The Problem And Possible Treatments Of Tuberculosis Biology Essay

Tuberculosis or merely called TB is an infective disease caused by the bacteriums called Mycobacterium TB which normally affects the lungs but it can besides affect about any portion of the organic structure. This airborne disease is a slayer for people largely those with HIV. In 1993, World Health Organisation ( WHO ) declared TB a planetary exigency as it has murdered about 2-3 million people per annum.

One tierce of World ‘s population infected with 5-6 % ends fatally. ( 1 ) Tuberculosis is an airborne disease which means it is spread through air. When an untreated pneumonic TB patient sneezes or coughs, the air incorporating pathogen released by patient is breathed in by individual nearby doing him or her get infected. ( 3, 11 ) About 90 % of the instances show that the host ‘s natural defense mechanisms prevent any farther patterned advance of the infection where the Host-Parasite equilibrium is reached in which many of the mycobacteriums are destroyed but some lie hibernating in tubercle focal point. Upon activation of the hibernating bacterium, the patients will endure chronic cough with sputum-containing-blood, thorax strivings, fever, dark workout suits, failing and weight loss. ( 2, 11 ) Since TB is fatal, what is possible intervention to bring around that disease?

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Possible intervention

Self-administered Therapy ( SAT )Before intervention, the patients must be stressed of the importance of conformity in order to forestall development of opposition of the bacterium towards the drugs used.

The continuance of drug therapy will take about 6 months or longer. The Full Blood Count ( FBC ) , liver, and nephritic map have to be checked. The drug therapy normally done by the patients themselves based on prescription given by doctors. ( 2 )Drug therapy is an effectual manner in supplying opportunities of to the full recovery.

The therapy is divided into two stages which are initial stage and continuance stage.Initial stage:This stage takes about 8 hebdomads. 4 drugs are given depending on susceptiblenesss.

The drugs are:Rifampicin 600-900mg ( child 15mg/kg ) Per Oral ( PO ) three times/weekIsoniazid 15mg/kg PO three times/week + vitamin B6 10 mg/24hPyrazimide 2.5g PO three times/weekEthambutol 30mg/kg PO three times/week for 2 monthsContinuance stage:For this stage, it takes about 16 hebdomads on two types of drugs, rifampicin and INH at same doses. The most common medical specialty used is Rifinah 300® which contains a combination of 300mg rifampicin and 150mg INH. The patients are advised about the conformity from clip to clip. The vitamin B6 is given throughout the intervention.Isoniazid is one of the most common drugs used to handle TB. It is effectual, cheap and easy to take.

When it is used with other types of drugs, it can forestall and even bring around TB. Thus, isoniazid preventative intervention is recommended to individual that:Have a close contact with individual who have infective TerbiumShow a positive tuberculin skin trial reaction ( 2, 7 )The drug therapy may necessitate a longer period if the TB patients besides suffer another disease like meningitis and osteomyelitis. The HIV positive patients may necessitate to be treated with extra-drugs and longer clip. ( 2 )Why SAT?The drug therapy works really expeditiously when TB patient takes medicine harmonizing to physician ‘s advice. This is because the mycobacteria TB will be destroyed from organic structure. The graph below shows how the drug therapy reduces instances of TB in US.

We can see that the rate of TB instances declined from 1981 to 1984. It has reduced at about 6-7 % yearly. The drugs used during the therapy had expeditiously retrieving many TB patients. This reduces farther spreading of that disease to other individual as the figure of active TB patients keeps cut downing. There is fluctuation from 1985 to 1991. This happens due to some grounds like poorness and substance maltreatment.

These grounds raise the rate of infection of TB. However, the drug therapy still able to command the figure of TB instances. ( 9 )

Social and economic deductions

SocialEconomicSome people might state that the cost for the initial therapy is comparatively low-cost that is about $ 1,206 or RM 3,789.98 but this lone include the direct costs of the initial therapy pretermiting the farther disbursement required if there is failure in the intervention. ( 15 ) This will necessitate more money for intervention.

The money that should be used for other necessities have to be spent for the intervention. This becomes a job in Malaysia as most Malaysians merely have a moderate income. Therefore, the patients will hold a heavy load to pay for the measures. Besides, as the drugs used for the intervention have side effects, more money will be needed to bring around the effects caused by the drugs.

This indicates that a batch of money required for the intervention.

Advantages and disadvantages

During drug therapy intervention, combination of different drugs is used to handle TB. Different drugs will respond otherwise. This improves to rate of endurance of the patients. The continuance of this intervention which is normally takes about 6-9 months provides sufficient clip for antibiotics to destruct the TB bacterium.

The drugs besides may be combined together as a individual tablet. For case, Rifater contains INH, Rifadin and pyrazinamide. The patients can take the medical specialty efficaciously and easy. ( 17 )However, TB drugs can do really serious side effects. They can do icterus ( a yellow coloring material to clamber ) , blurred vision, tenderness in venters, loss of appetency and purging. They besides can be extremely toxic to liver. ( 17 ) Besides, the intervention of TB by drug therapy may take the emerging of drug opposition bacterium. This happens as the patients are allowed to hold a self-administrated therapy.

They take the medicine wholly unsupervised. ( 8 ) Drug opposition happen when the patients fail to finish drug therapy that enduring about six months or longer. The TB bacteriums that manage survive will reproduce and multiply. They become more drug opposition. ( 16 ) Consequently, the intervention requires a longer period and a higher cost in order to bring around the airborne disease. The figure of people get infected will maintain increasing ( 18 ) Therefore, alternate manner shall be taken to forestall this occurrence.


Directly Observed Therapy ( DOT )It is a intervention where the doses of drugs used are increased for rifampicin, ethambutol and INH from 1-4 yearss but non with thiacetazone, ethionamide or streptomysin. The procedure is same as the SAT but it is to the full conducted and observed by infirmary. ( 4, 7 ) This provides better consequence instead than the patients take the drug without being monitored. In Hospital Albert Schweitzer, 138 Terbium patients were treated with DOT and 143 Terbium patients were treated without observation.

This gives a higher consecutive rate for DOT which is 87 % while self-administered drug therapy merely has 57 % consecutive rate. ( 5 )Besides, the intervention failure can be reduced and less drug opposition will be acquired. ( 6 ) This is because the patients are give doses on agenda. However, the plan the plans of straight observed therapy are non easy to carry on. They require a flexible disposal.

ImmunizationPrevention is better than remedy. With the development of scientific discipline, the BCG ( Bacillus Calmetta-Guerin ) vaccinum has been invented. BCG is made up of life attenuated strain of Mycobacterium Bovis ( M. Bovis ) that produces a localized and self-limiting infection. This will excite cell-mediated unsusceptibility.

( 12 ) The immature babes and individual that have high hazard of infection are given BCG injection. BCG will protect babies against TB. ( 10 ) The vaccinum is given intradermally by injection to upper left arm. Puting manus on hip so the arm is at 45 & A ; deg ; will do it easier for the nurse to administrate it.

After three hebdomads, a little ruddy topographic point appears. The site must be kept clean and dry. This finally heals to organize a unit of ammunition level cicatrix after 3-4 months. ( 12, 13 ) The use of this vaccinum is much more money-savings than intervention.


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