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EPI DISEASES

EPI DISEASES. 1. Tuberculosis. Consumption. Koch’s Disease. Pthisis. Mycobacterium tuberculosis. CAUSATIVE AGENT. Mycobacterium tuberculosis, TB bacillus, Koch’s bacillus, Mycobacterium bovis. MODE OF TRANSMISSION. Airborne, droplet. Incubation Period : 4 – 6 weeks.

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EPI DISEASES

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  1. EPI DISEASES

  2. 1. Tuberculosis Consumption Koch’s Disease Pthisis

  3. Mycobacterium tuberculosis CAUSATIVE AGENT Mycobacterium tuberculosis, TB bacillus, Koch’s bacillus, Mycobacterium bovis

  4. MODE OF TRANSMISSION Airborne, droplet Incubation Period: 4 – 6 weeks

  5. PATHOGNOMONIC SIGNS 1. Usually asymptomatic 2. low grade afternoon fever 3. night sweating

  6. 4. loss of appetite

  7. 5. weight loss 6. easy fatigability 7. temporary amenorrhea

  8. 8. productive dry cough

  9. 9. hemoptysis

  10. MANAGEMENT/TREATMENT Diagnostic test: Sputum Examination, Chest X – ray, tuberculin testing.

  11. Sputum Examination or the acid fasting bacilli (AFB). 1. The confirmatory test. 2. early morning sputum about 3 – 5 cc 3. maintain NPO before collecting the specimen 4. give oral care after the procedure 5. label and send to the laboratory

  12. Chest X – ray – is used to:

  13. 1. determine the clinical activity of TB if TB is inactive(in control) or active (ongoing)

  14. 2. To determine the size of the lesion: • Minimal – very small • Moderately advanced – lesion is less than 4cm • Par advanced – lesion is more than 4 cm

  15. Tuberculin test

  16. Purpose – to determine the history of exposure to TB. Uses PPD (purified protein derivative) Principle: If the person is exposed to TB he will develop PPD – leading to indurations of >10mm.

  17. Other name: Mantoux test – for individual screening, result interpreted after 72 hours.

  18. Tine test – mass screening, read after 48 hours. Treatment: Short Course Chemotherapy, DOTS Ripamficin, Izoniazid, Pyrazinamide, Ethambutol, Streptomycin

  19. Category of Treatment Regimen for DOTS • Category 1: 6 months SCC • Intended for: • New positive smear • New negative smear PTB with extensive parenchymal lesions on CXR • EPTB • Severe concomitant HIV disease

  20. Intensive phase: 2 months • R - ifampicin (R) 1 tab • I - soniazid (H) 1 tab • P - yrazinamide (Z) 2 tabs • E - thambutol (E) 2 tabs • Continuation phase: 4 months • R - ipamficin (R) 1 tab • I – soniazid (H) 1 tab

  21. Category 2: 8 months SCC • Intended for: • Treatment failure • Relapse • Return after default

  22. Intensive phase: 3 months • R - ifampicin (R) 1 tab • I - soniazid (H) 1 tab • P - yrazinamide (Z) 2 tabs • E - thambutol (E) 2 tabs • S - treptomycin (S) 1 vial/day • Continuation phase: 5 months • R - ipamficin (R) 1 tab • I – soniazid (H) 1 tab • E - thambutol (E) 2 tabs

  23. Category 3: 4 months SCC • Intended for: • PTB minimal • Negative sputum smear

  24. Intensive phase: 2 months • R - ifampicin (R) 1 tab • I - soniazid (H) 1 tab • P - yrazinamide (Z) 2 tabs • Continuation phase: 2 months • R - ipamficin (R) 1 tab • I – soniazid (H) 1 tab

  25. Side Effects of TB Drugs • Rifampicin– orange colored urine, hepatotoxic • Isoniazid– peripheral neuritis • Pyrazinamide – hyperuricemea/gouty arthritis • Ethambutol– optic neuritis • Streptomycin – damage to the 8th cranial nerve, ototoxic

  26. Prevention 1. Avoid Mode of Transmission

  27. 2. BCG vaccination

  28. Hepatitis B Serum Hepatitis

  29. CAUSATIVE AGENT Hepatitis B virus

  30. MODE OF TRANSMISSION Blood and body fluids Placenta Incubation period: 45 – 100 days

  31. PATHOGNOMONIC SIGNS

  32. PATHOGNOMONIC SIGNS • Abdominal pain 2. Jaundice 3. yellow colored sclera 4. anorexia 5. nausea and vomiting 6. muscle pain

  33. MANAGEMENT/TREATMENT Diagnostic test: HBsAg (Hepatitis B surface Agglutination test) Treatment: Hepatitis B immunoglobulin

  34. PREVENTION Hepatitis B Vaccine

  35. Hepatitis A Infectious Hepatitis Epidemic Hepatitis Catharral jaundice

  36. CAUSATIVE AGENT Hepatitis A virus

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