Epidemiology Paper
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Heydis Ferrer
TuberculosisDisease.docx
Summary
2341 Words
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Description of Tuberculosis Disease
Tuberculosis is a contagious communicable disease that usually affects the lungs of the
infected persons. If not treated rapidly, the infection can be spread to other body parts such as spine
Spelling mistake: Heydis Hades
Tuberculosis Disease
Name: Heydis Ferrer
Grand Canyon University
Course: NRS-428VN
Date: 12/20/2020
and brain. Tuberculosis disease is caused by Mycobacterium tuberculosis bacterium. The
bacterium is transmitted from one person to another when an infected person sneezes or coughs
and another person inhale the droplets containing it (Pai et al., 2016). However, tuberculosis
disease is not as contagious as flu or cold, although it is spread in a similar way. It is transmitted
when an individual spends a prolonged period in close contact with an infected person. For
instance, tuberculosis disease is mostly transmitted between family members living together in the
same house but is unlikely to be transmitted between people sited together in public transport.
Besides, not everyone suffering from TB is infectious. Persons with TB infections occurring
outside the lungs commonly referred to as extrapulmonary TB and children do not spread the
disease.
In healthy individuals, the immune system can destroy mycobacterium tuberculosis, the
bacteria that cause tuberculosis disease. In some cases, the individual does not show any symptoms
after infection by the bacteria. This condition is known as latent TB. However, the infection starts
to cause notable symptoms after some time, maybe weeks or even years, becoming an active TB.
About ten per cent of persons with latent TB eventually develop active TB some years after the
first infection. The symptoms are usually detected within one or two years after infection when the
immune system becomes weak. Therefore, only active TB shows symptoms of infections in the
body. These symptoms include coughing that persists more than one month, blood stained cough,
chest pains usually when coughing or breathing, loss of appetite, fever, fatigue, unintentional
weight loss, chills and night sweats. As mention earlier, tuberculosis infection can also infect other
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body parts such as brain, spine and kidneys. The symptoms vary depending on the body organs
infected. For instance, tuberculosis infection in the kidneys might cause bloodstains in the urine,
while that of the spine might cause back pains.
During diagnosis, the doctor usually checks patients' lymph nodes for any swelling. The
doctor then uses a stethoscope to carefully listen to the patient's lungs' sounds as they breathe. The
most frequently applied tuberculosis diagnostic method is a simple skin test. A slight quantity of
PPD tuberculin element is injected underneath the skin of inside forearm of the patient. The
medical care professional checks the patient's arm for swelling within 48 to 72 hours. If there is a
raised, hard red bump at the injection site, the patient will likely be infected with TB. However,
blood tests are currently widely used in testing for TB infections. The blood tests are used to rule
out or to confirm the presence of active or latent TB. These tests apply an advanced and
sophisticated technology to measure the reaction of a person’s immune system to tuberculosis
bacteria.
Medications are the primary mechanism for tuberculosis treatment. However, treatment of
TB usually takes longer than other bacterial infections. For active TB, the patient must take
antibiotics for a period of six to nine months. The duration of treatment and exact drugs depend
on the body part infected, possible drug resistance, overall health and age of the patient
(Churchyard et al., 2017). The most commonly used medications include isoniazid, rifampin,
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Web Content: http://vaccinetruth.org/tb-testing.html
Web Content: https://www.cdc.gov/tb/publications/factseries/exposure_eng.htm…
Web Content: https://www.mayoclinic.org/diseases-conditions/tuberculosis/diagnosis-treatment/drc-20351256…
currently: currently now
Web Content: https://www.mayoclinic.org/diseases-conditions/tuberculosis/diagnosis-treatment/drc-20351256…
Web Content: https://www.hindustantimes.com/health/tuberculosis-is-a-leading-cause-of-death-globally-here-are-4-myths-about-the-disease/story-ZlEitLnMYFlGn93CAT2rbK.html…
Student: Submitted to Grand Canyon University
Web Content: https://www.mayoclinic.org/diseases-conditions/tuberculosis/diagnosis-treatment/drc-20351256…
Student: Submitted to Grand Canyon University
ethambutol and pyrazinamide. In case the patient has drug-resistant TB, a combination of injectable medications and fluoroquinolones antibiotics are used for a period of at least 20 t0 30
m0nths. Tuberculosis disease can cause complications in the body such as joint damage, lung
damage, damage or infection of the bones, kidney or liver problems, and inflammation of the
tissues around the patient’s heart.
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Determinants of Health
Tobacco and alcohol
Tobacco has a great impact on tuberculosis infection. Passive and active tobacco smoking
activities are the main risk factors that contribute to latent TB progression to active TB infections
and increase the risk of contracting TB. Also, tobacco smoking reduces the rate of TB treatment
success, hence increasing the mortality rate. According to Thomas et al. (2019), there exists a close
connection between tobacco smoking and tuberculosis infection. Tobacco smoking negatively
influences the patient’s response to treatment and increases the risk of relapse.
