in class lecture note

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31 Oct 2010

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L10 Tuberculosis
- caused by mycobacterium, attacking the body but most commonly the lungs
- active tb - antibodies within body was unable to fight off virus, transmissible up to 10-
- inactive/latent tb - bacteria is in the body but there are no symptoms, not capable of
- 50% of people who are not cured die
- was widespread in last centuries - pale with red eyes coughing out blood (vampires)
- 19th century romanticism - infected were considered to be more creative
tuberculosis meningitis - infection of the brain or spinal cord (characterized by irritability and
restlessness) Æ stiff neck, headache, vomiting, changes in mental condition or behaviour, or
intestinal tuberculosis - infection of the intestinal tract
tuberculosis lymphadenitis - infection of lymph nodes (causing enlargement of nodes and
forming masses in the neck)
tuberculosis pericarditis - infection of the heart
- contracted via respiratory tract, inhaling infected droplets
- installed in lungs, trapped in the bloodstream, attacking other organs
- mainly in Asia, in 2008 - 55% of the global total
- Eastern Europe - 150 000 new cases in Russia in 2008
- 14 097 new cases in USA in 2005
- in UK, dubbed 'the disease that never went away' with 8113 new cases in 2005
Æ in parts of London, tb rates are 10 x the national rate
McCraig - tb linked to factors of poverty and ethnic belonging
- 9 million cases annually (1/3 in China and India)
- need to have high density/urbanization, poor hygienic conditions, long periods of contact
- Southern developing countries are most burdened by tb
- loss of healthy life - #10, 2.5%, less than traffic road accidents, heart disease, malaria,
- HIV & TB is interrelated - lowered resistance as tb is an opportunistic disease
- 80+ million patients since 1980, 17 million patients on DOTS (Directly Observed Therapy)
- according to different geographical areas, results of treatment vary - many within Europe
died and failed, Africa died, defaulted, and transferred
- after fall of Iron Curtain, difficulties for people increased and more people were burdened
with tb
- tb decreases life expectancies (Africa - excaberated by poverty and lack of social services)
- 2 million people infected with TB bacilli, someone in the world is newly infected with TB
every s
- disease of poverty, affecting mostly young adults in their most productive years
- 1.6 million people died from TB in 2005, estimated 4400 deaths/day
- leading killer among HIV-infected peoples, 200 000 people with HIV/AIDS die from
- 8.8 million new tb cases in 2005, 80% in 22 countries
- annual incidence rates are now stable or falling -
- worldwide pandemic - half of new cases are in 6 Asian countries (Bangladesh, China, India,
Indonesia, Pakistan, Philippines)
- multidrug-resistant tb - does not respond to standard treatments using first-line drugs
- 450 000 new mdr-tb estimated every year Æ highest in Russia and China
- extensively drug resistent tb (XDR-TB) - resistance to second-line drugs develops, difficult
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