 3

who is the BCG vaccine given to? what is the dose

Answer 3

Tuberculin non reactors
infants and preschool and school children (5 - 6 years)
0.1ml

Question 4

How long does it take for immunity to develop from BCG vaccine? what is the protective value?

Answer 4

3 months and persists for 5 years on average but can stay up tp 15 years
- protective values is 80%

Question 5

How do adverse effects arise?

Answer 5

if vaccine is given subcutaneously (supposed to be intradermal) may cause local inflammation, necrosis and ulceration and local adenitis of draining lymph nodes and abscess formation

Question 6

What is the dose for INH?

Answer 6

5 - 10mg/kg for one year

Question 7

who should receive INH?

Answer 7

high-risk tuberculin reactors to prevent development of active disease?

• close contacts of active cases
• children below 5 years
• recent tuberculin converters
• patients under immunosuppressive therapy, Hodgkin’s disease, leukemia, silicosis, and diabetes

Question 8

personnel of chest clinics and hospitals should receive what type of preventive measure?

Answer 8

if they’re non reactors: BCG
but it takes 3 months to become reactors so all should take the combined protection:
- BCG prepared from INH-resistant organisms
- temporary INH chemoprophylaxis

Question 9

What diseases have reemerged in last quarter of 20th century?

Answer 9

rotavirus 
HIV/AIDS
Hantavirus 
Cryptosporidiosis 
Lyme disease 
legionellosis 
hepatitis C

Question 10

What are the AGENT factors that contribute to re-emergence or emergence of a disease?

Answer 10

• evolution of pathogenic infectious agent
• development of resistance to drugs
• resistance of vectors to pesticides

Question 11

what are the HOST factors that contribute to re-emergence or emergence of a disease?

Answer 11

• inhabiting new areas
• human behavior (sexual and drug use)
• immunosuppression
• poverty and social inequality

Question 12

What are the ENVIRONMENTAL factors that contribute to re-emergence or emergence of a disease?

Answer 12

• climate & changing ecosystems
• urbanization & deforestation
• food processing & handling
• international travel & commerce
• war, unrest, & overcrowding
• lack of political wills

Question 13

what are possible causes of increase in TB incidence?

Answer 13

• HIV/AIDS epidemic
• increased poverty, IV drug abuse, and homelessness
• increased immigration of infected individuals
• increased elderly population in long term care facilities
• failure to complete antibiotic treatments