Tuberculosis is an infectious disease affecting the lungs, which is caused by Mycobacterium tuberculosis bacteria (Ah?mad & Mokaddas, 2013). In serious cases, tuberculosis can also spread to other body parts, which may include the kidneys and the brain through the blood (Ah?mad & Mokaddas, 2013). Tuberculosis can also lead to death if not addressed early and it is one of the leading causes of death in the United States. Tuberculosis is a communicable disease and can be transmitted from one person to the other through the air (Ah?mad & Mokaddas, 2013). Individuals near infected people may acquire the disease if they inhale the bacteria when the infected person coughs or sneezes. The bacteria may enter through the mouth or the nose and infect the individuals. The most infectious tuberculosis is the tuberculosis in the lungs and the throat due to the breathing system (Ah?mad & Mokaddas, 2013).
Tuberculosis, which has spread to other body parts, is not infectious as there is no medium to transmit the disease (Ah?mad & Mokaddas, 2013). Tuberculosis infection starts with a latent infection, which is an individual who have been infected with the bacteria but have not become sick and have no symptoms of tuberculosis. During this stage, they cannot spread the disease to other individuals. Individuals with latent tuberculosis infection may get the tuberculosis disease where they can get symptoms and transmit the disease to other individuals (Ah?mad & Mokaddas, 2013). Some individuals with latent tuberculosis infection who have a strong immune system may never develop the tuberculosis disease even though their blood samples may test positive for tuberculosis. Luckily, there is medication to cure tuberculosis completely even for the individuals with latent tuberculosis infection can take the medications to prevent the infection from developing to a tuberculosis disease (Ah?mad & Mokaddas, 2013).
Symptoms of the tuberculosis disease include chronic cough sometimes with blood sputum, rapid weight loss, fever, and sweating at night (Palmer, 2014). If it spreads to other body organs, it can lead to other symptoms. Individuals at a high risk of tuberculosis infection include individuals who smoke, children, and individuals infected with HIV/AIDS due to their low immunity (Palmer, 2014). Tuberculosis can be diagnosed through a blood sample at a health care facility. Tuberculosis can be prevented by individuals at a high risk through vaccinations with the Bacillus Calmette-Guerin vaccine, wearing protective masks, and ensuring ventilation in rooms with many people (Palmer, 2014). These individuals may include close relatives to tuberculosis-infected people including close families, schoolmates, and workmates (Palmer, 2014).
Early detections can also enable early treatment enabling easy mitigation of the disease. Tuberculosis medications may have a negative effect on the liver of the patients, which may lead to jaundice which is whitening of the eyes and the skin becoming yellow, nausea and vomiting, and loss of appetite (Palmer, 2014). Those infected by active tuberculosis bacteria can take medications, which are administered for a long period although most people are becoming resistant to the tuberculosis antibiotics increasing the major concern (Palmer, 2014). Research has indicated that about a third of the world’s population is infected with tuberculosis making it a major concern (Palmer, 2014). Due to the drug resistance in current population, new infections are rising each year with the number of deaths related to tuberculosis rapidly increasing.
The worst hit countries across the globe are the developing countries due to their lack of enough health care resources to mitigate the disease (Ah?mad ; Mokaddas, 2013). The United States has not been adversely affected by tuberculosis due to the increased funding and research on the tuberculosis problem, which has resulted to a decrease in the number of individuals affected by tuberculosis (Ah?mad ; Mokaddas, 2013). The population living in high-risk areas in the United States due to ethnic and racial differences has faced a major challenge in addressing the tuberculosis disease. Complications of tuberculosis if left untreated may include infection on the liver, damage to body joints, and sometimes meningitis if it has affected the brain (Ah?mad ; Mokaddas, 2013).
Tuberculosis is a one of the reportable diseases in the United States because of its great public impact. Healthcare practitioners in the laboratories or in public healthcare facilities should do the reporting after they have diagnosed a patient and reported to the state health departments and in the United States Centers for Disease Control and Prevention. The reporting of new tuberculosis infections will help in the collection of statistics about the disease, which include how often the disease occurs, and the trends of the disease, which may help prevent future infections (Palmer, 2014).
Determinants of Health and How These Factors Contribute To the Development of Tuberculosis
Biology and Genetics
The determinants of health in the development of tuberculosis include biology and genetics. Biology and genetic factors include the age of the population, the sex, genetically inherited conditions, and family history (Heemskerk, Caws, Marais, ; Farrar, 2015). Immunity levels have been attributed to the infection of tuberculosis, which are passed from one person to another. Studies have indicated a relationship between family histories and tuberculosis infections. Genetic background can determine the outcome of a tuberculosis infection (Heemskerk et al., 2015).
The age of a population also influence tuberculosis infection and it is more prevalent in young children and older generation due to their lowered immune system. Young children have under developed immune systems which are unable to fight diseases so are old people who their immune system have been affected by their old age are not strong enough to fight diseases (Heemskerk et al., 2015). The sex type also influences tuberculosis infection. More men are infected with tuberculosis due to the high-risk behavior factors affecting men, which include smoking and alcoholism (Heemskerk et al., 2015).
