Public Health Ethics Expert on Quarantine Order for TB Patient

Health is a unity and harmony within the mind, body and spirit which is unique to each person, and is as defined by that person. The level of wellness or health is, in part, determined by the ability to deal with and defend against stress. Health is determined by physiological, psychological, socio-cultural, spiritual, and developmental stage variables.

Tuberculosis :: Public Health Ethics Expert on Quarantine Order for TB Patient

Marc Hiller, associate professor of health management and policy at the University of New Hampshire and a specialist in ethical issues in public health, is available to comment on the recent federal order that placed a Georgia man with a lethal form of tuberculosis into quarantine.
The order, by the U.S. Centers for Disease Control and Prevention, is believed to be the first federal order of quarantine in 44 years.

Although mandatory quarantine measures have not been invoked in recent years, Hiller believes that the risk of spreading such an antibiotic resistant strain of tuberculosis (XDR-TB) that has ki lled most of those who have been infected with it justifies such action in an effort to protect the health of the public at large.

“It’s a struggle to balance promoting and assuring the public’s health and well-being while protecting individual rights and liberties,” says Hiller. “While the preservation of individual liberty is a long-cherished ideal in a democracy and in health care, it must be viewed as secondary when an individual’s health (or disease) status thr eatens the health – and in this case, possibly the lives – of others, particularly potentially large populations.”

“If one reviews the history of public health in the United States, whether it be extreme pandemics such as the Spanish Influenza outbreak in 1918 or the infamous case of Typhoid Mary, clearly the need to restrict individual rights and spread of contagion is merited in order to protect the health and lives of the public, or the overall social good of society,” he says.

Hiller, whose primary areas of teaching and research are public health and ethical issues in health care, has been a National Endowment for the Humanities Fellow in medical ethics at the University of Virginia and a visiting faculty member in the ethics program of the University of Wisconsin School of Medicine and at the Muskie Institute of the University of Southern Maine.
source:www.spiritindia.com

Tuberculosis Testing Products and Therapeutics Market Worth More than $8 billion Says a New Report

Tuberculosis Testing Products and Therapeutics Market Worth More than $8 billion Says a New Report
Tuberculosis Testing Products and Therapeutics Market worth more than $8 billion, says a new report available from ReportBuyer.com.



Report Buyer, the online destination for business intelligence for major industry sectors, has now added a new report on the market for tuberculosis testing and therapeutics products. “Global Tuberculosis Strategies,” forecasts the total market potential for these products exceeds $8 billion based on currently reported TB status and pricing structures.

Tuberculosis is again presenting a major public health crisis even though it was nearly extinct at the end of the last century. More than 1.6 billion people are infected and global hotspots continue to be burdened with insufficient screening, diagnosis, and treatment.

This disease requires a cure for the individual and minimisation of its transmission to others. This requires advanced screenings and treatments being made available to hard hit regions. Because of the contagiousness of this disease, there are huge payoffs for investment in diagnostics and therapeutics, which have not yet been tapped.

Lack of proper diagnosis is a major barrier to tuberculosis treatment, and the report details current screening techniques and the potential market for advanced diagnostic products. Skin testing remains the most common form of testing and though the Mantoux test dominates, others are being developed that will impact the market. Sputum smears and cultures, considered better options for diagnosis, lag behind skin testing as they pose difficulties in field use.

The report illustrates three primary focal points for the development of a global strategy for combating tuberculosis. This includes potential market, epidemiology (tuberculosis patient trends) and technology. It also reviews how diagnostic and pharmaceutical companies can incorporate these focal points into their own TB eradication plan.

The study contains an extensive tuberculosis etiology, epidemiologic statistics, including 30 tables of incidence, prevalence, and mortality statistics by country, region, and type of tuberculosis, and a comprehensive glossary of terms. It also includes theoretical market sizes for screening/diagnosis as well as treatment by region and by type of TB (MDR and non-MDR) and a comprehensive review of products for the treatment of TB.

“Global Tuberculosis Strategies,” is available in pdf format from Report Buyer.

Report Buyer product ID: KAL00024

About Report Buyer
Report Buyer is a UK-based independent online store supplying business information on major industry sectors. These include the Automotive Industry, Banking & Finance, Energy & Utilities, Food & Drink, Telecoms and Pharma & Healthcare. The website now carries over 24,000 business information products, including market reports, studies and books. Report Buyer is the intelligent way to buy market research making it an essential resource for executives and information buyers worldwide. Subscribers receive a free monthly newsletter and email alerts on new titles in their areas of interest. A regularly updated blog provides information on the latest market trends.

