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RESEARCH ARTICLE
Department of Pharmacy
COMMUNITY PHARMACIST IN THE PREVENTION OF CONTAGIOUS DISEASE MYCOBACTERIUM TUBERCULOSIS
AS KEY PART OF HEALTHCARE ASSOCIATES
infectious disease caused by MYCOBACTERIUM TUBERCULOSIS, TB is multi-systemic disease with myriad manifestations. The rate of TB is increasing day by day in many parts of the world [1]. M tuberculosis is obligate anaerobe slowly growing and facultative curved intracellular rod parasite which is non-motile, and non-spore forming [2]. According to the Robert Koch M Tuberculosis is a microorganism as a causative agent of disease [3] Globally the mycobacterium tuberculosis have ability to persist long time period unrecognized by human immune system[4] Recent study's shows that Tuberculosis is the leading reason of death in those individuals who are infected with HIV and
Tuberculosis (TB),is the most common
INTRODUCTION
HIV-TB. There are many different situations that may leads to a greater risk for Mycobacterium tuberculosis infections susceptibility such as hyperglycemia, aging, use of corticosteroids for long period of time, TNF-á blockers, Vitamin D receptor polymorphism, INF-á genes, and polymorphism in IL-12 [5]. The greater prevalence of tobacco exposure and use increases the chances of tuberculosis [6]. Tuberculosis has become the world wide problem. WHO considerers a general health emergency. Pneumonia and community acquired Pneumonia may also lead to development of tuberculosis, symptoms can be include shiver, chronic cough, phlegm excretion, pleurisy chest pain, increased respiratory rate, bronchial lung sound etc [7].
Maria Ayub*, Bushra Riaz Khan, Uzma Bano, Falak khalil
Department of Pharmacy, Jinnah University for Women, Karachi 74600, PAKISTAN
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ARTICLE INFO:Article history: Received:20 October 2015Received in revised form:23 October 2015Accepted: 1 November 2015Available online: 10 November 2015
AbstractTuberculosis is a wide spread infectious disease that usually caused by mycobacterium tuberculosis (MTB). It typically attack the lungs and also affect other body parts and leading to severe cough, chest pain, sneeze and fever. TB affect the strains on public health and causing high mortality ratio to the HIV/AIDS. The effect of M tuberculosis only prevent by the vaccine that is bacillus camette guerins for adult. M bacterium tuberculosis from sputum specimen may very helpful in early diagnosis and also very effective for the early treatment of TB particularly those patient who have acid fast negative sputum.In this study we observed the worse situation of community pharmacies especially in TB prevention .for the purpose of eradication of TB completely or overcome this disease from PAKISTAN too like other developed countries. We found that pharmacist need to be trained or should be the part of community pharmacy where they can aware patient easily gain trust of the patient , and patient can also understand them . without any difficulty can easily communicate with pharmacist regarding to their problems side effect and pharmacist can also aware the patient about the drug management, regimen what happened if the dose miss all information which may be helpful for the TB patient also pharmacist should force the patient to follow their physician advices and pharmacist physician should cooperate with each other this healthy relationship may be helpful for both patient and pharmacist.
Mycobacterium tuberculosis, vaccination, community pharmacist, HIV/AIDS, strains.
Key words
Corresponding Author:
Maria AyubLecturer, Faculty of Pharmacy, Jinnah University for Women,Karachi 74600, PAKISTAN E-mail: [email protected]: +92331-3119160
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RESEARCH ARTICLE
Department of Pharmacy
Tuberculosis remains a disease with unknown cause and death among where the areas endemic and the rate of progression of disease is variable [8]. TB patient sera they had a greatly abundance in factor with chemo tactic and also effect on activate monocytes, macrophages, & neutrophillis as compare to healthy individuals [9]. The risk of tuberculosis progression also consist upon age and co-morbid conditions. [10]. The early diagnosis and proper treatment are effective to reduce the risk of TB and also reduces the mortality, morbidity and TB transmission in-spite of low sensitivity detection of Mycobacterium tuberculosis, The main and most common method of diagnosis is acid fast sputum [11]. Sometime culture of sputum and gastric fluid test was not considered as useful to detect TB specially in Pneumonia [12]. In people living with human immunodeficiency virus (HIV) infection, the Antiretroviral therapy (ART) is main intervention for the prevention of TB [13]. Rifampicin, isoniazid, ethambutanol and pyrazinamide for 2months and 4months followed by isoniazid & rifampicin. A 6 month therapy regimen in which combination of four drugs are used with cure rate 90% [14]. Drug resistant tuberculosis (DR-TB) currently treatment is not good enough as compare to susceptible TB [15].
Sometime to change the epidemiology of the disease, social and behavioral research on patients is important [16].
Untreated TB patient are better than partially treatment TB patient it is accepted universally. Pakistan is a country included in the list where extremely high rate of defaulter for the complication of TB treatment [17].
As a pharmacist it is our duty to providing treatment information and can help alleviate barriers to adherence [18]. Its important that the community pharmacist must counsel the patients who are taking TB medication to make the treatment successful they also provide the stress to complete the antibiotic treatment even patient feel better [19].
It is responsibility of Pharmacist and public health sector to notified cases of TB. Counseling about primary care, internal medicine, or counsel about that the initiating therapy is useful to reduce the TB infection and may be appropriate for manage the anti-tuberculosis chemotherapy. Individual who are infected with TB are knowledgeable about their
disease, patients must received counseling before pre-treatment, educated with prevalence of various symptoms associated with TB, identify the factors that leads to fail the treatment, also suggest the ways of improving the treatment efficacy [20]. The objective of the study is to evaluate an effective role of community pharmacist to prevention and counseling against awareness of Tuberculosis.
