INTRODUCTION

Tuberculosis causes a great deal of ill health and an enormous burden on the populations of most low-income countries. The tuberculosis situation, like many other developing countries is very serious in Pakistan. As per W.H.O estimates, more than 300,000 new cases of tuberculosis develop in the country every year, three quarters of, which are concentrated in the productive age group. The delay in diagnosis and inability to cure a high proportion of pulmonary smear-positive cases are the main reasons of increased risk of infection, high death rate and multi drug resistant cases in our country.

           Cure of infectious cases of tuberculosis is the key to effective control of the disease. Treatment of tuberculosis patients reduces suffering and, if adequately applied, prevents death from tuberculosis.
The major objective of these guidelines is:

        To help you in the diagnosis and treatment of a TB patient and identify your important role in the control of Tuberculosis in the community.

What is Tuberculosis?

         Tuberculosis is an infectious, systemic, chronic and granulomatous disease, caused by mycobacterium tuberculosis.

M. Bovis and M. Avium can rarely cause tuberculosis.

How does tuberculosis develop?
     Infection occurs almost exclusively through the respiratory system by inhalation of tubercle bacilli. Tuberculosis spreads from the primary lung lesion to other parts of the body via the blood stream, lymphatic or by direct extension, and in this way may affect any organ.

Forms of tuberculosis.

Pulmonary Tuberculosis: Tuberculosis affects the lungs in more than 80% of cases. Pulmonary tuberculosis in adults is often sputum smear-positive and therefore highly infectious.
        Cases, which are sputum smear-negative or positive only on sputum culture-positive are 7 to 10 times less infectious than those the are positive on direct microscopic examination of sputum smears.

Extra-Pulmonary Tuberculosis affects various organs, such as lymph nodes, bones and joints, genito-urinary tract, the nervous system (meninges), intestines, and many other parts of the body. Diagnosis is often difficult and should usually be made by physicians at referral hospitals. Extra-pulmonary tuberculosis is usually non infectious.

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