Tuberculosis: Prevention & Global Impact
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Based on the information provided, what ethical consideration is MOST crucial in TB prevention strategies?

  • Ensuring equal access to diagnostic technologies regardless of socioeconomic status. (correct)
  • Implementing strict quarantine measures for individuals with active TB, even if it leads to job loss.
  • Mandatory BCG vaccination for all newborns without parental consent to achieve herd immunity.
  • Prioritizing research funding towards developing novel TB vaccines over treatment methods.
  • Considering the global impact of TB, which strategy would be MOST effective in reducing its prevalence worldwide?

  • Implementing mass BCG vaccination campaigns in developed countries with low TB rates.
  • Restricting international travel from countries with high TB burden to prevent importation of cases.
  • Integrating TB prevention and treatment programs with existing HIV/AIDS initiatives. (correct)
  • Focusing solely on developing new antibiotics to combat drug-resistant strains.
  • A public health official is designing a TB prevention program. Which intervention represents a secondary level of prevention?

  • Improving ventilation systems in crowded living environments to reduce airborne transmission.
  • Conducting routine tuberculin skin tests (TST) for early detection in healthcare workers. (correct)
  • Providing Directly Observed Treatment (DOT) for individuals diagnosed with active TB.
  • Administering the BCG vaccine to newborns in a high-risk area.
  • Given the history of TB interventions, which development had the MOST significant impact on reducing TB mortality rates in the mid-20th century?

    <p>The discovery of streptomycin and the subsequent development of isoniazid and rifampicin. (A)</p> Signup and view all the answers

    Considering the information provided, what is the MOST likely reason TB ranks as the second leading cause of death from an infectious disease worldwide?

    <p>The emergence of drug-resistant strains and its association with HIV/AIDS. (A)</p> Signup and view all the answers

    What percentage of the 9 million TB cases reported in 2013 were concentrated in the South-East Asia and Western Pacific regions?

    <p>56% (B)</p> Signup and view all the answers

    According to the WHO's post-2015 Global TB Strategy, what is the target reduction in TB deaths by 2035, compared to 2015 levels?

    <p>95% (A)</p> Signup and view all the answers

    What is the targeted TB incidence rate (cases per 100,000 population) according to the WHO's milestones for 2025?

    <p>Less than 55 (D)</p> Signup and view all the answers

    Which of the following is NOT a stated principle of the post-2015 Global TB Strategy?

    <p>Independent healthcare systems for each country (D)</p> Signup and view all the answers

    Between 1990 and 2013, what was the approximate decrease in the TB prevalence rate?

    <p>41% (C)</p> Signup and view all the answers

    What is the primary approach to controlling disease, according to the text?

    <p>Identifying and breaking the weakest links in the chain of transmission (A)</p> Signup and view all the answers

    What encompasses the goals of medicine?

    <p>Promoting health, preserving health, restoring health and minimizing suffering. (B)</p> Signup and view all the answers

    What does the modern concept of 'prevention' in disease control primarily focus on?

    <p>Eradicating, eliminating, or minimizing the impact of disease and disability. (D)</p> Signup and view all the answers

    Which of the following best describes primordial prevention?

    <p>Measures that inhibit the emergence of risk factors by addressing underlying environmental, social, and economic conditions. (A)</p> Signup and view all the answers

    A public health initiative aims to improve ventilation in workplaces and homes, particularly where individuals are in contact with tuberculosis patients. Which level of prevention does this initiative represent?

    <p>Primary prevention (C)</p> Signup and view all the answers

    Which intervention is an example of health promotion within primary prevention?

    <p>Conducting health education programs about the benefits of good nutrition and hygiene. (B)</p> Signup and view all the answers

    A physician recommends a daily vitamin D supplement to a patient at risk of deficiency. Under which category of primary prevention does this action fall?

    <p>Specific protection through supplementation (D)</p> Signup and view all the answers

    Which activity exemplifies secondary prevention of a chronic disease?

    <p>Conducting regular blood pressure screenings at a community health fair. (A)</p> Signup and view all the answers

    What is the main goal of secondary prevention strategies?