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nt’l day to combat tuberculosis marked

The 24th of March of every year is marked worldwide as the international day for combating Tuberculosis. On this day, World Health Organization (WHO) amid many other health organizations call upon developing countries that suffer from this disease to combat it and spread awareness regarding the social and health dimensions and consequences of the disease. WHO stressed in its call this year on the importance of governmental and nongovernmental organizations’ cooperation in fighting this fatal disease.

International Statistics:
Tuberculosis is one of the main reasons behind early death worldwide. Around one quarter of the world’s population is infected with the bacteria and as many as 8 million new cases are reported yearly out of which 2 million are fatal according to 1997 census.
Ninety five percent of the infections and 98% of death cases resulting from this disease are reported to be in developing countries only while in the developed world it is almost extinct. The disease in poor countries has taken the shape of epidemics where the immunity to the medication is strong and failure of combating programs is drastic in most of the developing countries.

In Yemen:
Forty five out of every 100,000 people in Yemen were said to be infected with Tuberculosis in the 1990 census. However, recent statistics raised the figure to 100 cases in every 100,000. UNICEF explained that this increase is due to the deterioration of living conditions, malnutrition, early and repetitive pregnancies and population congestion.
During the mid-1990s the National Program for Eradication of Tuberculosis (NPES) started a strategy to provide short term chemical treatment under direct supervision by experts. Medically this was known as DOTS. This strategy was promoted by WHO due to its effectiveness in eradicating the disease as 85% of patients treated by this method are reported to heal completely.

Misconceptions:
A sum of common misconceptions regarding Tuberculosis in the Yemeni society plus the gap between the NPES and the society were factors that lead to the failure of various Tuberculosis combating programs. These were related to the disease itself, to the treatment and to the perception of the society’s role in these matters.
Many Yemenis think that the disease is incurable, or could not be cured completely. Some people try to ignore or even hide the symptoms of the disease either out of shame or ignorance. Some of the patients stop taking the medications once they start feeling better and some are not regular or accurate in taking them. All these factors that originate from illiteracy and lack of awareness should be eliminated through education programs and consistent follow ups by medical teams. Governmental institutions and NGOs along side donors should join hands to help promote awareness and eliminate the disease throughout the country. The medical treatment should be made available and accessible by all Yemenis, especially the poor segments of the society, which is the segment that suffers from most of Tuberculosis infections.
Not only among patients, but awareness should be spread among those who work in the medical field as well, especially with regards to the DOTS method of treating that requires continuous monitoring of patients while they take the medications in the first two months of treatment.
In essence, for the ultimate success of this method, five factors should be achieved:
- Government commitment to combating Tuberculosis
- Diagnosis of the cases through microscopic testing
- Continuous and nonstop supply of medications to all patients
- A standard gauge for monitoring and supervision of the treated cases
- Finally, the should be a two month intensive medication program in medical centers where patients receive their medical doses.
source:yementimes.com

$2 billion response plan to contain TB launched

Health is a unity and harmony within the mind, body and spirit which is unique to each person, and is as defined by that person. The level of wellness or health is, in part, determined by the ability to deal with and defend against stress. Health is determined by physiological, psychological, socio-cultural, spiritual, and developmental stage variables.
Health is a unity and harmony within the mind, body and spirit which is unique to each person, and is as defined by that person. The level of wellness or health is, in part, determined by the ability to deal with and defend against stress. Health is determined by physiological, psychological, socio-cultural, spiritual, and developmental stage variables.
source:www.spiritindia.com

TB crisis plan set up

The provincial health department says it is trying to deal with the problem. Sizwe Khuphelo, of the Eastern Cape department of health, says: "This is part of our TB crisis plan that we have launched recently. With that plan we are getting a 50% TB cure rate in Nelson Mandela Metro, Amathole and O.R Tambo District municipalities. We have also set aside R150 million to deal with TB that includes ordinary TB cases in the province. Now we are also trying to spread our wings by building another MDR-TB facility on this part of the province because currently we have only one MDR-TB facility that deals with MDR which is Jose Pearson in Port Elizabeth. So this is going be the second facility that will deal with MDR-TB cases for the province. We have launched a TB crisis plan as the department to deal with TB."

The old Sir Henry hospital in Mthatha is to be demolished to make way for a 500 bed health facility to handle TB, MDR and XDR cases from around the Transkei area in particular.

source:www.sabcnews.com

Eastern Cape struggling to cope with TB outbreak

The Eastern Cape has been caught off-guard by outbreaks of the feared multi-drug-resistant (MDR) and extreme-drug-resistant (XDR) tuberculosis (TB) strains.