METHODOLOGY
For the desire to realize the need of community pharmacist to prevent spreading of TB this study was conducted among TB's patients and private practitioners in and near hospitals. During data collection found that there was lacking of strong relationship between patient and pharmacist and this relation is of great concern in this study. Most of Community pharmacist was found just to supply medicines by consultant due to lack of rights. For prevention of TB or to beat this disease were directed to pay great attention to evaluate effective role of pharmacist to serve the patient best and also to save the countrymen from these circumstances by providing awareness.
RESULT
According to the survey from different communities of Karachi we observed that the 50% of pharmacies create awareness against TB, but there is no particular programs to cure TB, as shown in (TABLE # 1). There is no proper establishment of community pharmacies and also poor counseling were seen. Mostly answers of the pharmacist were negative to prevent TB ( FIG.1) there is also a need to counsel the patients to complete there treatment even if they feel better to avoid antibiotic resistance. We also observed that according to poor counseling patient do no aware about side effects of drug and transmission of TB, which would, increases the ratio of TB in our nation there is a poor management and establishment of health care system, awareness programs, also government do not full fill requirement of training programs, lack of trained pharmacist there is no particular community pharmacies thats why pharmacist do no play their role to prevent the diseases, Government do not give the authority and importance of pharmacist to perform their requirements.
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Pharmacists have an slot turn to monitor their patients with chronic and severe type of disease condition and give information about the use of combined medications, also pass along information about possible sign and symptoms of tuberculosis, aware about vaccination with proper counseling for all of these purposes there is a need of communities to aware and protect population against chronic types of diseases. Pharmacist raising the awareness about tuberculosis by using different methods such as by organizing programs against awareness, counseling about TBLHIV vaccination, consequences of TB, to complete proper treatment to avoid many infectious diseases and also to prevent against drug resistance. The world health organization developed the Stop TB Strategy to increase worldwide awareness for superior and valuable treatment, prevention, and mastery of
tuberculosis and all nations should be follow to cure people and nation against tuberculosis and many other severe type of infections and diseases.
DISCUSSION
Tuberculosis has become the world wide problem. All developed countries like USA has overcome this problem but under developed countries like Pakistan, India, and many other countries is deprived to reduce prevention and prevalence of TB. With Physician, Nurses, private practitioners can also play a vital role to decreasesthe proliferation of TB by providing awareness, education, patient counseling, and information about the risk factor of TB being a part of pharmacist duty. Pharmacist need greater efforts can towards treating infection of TB. These effort
Table 1: Role of Community Pharmacists
Figure 1: Percent respondent of Tuberculosis prevention measures
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can be accommodating for control of TB in Pakistan
by community sector, Health care including
pharmacist and well developed community
pharmacies can play an effective role in prevention
and cure of Tuberculosis. Plenty of peoples do not
follow their prescribed medicine and direction
related to their diseaseso counseling is necessary
here. Pharmacist should provide basic information
and utility of TB vaccination that is Bacillus
calmette Guerins (BCG). They must knowledgeable
them that vaccine does not fight against all TB
strains. Pharmacist should counsel the infected the
patient to wear special surgical mask known as
respirator to prevent the spreading of TB particles
through the air Community pharmacist can play a
vital role to prevent peoples from different type of
diseases, during counseling pharmacist should
motivate the patient to take additional test if needed
by developing mutual trust and respect as well.
There is a need of clinical and community
pharmacies at compartment level to improve the
patient compliance to therapy and treatment as well
as to control illogical prescription. 45% pharmacist
should choose community pharmacy profession
because it holds the actual pharmacy practice and
also business benefits. Community/Retail
pharmacists have a duty to create awareness among
the people about TB by distributing leaflets,
booklets, pamphlet, and displaying posters at
prominent places in local languages which are
easily understand by everyone. Pharmacist should
counsel the patient with infected TB in various
manners of treatment therapy like how to take dose,
stress that should complete their coarse, which food
to be taken in TB etc. Community pharmacist
should arrange the National Tuberculosis Programs.
In order to control TB and perform essential roles
trained pharmacists are required to understand
disease well and to manage the undesired effect of
drug therapy and this can be possible with the
support of our Government & society for the social
performing activity Government should motivate
pharmacist to organized training programs.
Pharmacist should encourage rational use of anti-
tuberculosis medicines additionally dispensing
anti-tuberculosis medicines that should not be safe
and effective and sale of other combination of drug
can be stop to avoiding misuse and without
prescription medication should not be given to the
patient. Moreover by following and established the
community pharmacy, pharmacist should cure,
prevent and aware peoples about tuberculosis and
it's also a basic need of our country. Pharmacies are
often the first support and can play a key role in TB
control and its eradication.
CONCLUSION
In conclusion, our survey and studied designate that
the tuberculosis is necessary to reduce in all local
and national scales. We also concluded that in our
nation there is a lack of particular communities and
retail pharmacies and we need to establish them to
sort out the patient compliance as well as to stop the
prevalence of TB and many other infected diseases.
In community pharmacies pharmacist should have
opportunity to counsel the patient about their
disease, and should also aware the patient about the
transmission, symptoms, pretreatment, proper
regimen. Pharmacist must counsel the patient to
complete their antibiotic treatment to avoid the
eradication of infection as well as reduces the risk
of developing of antibiotic drug resistance. If these
things can be measure properly so it can expand the
awareness of TB in among all the nation.
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