    <p>To halt the progression of a disease at its early stage and prevent complications. (B)</p> Signup and view all the answers

    Which of the following public health initiatives is an example of primordial prevention for cardiovascular disease?

    <p>Establishing policies that promote access to affordable, healthy food options in underserved communities. (B)</p> Signup and view all the answers

    A local government implements policies to reduce air pollution from industrial sources. Which type of prevention does this represent, and what is its primary aim?

    <p>Primordial prevention; to inhibit the emergence of environmental risk factors for respiratory diseases. (A)</p> Signup and view all the answers

    Which of the following scenarios best exemplifies tertiary prevention in the context of tuberculosis (TB) management?

    <p>Providing occupational therapy and social support to a TB patient with lung damage to help them return to work. (D)</p> Signup and view all the answers

    A patient with HIV is diagnosed with latent tuberculosis (TB). Considering the guidelines for prevention, which is the MOST appropriate initial step?

    <p>Initiate Antiretroviral Therapy (ART) to improve the immune system, then consider Isoniazid Preventive Therapy (IPT). (C)</p> Signup and view all the answers

    Which of the following is the PRIMARY goal of secondary prevention strategies in managing infectious diseases like tuberculosis?

    <p>To reduce transmission of the infection from infected individuals to others. (D)</p> Signup and view all the answers

    A 68-year-old patient is undergoing chemotherapy for lung cancer when they get diagnosed with active tuberculosis. Considering risk factors, what is the MOST likely reason they developed active TB?

    <p>Compromised immune system due to cancer and chemotherapy. (A)</p> Signup and view all the answers

    In a community with a high prevalence of tuberculosis, resources are limited. Which intervention would provide the MOST effective primary prevention strategy?

    <p>Administering the BCG vaccine to newborn infants. (B)</p> Signup and view all the answers

    Which of the following is the BEST example of disability limitation in the context of tertiary prevention for Tuberculosis?

    <p>Offering vocational rehabilitation services to patients with TB-related disabilities. (B)</p> Signup and view all the answers

    A public health campaign aims to reduce the incidence of tuberculosis in a vulnerable population. Which approach combines both secondary and primary prevention strategies?

    <p>Screening and early treatment of individuals with active TB, which in turn prevents transmission and protects others. (B)</p> Signup and view all the answers

    A patient with a history of drug use has been diagnosed with tuberculosis. Which of the following factors MOST increases their risk of developing active TB disease?

    <p>The weakened immune system associated with drug use. (C)</p> Signup and view all the answers

    In the context of infectious disease control, what is the primary purpose of 'observation' and 'quarantine' when managing 'contacts'?

    <p>To monitor contacts for any symptoms and prevent potential spread of the disease, while diagnosis occurs. (A)</p> Signup and view all the answers

    Which of the following interventions directly targets the 'reservoir and source' link in the cycle of infection?

    <p>Implementing control measures targeting animal vectors. (D)</p> Signup and view all the answers

    What is chemoprophylaxis? (Select the best answer)

    <p>The use of chemicals/drugs to prevent the <em>spread</em> of a disease. (B)</p> Signup and view all the answers

    How does 'regional elimination' differ from 'disease eradication'?

    <p>Regional elimination aims to interrupt disease transmission in a specific geographic area, whereas eradication aims to terminate global infection transmission. (A)</p> Signup and view all the answers

    What defines 'disease eradication' as an absolute process?

    <p>The disease is completely eliminated worldwide, with no further transmission. (B)</p> Signup and view all the answers

    Which intervention aims to control the 'mode of transmission' (MOT) of an infectious disease?

    <p>Implementing personal hygiene practices. (A)</p> Signup and view all the answers

    Why is surveillance crucial in breaking the cycle of infection?

    <p>Surveillance helps in identifying cases, contacts, and carriers, thus enabling targeted interventions. (A)</p> Signup and view all the answers

    What is the ultimate goal of implementing interventions, such as surveillance, quarantine, and treatment, in controlling infectious diseases?