There are not enough beds in the hospitals to isolate patients suffering from the highly infectious variants of the disease. There is only one designated TB hospital for the whole province situated in Port Elizabeth while two other hospitals also treat patients, giving a total of only 52 beds and 72 patients diagnosed with MDR and XDR.

The Jose Pearson hospital in Port Elizabeth has been the only referral health centre for all patients in need of advanced treatment for TB. Recently there has been an upsurge in the number of new cases of MDR and the previously not so well-known XDR forms of TB in some parts of the province. They were all referred to the Jose Pearson hospital. However some hospitals like the new modern Madzikane Memorial hospital in Mount Frere have been provided with isolation wards.
source:www.sabcnews.com

Tubercolosis case on trans - Atlantic flights prompts warnings

Tuberculosis is caused by germs that are spread from person to person through the air. TB usually affects the lungs, and can lead to symptoms such as chest pain and coughing up blood. It kills nearly 2 million people each year around the world.

Thanks to antibiotics and other measures, the TB rate in the United States has been falling for years. Last year, it hit an all-time low _a total of 13,767 cases, or about 4.6 cases per 100,000 Americans.

But health officials worry about "multidrug-resistant" TB, which can withstand the mainline antibiotics isoniazid and rifampin. About 1.2 percent of U.S. TB cases fall into that category, according to CDC statistics.

A more rare, even-worse category of "extensively drug-resistant" TB — or XDR-TB — does not respond to at least three of six classes of second-line drugs. Last year, there were two U.S. cases of that infection.

source:www.iht.com

Tuberculosis facts

Tuberculosis, or TB, is most common in Latin America, the Caribbean, Africa, Asia, Eastern Europe and Russia.

TB is a contagious disease spread through the air like the common cold, though more direct contact is necessary.

Someone in the world is newly infected with TB bacilli every second.

More than one-third of the world's population has the TB bacterium in their bodies.

One in 10 latent infections progresses to active TB disease.

Left untreated, each person with active TB disease will infect on average 10 to 15 people every year.

People with HIV and TB infection are much more likely to develop TB.

In the United States, TB is most prevalent in jails and prisons, homeless shelters, migrant farm camps and some nursing homes.

More than 14,000 TB cases were reported in the United States in 2004.

Tuberculosis has also been known as consumption, phthisis (Greek for consumption), wasting disease, white plague and Pott's disease.

Greek physician Hippocrates, born about 460 B.C., identified tuberculosis as the most widespread disease of his time. Evidence of TB has also been found in Egyptian mummies and the remains of prehistoric animals.

The bacillus causing tuberculosis, Mycobacterium tuberculosis, was first identified in 1882 by Robert Koch, who received the Nobel Prize in physiology or medicine in 1905 for the discovery.

The first vaccine for TB was developed at the Pasteur Institute in France between 1905 and 1921. The first of several drugs currently used to treat TB was developed in the 1940s.

The Christmas Seals promotion began in Denmark in 1904 as a fund-raiser for tuberculosis programs.
source:deseretnews.com

