Tuberculosis

Question 1

What is the causative agent of TB?

Answer 1

• Mycobacterium Tuberculosis
• Mycobacterium bovis (present in milk, destroyed by pasteurisation)

*has a waxy coating - makes it impervious to Gram staining

Question 2

Where is TB most prevalent in?

Answer 2

overcrowded, congested living conditions in slumps and inner cities

Question 3

Why are TB cases high in Selangor?

Answer 3

High population density

especially in urban areas populated by people in lower socioeconomic levels

Question 4

Why are TB cases high in Sabah?

Answer 4

Presence of illegal immigrants who do not seek medical treatment in fear that they may be apprehended by the authorities

Question 5

Mode of transmission of TB

Answer 5

Airborne

Question 6

What are the 2 types of TB-related conditions?

Answer 6

(i) Latent TB infection

ii) Active TB (TB disease

Question 7

Describe latent TB infection

Answer 7

infected person fight off bacteria and stops them from growing.

bacteria becomes inactive but remain alive and can be active later (usually when immune system is weakened).

these people do not feel sick, have no symptoms and can’t transmit TB to others but would get a positive reaction to TB blood test

Question 8

Describe active TB (TB disease)

Answer 8

TB bacteria overcome immune system and begin to multiply, resulting in progression from latent TB to TB disease

Question 9

What are the 2 types of TB disease?

Answer 9

Pulmonary TB - lungs are affected (can transmit to others)

Extra-pulmonary TB - other parts of body are affected (doesn’t easily transmit to others)

Question 10

Signs and symptoms of TB

Answer 10

• coughing blood
• fever
• chest pain
• chills
• lack of appetite

Question 11

TB Diagnosis methods

Answer 11

TB skin test / Montoux test

refer to notion for details

Question 12

TB treatment

Answer 12

• patients isolated (esp those at week 2-4, most infectious)

- combination of antibiotics - ensure all bacteria are killed (takes a long time)

Question 13

What will happen if infected people do not complete their treatment?

Answer 13

they may be harbouring drug-resistant bacteria and spread them to others if bacteria become alive

Question 14

What ensures a successful TB treatment?

Answer 14

DOT/S aka TB-DOTS

where a trained healthcare worker provides the prescribed TB drugs and watch as the patient swallows every dose

Question 15

Advantages of DOTS

Answer 15

• prevent TB from spreading to others
• decrease risk of drug-resistance development
• decrease chances of treatment failure and relapse

Question 16

Is there a vaccine available for TB?

Answer 16

Yes, the BCG vaccine (derived from M. bovid)

• protects up to 70-80% of people who receive it
• effectiveness decrease with age unless there is exposure to TB

Question 17

Preventive methods for TB

Answer 17

• BCG vaccine
• herd immunity
• prevent transmission between cattle and humans
• contact tracing

Question 18

Factors for re-emergence of TB

Answer 18

• drug resistance in causative agent
• TB/HIV co-infection
• poor housing conditions
• migration

Question 19

Why is TB treatment spread out over a long period of time?

Answer 19

• bacteria are inside body cells (liver cells / RBC) - protected from action of antibiotics
• long treatment ensures all bacteria are killed
• prevent reservoir of infection