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Lecture 7

ANTB15- Lecture 7- Nov 11- TB.docx

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University of Toronto Scarborough
Larry Sawchuk

Tuberculosis- November 11, 2013 – Lecture 7 The Captain of Men of Death Tuberculosis (TB) is a contagious disease which infects nearly 9 million people annually - one every second - and kills over 2.5 million people every year - or one every 15 seconds! • Social Conditions context of women’s lives; women as primary caregivers Women spending most of their time at home exposed to the sick • Physiological Differences The onset of childbearing (possible stressor) Symptoms of cough and sputum expectoration less common in women – delay in treatment seeking (Long et al., 2002) Bovine (M. bovis) • Possible that human TB is a mutant of bovine form • Cattle first domesticated in Neolithic (6000-7000 B.C.) in the Old World - suggestions that TB became an endemic human disease at this time.  Drinking unpasteurized milk will cause TB Mycobacterium tuberculosis • Non-motile, rod-shaped bacillus • Covered in ‘waxy sheath’ • Does not produce any significant toxin • Multiplies slowly (6-12 hrs) • Can survive outside of human host • Can survive dessication • 4,000-gene sequence or genome of the TB bacillus. • In a 24hr period an infected host can expel 2-4 billion bacilli • Immune system response - only a fraction of those infected will develop active disease • Influence of genetics Optimal Conditions for Transmission • Overcrowding • Poor personal hygiene • Poor public hygiene TB: an opportunistic disease Robert Koch: made a discovery : I know what causes TB -> bacillus Ex. of a disease becoming less problematic with no intervention So, what’s happening? : people are becoming more immune Those people who are less susceptible are those that are the ones who survived At the very end of the wave, they’re all immune to the disease At some point everyone gets sick and they die Crisis Mortality as an Agent of Change o the sudden and dramatic increase in the death rate arising from a common, unusual causal factor operating for a limited period o Can be triggered by a number of events: famine, flood, drought, war, epidemic, smog! Proxy Indicators of Health • Morbidity – sickness • Mortality – deaths • Mortality or Death Rate [total number of deaths/population at risk] Expressed as a proportion or in some cases as a rate Mortality Patterns – some Generalizations • In most western industrialized countries or “resource rich” countries there has been a progressive decline in the death rate • The improvement in health varies from one population to the next Uniqueness of the mortality experience • The decline occurred before modern medical biomedicine • All of these countries has fallen mortality rates: France, Hungary, Ireland, England and Wales Epidemics • a sudden increase in an infectious disease frequency above typical background or prevailing death rates for a given population Pandemic A special case of an epidemic which is spread over a vast geographic area Scapegoat: blaming on someone Harvesting Effect or short-term mortality displacement • occurs when there is a heightened, temporary, mortality rate in those with health complications because of underlying health problems, especially cardio-respiratory diseases and among the elderly or increased vulnerability associated with lower socioeconomic status. (Dominici et al., 2003; Nobetti et al., 2000
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