TB is not easily spread

The frenzy over tuberculosis spawned by a single "extensively drug-resistant" case is capturing headlines. But most people exposed to the airborne bacteria will never develop active disease.
The Atlanta attorney's case has health officials concerned because his TB falls into a class of infections that resists two first-line TB drugs and some second-line drugs — one of only 49 other extensively drug-resistant cases reported in the United States between 1993 and 2006. There's also a class called multidrug-resistant TB, which is easier to treat than cases like this one but more difficult than typical TB.
Although it's harder to kill, it's no easier to spread than any other tubercolosis, according to Carrie Taylor, an infection control practice nurse at LDS Hospital. "You have to breathe in air that's coughed."
Doctors treat an average of 38 active TB cases each year in Utah, according to the Utah Department of Health. The disease usually settles in the lungs, although it can affect the kidneys, spine, brain and other organs.
The disease is caused by Mycobacterium tuberculosis, which spreads person-to-person but only through close contact. Taylor and her colleague Vickie Anderson, also an infection-control practice nurse at LDS Hospital, describe it as passing from one person's lungs directly into another's. It's not like a cold that is easily spread and fairly hardy. In fact, sunlight kills it.
Unless the individual has a drug-resistant TB strain — "not common in Utah," said Taylor — it's very treatable, although it takes a long time and several medications. Left untreated, it can kill. At least initially, patients are isolated to avoid spread of the disease.
Both chicken pox and measles are more contagious, said infectious disease specialist Dr. John Kriesel of University Hospital. As an example, when a Provo High School student was recently diagnosed with tuberculosis and health officials asked 250 of the student's school contacts to be tested for it, Kriesel predicted "not one of them will test positive for TB."
People in casual contact are extremely unlikely to get the disease. Just being exposed doesn't mean you could pass it on, Taylor said. Without symptoms, you can't spread it, even if you have a positive skin test. People who live with a patient are at higher risk, but most won't get it, either.
As for folks who sit by someone on a plane, spread is unlikely unless the individual is coughing directly into the faces of seatmates.
TB symptoms include coughing that lasts three weeks or more, pain in the chest, blood in sputum, weight loss, night sweats, fever and fatigue, in various combinations.
In some people who breathe in the mycobacterium, it is "inactive but alive" in the body, Anderson said. That person has no symptoms, doesn't feel sick and can't spread it. At some later point, though, it can become active, so Kriesel said those with a positive skin test for TB are treated.
Treatment for TB that's not drug-resistant consists of pills containing antituberculosis agents, similar to antibiotics, but effective specifically against the mycobacterium. A patient is given the four recommended drugs seven days a week or five days a week for eight weeks, then two of them are dropped and the other two continue for another six months.
Tuberculosis is relatively uncommon in young people compared to older people, who are also more likely to have reactivation disease, although the risk is still low.
Salt Lake Valley Health Department infectious disease expert Kyle Cannon said they see "bumps" in the numbers in the very young, the very old, and late teens and early 20s.
While risk of spread is relatively low, health officials take it very seriously. They actually watch someone with TB take the needed medication, Cannon said. And people who refuse treatment can be forcibly quarantined and treated under court order.
Taylor said health-care providers have to notify the state when they find TB in a patient, then coordinate treatment.
Andrew Speaker, the Atlanta man quarantined with a dangerous strain of tuberculosis, will likely spend up to two months in a hospital while he receives a battery of antibiotics and is evaluated for possible surgery, his doctors said.
Speaker is the first infected person quarantined by the U.S. government since 1963. In a TV interview Friday, Speaker apologized to airline passengers and crew members he may have exposed to the infection while on a trans-Atlantic flight.
Twenty-six students and two faculty members from University of South Carolina Aiken were aboard the May 12 flight from Atlanta to Paris. Many on the flight are now anxiously awaiting the results of their TB tests, though two people have tested negative, South Carolina health officials said.
Health officials have contacted 74 of the 310 U.S. citizens who were on the flight, according to the Centers for Disease Control and Prevention. That count includes all 26 who sat in the five-row area around Speaker — the ones considered at greatest risk.
None is exhibiting symptoms, CDC officials said.
Speaker, 31, said he, his doctors and the CDC all knew he had TB that was resistant to some drugs before he flew to Europe for his wedding and honeymoon last month. But he said he was advised at the time by Fulton County, Ga., health authorities that he was not contagious or a danger to anyone.
Officials told him they would prefer he didn't fly, but no one ordered him not to, he said.
source:deseretnews.com

CT scan not advised for probable appendicitis

When someone has all the signs of acute appendicitis, waiting to get a CT scan to confirm the diagnosis is not a good idea, researchers report. Compared with a straight-to-surgery approach, the CT strategy is linked to delayed surgery and increased risk of a burst appendix.

"There has been a somewhat reflexive use of CT since it has become widely available," Dr. Herbert Chen of the University of Wisconsin at Madison said during a presentation at Digestive Disease Week 2007, which is underway here.

Pre-operative CT is not necessary in cases with straightforward signs and symptoms of appendicitis, the investigator advised. "If, after a thorough physical examination, the diagnosis is still in question, then patients should be scanned." These patients tend to be older, female and have symptoms that are not typical for acute appendicitis.
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Chen and his colleagues reviewed the records of 410 adult patients who underwent appendectomy at their institution over a 3-year period. Of these, 62 percent had a pre-operative CT scan, while 38 percent were taken straight to the operating room.

Patients who did not have a CT scan were in surgery within about 5 hours, but for those who had a scan, surgery was not performed for more than 8 hours.

The perforation rate was 17 percent in the patients who had a CT scan before surgery compared with 8 percent in those who did not.

The significantly longer time with the scan may also account for the more than two-fold increase in complications. Even with rapid intervention, there is a "significant complication rate" with acute appendicitis, Dr. Chen pointed out.

