Mention the causative agent, mode of transmission, symptoms of pulmonary tuberculosis. Highlight various strategies for its prevention. Why is it called "disease of poverty" ? [1+2+2+2+1]

Causative Agent

The causative agent of pulmonary tuberculosis (TB) is the bacterium Mycobacterium tuberculosis. It is an acid-fast, aerobic, rod-shaped bacterium that primarily infects the lungs.

Mode of Transmission

Pulmonary tuberculosis is transmitted primarily through the airborne route.

1. Droplet Nuclei: When a person with active pulmonary TB coughs, sneezes, speaks, or sings, they expel tiny droplets containing the bacteria into the air.
2. Inhalation: These droplets remain suspended in the air for several hours. A healthy individual inhales these droplet nuclei, which settle in the alveoli of the lungs, initiating infection.
3. Direct Contact: Transmission via direct contact with sputum is less common but possible if the sputum dries and becomes airborne as dust.

Symptoms of Pulmonary Tuberculosis

The symptoms often develop gradually over weeks or months. Key symptoms include:

• Persistent Cough: A cough lasting for more than two to three weeks.
• Hemoptysis: Coughing up blood or rust-colored sputum.
• Fever: Low-grade fever, often in the afternoon or evening, accompanied by night sweats.
• Weight Loss: Unintentional and significant loss of body weight.
• Fatigue: General weakness, loss of appetite, and malaise.
• Chest Pain: Pain in the chest that worsens with breathing or coughing.

Strategies for Prevention

Prevention of tuberculosis involves a multi-faceted approach focusing on early detection, treatment, and public health measures:

1. BCG Vaccination: The Bacillus Calmette-Guérin (BCG) vaccine is administered to newborns and children to provide protection against severe forms of TB, particularly TB meningitis and miliary TB.
2. Early Diagnosis and Treatment: Prompt identification of TB cases through sputum smear microscopy, culture, or GeneXpert testing and providing the full course of Directly Observed Treatment, Short-course (DOTS) therapy prevents the spread of the disease.
3. Contact Tracing: Identifying and screening close contacts of active TB patients allows for early detection of latent TB infection (LTBI) and preventive treatment.
4. Improving Living Conditions: Reducing overcrowding, ensuring proper ventilation in homes and workplaces, and improving nutrition strengthen the immune system and reduce transmission risks.
5. Public Awareness: Educating the community about TB symptoms, transmission, and the importance of seeking timely medical care reduces stigma and encourages early treatment.
6. Infection Control in Healthcare Settings: Healthcare workers should use personal protective equipment (PPE), and facilities should have adequate ventilation to prevent nosocomial transmission.

Why is it called "Disease of Poverty"?

Tuberculosis is termed the "disease of poverty" because it disproportionately affects populations living in poverty due to the following factors:

• Malnutrition: Poor nutritional status weakens the immune system, making individuals more susceptible to TB infection and progression to active disease.
• Overcrowding: Poverty often forces families to live in cramped, poorly ventilated conditions, facilitating the airborne spread of the bacteria.
• Lack of Access to Healthcare: Poor communities often lack access to timely diagnosis, affordable medication, and proper treatment facilities, leading to delayed treatment and continued transmission.
• Occupational Hazards: People in poverty are more likely to work in hazardous, dusty environments that damage lung tissue, increasing vulnerability to TB.
• Co-morbidities: Poverty is associated with higher rates of HIV/AIDS and other chronic diseases, which significantly increase the risk of developing active TB.

In conclusion, TB is a preventable and curable disease, but its persistence in impoverished communities highlights the need for integrated social and medical interventions to eradicate it.