Social factors are also determinants of health as they impact the environment surrounding different individuals in certain groupings (Heemskerk et al., 2015). Social factors impact the behavior of individuals affecting their health based on the lifestyles of the individuals. Some of the social factors include the availability and access of basic needs that impact the health of individuals, cultural practices, environmental factors which may include health care facilities availability, access to health care services, and safety which may include safety from hazardous and harmful factors (Heemskerk et al., 2015). Social interactions may also influence the health of individuals. Other social factors may also include exposure to technologies, which impact the whole perspectives of individuals with health being the most important aspect (Heemskerk et al., 2015).
These factors contribute to the development of tuberculosis as they affect the health of individuals. Lack of basic needs like food will lead to malnutrition, which will lead to reduced immunity (Heemskerk et al., 2015). Reduced immunity is one of the major risk factors for tuberculosis infection. Environmental factors, which include lack of access to health care services, may lead to deterioration of the health of individuals as early detections and treatment plans will not be implemented which may lead to serious negative effects of tuberculosis infections (Heemskerk et al., 2015). Cultural practices may involve social gatherings and drinking which may increase the chances of tuberculosis infection in situations where some members may be affected by the disease (Heemskerk et al., 2015).
Health services also determine the health of individuals (Gagneux, 2017). Health services include the access to quality health care services. Lack of this important aspect negatively impacts the health of individuals in certain regions. Some of the health care services include health insurance, which is important in preventive care (Gagneux, 2017). Lack of health insurance is going to affect individuals who may not access healthcare services or delay in accessing these services, which may have a negative effect on their health. Tuberculosis infection can be prevented but a lack of it will lead to active tuberculosis infection (Gagneux, 2017).
Information on preventive care is also available in the health care facilities. Lack of access to these services will increase the chances of infection and deaths as treatment services may be acquired too late (Gagneux, 2017). Some of the challenges in accessing healthcare services may include the high costs associated with healthcare, lack of insurance cover, and lack of health care services availability (Gagneux, 2017). These challenges in accessing quality health care can lead to more severe health issues since the current health issues will not be addressed early in advance. Delays in accessing the healthcare services may also worsen the situations. Tuberculosis can be prevented and treatment can start early for latent tuberculosis infection before it proceeds to active tuberculosis. Lack of access to healthcare services will increase tuberculosis infection and its effects on individuals (Gagneux, 2017).
Individual factors determine the health status of individuals (Gagneux, 2017). Individual factors include individual behaviors that different individuals engage. Some of these behaviors either increase the health status of individuals while some decrease the health status of individuals (Gagneux, 2017). Examples of individual behaviors include smoking, drinking, and lack of physical exercise that can lead to other major health concerns (Gagneux, 2017). Substance abuse may increase the chances of tuberculosis infection while physical activity and a good diet may decrease the chances of infection of tuberculosis (Gagneux, 2017).
Tuberculosis Epidemiologic Triangle
The epidemiologic triangle is a model for an infectious disease, which has three corners consisting of agent factors, host factors, and environmental factors (Nelson ; Williams, 2014). The epidemiologic triangle is meant to help healthcare practitioners in understanding health care complications by understanding the causes of certain diseases, their symptoms, and how they are transmitted to other individuals (Nelson ; Williams, 2014). Agent factors are the causes of the disease also known as microbes. The host is an organism in which the disease causing agent thrives in where else the environment are the physical factors that surround an individual and lead to the cause or transmission of the disease (Nelson ; Williams, 2014).
In tuberculosis epidemiology triangle, the agent that cause tuberculosis is the Mycobacterium tuberculosis bacteria, which first affects the lungs, then multiplies to other body parts (Nelson ; Williams, 2014). The Mycobacterium tuberculosis is transmitted through coughing or sneezing of infected individuals. The host is the human body since the bacterium affects humans more. This may also include poor nutrition and poor diet that leads to a weak immune system (Nelson ; Williams, 2014). The environmental factors that allow the transmission of the bacterium include poor ventilation, crowding in places, mobility of individuals, and lack of access to health care services (Nelson ; Williams, 2014). Special considerations for the community, schools, and general population must be made since the disease is easily transmitted in public gatherings, which include the schools, and other social gatherings and preventive measures should be taken to avoid the spread of the disease (Nelson ; Williams, 2014).
Agent (Mycobacterium tuberculosis)
Environment (social factors and poor ventilation) Host (Humans, poor nutrition)
The Role of the Community Health Nurse
The community nurse has an important role in educating the community about tuberculosis and preventive strategies that can be useful to the community in addressing the disease (Acton, 2012). The community nurse is also responsible in providing treatment health care services to the infected population. Due to the long-term usage of tuberculosis medications, follow-up’s must be made to ensure that patients are adhering to the treatment drugs as an irregular usage of the drugs may lead to a resistance by the individuals resulting to more negative side effects and serious consequences (Acton, 2012). The community health nurse can liaise with the community in creating a suitable environment, which is important in preventing new infections, as the environment is the major contributor to the disease infection (Acton, 2012).
