Click to edit Master subtitle style

A rice farmer with pulmonary TB is examined during a home visit by the NGO.
James Nachtwey/VII

4/14/12

Click to edit Master subtitle style

A patient with advanced pulmonary TB receives a daily injection as well as oxygen. James Nachtwey/VII

4/14/12

Click to edit Master subtitle style

A boy experiencing severe pain from TB meningitis is comforted by his mother. Family members provide much of the personal care at hospitals in the developing world. James Nachtwey/VII
4/14/12

Click to edit Master subtitle style

A prisoner who was convicted of murder was moved from prison to the TB ward when he was diagnosed with TB. He is co-infected with AIDS. James Nachtwey/VII

4/14/12

Click to edit Master subtitle style

A woman with TB meningitis is cared for by her husband.

James Nachtwey/VII

4/14/12

Click to edit Master subtitle style

Tuberculosis is both PREVENTABLE and CURABLE

4/14/12

Click to edit Master subtitle style

What is Tuberculosis?

4/14/12

Outline
Facts about TB Transmission Signs and Symptoms Drug Resistant TB Prevention and Control Burden of TB

4/14/12

Facts About TB

Caused by a rod-shaped bacteria = Mycobacterium tuberculosis affects the lungs (pulmonary TB) also cause extra-pulmonary disease disease

Commonly

Can

Contagious

4/14/12

Transmission
Transmitted

via:

from person to person

- coughing - sneezing - talking - spitting

4/14/12

TB

is NOT spread by:

- shaking someones hand - sharing food or drink - touching bed linens or toilet seats - sharing toothbrushes - kissing
4/14/12

Natural Course of TB
TB infection
Immune system intact

Disease

No disease / Latent

Immune system becomes Diseas weak

4/14/12

1/3

of the worlds population or around 2 billion people are infected1 in every 10 of those people will become sick with active TB2

SOURCE: 1 WHO Global Tuberculosis Control Report 2009 2 WHO 10 Facts About Tuberculosis (http://www.who.int/features/factfiles/tuberculosis/en/) 4/14/12

Signs and Symptoms

Pulmonary TB is suspected if a person has: - cough for 2 weeks or more

With or without: - fever - chest and back pain - poor appetite - weakness - weight loss 4/14/12 - night sweats

Click to edit Master subtitle style

TB is CURABLE!
4/14/12

Drug Resistant TB
TB develops due to improper use of anti-TB drugs - improper treatment regimens e.g. wrong dosage, wrong time, - patient does not complete whole course of treatment
4/14/12

Resistant

Drug Resistant TB
Multi

drug-resistant TB (MDR-TB) is a form of TB that does not respond to the standard treatment using first-line drugs, specifically rifampicin and isoniazid. drug-resistant TB (XDR-TB) occurs when resistance to second-line drugs develops.
4/14/12

Extensively

Prevention and Control

ALWAYS

cover your mouth when you cough and sneeze; NOT spit anywhere; hands properly and;

Do

WASH

Protect

your family and friends from TB take the correct kind and quantity of 4/14/12 drugs and complete the

Click to edit Master subtitle style

The Burden of TB

4/14/12

TB Burden
Global

Situation Situation

National Local

Situation

4/14/12

Tuberculosis in the World, 2007

People

billion New TB cases 9.27 million (139/100,000 pop) New ss+ TB cases 4.1 million (61/100,000 pop) Cases of MDR-TB 0.5 million Deaths from TB (non-HIV) 1.3 million (20/100,000 pop) Deaths from TB (HIV positive) 456,000 4/14/12

infected 1/3 of global pop 2

4/14/12

SOURCE: WHO Global Tuberculosis Control Report 2009

4/14/12

The Extent of the Problem

1/3

SOURCE: WHO Global Tuberculosis Control Report 2009

of the global population is infected with Mycobacterium tuberculosis 8 million suffer from TB annually 95 % of the cases in developing countries 2 million die of TB every year 14.8% of TB cases are co-infected with HIV
4/14/12

TB Burden in the Philippines, 2007

9th among the 22 High burden countries1 in the Western Pacific Region (New ss+ cases)2 leading cause of Morbidity and Mortality 3 per year (New ss+ cases)1

2nd

6th

115,000 98

SOURCE: 1 WHO Global TB Control Report 2009 2 Tuberculosis Control in the Western Pacific Region 2009 Report 4/14/12 3 FHSIS 2007

Filipinos die daily 1

TB Burden in the Philippines, 2007

6

billion of annual income lost due to TB morbidity billion pesos lost (foregone wages) annually billion pesos in actual wages lost

27

Source: The Burden of Disease, Economic Costs and Clinical 4/14/12 Consequences of Tuberculosis in the Philippines, 2005, Peabody, John et al.

Magnitude of TB: A Comparison of the (3) National TB Prevalence Surveys Measurement

Prevalence of Smear (+)/1000 Prevalence of Culture (+)/1000 MDR-TB among New cases MDR-TB among Re-treatment cases 1983 1997 2007 1st NTPS 2nd NTPS 3rd NTPS

6.6 8.6 (-) (-)

4/14/12

3.1 8.1 1.5 14.5

2.0 4.7 2.1 13.0

2007 NTPS Conclusions

The

burden of TB disease in the country has declined over the past 10 years since the launching of the DOTS program.

decline in TB disease: - 35.5% decline in ss+ Pulmonary TB - 42.0% decline in sputum culture + PTB
4/14/12

Significant

2007 NTPS Conclusions

The

rate of MDR-TB showed no significant difference from 1997 indicating no increase in generation, but ongoing transmission interventions in the past decade has lead to better control, prevention, case management and better survival of TB patients

NTP

4/14/12

Trend of TB* Mortality and Morbidity Rate Rate/100,000 Philippines 1993-2003

400 350 300 250 200 150 100 50 0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Morbidity Rate

Mortality Rate

45 40 35 30 25 20

Click to edit Master subtitle style

The goal is here.

15 10 5 0

Philippine Health Statistics, 2003 * All TB forms 4/14/12

New SS (+)s by Gender and Age Groups, 2004-2008

4/14/12

Click to edit Master subtitle style

THANK YOU!

4/14/12