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Casestudy : |
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Infectious
Diseases - Casestudy
Tuberculosis
in India
There are 14 million TB patients in India, accounting for one-third
of the global cases of TB. Every day, 20,000 Indians contract
TB and more than 1,000 die due to this chronic illness. TB attacks
working adults in the age group of 15-50 years.
HIV is accelerating the spread of
TB
The link between HIV and TB affects a large number of people,
each disease speeding the other's progress. HIV weakens the
immune system. Someone who is HIV-positive and infected with
TB is much more likely to become seriously ill with TB, rather
than someone infected with TB who is HIV-negative. TB is a leading
cause of death among people who are HIV-positive, accounting
for about 11% of AIDS deaths worldwide.
Poorly-managed TB programs are threatening to make TB incurable
Until 50 years ago, there were no drugs to cure tuberculosis.
Now, strains that are resistant to one or more anti-TB drugs
have emerged. Drug-resistant tuberculosis is caused by inconsistent
or partial treatment-when patients do not take all their drugs
regularly for the required period, when doctors or health workers
prescribe inadequate treatment regimens, or where the drug supply
is unreliable. From a public-health perspective, poorly-supervised
or incomplete treatment of TB is worse than no treatment at
all. When people fail to complete standard treatment regimens,
or are given the wrong treatment, they may remain infectious.
The bacilli in their lungs may develop resistance to anti-TB
drugs. The people that they infect will have the same drug-resistant
strain. While drug-resistant TB is treatable, it requires extensive
chemotherapy that is often very expensive and is also more toxic
to patients.
Malaria
Malaria is a life-threatening parasitic disease transmitted
by mosquitoes. The cause of malaria, a singlecelled parasite
called plasmodium, was discovered in 1880. Later, it was found
that the parasite is transmitted from person to person through
the bite of a female Anopheles mosquito, which requires blood
for the growth of her eggs.
At present, approximately 40% of the world's population, mostly
those living in the world's poorest countries, risk getting
malaria. The disease was once more widespread but it was successfully
eliminated from many countries with temperate climates during
the mid-20th century. Today, malaria has returned and is found
throughout the tropical and sub-tropical regions of the world
and causes more than 300 million acute illnesses and at least
one million deaths annually (WHO).
There are several types of human malaria. Falciparum malaria
is the most dangerous type of infection and is most common in
Africa south of the Sahara, where it accounts for extremely
high mortality rates. There are also indications of the spread
of P. [alciparum malaria in India and it has reappeared in areas
where it had been eliminated.
The malaria parasite enters the human host when an infected
AnQpheles mosquito bites an. individual. Inside the human host,
the parasite undergoes a series of changes as part of its complex
life-cycle. Its various stages allow the plasmodia to evade
the immune system, infect the liver and red-blood cells, and
finally develop into a form that is able to infect a mosquito
again when it bites an infected person. Inside the mosquito,
the parasite matures until it reaches the sexual stage where
it can again infect a human host when the mosquito takes her
next blood meal, 10 or more days later.
Malarial symptoms appear about 9-14 days after the mosquito
bite, although this varies with different plasmodium species.
Malaria produces high fever, headache, vomiting and body ache.
If drugs are not available for treatment, or the parasites are
resistant to them, the infection can progress rapidly to become
life-threatening. Malaria can kill by infecting and destroying
red blo.od cells (anemia) and by clogging the capillaries that
carry blood ~o the brain (cerebral malaria) or other vital organs.
Malaria parasites are developing unacceptable levels of resistance
to drugs. Besides this, many insecticides are no longer useful
against the mosquitoes transmitting the disease. Good environmental
management by clearing pools of stagnant water during the monsoons
is effective in reducing the number of mosquitoes. Mosquito
nets treated with insecticide reduce malaria transmission and
child deaths. Prevention of malaria in pregnant women, through
measures such as the Intermittent Preventive Treatment (IPTN)
and the use of insecticide-treated nets (ITNs), results in improvement
in maternal health, as well as infant health and survival. Prompt
access to treatment with effective up-to-date medicines, like
artemisinin-based combination therapies (ACTs), saves lives.
If countries can apply these and other measures on a wide scale
and monitor them carefully, the burden of malaria on society
will be significantly reduced. |
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