Describe following Communicable Diseases in terms of their signs and symptoms(s/s) and treatment:- (a) Childhood Tuberculosis (b) Hepatitis B

(a) Childhood Tuberculosis:

Signs and Symptoms (S/S):

1. Respiratory Symptoms: Persistent cough lasting more than two weeks, which may be accompanied by chest pain, hemoptysis (coughing up blood), and difficulty breathing.
2. Fever: Low-grade fever that may be intermittent or persistent, often accompanied by night sweats.
3. Weight Loss and Poor Growth: Failure to thrive, decreased appetite, and weight loss despite adequate caloric intake.
4. Fatigue and Weakness: Generalized weakness, fatigue, and lethargy due to chronic infection.
5. Lymphadenopathy: Enlarged lymph nodes, particularly in the neck (cervical lymphadenopathy), may be present.
6. Extrapulmonary Manifestations: In severe cases, tuberculosis (TB) can spread beyond the lungs, leading to symptoms such as joint pain, swelling, bone deformities, and neurological deficits.

Treatment:

1. Antitubercular Therapy (ATT): The primary treatment for childhood tuberculosis involves a combination of antibiotics to eradicate the Mycobacterium tuberculosis bacteria. The most commonly used drugs include isoniazid, rifampicin, pyrazinamide, and ethambutol.
2. Duration of Treatment: The duration of antitubercular therapy varies depending on the severity and location of the infection but typically lasts for a minimum of six months. Children with severe or disseminated TB may require longer treatment durations.
3. Directly Observed Therapy (DOT): Children with tuberculosis should receive treatment under direct observation by healthcare providers or trained community health workers to ensure medication adherence and minimize the risk of treatment failure or drug resistance.
4. Nutritional Support: Adequate nutrition is essential for children with tuberculosis to support growth, immune function, and medication tolerance. Nutritional supplementation and counseling may be provided to ensure optimal dietary intake.
5. Monitoring and Follow-Up: Children undergoing treatment for tuberculosis require regular monitoring of symptoms, weight, and medication adherence. Follow-up visits with healthcare providers are essential to assess treatment response, manage side effects, and prevent disease recurrence.

(b) Hepatitis B:

Signs and Symptoms (S/S):

1. Asymptomatic: Many children with hepatitis B infection may be asymptomatic and remain undiagnosed until complications develop or routine screening is performed.
2. Acute Hepatitis Symptoms: Children who develop symptoms of acute hepatitis B infection may experience fatigue, malaise, jaundice (yellowing of the skin and eyes), dark urine, pale stools, and abdominal pain.
3. Chronic Hepatitis: Some children with hepatitis B may progress to chronic infection, which can lead to long-term liver damage, cirrhosis, liver failure, and hepatocellular carcinoma (liver cancer).
4. Fulminant Hepatitis: In rare cases, acute hepatitis B infection can progress rapidly to fulminant hepatitis, characterized by severe liver dysfunction, encephalopathy, and coagulopathy, which can be life-threatening.

Treatment:

1. Antiviral Therapy: Antiviral medications such as interferon-alpha and nucleos(t)ide analogs (e.g., lamivudine, entecavir, tenofovir) are used to suppress hepatitis B viral replication and reduce liver inflammation in children with chronic hepatitis B infection.
2. Management of Complications: Children with advanced liver disease or complications of chronic hepatitis B infection may require supportive care, including management of liver failure, ascites, variceal bleeding, and hepatocellular carcinoma.
3. Vaccination: Hepatitis B vaccination is the most effective preventive measure against hepatitis B infection. All newborns should receive the hepatitis B vaccine at birth, followed by additional doses according to the recommended immunization schedule.
4. Screening and Surveillance: Children born to hepatitis B-positive mothers should undergo serologic testing for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBs) to determine their hepatitis B status. Regular monitoring of liver function tests and viral markers is essential for children with chronic hepatitis B infection to assess disease activity and progression.

In summary, childhood tuberculosis and hepatitis B are serious communicable diseases that require early diagnosis, appropriate treatment, and comprehensive management to prevent complications and improve outcomes in affected children. Close collaboration between healthcare providers, public health agencies, and families is essential for effective disease control and prevention.