Epidemiology Paper: Tuberculosis

Epidemiology Paper: Tuberculosis Name of Student Institution Affiliation Table of Contents TOC \o "1-7" \h \z \u 1.0. Introduction PAGEREF _Toc4172907 \h 32.0. Discussion PAGEREF _Toc4172908 \h 32.1. Tuberculosis PAGEREF _Toc4172909 \h 32.1.1 Causes PAGEREF _Toc4172910 \h 42.1.2 Symptoms PAGEREF _Toc4172911 \h 42.1.3 Mode of Transmission PAGEREF _Toc4172912 \h 52.1.4 Complications PAGEREF _Toc4172913 \h 62.1.5 Treatment PAGEREF _Toc4172914 \h 62.2. Demographic of Interest PAGEREF _Toc4172915 \h 62.3. Social Determinants of Health PAGEREF _Toc4172916 \h 72.4. Epidemiologic Triangle PAGEREF _Toc4172917 \h 82.5. Role of the Community Health Nurse PAGEREF _Toc4172918 \h 92.6. National Agency PAGEREF _Toc4172919 \h 102.7. Global Implication of the Disease PAGEREF _Toc4172920 \h 103.0. Conclusion PAGEREF _Toc4172921 \h 104.0. References PAGEREF _Toc4172922 \h 12 Epidemiology Paper: Tuberculosis 1.0. Introduction Tuberculosis is one of the oldest viral diseases and is still one of the most dangerous among the communicable infectious diseases in the world. Up to one-third of the world's population suffering from communicable diseases is infected with this virus, and up to 5 thousand people die in the world every day. The World Health Organization (WHO) is taking measures to eradicate tuberculosis from different regions, while it is evident to refuse vaccination in the countries where the incidence is low. Tuberculosis remains an essential task of the health community as a whole that influences the main directions and development of global public health diseases. The WHO tuberculosis statistics are used while developing strategies and programs to combat this disease and assess their effectiveness and presentation of results in publications. The rationale for conducting this research is to emphasize the global epidemic of tuberculosis disease, demonstrating its causes, symptoms, mode of transmission, complications, and treatment. The paper primarily focuses on the demographics of the disease, underlying social determinants, epidemiologic triangle, role of community health nurses, national agencies involved, and the global implication of this disease. The epidemiology of tuberculosis has remained an issue of concern for the global health system. Despite the implementation of different preventive measures, this communicable disease is still widespread. 2.0. Discussion 2.1. Tuberculosis  The tuberculosis is an infectious and contagious disease in which the microorganism attacks and invades the lung of the infected person, though this disease may occur in other parts of the body as well, such as bones and kidney (Hallensleben, de Vries, Lettinga, & Scherpbier, 2016). The causative microorganism for this disease is Mycobacterium tuberculosis. 2.1.1 Causes Tuberculosis (TB) is an infectious disease that spreads by airborne droplets, that is, by inhalation of the patient’s sputum particles. Therefore, a person can only get exposure to an organism from a patient with an open form of tuberculosis. The initiation of infection does not mean that there will be a distinct disease, which, as a rule, begins with the first complex in the lung. If the immune system functions normally, then the infection remains dormant for life and does not affect the carrier (Seo, Kim, Hwang, Hong, & Lee, 2016). The primary tuberculosis complex develops when the tubercle bacillus in the lung begins to multiply and forms a lesion in the lung tissue, then spread to the nearest lymph nodes. It is not necessary that explicit tuberculosis develops immediately after infection, as it may occur later. In a small number of cases, the disease develops from the first complex, but in adults, it is often a sizeable pulmonary process, although tuberculosis can occur in any organ, such as the kidneys, bones or lymph nodes. 2.1.2 Symptoms Patients with tuberculosis usually present complaints that concern them for at least a month, and the symptoms worsen over time. Since pulmonary tuberculosis is most often the case, patients will most likely complain about coughing and occasionally hemoptysis, i.e., blood in the sputum. Symptoms of a more advanced process are weight loss, loss of appetite, and night sweats. Almost all patients with pulmonary tuberculosis show changes on the chest radiograph, they are usually located in the upper lobes, although now the typical picture of pulmonary tuberculosis is less common. In case of severe infection, several lung lobes may be affected, and an increase in the intra-thoracic lymph nodes (Coelho et al., 2016). If changes are found on the radiograph of the chest organs, the patient must take sputum for analysis. This should be done in all patients who cough for three weeks or longer. The cough is expected to last for approximately two weeks up to a month. 2.1.3 Mode of Transmission The primary source of infection is a patient with pulmonary tuberculosis with a massive bacterial excretion, which in a day can emit a billion or more Mycobacteria tuberculosis (MBT) with sputum. With poor bacterial excretion, when MBT is detected only by unique methods (bacteriological tests), the infection of those around is much less. The risk of developing tuberculosis depends on the number of MBT that enters the body. In most cases, long-term and close contact with the patient is required for the development of the disease. Infection with tuberculosis can be transmitted through direct contact with a patient who dispels mycobacteria when coughing, sneezing, and talking. For a long time, the main route of infection was considered airborne (Getahun et al., 2015). However, infection is possible without direct contact with the patient. For instance, being in contact with the contaminated objects, linen, dust particles containing dried sputum, other material containing mycobacteria may also develop the infection. Similarly, a risk factor for developing tuberculosis is immunosuppression of any origin, alcohol abuse, old age, and lack of housing and work. In the sputum for tuberculosis there are stick-like structures; if they are detected by simple microscopy, these patients are called smear positive. Such patients are highly contagious. However, the absence of sticks when examined under a microscope does not exclude tuberculosis at all, though such patients are significantly less infectious. Other non-specific indicators, such as an increase in ESR, or C-reactive protein, can also be observed in the patients that confirm the transmission of the disease. 2.1.4 Complications The development of TB infection may lead to the development of different complications if remained untreated. TB is proved to be fatal if proper treatment is not taken. The causative bacteria may penetrate the bloodstream and affect other parts of the body (Hoppe, Kettle, Eisenhut, & Abubakar, 2016). It may cause spinal pain, stiffness, meningitis, Tuberculous arthritis (joint damage), renal and hepatic complications, heart diseases, and HIV/AIDS. 2.1.5 Treatment Tuberculosis is a treatable disease. Treatment should begin as soon as possible, especially in cases of an open form of tuberculosis. Treatment consists of taking a combination of anti-TB drugs. Tuberculosis cannot be cured with a single medicine since the pathogen very quickly develops resistance. Therefore, in order to kill all tuberculosis bacteria, it is necessary to take more than one medicine. Treatment consists of two phases; the intensive phase of treatment, usually 4 drugs for 2 to 3 months and the continuation phase of treatment which involves 2 drugs over 4 months. Therefore, the patient tends to receive several different anti-TB drugs at the same time (Vries et al., 2017). The most common drugs used in the treatment of tuberculosis are rifampicin, isoniazid, pyrazinamide, ethambutol and, streptomycin. 2.2. Demographic of Interest Today, tuberculosis is a significant public health issue, claiming about 5 thousand lives daily. In 2016, about 10.4 million people got affected by this communicable disease. The morbidity and mortality have been declining since 2000, and 53 million lives have been saved particularly with the help of existing methods of diagnosis and treatment. However, the epidemiologic burden of tuberculosis is still enormous (Huang, Lee, Yen, Chen, Yu, 2016). Also, resistance to anti-tuberculosis drugs is also an alarming situation. Every year, 600 thousand people are found to have forms of tuberculosis that require long-term treatment with more potent and expensive dr...