The community health nurse can conduct campaigns on the benefits of a safety environment. The nurse can also train the community how they should help in the care of tuberculosis patients (Acton, 2012). One of the preventive strategies includes administration of tuberculosis vaccine to children and infants and the community nurse can help in this process and ensuring that other individuals at a high risk get the vaccine (Acton, 2012). The community health nurse should also carry out her roles as a nurse in controlling and preventing tuberculosis infections, other side effects associated with the disease, and other communicable diseases. This can be achieved by implementing healthcare policies in the community and monitoring their implementation (Acton, 2012).
National Organization That Addresses Tuberculosis and How the Organization Contributes To Resolving or Reducing the Impact of Tuberculosis
National Tuberculosis Controllers Association
The National Tuberculosis Controllers Association is a United States based organization aimed at achieving a world free of tuberculosis (Nelson & Williams, 2014). The organization achieves this by rolling out tuberculosis programs that help in mitigating tuberculosis in the United States. These programs are coordinated between the national, state, and local governments in the United States (Nelson & Williams, 2014). The National Tuberculosis Controllers Association works and supports other health care organizations in the control of tuberculosis at all government levels in the United States. The National Tuberculosis Controllers Association also comes up with policies aimed at controlling and reducing tuberculosis infections and performs implementation and monitoring responsibilities (Nelson & Williams, 2014).
Federal TB Task Force
This task force was established by the Centers for Disease Control and Prevention to help in tuberculosis research and control efforts in the United States (Nelson & Williams, 2014). This task force coordinates tuberculosis control activities between different federal agencies. The task force has a vital role in addressing the resistance to tuberculosis medications. This has been achieved through the establishment of a national action plan to address the multidrug-resistant tuberculosis (Nelson & Williams, 2014). The taskforce is also responsible for determining and addressing shortages of the tuberculosis drugs and ensuring that all health care facilities have adequate supplies able to cover their patients (Nelson & Williams, 2014). All these activities of the Federal TB Task Force are aimed at reducing the impact of tuberculosis.
Global Implication of Tuberculosis. How Is This Addressed In Other Countries Or Cultures? Is This Disease Endemic To A Particular Area? Provide an Example
Tuberculosis has affected all countries across the globe making it a major global concern. Tuberculosis is among the infectious diseases causing death all across the globe (Gagneux, 2017). A World Health Organization research has indicated that tuberculosis has affected an estimate of a third of the total population of the world (Gagneux, 2017). Due to the nature of its transmission, it can be easily transmitted between individuals of different countries making it the leading infectious cause of death across the globe. Due to the high number of infected individuals and its rapid transmission, its control has negatively impacted the economic strength of countries resulting to poverty in communities and even in countries (Gagneux, 2017). In addition, because of the high numbers of individuals developing resistance, it is further straining the economic strength of countries and increased negative effects of the disease (Gagneux, 2017).
Due to the latent tuberculosis, which has no symptoms, most individuals do not seek medical care and the disease can proceed to become active tuberculosis making the treatment process more difficult (Gagneux, 2017). Tuberculosis may also affect a countries economy due to the high number of deaths leading to a decreased workforce. Most patients are unable to go to work or perform their duties, which can impact a country’s economy negatively (Gagneux, 2017). These effects can be addressed by getting financial funding from global donors who can boost a country’s health budget especially for developing countries and implementation of strategies, which have had positive results in the developed countries (Ah?mad & Mokaddas, 2013). Tuberculosis is endemic to developing countries, which have no sufficient resources to address the disease. Most of the countries in the African continent, which include Kenya, Ethiopia, Nigeria, and South Africa, are the most affected by tuberculosis (Ah?mad & Mokaddas, 2013).
Acton, Q. A. (2012). Tuberculosis: Advances in research and treatment. Atlanta, Georgia: Scholarly Editions.
Ah?mad, S., & Mokaddas, E. (2013). Tuberculosis and multidrug-resistant tuberculosis: Epidemiology, diagnosis, resistance mechanisms, treatment strategies and novel drug. New York: Nova Biomedical.
Gagneux, S. (2017). Strain variation in the mycobacterium tuberculosis complex: its role in biology, epidemiology and control. Cham: Springer International Publishing.
Heemskerk, D., Caws, M., Marais, B., & Farrar, J. (2015). Tuberculosis in Adults and Children. Cham: Springer International Publishing.
Nelson, K. E., & Williams, C. M. (2014). Infectious disease epidemiology: Theory and practice. Sudbury: Jones and Bartlett.
Palmer, P. E. S. (2014). The Imaging of Tuberculosis: With Epidemiological, Pathological, and Clinical Correlation. Berlin, Heidelberg: Springer Berlin Heidelberg.