"The CT should theoretically be relatively quick," Dr. Chen told Reuters Health. "But if contrast is used, then that takes time to swallow and be absorbed. Contrast is typically used, because physicians want to maximize the information obtained with exposure to radiation."
source:www.sciam.com

Tuberculosis

Tuberculosis (TB), a disease which man has been fighting for centuries and even had hopes of irradicating in the year 2000 is back in full swing. TB kills more adults than any other infectious disease. According to Internet source What is TB? "The World Health Organization (WHO) estimates that 8 million new cases and 3 million deaths are attributed to TB each year." The paper goes on to explain there are 26,000 new active cases reported yearly and is estimated that each person with untreated, active TB will infect 10 to 15 others every year (2). In March of 1998, there was an article in the Arizona Republic telling of a current TB case here in the Phoenix area. A portion of the article read, "The physician held up Madeleine Weekley’s chest x-ray and pointed to the quarter-size hole on the 32-year-old’s lung. The cavity could be caused by one of four things: lung cancer, pneumonia, valley fever or tuberculosis. "I don’t smoke, so I didn’t think it was lung cancer. I was praying for pneumonia. I never thought of TB," said Weekley, a communications specialist who went home and spent an anxious weekend waiting for test results. A sputum test narrowed in down to one culprit: tuberculosis" (1).
TB is an airborne bacterial disease and according to author Julliana Newman, today’s tuberculosis afflicts people of all ages, nationalities, and income levels and is more threatening and stronger than ever with its new antibiotic resistant mutations (392). Therefore, in order to gain some control on this re-appearance and prevent tuberculosis from exploding to epidemic proportions, we must increase public awareness and education to include early detection, proper treatment plans, and preventative measures.
Micobacterium TB
TB is caused by rod-shaped bacillus (germs) called Mycobacterium tuberculosis (Mtb). Mycobacterium is believed to be among the oldest bacteria on earth and are found as free-living organisms in the environment. These bacteria can be infectious to many animals including cattle and pigs as well as humans.
Mycobacterium TB is approximately 1 to 5 um in length and "has an unusual cell wall, a waxy coat comprised of fatty molecules whose structure and function are not well known (Tuberculosis (TB), a chronic bacterial infection 4). Not only does this cell wall make the bacteria more challenging for the human immune system; it also makes Mtb difficult to study in a laboratory setting. To the biologist, this bacterium is called "acid-fast" because this waxy coating on the walls keeps the cell from being decolorized during testing. They also multiply very slowly and tend to form clumps instead of colonies, making them microscopically harder to count and examine. Lastly, since Micobacteria are airborne, they must be studied in laboratories with special equipment to handle airborne contaminants.

What you Need to Know About Tuberculosis,

According to Newman, tuberculosis bacteria are not spread through touch or handling of personal items, but rather by inhalation. Tuberculosis is "spread when an infected person sneezes, coughs, speaks, or sings" (see figure 1) (383). When these actions occur, tiny particles known as droplets nuclei, which are basically microscopic drops of phlegm, are released into the air. If these droplets are expelled from an infected person, they will contain Mtb bacteria.
Most of the bacilli that do become airborne die before reaching a potential victim. However experiments under controlled temperature settings have shown airborne tubercles surviving for about six hours. "The probability of infection is proportional to the concentration of infectious droplets in the air and the volume of air breathed during exposure" (383). The Internet article titled Tuberculosis (TB), a chronic bacterial infection explains, "adequate ventilation is the most important measure to prevent the transmission of the disease" (4). Only the droplets expelled from an infected person with active TB contain bacilli. "Because most infected people expel relatively few bacilli, transmission of TB usually occurs only after prolonged exposure to someone with active TB. Researchers have estimated on average, people have a 50 percent chance of becoming infected with TB if they spend eight hours a day for 6 months or 24 hours a day for two months working or living with someone with active TB" (4). Most of these droplets die in transit. Only if the bacillus happens to survive long enough to be inhaled by a susceptible person can it then pass to the upper respiratory system. Nose hair and bronchial tube linings are designed to filter out bacterial pathogens. Therefore, "infection begins only if the bacilli make it deep inside the lungs to tiny air sacs known as alveoli, where they multiply within macrophages" (5). Once in the alveoli of the lung, the bacteria are ingested by alveolar macrophages, which are then modified to become epithelioid cells. Within two weeks, necrosis begins within the tissue containing these epithelioid cells, a process referred to as caseation (Newman, 383). The end result is a fully formed tubercle or small, rounded mass. These tubercles grow and fuse as the caseation process continues and wide areas of tissues are destroyed, which is indicative of active TB disease.

