Communicable Disease Selection

nTuberculosis

nCauses of Tuberculosis

nTuberculosis (TB) is a communicable disease, which is caused by Mycobacterium tuberculosis. The bacteria normally attack the lungs. TB is the second largest cause of deaths across the globe among all infectious diseases with a single causative agent. Moreover, according to the WHO, TB is one of the re-emerging disease and a global emergency. Fortunately, the disease is curable and preventable. The two types of TB include Active TB and Latent TB. In the latent TB, the bacteria exist in human tissue in an inactive form hence they cannot infect others. However, in active TB, the bacteria in human body have the capacity of producing symptoms hence it can be spread to others. Tuberculosis generates a serious public health concern in the world because of its severity, mode of transmission, complications, disease determinants and its development.

nMode of Transmission

nTB is an airborne disease hence Mycobacterium tuberculosis is transmitted via air when an infected individual talk, laughs, spits sneezes or coughs. Persons with Active TB have a higher chance of spreading the bacteria to healthy persons. However, if such people receive suitable treatment for more than 2 weeks they cannot infect other people.

nSymptoms

nPersons infected with the disease exhibit a wide range of signs and symptoms. However, individuals with Latent TB do not have any symptoms. In this regard, active TB generates numerous symptoms including, chills, fatigue, fever, coughing with blood or mucus, and loss of appetite. Moreover, they demonstrate night sweats, and loss of weight. Although TB often infects the lungs, it can also infect other body organs. When it spread to other organs, it produces varying symptoms. For instance, if it affects the bones, it can cause joint destruction and spinal pain. Similarly, when it attacks the brain, it can lead to meningitis and when it infects the kidneys, it damages their abilities to filter waste hence causing urine with blood.

nThe physician can diagnose tuberculosis through skin test by injecting PPD tuberculin inside foreskin. Prior to this test, doctors can review the medical history and symptoms of the patient as well as their exposure risk to the disease. The site is examined after 2-3 days to check whether there are swollen red or hard bump which signals the likelihood of the disease. However, the test is not very accurate hence, other tests such as sputum tests, chest X-rays and blood tests can be used to determine the existence of the bacteria.

nTreatment

nThe largest proportion of tuberculosis cases can be treated if the appropriate medication is accessible and health practitioner appropriately administers the drugs. The exact length and type of antibiotic treatment is based on the area of infection (kidney, brain or lungs), possible resistance ability of drugs, general health and age of a patient. Antibiotics are normally needed to be administered for a long period. The typical duration for TB medication is nearly 6 months. However, some tuberculosis strains are quite resistance to the standard medication hence they cause Multi-drug resistance tuberculosis (MDR-TB). Therefore, the treatment of MDR-TB needs longer prescription of a wide range of drugs. Directly observed therapy (DOT) is encouraged where the nurse is involved in the administration of medication in order to guarantee complete treatment. Precisely, four TB antibiotics (Priftin, Rifapentine, Rifampin, and Isoniazid) are used coupled with appropriate support, supervision and health education.

nComplications

nEven though some people never have TB complication, many exhibit problems ranging from severe to mild complications. Some of the severe complications associated with TB infections include visual disturbances, cardiac tamponade, liver or kidney malfunction, meningitis, and bone, joint and spine pain. Additionally, it can cause damages on the lung function. Research has also indicated that TB can lead to haemoptysis, right middle lobe syndrome, bronchiectasis, empyema and immune reconstitution inflammatory syndrome (IRIS).

