Flashcards in L24. Social and Economic Determinants of Health: TB Deck (21)
What is a major driving factor for the incidence of TB?
Poverty and malnutrition
Why does TB in children often go undiagnosed?
Because they don't have access to health services and even if they do, they are often ill equipped or not trained enough to diagnose
Children count for 6% of the diagnosis of TB
There is a 20-37% increased risk of contracting TB and a 13% of dying from TB as a result of which risk factor?
What is the incidence of TB in Australia?
4 per 100,000 people
How is TB spread?
By droplets (sneezing, coughing, spitting)
Where do up to 80% of the worldwide cases of TB occur?
In poverty stricken nations
The epidemiological impact is far less than predicted. What is an important need as a result of this?
To target additional interventions including social and economical: peoples vulnerability to TB
What were the millennium development goals?
An attempt to bring focus to key aspects of health and disease and set targets and timelines to achieve them
Have there been decreases in TB incidence since 1990? (has the MDG for TB been achieved?)
2.2% decrease in incidence and a decrease in about 41% in mortality
But this is not enough
What is an emerging problem in TB?
What are reasons for the steady decline in TB incidence?
Bettering health and social environments
Germ era and antimicrobial therapy
What are DOTS?
Directly Observed Treatment Short course: ensuring people taking TB medication do so and are observed. (6 month course, daily)
Why are biomedical approaches not showing the benefit they are expected to?
Little regard for reducing the VULNERABILITY to disease
Even when biomedial approaches (DOTS) are successfully implemented, the decrease in TB incidence is less than expected.
There is a need to address UNDERLYING factors making people vulnerable to disease
Describe the Socio-economic gradient in terms of TB risk
Linear relationship, the richer the socio-economic status the less risk of TB of the community/country
What are proximate risk factors to TB?
- Exposure to infectious droplets (related to the underlying burden of disease in the community)
- Host defences (HIV)
- indoor air pollution
- smoking and alcohol abuse
- other diseases
- depression and stress
What are some common features of low socioeconomic status (SES) groups?
More frequent contact with active TB disease including crowding
Limited access to safe cooking facilities and food insecurity
Low levels of awareness and less power to act
Limited access to high quality health services
What is the Poverty-ill health cycle?
Poverty predisposes people to risk factors like malnutrition, poor sanitation, illiteracy which leads to disease. Then disease increases health care costs and reduces labour and work. This leads to poverty and the cycle starts again.
What are the 6 goals of the WHO "Stop TB" Stragery?
1. pursue high quality DOTS
2. TB-HIV and MRD-TB addressal and the needs of poor and vulnerable
3. Contribute to strengthening primary health care
4. Engage all care providers
5. Empower people with TB and communities
6. Enable and promote research
What are some ways to achieve goals?
High quality medical technologies