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Lecture 8

GGRB28 Lecture 8.docx

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Department
Geography
Course
GGRB28H3
Professor
Suzanne Sicchia
Semester
Fall

Description
GGRB28 Lecture 8: Geographies of TB- Nov 8, 2012 Sample Test Question: 1. Explain the difference b/w MDR and XDR Tuberculosis Tuberculosis - Air borne illness o Transmitted through air droplets - latent infections (90%) and active disease (10%) o latent means the infections are asleep; you have them but not active in the body  you cannot catch TB from these people  they are not infectious!  Not affecting them in any way  Unless you took a test, you would never know that you had TB diagnosis! o Active disease = infectious  You are being affected by the disease o latent infection can turn into the active disease when immune system is compromised or weakened!!!! - Symptoms: cough, fever, chills, weight loss - Also known as “consumption” or the “white plague” o Consumption = b/c you waste away, you become a skeleton (something was consuming your body!) - Creation of sanatoriums o Huge rates of TB in Canada and US up until the 1950s o As a result, sanatoriums created – send people there when 1) sick, for rest and treatment and 2) they didn’t infect any one else o These people had active TB o Send of their relatives to these sanatoriums o Spa-like places, clean air o Also be seeking treatment there; some treatments were barbaric (cutting some of ribs, trying to get rid of the diseased lungs!) o Very rarely survived when you went into sanatoriums! o Pic – waverly hill sanatorium in Kentucky; all patients lying in bed overlooking meadow as getting TB treatments o 100s of people dying a day; had a shute to dispose bodies! o Very much a plague during this period of western history - discovery of streptomycin in 1940s o really changed effects of TB o effective drug treatments; decrease TB infections in western world! - improvement in social conditions o understandings of hygiene and sanitation were coming about o social developments were cleaner o were understanding water sanitation, cleaner houses etc. o animals no longer living in areas near people o waste management! - BCG vaccine – given to children (immunity only 10 years) o No vaccine for TB 1 o Often times not given to adults, only given to children in childhood so they don’t have damage to body as they are developing o BCG doesn’t work on adults; and if administered to adults may give a false positive o We just treat it when it shows itself TB – A social Disease - TB is contracted through airbone drops o Someone has to have active form and cough in your face to transmit TB - Not particularly infectious, requires long and frequent exposure o In close proximity for extended period of time, if you are healthy - TB can progress quickly with lower resistance o Length of time it takes you from having actual disease and dying will be shorter b/c body in unable to fight disease! (immune system is already compromised/weakened) - Associated with poverty o People living in slum-like conditions o Continued to have effect in third world now o Allow for weakened immune conditions – therefore more susceptible! o Highest rate in highest poverty-striken areas o i.e. southern Africa! (also have high HIV rate here) – overlap b/w the two! TB & DOTS - “Directly Observed Therapy, Short – course” - DOTS involved greater observation (i.e. people watching patients swallowing their pills) o watch people take pills, and individually going door to door to take medication to the patient! o Health is reduced in 3 world countries DUE TO ACCESS! Access issues prevent people from seeking treatment. o Ensures completion of 6- 8 month treatment plan - DOTS is 95% effective, cheap, 6-8 months o TB treatment you need antibiotics for 6-8 months o If your clinic is very far, and you barely work (don’t have enough $), you wont have the time to take o TB continues to spread due to poor compliance – not taking medication properly! (blaming the victims…) o This doesn’t take into account for people not being able to afford to buy medicine or be able to take off work; infrastructure – (bridge washes out during stor,) o May have will to do it.. but not the means! o Generic products so its very cheap o It doesn’t take a lot of time b/c you train community members to do it! Get a little bit of money o DOTs is breaking down all those barriers MDR & XDR TB - MDR (Multi-Drug Resistance) – Resistant to 2 or more “1 line‟ drugs o 1 line drugs = first drugs created to treat TB (basic antibiotics) 2 - XDR (Extreme-Drug Resistance) – Resistant to 3 or more 2 ndline drugs o Over the years we have created stronger antibiotics = 2 line drugs o There’s only 6 of them; you are reducing your chances of finding something that will actually help you! o So there’s three types of strains – normal TB, then MDR, then XDR - Improper use of medications o New protocol for docs to reduce amount of antibiotics o They are taking antibiotics for things that you don’t really need antibiotics for! (doesn’t really work)
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