Tuberculosis is one of severe diseases. Due this thousand of people died yearly. In Nepal for prevention of T.B. there are many programs.
Tuberculosis, types and Current situation in Nepal
Introduction to Tuberculosis
Tuberculosis is a contagious disease. This is Mycobacterium tuberculosis that is invisible to the naked eyes. It is spread by germs and is transmitted by respiratory diseases. The bacterium (Mycobacterium tuberculosis) was discovered by German scientist Dr. Robert Koch in 24 March 1882 A.D.
It is one of the major problems in the world. It has been I the form of 10 high mortality rates. In 1993 The World Health Organization, (WHO) declared tuberculosis a major public health issue disease. Tuberculosis is a major public health problem in Nepal as well as is poverty, illiteracy, lack of consciousness, including internal migration and open border etc. Due to this, the rate of TB infection is increasing.
Tuberculosis transmission method
Since tuberculosis is a contagious disease, it is caused by the spread of Tuberculosis in the sputum when a patient coughs or sneeze. Droplet nuclei are released into Air. Most of these shades are small dusty dust particles stay in the outdoor environment for only a short time, but only slightly in time all can last a long time. Droplet nuclei only ten micrometers (10 um) in size and smaller the smallest part of the fade can be as far as the alveoli. Droplet nuclei are respiratory. The upper part of the tube is blocked by the mucocllay stream in the upper respiratory tract and cannot reach the lungs these Droplet Nuclei are swallowed or thrown out.
In this way, when these germs enter the lungs, the macrophages try to kill the germs by surrounding them. Primary focus begins in the affected part of the lungs. From there, these germs spread to the Hlum granny affects. The combination of primary focus and the affected helium glands is called primary complex. Not all people affected by germs get TB if the person infected with TB germs is infected with the diseases. If the ability to fight is good, the disease does not occur, but if the ability to fight the disease is low, the disease spread quickly. The disease develops rapidly in people with dementia. Among those infected with TB germs only about 10% of people can develop tuberculosis.
The number of people who come in close contact with a patient who has been infected with Tuberculosis germs some are only infected.
Types of Tuberculosis
- Pulmonary Tuberculosis
- Extra-Pulmonary Tuberculosis
Pulmonary Tuberculosis: - Pulmonary tuberculosis is also two types
I. Pulmonary Bacteriologically confirmed TB
ii. Pulmonary Clinically Diagnosed
The main Symptoms of Pulmonary TB.
- Persistent coughing for 2 weeks or more is the main symptom of laryngeal Tuberculosis.
- Mild fever and sweating may occur
- They don’t want to eat
- Weight loss
- Chest pain and shortness of breath are common
- Blood in sputum.
Extra pulmonary Tuberculosis: - Tuberculosis of the body other than the lungs is called extra pulmonary tuberculosis (EP TB). Such as glands lymph node, bone joints, reproductive and urinary system, nervous system, stomach intestine and other parts of the body in some cases, the disease can be considered contagious. Physician needed to detect extra-pulmonary TB.
Extra pulmonary tuberculosis is also two types
I. Bacteriologically confirmed-(BC)
ii. Clinically Diagnosed(CD)
The main symptoms of extra pulmonary TB are
- Bone marrow tuberculosis
- TB meningitis: Headache, fever and neck stiffness, mental confusions etc.
- Miary TE : severe fever, cough etc
- TB in the inner part of the valley: sore throat, hoarse voice, sometime hoarseness.
Current Situation of Tuberculosis in Nepal and World
Government of Nepal solves the problem of tuberculosis to be kept under priority program and different programs are running currently. National tuberculosis program is under Ministry of Health and population. Effectively from the center to the community level is being operated.
Current Status of Tuberculosis:
According to 2018 report of World Health Organization, in 2017
- An estimated 10 million people worldwide were infected with tuberculosis.
- Of those, only 6.4 million were diagnosed and treated, which is only 64% of the estimated number.
- The incidence rate of tuberculosis is 133 million. 44% of notified TB patent in Southeast Asia, 25% in Africa, 18% in the pacific, 77% in the Middle East, 2.8% in the United States and 2.7 are in Europe.
- 1.3 million TB patients died. The death rate from tuberculosis is 16%. 30,000 deaths were caused by HIV and TB.
- The treatment success rate is 82%
- It is estimated that 23% of the world’s population has latent TB infection.
- Of the 1, 60,684 MDR/RR TB patients diagnosed worldwide, only 87% were registered.
- RR TB was found in 558,000 new patients, while the remaining 82% were MDR TB.
- 8.5% XDR TB has been found worldwide.
According to the report of the National Tuberculosis center for 2074/075, the state of tuberculosis in Nepal:
- A total of 32,478 TB patients were registered.
- Of those, 98% were new and relapsed TB patients.
- 80% of the total patients were PBC patients.
- Estimated incidence rate 152/100000(2018)
- Case notification rate is 112/100000.(In 2018 population)
- The treatment success rate of the patient is 91%
- Annually, about 13,000 TB patients have not been identified and treated.
- Estimated daily: 123 new cases are diagnosed, 18 deaths due to tuberculosis and 34 deaths are undiagnosed or lost.
- It is estimated that about 6,000 to 7,000 people died of tuberculosis each year.
- About 9.9% of HIV patients have TB Co infection and 2.5% of TB patients have HIV co infection.
- Of the estimated 1,500 MDR patients per year, only 420 were diagnosed with MDR.
- A total of 86 pre XDR patients were registered in FY 2073/07.