Infectious communicable disease

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1.1 Overview

Tuberculosis is a common and infectious communicable disease that is caused by mycobacterium tuberculosis. It is of two principle kinds: pulmonary TB, which usually attacks the lungs, and extra-pulmonary TB, which attacks any part of the body, such as: the lymphatic, pleural, bone and/or joint, genitourinary, miliary, peritoneal, meninges and/or central nervous system (CNS), and all other sites combined. Pulmonary TB sometimes combined with extra pulmonary tuberculosis (Parimon, 2008; Sreeramareddy et al., 2008; Friedman, 2001).

Tuberculosis is spread in form of droplets which are expelled when the infected persons cough, sneeze, speak, or sing. Close, prolonged, frequent, or intense contacts are the main ways that leads to 22% of the infection rate. Other resources include: foreign-born from areas where TB is common, residents and employees living in plagued congregate settings, health care workers who serve severely infected clients, low-income populations, highly inflicted racial or ethnic minority populations, children exposed to severely infected adults, and persons who inject illicit drugs.

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Extra pulmonary TB that occurs outside the lungs may spread through lymphatic or hematogenous dissemination to any tract or through coughing and swallowing to the gastrointestinal tract. Such a type of bacteria may remain dormant for years at a particular site before causing the disease. Since extra pulmonary TB can affect virtually all organs, it has a wide variety of clinical manifestations. A matter which causes difficulty and delay in its diagnosis (Mehta, 1991; Gonzalez et al., 2003). Though, it is said to be more often diagnosed in women and young patients (Rieder et al., 1990; Gonzalez et al., 2003; Yang et al., 2004; Noertjojo et al., 2002; Cowie and Sharpe, 1997; Antony et al., 1995; Chan-Yeung et al.,2002). In the United States, extra pulmonary TB is associated with ethnic minorities and with those born in other countries (Rieder et al., 1990) while in Asia, lymphatic TB occupies the front position of the risky infectious diseases (Cowie and Sharpe, 1997, 1998; Moudgil and Leitch, 1994; Nisar et al., 1991; Ormerod, et al., 1991). A study of Somali TB patients in Minnesota showed frequent lymphatic TB as well (Kempainen, et al., 2001). In HIV-infected patients, the frequency of extra pulmonary TB depends on the degree of decrease in cellular immunity (Huebner and Castro, 1995; Barnes,, 1991). While in patients with

1.2 Economic and Social Effect of Tuberculosis

Statistically speaking, Mycobacterium tuberculosis infects one-third of the world’s population and is the most common single death causing agent in young adults (WHO, 2008). Globally, it accounts for 2.5% of the other diseases. However, the consequences of tuberculosis (TB) on society are huge. Worldwide, one person out of three is infected with Mycobacterium tuberculosis, i.e. two billion people in total. Currently, it holds the seventh place in the global ranking of the causes of death.

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