1. Tuberculosis In Thailand By Junior Sethasathien

2. What is tuberculosis(TB)? An infectious disease that mainly affects the lungs Cause by a bacteria Spread through microscopic droplets which are released into the air by coughing and sneezing

3. Causes Mainly caused by a non-motile bacillus called Mycobacterium Tuberculosis Humans are the only known reservoirs of M. tuberculosis Other TB causing mycobacteria includes: M. bovis, M.microti, M.africanum, M.canetti

5. Risk Factors Most people who are infected with TB do not develop active TB. However, there are certain factors which increases the risk that the latent TB will develop into the active TB HIV (50 670 TB patients with known HIV status) Diabetes Alcohol Tobacco Certain cancers Chemotherapy Immunosuppressant

6. Epidemiology

8. Symptoms Latent TB No symptoms Not contagious Active TB Coughing (lasting 3 weeks or more or with blood) Chest pain Unintentional weight loss Fatigue Fever Night sweats Chills Loss of appetite

9. Without treatment Can spread to other parts of the body through the bloodstream (15-20% of the active cases) Spinal pain (Pott disease) Lymph nodes (swelling) Joint damage Tuberculous Meningitis Liver and Kidney problems Heart Disorders(cardiac tamponade)-rare

10. Tests Tuberculin Skin Test patient is injected with a small amount of tuberculin and must return within 48-72 hours to check the results of the skin test (if positive, a raised, hard area, or swelling is found) TB blood Test (IGRAs = interferon-gamma release assays) Measures how the immune system to reacts to the bacteria that causes TB

11. Treatment Less resistantActive TB Latent: May only need 1 type of drug depending on the strain of TB Active: Several types of drugs at once At least 6-9 Months Common drugs Isoniazid Rifampin Ethambutol Pyrazinamide Combination of antibiotics and injectable medications fluoroquinolones Amikacin Kanamycin Capreomycin At least 20-30 Months

12. Vaccine Bacille Calmette-Guerin (BCG) vaccine Partially affective Provides some protection against severe form of paediatric TB Not completely protective against infants and Adult Pulmonary TB Use of BCG makes the Tuberculin skin test a false positive

13. Future Development Several new anti-TB drugs are in the advanced phases of clinical trials A new platform called the GeneXpert Omni is in development which would be used for testing TB and rifampicin-resistant TB 15 vaccines candidates are in clinical trials whom are focused on adolescents and adults

14. Bibliography In search of a new paradigm for protective immunity to TB Cláudio Nunes-Alves, Matthew G. Booty, Stephen M. Carpenter, Pushpa Jayaraman, Alissa C. Rothchild & Samuel M. Behar Nature Reviews Microbiology 12, 289–299 (2014) van Soolingen D, et al. (1997). "A novel pathogenic taxon of the Mycobacterium tuberculosis complex, Canetti: characterization of an exceptional isolate from Africa".International Journal of Systematic Bacteriology 47 (4): 1236–45Sdfsdf Teo, SS; Shingadia, DV (June 2006). "Does BCG have a role in tuberculosis control and prevention in the United Kingdom?". Archives of Disease in Childhood 91 (6): 529–31 http://www.mayoclinic.org/diseases-conditions/tuberculosis/basics/definition/con- 20021761 http://www.cdc.gov/tb/topic/vaccines/ http://www.cdc.gov/tb/topic/testing/ http://apps.who.int/iris/bitstream/10665/44241/1/9789241598866_eng.pdf http://www.who.int/tb/publications/global_report/gtbr2015_executive_summary.p df?ua=1