nDemographic (mortality, morbidity, incidence, and prevalence)

nAccording to the WHO, often infects persons of all ages although it is commonly found among adults. Interestingly, more than 95 per cent of TB deaths and cases are found in the developing nations. Precisely, Asia and Africa recorded the highest number of new cases in 2015 at 61 per cent and 26 per cent respectively. Moreover, in the same year, the burden of the disease morbidity was recorded in only 30 countries, which had over 87 per cent of new tuberculosis cases. Similarly, the top six nations registered over 60 per cent of new cases. They included South Africa, Pakistan, Nigeria, China, Indonesia and India. Research has also noted that about 33.3 per cent of the total population in the world are infected with the causative bacteria (M. tuberculosis). However, large proportion (95 per cent) of these infections remains in latent TB hence they are asymptomatic. However, about 1 per cent progress to active TB. In 2012, there were approximately 8.6 million active TB cases across the globe. Out of these, nearly 1.5 million deaths occurred. Most of the deaths arise from persons co-infected with TB and HIV/AIDS.

nDeterminants of Health and how they contribute to disease Development

nVarious scholars have noted that there is a broad range of determinants that are associated with TB development. For instance, poverty is a key determinant of the disease. Living in poorly ventilated and crowded environments is usually linked to poverty and create direct risk factors for the transmission of TB. Moreover, under-nutrition is a critical determinant for progression of active TB because it compromises the body immunity. Furthermore, poverty is accompanied with lack of adequate health information and knowledge. Similarly, it contributes to inability of the individual to utilize available information, which plays a part in greater disease exposure. In this regard, incapacity to apply available health knowledge exposes an individual to various TB risk factors including alcohol abuse, smoking and HIV. Poverty also acts as a barrier to access quality medication and health services as well as adherence to advised treatment. Finally, it also promotes use of illegal drugs, which discourages observance of recommended medication.

nEpidemiologic Triangle (Host, Agent, and Environmental Factors)

nThe epidemiologic triad explains the interaction between environmental, host, and agent factors. It is utilized to describe a particular health concern especially communicable infection and how it is transmitted. The Agent represent microorganism that is responsible of causing the infection. In this respect, the agent is Mycobacterium tuberculosis. Secondly, the epidemiologic triad contains the Host, which represent an organism sheltering the tuberculosis. The host is normally an animal or human, which is exposed to infection. Various hosts have different immunity reaction to the agent. In this case, the host factors include human low immunity and weakened resistance. Finally, the environment factors refer to favourable conditions or surroundings outside the host that promote or cause TB to be spread. Some of these include living in crowded places, poor sanitation and ventilation.

nRole of Community Health Nurse

nCommunity health nurses have special part to play in TBs primary, secondary, and tertiary prevention efforts. Primary prevention activities aim to avert TB prior to its occurrence. Therefore, community health nurse work to control exposures that leads to the disease, changing unsafe or unhealthy behaviours and raising disease resistance. In this regard, nurses participate in health education in the community among at risk population in order to instil safe and healthy habits. For instance, nurses will attempt to create awareness on the reasons for avoiding smoking, proper nutrition, living in well-ventilated rooms and proper hygiene. Secondary prevention efforts should focus on early detection of TB in order to slow or halt its development. In addition, they should initiate programs that control long-lasting challenges. For instance, community health nurses should conduct regular screening and exams to identify early stages of TB so that appropriate interventions can be commenced. Finally, community health nurses have a role in tertiary prevention, which are intended to moderate or ease the effects of TB that has permanent impacts. Therefore, nurses will assist TB patients to manage complex and long-term complications and problems aiming at improvement of their life expectancy and quality of life. For this reason, they should initiate support programs that enable TB patients to share approaches of management of the disease and living appropriately.

nNational Agency that Addresses TB

nIn the United States, the National Tuberculosis Controller Association (NTCA) is mandated to safeguard the public health by enhancing the eradication of TB in the country via coordinated action of territorial, local and state programs. In addition, it initiates and designs a shared effort for TB controllers to advocate and advance the elimination and control mechanism in the country. The NTCA offers guidance and advices the task forces, committees, organizations, and agencies on actions and issues affecting elimination and control of TB at various levels. Moreover, it is responsible for sponsoring laws, policies, and positions and ways to enhance the disease eradication at territorial, local, and state levels.