Furthermore, passive smoking increases the risk of contracting TB infection, especially in
children. Smoking cessation is usually associated with higher cure rates as compared to smokers.
Therefore, smoking cessation programs are recommended as part of TB control and treatment
plans. On the other hand, there is a causal relation between TB and heavy alcohol consumption.
According to Thomas et al. (2019), approximately seventeen per cent of TB cases could be
prevented if there was no heavy alcohol consumption. Besides, about 15% of the total fatalities
could be prevented if the Patients were not involved in heavy drinking. Alcohol abuse is usually
associated with severe and more contagious manifestations of TB infections. Diagnosis of an
alcohol-related disorder and consumption of more than 40g of ethanol per day has been proven to
increase the risk of TB infection. Heavy alcohol consumption is associated with the cavitary
disease, poor adherence, increased drug toxicity, greater risk of smear-positivity, and death due to
tuberculosis disease.
Poverty
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on the other hand (...: On the other hand But
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There exists a symbiotic relationship between poverty and TB. Tuberculosis disease
infection is not only caused by poverty but also results in poverty of infected households.
Therefore, fighting poverty and TB together is essential to reduce the global burden of the disease.
It is evident that the poorer the individual or community, the greater the risk of contracting
tuberculosis. Poor nutrition, lack of primary health services and inadequate living standards among
the poor communities enhance the spread of TB infection and its impact upon the community.
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Mycobacterium tuberculosis (the agent factor) is transmitted from an infected person (the host
factor) through respiratory exposure in public gatherings, communal or family settings (the
environment factor). Individuals with a weak immune system, especially those with underlying
conditions such as HIV/AIDS, corticosteroid therapy, diabetes mellitus, and cancer are at a greater
risk of being infected with tuberculosis. However, even individuals with a healthy immune system
can also contract the disease, especially when in close contact with an infected individual for a
prolonged time. Therefore, to prevent the rapid spread of mycobacterium tuberculosis from the
host to other healthy individuals, infected individuals and those with similar systems should not
interact too closely with other people. Since the agent is airborne, the environment factor is
fundamental in controlling its transmission from the host to other susceptible persons. Besides,
early diagnosis and treatment of infected individuals are crucial in preventing the spread of
tuberculosis in the community. The environmental factors that influence tuberculosis's spread
include overcrowding, poor diet, poverty, homelessness, and lack of adequate quality healthcare
facilities.
Special considerations and notification should be put in place when an individual infected
with tuberculosis is travelling abroad. The state TB control officials should notify the destination
country officials concerning the infected person's travel plans. Notifying their counterparts is to
ensure continuity of care and necessary treatment of the person with tuberculosis. The patient
should be advised about seek medical care in the destination country to help in ongoing care. Also,
enough anti-TB drugs should be prescribed or dispensed to last until the supply can be refilled to
avoid a break in treatment.
Web Content: https://en.wikipedia.org/wiki/M._tuberculosis…
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be advised: be advised
Lack of good quality healthcare facilities is common in poor communities, which delays diagnosis
and treatment of the disease, hence perpetuating its spread. Besides, inadequate diet and poor
nutrition associated with poor communities weaken the immune system and increase tuberculosis
infection risk.
Epidemiologic triangle
An epidemiological triangle is a tool that consists of host factors, agent factors and
environmental factors used to evaluate the spread of a disease in a community. It is applicable in
identifying intervention points to prevent further transmission of the infection in the community.
The agent factor in tuberculosis is Mycobacterium tuberculosis. It is the causal agent of
tuberculosis and belongs to pathogenic bacteria species and Mycobacteriaceae family. The
physiology of Mycobacterium tuberculosis is greatly aerobic, therefore requires high amounts of
oxygen. Also, it reproduces gradually and is hypersensitive to UV light and heat. Tuberculosis
mainly infects the lungs, but can also affect reproductive organs, lymph nodes, pericardium,
Menges, joints, bones and kidneys.
Mycobacterium tuberculosis is transmitted from one person to another through airborne
droplets that are ejected from an infected person (the host) through coughing or sneezing.
Role of the Community Health Nurse
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community should be a priority of the community health nurse. They should keep accurate data
about the spread of TB in the community, and individuals under treatment for easy follow up.
USAID Role in Addressing Tuberculosis
USAID is the leading organization supporting the United States government efforts to
address TB disease globally. The organization works closely with governments, other
organizations and agencies globally to reach every individual infected with TB, cure the patients
in need of treatment, and prevent further spread of new infections. USAID is working to support
countries globally to attain the global targets of diagnosing and enrolling forty million individuals
Web Content: https://www.cdc.gov/tb/education/corecurr/pdf/chapter8.pdf…
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Web Content: https://www.cdc.gov/tb/education/corecurr/pdf/chapter8.pdf…
accurate: accurate right
Controlling and preventing the spread of tuberculosis is a primary responsibility of the
local and state health departments. Tuberculosis control is a complex process that requires the
effective collaboration of various organizations, institutions and individuals inside and outside the
public health sector. A community health nurse is one of the most critical individuals responsible
for controlling tuberculosis spread in the community. A community health nurse's primary role is
contact investigation, diagnostic and clinical services for TB patients and their contacts, training
and education, and data collection and management.
