TUBERCULOSIS

TUBERCULOSIS:
 
Tuberculosis (TB) is a major health problem in India.
It is a communicable disease caused due to infection with a bacterium called Mycobacterium tuberculosis (MTB), which mainly causes Pulmonary TB
It is mainly diagnosed by Microscopic examination of smear of sputum (Sputum Smear) , Chest X-ray and by culture of Mycobacterium tuberculosis bacilli.
Around 18 Lakh people develop TB and 4 Lakh die from it every year. India contributes 20 % to this statistical data. Following are some startling figures about TB in India.
-         > 40,000 people get infected by TB daily.
-         > 5000 people develop TB disease daily.
-         > 1000 people die of TB everyday, which roughly comes to 2 deaths every 3 minutes!!!!
 
In the year 1992, the Government of India introduced the National TB Programme. However this Programme was a failure since it could not achieve its objectives because of
-         Low priority
-         Over dependence on X-Rays for diagnosis
-         Managerial weakness
-         Lack of Supervision
-         Lack of funds
 
Hence, the government came up with Revised National tuberculosis Control Programme (RNTCP), which was implied in a phased manner since its concept of as a Pilot project in 1993.
 
Objectives of RNTCP:
Maintain atleast 85% cure rate of new sputum smear-positive patients and to achieve and maintain detection of atleast 70% of such cases in the population.
RNTCP uses the DOTS (Directly Observed Treatment Short course) in which the patient has to go to the concerned Health clinic and have the medicines in front of the Doctor/Health worker. This increases patient compliance and the patient takes the whole course.
 
Identification of TB suspects:
It is very important to identify suspects who have symptoms of TB early since it is an infectious disease and spreads very easily.
Anyone who is suffering from cough of 3 or more weeks is to be considered as TB suspects and such persons should get their sputum checked immediately.
3 sputum samples are collected over 2 consecutive days:
-         Spot sample on the 1st day
-         One early morning sample on 2nd day.
-         One spot sample on the 2nd day.
 
Please remember that Sputum examination and anti-TB treatment are FREE of CHARGE at govt. facilities under RNTCP.
 
-Patients with 2-3 sputum positive smear results are diagnosed as having pulmonary sputum smear-positive TB
 
-Patients with only 1 sputum smear-positive results will have to undergo a chest X-Ray examination and if the chest X-Ray is suggestive of pulmonary TB then the physicians diagnosis it as pulmonary sputum smear-positive TB.
 
-Patients in whom all 3 smears are negative are prescribed broad spectrum antibiotics, none of which having any anti-TB effects.



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