    <p>To break the cycle of infection and mitigate the burden on healthcare systems. (A)</p> Signup and view all the answers

    Flashcards

    Ethics of TB prevention

    Moral principles guiding tuberculosis prevention strategies.

    Global TB Strategy

    Comprehensive plan to reduce TB incidence and mortality globally.

    Levels of prevention

    Different stages of preventing TB: primary, secondary, tertiary.

    History of TB

    Key events leading to the understanding and treatment of tuberculosis.

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    Directly Observed Treatments (DOTS)

    Treatment strategy to ensure patients complete TB therapy effectively.

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    Primordial prevention

    Actions to inhibit emergence of risk factors in populations.

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    Methods of Primordial Prevention

    Measures such as improving living conditions and education to prevent risk factors.

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    Primary prevention

    Actions taken to prevent disease before it occurs, targeting the pre-pathogenesis phase.

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    Methods of Primary Prevention

    Includes health promotion and specific protection like vaccinations.

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    Health promotion

    Activities aimed at enhancing well-being to prevent diseases.

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    Secondary prevention

    Actions to halt disease progress at an early stage to prevent complications.

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    Examples of Secondary Prevention

    Includes early diagnosis through screenings and timely treatment.

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    Environmental modifications

    Adjustments to surroundings to eliminate health hazards and promote prevention.

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    Global TB Vision

    A TB-free world with zero deaths, disease, and suffering from TB.

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    Global TB Goal

    End the global tuberculosis epidemic by reducing deaths and incidence.

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    TB Milestones for 2025

    Targets to reduce TB deaths by 75% and TB incidence by 50% by 2025.

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    TB Targets for 2035

    Aim for 95% reduction in TB deaths and 90% reduction in incidence by 2035.

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    Principles of TB Strategy

    Government accountability, community involvement, and human rights focus in TB control.

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    Disease Weak Points

    Identifying vulnerabilities in disease transmission to control outbreaks.

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    Disease Prevention Concept

    Actions aimed at eradicating, eliminating, or minimizing disease impact.

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    Epidemiological Knowledge

    Understanding disease distribution, history, and transmission dynamics.

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    Tertiary Prevention

    Measures to reduce impairments and promote adjustment in advanced disease stages.

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    Disability Limitation

    Efforts to minimize the impact of disease-related disabilities.

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    BCG Vaccine

    A vaccine primarily used for tuberculosis prevention in healthy individuals.

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    Antiretroviral Therapy (ART)

    Treatment to boost the immune system in HIV patients.

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    Isoniazid Preventive Therapy (IPT)

    Treatment to prevent progression to active TB in at-risk individuals.

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    Risk Factors for TB

    Conditions that increase susceptibility to tuberculosis infection.

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    Rehabilitation in Tertiary Prevention

    Support for adjusting to life with disabilities due to illness.

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    4 C's of Control

    Framework for managing infectious diseases: Cases, Contacts, Carriers, Community.

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    Surveillance

    Monitoring for the presence of disease in populations to implement timely interventions.

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    Quarantine

    Separation of individuals who may have been exposed to a disease to prevent its spread.

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    Vaccination

    Administration of a vaccine to stimulate an immune response against a specific disease.

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    Regional Elimination

    Interruption of disease transmission in specific geographic areas; precursor to eradication.

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    Disease Eradication

    Complete termination of all transmission of an infection globally.

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    Mode of Transmission

    The way in which a disease spreads from one individual or reservoir to another.

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    Epidemiological Investigation

    Study to identify the source and spread of infectious diseases in populations.

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    Study Notes

    RES 301: Prevention of TB

    • TB prevention lecture, presented by Dr. Mohammed Abdulrazzaq, on February 9, 2025
    • The lecture covered ethics of TB prevention, global TB strategy, levels of prevention, and prevention of infectious diseases.
    • Learning outcomes included assessing factors influencing successful TB prevention and differentiating between prevention levels.