Community health nurse is responsible for ensuring that patients with confirmed or
suspected tuberculosis infection have access to quality diagnostic and treatment services. These
services are usually provided by locally supported and state TB speciality facilities, which are
staffed by contracted service providers or health department professionals. However, individuals
infected with TB can seek medical care in private medical facilities. A community health nurse
has the responsibility of ensuring that TB patients access quality care regardless of where the
individual patent seeks medical care. Therefore, the nurse should maintain a close relationship
with state, local, and private health facilities to ensure treatment and care standards are met.
Second, a community health nurse is responsible for providing education and training to the
community that they represent. The training should cover various aspects of the disease such as
symptoms, transmission and ways to prevent it, and taking care of TB patients. The nurse should
develop programs to educate community members, healthcare providers and other public health
officials on TB control and prevention. Third, the nurse is responsible for case finding. The nurse
must regularly conduct investigations to identify individuals infected with TB for timely treatment
and isolation when necessary. Lastly, the collection and management of data related to TB in the
on TB treatment procedure, and further thirty million persons on TB preventive therapy the year 2022. To achieve these targets, USAID adopted a new tuberculosis business model known as the
global accelerator to end TB (Nieburg & Jackson, 2016). The accelerator was established to
improve investments from private and public sectors to end the tuberculosis epidemic globally.
The accelerator also seeks to build local capacity and commitment to accomplish the goals set
forward at the UNHLM. It mainly focuses on 23 countries with a huge burden of TB infections.
The organization aligns with local partners and communities to provide performance-based
outcomes toward the global target. The accelerator was developed to ensure that USAID is fighting
to eradicate tuberculosis effectively and efficiently by developing local capacity and commitment
with an emphasis on locally generated solutions that enhance the response of the Agency to TB
and combat discrimination and stigma. Besides, USAID assists in training healthcare workers on
how to find active TB cases, collecting and analyzing data on TB transmission, and taking care of
TB patients.
Global Implication of Tuberculosis
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Web Content: https://www.kff.org/global-health-policy/fact-sheet/the-u-s-government-and-global-tuberculosis-efforts/…
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Web Content: https://www.kff.org/global-health-policy/fact-sheet/the-u-s-government-and-global-tuberculosis-efforts/…
Web Content: https://www.dailyeducation.in/tuberculosis-chemotherapy/…
Web Content: https://www.who.int/hiv/topics/tb/en/
Tuberculosis disease is a leading cause of death globally, despite it being often curable and
preventable. About a quarter of the population globally has latent TB. Hence, these people ate
infected by mycobacterium tuberculosis, but they are not yet ill with the tuberculosis disease and
cannot transmit the bacteria. About ten million individuals contract active TB per year globally,
which can be transmitted to other individuals. Tuberculosis disease is not endemic, since it is
present in all countries and regions globally, though most TB cases are concentrated in the
developing countries. For instance, in 2018, the number of high burden countries was one in
America, one in Europe, six in south-east Asian and sixteen in Africa.
In the late 1990s and early 2000s, concerns about the emergence of TB medication
resistance, HIV/TB co-infection, new outbreaks, and rising incidence in some areas prompted
governments and primary health actors globally to make advancing and preserving the progress of
efforts against the disease a priority. In the year 1993, the World Health Organization (WHO)
affirmed tuberculosis disease as a worldwide health emergency. As a result, global efforts to
address the disease become more prominent, leading to globally reducing TB incidences and
mortality rate. In 2018, there were about ten million new TB cases globally, including
approximately 0.9 million cases in people living with HIV. Although TB is curable and treatable
in most cases, about 1.45 million individuals died from the disease in 2018 globally. The global
mortality rate of tuberculosis fell by eleven per cent between 2015 and 2018.
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References
Churchyard, G., Kim, P., Shah, N. S., Rustomjee, R., Gandhi, N., Mathema, B., ... & Cardenas, V.
(2017). What we know about tuberculosis transmission: an overview. The Journal of
infectious diseases, 216(suppl_6), S629-S635.
Nieburg, P., & Jackson, A. (2016). US Government Roles in Control of Global Tuberculosis.
Pai, M., Behr, M. A., Dowdy, D., Dheda, K., Divangahi, M., Boehme, C. C., ... & Raviglione, M.
(2016). Tuberculosis. Nature reviews. Disease primers, 2, 16076.
Thomas, B. E., Thiruvengadam, K., Kadam, D., Young, S., Sivakumar, S., Bala Yogendra
Shivakumar, S. V., ... & TRIUMPH-RePORT India Study. (2019). Smoking, alcohol use
disorder and tuberculosis treatment outcomes: A dual co-morbidity burden that cannot be
ignored. PLoS One, 14(7), e0220507.
