Tuberculosis (TB)
Overview
Tuberculosis (TB) caused by Mycobacterium tuberculosis, spreads from person to person through the air by coughing. TB is a global pandemic affect 1/3 of the World's population. 9 million people develop active TB each year and someone is newly infected every second with this disease. TB is a life threatening disease that normally affects the lungs but can affect any part of the body. It causes fever, weight loss, fatigue and a range of specific symptoms related to the area of the body infected. However it is a preventable and curable disease.
Only people who are sick with TB in the lungs (pulmonary TB) are infectious. Left untreated, a person with active pulmonary TB will infect approximately 15 people each year. But many of these newly infected people will not become sick. The immune system "walls off" the TB bacilli that may remain dormant for years. When the person's immune system is weakened, the chances of becoming sick increases. People living with HIV/AIDS have a weakened immune system, and are many times more likely to develop active TB than healthy individuals.
Background
In 1993 the WHO declared TB a global emergency and since then there has been development of many strategies to combat TB around the world. The Millennium development Goals, aim to half the burden of TB by 2015 and the WHO has begun a Stop TB Partnership which details a global plan to stop TB by 2015 also. A key element of these schemes focuses on Community Health Care, with a key aim of the Stop TB partnership - "to foster community participation in TB care prevention and health promotion."
In the Community
A key aspect of community TB prevention and care is through DOTS programmes. A DOTS programme stands for directly observed treatment, short course. This is a 5 component programme of the WHO - the administration of anti TB medication is just one component of the program. The components are as follows:1) Direct observation of treatment (DOT)
2) Microscopy services
3) Drug Supplies
4) Monitoring and recording
5) Political Will
Deciding whether to participate in a TB Programme
Although TB is a curable disease it is difficult to treat and requires a time, commitment and funding. There are also complex guidelines specific to each area dependant on multi drug resistance and HIV/aids prevalence. This means participation in a programme requires careful consideration.Treating TB inadequately is worse than not treating it at all.
Before starting any TB programme, there are several questions that need to be asked.
1) Does the community wish to have a programme?
Will local people work in partnership with the project you wish to set up? Are they prepared to take on increasing responsibility for the programme?
2) Is TB common or important in our programme area?
This can usually be discovered from national data of annual rates of infection.
3) Is TB already being adequately treated?
National treatment programmes may be in place locally, but they may be in private clinics and not in the neediest areas. Meeting the district medical officer or TB officer and directors of any other programmes involved in treating TB is a key aspect of project development. It is essential to work alongside existing programmes.
4) Have we the resources to set up a TB programme?
Setting up a programme requires:
- A doctor to plan, advice and give clinical care
- Health workers to identify cases
- Drugs
- Money, unless free supplies are available and guaranteed.
- A referral system for diagnosis and treatment
- Effective management
It takes many years for a TB programme to be effective. Project planners will need to make sure that the projects can continue for a number of years
Related Organisations
- Target Tuberculosis
- Stop TB Partnership
- World Health Organisation
- Centers for Disease Control & Prevention
Related Papers and Research
- Multi Drug resistant TB in South Africa
- TB: Something incredibly obvious
- How can the community contribute in the fight against HIV/AIDS and tuberculosis?
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