MICRO: Tuberculosis and Development

Question 1

What are the goals to end global TB epidemic by 2030?

Answer 1

1. Reduce TB deaths by 95%
2. Reduce new cases by 90%
3. Ensure that no family is burdened with catastrophic expenses due to TB

Question 2

What is driving the TB epidemic?

• HIV
• POVERTY
• LACK OF N95 MASKS AND PPE
• THE ANTIVAX MOVEMENT

Answer 2

Poverty

Question 3

Socioeconomic development (GDP/capita) is an important factor for reducing TB rates in developing countries

To improve social deteminants of TB you start with the downstream factors first (e.g. impaired host immunity, high level contact) and then move upstream (e.g. policies, poverty, healthcare systems)

Answer 3

• Crowding in rooms
• Malnutrition - biggest Population attributable factor
  (high BMI protects you)
• HIV
• Alcoholism

Question 4

What are the consequences of TB that cause a vicious cycle?

Answer 4

Increases poverty, low SES, low education which is a risk factor for TB

Question 5

How does TB treatment impact infectivity

Answer 5

Reduces Coughing
Reduces TB in sputum
within days to weeks

Question 6

What % of patients complete TB treatment?

• 2%
• 56%
• 85%
• 95%

Answer 6

In drug senstitive cases - completion rates are ~ 85%

In MDR/RR-TB cases - completion rates are ~ 56% - more die or are lost to follow up.

Question 7

Why is TB treatment completion low?

Answer 7

• Cost - lost income
• Side effects - more important for drug resistant
• Lack of education
• Stigma
• Patient feeling better and stopping treatment prematurely