Tuberculosis

Question 1

Primordial level

Answer 1

Target population: General public
Objective: Prevent onset of illness
Means: Social media, fliers, radio station, TV, religious and community leaders, medical outreaches etc
Method: define, risk factor/ mode of transmission, clinical features and prevention.

We inform the general public that Tb is an infectious disease caused by mycobacterium tuberculosis, that is multi systemic but mainly affects the lungs.
MOT: inhalation of droplets, ingesting infected food, meat or unpasteurized milk
Clinical features: cough, drenching night sweat, fever, weight loss.
Prevention:

Improvement of housing ( good ventilation, avoid overcrowding)
Better personal habits with regards to spitting, coughing, and sneezing
Good nutrition to enhance immunity
Proper environmental sanitation

Question 2

Primary level of prevention

Answer 2

Target population: General public with focus on healthy and high risk individuals
Objective: To prevent onset of illness
Means: Community outreach, social media, religious leaders, traditional rulers
Methods:
1) Active immunization with BCG vaccine ( Bacille Calmette Guerin)
2) Chemoprophylaxis with Isoniazid
For immunocompromised , close contact with Tb patient
3) control of animal Tb example pasteurization of milk , condemn any meat with signs of Tb

Question 3

Secondary level of prevention

Answer 3

Target Population: Sick individuals
Objective : Early diagnosis and Prompt treatment
Method: history, examination, investigation . treatment)
Take a good history from patient
Diagnosis: rapid Tb test
PCR
Sputum culture
Microscopic analysis
FBC

Treatment:
2 months of RIPE: Rifampicin, Isoniazid, pyrazinamide, Ethambutol
Followed by 4months of Rifampicin and isoniazid. Given thrice a week

Question 4

Tertiary level of prevention

Answer 4

Target population : Sick individuals
Objective : Limit damage and complications
Method :
Manage/prevent complications:
Treat adequately
Active physiotherapy eg breathing exercises, body exercises
Weekly investigation to monitor treatment response
Treat complications eg pleural effusion, pneumothorax early

Question 5

Quaternary level

Answer 5

Target population: Convalescent or recovering individuals
Objective: Rehabilitation and prevention of overmedicalization
Method:
Occupational Therapy
Physical chest therapy
Provide wheelchair if need be
Education of relatives and community to break down prejudices