Lecture topic:

TUBERCULOSIS EPIDEMIOLOGY

A section of phthisiology that studies sources of tuberculosis infection, routes of transmission, prevalence of tuberculosis as an infectious disease in the population, adverse endo- and exogenous factors influencing the epidemic process, and the most endangered groups in the population to become ill with tuberculosis.

EPIDEMIC

- a massive spread of an infectious human disease in an area, significantly exceeding the normal incidence of the disease (5-6 times).

In terms of the rate of increase in the incidence of the disease, a distinction is made between explosive epidemics and long-term epidemic processes with a slow (over many years) rise and a slow decline. The latter include tuberculosis.

A reservoir of TB infection is individuals infected with MBT, some of whom become ill during their lifetime, as well as some animals. Divided:

Potential part of the reservoir (infected but not sick people);

Active part of the reservoir (detected and undetected active TB patients).

The source of tuberculosis is people and animals with tuberculosis that excrete MBT into the external environment.

THE WAYS IN WHICH TB INFECTION

SPREADS:

1.Airborne.

2.Airborne infection is caused by inhaling dust particles containing MBT;

3.Alimentary - by eating food contaminated with MBT.

4.The contact route of infection through the skin and mucous membranes can be observed in persons who work directly with an MBT culture or infectious material (pathologists, laboratory workers).

5.The intrauterine route of infection (very rare) occurs when the placental barrier is breached or by ingestion of placental fluid containing MBT.

THE POSSIBILITY OF FALLING ILL

INCREASES IN THE FOLLOWING

SITUATIONS:

1.In the first years after infection.

2.During puberty.

3.If reinfected with MBT (exogenous superinfection).

4.In the presence of HIV infection (up to 8 - 10% per year).

5.In the presence of co-morbidities (diabetes, PBC and duodenal ulcers, pregnancy, alcoholism).

6.During therapy with glucocorticoids and immunosuppressants.

Primary TB infection occurs when a person becomes infected for the first time.

Exogenous superinfection is the re- infection of MBT and its multiplication.

Endogenous reactivation of tuberculosis arises from surviving or aggravated primary or secondary organ reactivations.

THREE MAIN GROUPS OF FACTORS THAT DETERMINE AN INCREASED RISK OF TUBERCULOSIS:

1.Close contact with TB patients (domestic or occupational).

2.Various diseases and conditions that reduce the body's resistance and create conditions for the development of tuberculosis.

3.Socio-economic, household, environmental, occupational and other factors.

FIRST-TIME PATIENTS ON ADMISSION

PATIENTS TO BE EXAMINED:

1.With symptoms of inflammatory bronchopulmonary disease:

prolonged cough (more than 2-3 weeks) with sputum production;

haemoptysis and pulmonary haemorrhage;chest pain related to breathing;

2. With intoxication symptoms persisting for more than 2-3 weeks:

an increase in body temperature;weakness;

increased sweating, especially at night;weight loss.

All persons with symptoms of respiratory disease are given an ODM:

1.Clinical examination: examine complaints, history, and perform physical examination.

2.Laboratory examination: sputum (if available) is examined three times under a microscope for acid- fast mycobacteria using Ziehl-Nelson staining.

3.Radiological examination of the thorax in an institutionally accessible volume (best practice: use of digital fluorography).