1. Dr Paul T Francis, MD Community Medicine College of Medicine, Zawia
Tuberculosis
Dr Paul T Francis, MD
Community Medicine
College of Medicine, Zawia

2. Tuberculosis TB is one of the major health problems worldwide
In developing countries it is still one of the major cause of morbidity and mortality
The combination of HIV infection and TB has led to a very dangerous situation
Antibiotic resistance to anti-TB drugs is another important problem

3. TB (pulmonary) problem in Libya
A national survey was done in to find out the prevalence of TB in Libya
Prevalence of infection - 28%
Prevalence of Pulmonary TB – 0.16%
BCG coverage – 50%
Prevalence among immigrants -22%

4. Agent factors Agent – M tuberculosis (human and bovine strains)
Source of infection – sputum
Bovine TB – infected milk
Mode of transmission – droplet infection

5. Scanning electron microscope picture of M tuberculosis

6. Host factors Age – young adults Sex – more prevalent in males
Occupation – migrant laborers
Social factors – more in the low socio-economic class
Incubation period – few months to years

7. Control of TB Case finding Treatment BCG vaccination Chemoprophylaxis
Health education

8. Case finding
A case is a person whose sputum is positive for TB bacilli
Sputum should be examined for AFB (acid fast bacilli) if
There is cough more than 4 weeks duration
Hemoptysis
Low grade fever
Loss of weight
Pain in the chest

9. Case finding in the Jamahiriya
Examination of all contacts of a case of TB
Examination of all foreign laborers before they start work in Jamahiriya, repeated every 3 years
Mass case finding in high risk groups – hairdressers, doctors, nurses, teachers
Examination of patients with chest symptoms

10. Direct Observed Therapy Short course
Treatment - DOTS
Direct Observed Therapy Short course
The patient has to eat the medicines in front of the Doctor or a health worker to make sure that the patient takes the treatment
In the intensive phase(4 drugs) all the doses are taken in front of health worker
Intensive phase is for 2 months

11. DOTS
In continuation phase(2 drugs) drugs for one week is given to the patient
When the patient returns the empty packet, medicines for another week is given
Intensive phase is for 4 months
Total treatment period is for 6 months