Orientation of the district level health workers for TB and Tobacco integration and training on counselling for smoking cessation

Kathmandu, April 7 – 8, 2014

Tobacco as a risk factor for TB and screening strategies

Giampaolo MezzabottaMedical Officer/TuberculosisWorld Health OrganizationNepal Country Office

How tobacco influences TB

* =

smoking-related cough can mask TB, thus delaying patients’ care seeking behaviour and making harder for clinicians to recognize TB.

SMOKING?

Who should be screened for TB?

TB prevalence in Nepal is estimated at 241/100,000.

Who is at higher risk of active TB?

Setting

Published in 2007 but still the main source of information about TB and tobacco control

Estimated number of cases

Estimated number of deaths

1.3 million*• 74.000 in children• 410.000 in women

8.6 million• 0.5 m in children• 2.9 m in women

450,000

All forms of TB

Multidrug-resistant TB

HIV-associated TB 1.1 million (13%)

320,000

Source: WHO Global Tuberculosis Report 2013 * Including deaths attributed to HIV/TB

The global burden of TB -2012

170,000

The Tobacco epidemic

How and where the two epidemics merge?