    History of TB

    • 1882: Koch identified TB bacilli
    • 1907: Tuberculin skin test developed (von Pirquet)
    • 1919: BCG vaccine introduced (Bacille Calmette-Guérin)
    • 1943: Schatz and Waksman discovered streptomycin
    • 1948: BMRC trial of streptomycin vs. bed rest
    • 1952: Isoniazid developed
    • 1966: Rifampicin developed
    • 1978: Short course chemotherapy (DOTS) introduced

    Global TB Strategy (Post-2015)

    • Vision: A TB-free world (zero deaths, disease, and suffering)
    • Goal: End the global tuberculosis epidemic
    • Milestones for 2025: 75% reduction in TB deaths, 50% reduction in incidence (less than 55 cases per 100,000 population), no affected families facing catastrophic costs
    • Targets for 2035: 95% reduction in TB deaths, 90% reduction in incidence (less than 10 cases per 100,000 population), no affected families facing catastrophic costs

    Principles of Post-2015 Global TB Strategy

    • Government stewardship and accountability with monitoring and evaluation
    • Strong coalition with civil society organizations and communities
    • Protection and promotion of human rights, ethics, and equity
    • Adaptation of strategy and targets at the country level with global collaboration

    Disease Prevention and Control

    • Weak points within a disease need to be identified and the weakest links in transmission broken
    • Sound epidemiologic knowledge is required. This includes natural history, time/place/person distribution, multifactorial causation, sources of infection, and disease transmission dynamics.

    Prevention: Definition and Concept

    • Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability
    • In the modern-day, prevention is broad-based, encompassing primordial, primary, secondary, and tertiary prevention levels.

    Primordial Prevention

    • Aims to prevent the emergence of risk factors, such as behavioral, environmental, economic, social conditions that may negatively affect health.
    • Includes improving living conditions, boosting good nutrition, education/awareness initiatives, reinforcing healthcare infrastructure, and preventing migration to high-risk areas.

    Primary Prevention

    • Actions taken prior to the onset of disease, preventing it from occurring altogether.
    • Includes health promotion measures to improve health outcomes.
    • Includes specific protection measures such as immunization, chemoprophylaxis, exposure control, and nutritional considerations for vulnerable populations.

    Secondary Prevention

    • Halts disease progression early and avoids complications
    • Early diagnosis (screening), proper case identification, and adequate treatment are key components.
    • This level aids in preventing both immediate complications and further transmission to others.

    Tertiary Prevention

    • Aimed at minimizing impairments and disabilities.
    • Focuses on rehabilitation and adaptation to irremediable conditions after a disease process has progressed beyond its early stages.
    • Tertiary measures prevent further complications, long-term disability, social limitations, and loss of quality of life.

    TB in Weakened Persons

    • Vulnerable individuals (HIV, diabetes, poor nutrition, cancer treatments, steroid use, drug use, smoking, and older age) are more susceptible to TB infection.
    • Priority for individuals with compromised immune systems may include prophylactic antibiotics.

    Examples of TB Prevention Levels

    • Vaccination (e.g., BCG) for newborns (primary)
    • Screening/early treatment of active TB (secondary)
    • Occupational/social rehabilitation for advanced TB (tertiary)

    Intervention to Break the Cycle of Infection

    • This involves actions to curb the disease process at multiple points within its life cycle (e.g., surveillance, disinfection, isolation of cases/carriers, observation of contacts, etc).

    Control of Infectious Diseases (“4 C's”)

    • Diagnosis
    • Notification
    • Isolation
    • Disinfection
    • Treatment
    • Follow-up
    • Release
    • Observation
    • Quarantine
    • Detection of carriers in the community
    • Community Epidemiological investigations and containment

    Disease Elimination and Eradication

    • Elimination stops transmission within a region or area.
    • Eradication eliminates the disease globally.
    • Eradication of disease is a significant step toward halting its continued spread within a population and in future populations.

    References

    • Park’s Textbook of Preventive and Social Medicine, 25th ed
    • WHO: Global strategy and targets for tuberculosis prevention, care and control after 2015 (2015)

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    Description

    This quiz focuses on critical ethical considerations in TB prevention, effective global strategies, and levels of intervention. It addresses the historical impact on reducing TB mortality and the reasons for its continued prevalence. Also, quiz tests knowledge of TB cases in regions and WHO's goals to reduce deaths.

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