What You Need to Know about Tuberculosis

This process, however, in a healthy immune system, is usually kept in check. The bacteria aren’t allowed to proliferate and, although the germ exists in the patient’s body, it doesn’t make the person sick. "The immune system ‘walls off’ the TB bacilli which, protected by a thick waxy coat, can lie dormant for years and years" (Tuberculosis Fact Sheet 1). These ‘walled off’ inactive bacilli aren’t considered damaging or contagious, although these patient’s will have a positive tuberculin skin test (see figure 2).
People infected with the TB germ are at a greater risk of developing the active disease during the first two years post infection, but can develop TB many years after exposure, especially if the immune system should become weakened. "On average, people infected with M. Tuberculosis have a 10 percent chance of developing active TB at some time in their lives" (Tuberculosis (TB), a chronic bacterial infection 6).

CLINICAL ASSESMENT

A prompt and accurate diagnosis is a key component to limiting the spread of TB. Newman explains that "prolonged exposure to undiagnosed patients with MDR-TB is directly related to the present proliferation in reported cases" (388). Anyone who experiences a combination of fever, night sweats, unexplained weight loss, a loss of appetite, a chronic cough, or coughs up blood, could be actively infected and should be tested (Treatment of Tuberculosis Infection/AAFP Pa, 1). Also, anyone who has close day-to-day contact with someone who has active TB disease (i.e. a family member, friend or co-worker) should be tested. Individuals with HIV infection or other immunosuppressive disorders as well as workers who might be in frequent contact with TB patients, such as correctional officers and health care employees, should also be periodically tested.
Testing usually always begins with the Mantoux (PPD) skin test. "A substance called purified protein derivative (PPD) is injected just under the skin of the forearm and examined about 48 to 72 hours later." A positive test is indicated when this area appears red and hardened (Tuberculosis (TB), a chronic bacterial infection 6,7). However, a positive skin test does not mean the patient has active TB disease. In most cases, just being exposed to micobacterium will produce a positive reaction. Remember that you can be exposed to the bacteria without developing active TB disease. Therefore, a positive test reading should be followed with an additional Mantoux test and a standard chest x-ray. If these initial test results continue to produce positive results, sputum and other samples are usually requested as a laboratory culture is necessary to confirm the TB diagnosis and to determine which anti-TB drugs will be most effective. "Since M. tuberculosis is slow-growing, it takes approximately a month to get the sputum culture results. An additional two to three weeks usually are needed to determine the drug susceptibility of the organism, making treatment decisions difficult." (Tuberculosis (TB) a chronic bacterial infection 7).
Recently, advances have been made in research, which has led to the development of new laboratory culture tests capable of producing results in two days by using "nucleic acid amplification." "Another test in development uses luminescent chemicals from the firefly to determine, in 24 to 48 hours, which drugs can kill the TB strain a patient caries" (Tuberculosis (TB), a chronic bacterial infection 7).
If treatment of active TB is indicated, it normally involves a combination of three anti-TB drugs, isoniazid, rafampin, and pyrazinamide. These drug combinations are usually prescribed for a minimum of 6 months, what is referred to as a short course chemotherapy. At this point, patient education is crucial to the success of the treatment plan, and it is extremely important that the medications be taken as long as is prescribed. Again, stopping the medication early is what leads to the development of multi-drug resistant strains (MDR-TB) Consequently; "treatment for MDR-TB often requires the use of a second line of drugs, all of which can produce serious side effects. Drug therapy for 18 months to 2 years may be necessary" (Tuberculosis (TB), a chronic bacterial infection 2, 8). Prevention of TB begins with the diagnosis. Newman writes that "prompt and accurate diagnosis is key to controlling the spread of tuberculosis" (384). Extra attention should be given to those at highest risk of developing the disease and treatment plans utilizing DOTS should be initiated.
In the workplace, prevention for health care workers who care for high-risk patients, or who might be involved in procedures, which could increase the risk of exposure, should have a Mantoux skin tests every six months. Hospitals and clinics can further protect the population by teaching patients to cover their nose and mouth when coughing or sneezing. They can also make use of "Ultraviolet light to sterilize the air along with negative pressure rooms and special room air filters" (Tuberculosis (TB), a chronic bacterial infection 9). Special MTB masks that filter out the droplets nuclei should be provided along with proper use instructions.

source:www.gwc.maricopa.edu