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Health Behaviors That Contribute to Contracting TB

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Health Behaviors That Contribute to Contracting TB

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According to the World Health Organization (2018), ten million people contract tuberculosis (TB) annually. TB remains as the leading infectious cause of mortality worldwide, with 1.3 million deaths in 2017. The causative agent of TB is Mycobacterium tuberculosis. It is a multisystemic disease affecting different organs of the body, most commonly the lungs. Patients with active pulmonary tuberculosis classically present with 3-week cough, anorexia, fever, night sweats, fatigue and hemoptysis (Herchline, 2018). On the other hand, some people who are infected with TB bacteria may not manifest these signs and symptoms; hence, they have latent TB infection (LTBI) (CDC, 2016).
TB is spread into the air by people with active infection; for instance, when they cough and sneeze among others. While not all develop the actual disease, there are particular groups of people who have higher risk of acquiring TB. These include persons with immunosuppressed conditions and people who have direct contact with TB patients that includes family members and healthcare workers (CDC, 2016; Uden et al., 2017). Furthermore, meta-analysis of Uden et al. (2017) revealed a prevalence estimate for LTBI among healthcare workers of 37% and have three times greater risk of having active TB in comparison to the general population. On this paper, we will further look on the health behaviors that can contribute to contracting TB and how the healthcare team should respond and communicate with regards to the disease. Furthermore, we will relate it into Sara’s case, a healthcare worker who contracted TB.
Health Behaviors That Contribute to Contracting TB
There are several risk factors that contribute to the progression of TB from exposure, infection to cure. Most literatures classified these into two: individual factors and socioenvironmental factors.
Individual factors include immunocompromised state, malnutrition, age, diabetes, tobacco and alcohol consumption (CDC, 2016; Duarte et al., 2018; Narasimhan et al., 2013).
Immunocompromised individuals, particularly, people with Human Immunodeficiency Virus (HIV) have 20 times higher risk of coinfection with TB as compared to others (WHO, 2018). HIV targets human cell-mediated immunity which is essential for defense mechanism against TB bacteria. As a result, TB patients with HIV coinfection progressed much rapidly and have poorer outcomes (Narasimhan et al., 2013). Other factors such as malnutrition, extremes of age and diabetes have similar scenario. These groups of people have impaired and weakened immune response; hence, they are more prone to TB infection. A study estimated that 27% of the population with TB are malnourished (Duarte et al., 2018). TB patients who have with diabetes, on the other hand, have increased risk of death up to two times as compared with nondiabetic—as both innate and adaptive immune responses are attacked by diabetes (Narasimhan et al., 2013).
Unhealthy lifestyles such as cigarette smoking and alcohol drinking are also linked to higher risk of acquiring TB. WHO data (2018) showed that smoking and alcohol abuse attributed to 0.83 million and 0.49 million on the number of TB incidences last 2017. Research revealed that both alcohol and tobacco are associated with TB cavitations and delay of smear conversions (Duarte et al., 2018). Smokers’ vulnerability to TB is due to impaired mucosal secretion and phagocytic ability of macrophages in the lungs. On the other hand, alcohol affects cytokine production leading to impaired immunity (Narasimhan et al., 2013).
In addition to the previous risk factors, there are also socioenvironmental factors that contribute to the incidence and prevalence of TB worldwide. Some of these include: proximity to a known case, social stigma, poverty and poor health systems.
Health care workers, together with TB patients’ household contacts, are more susceptible since TB is acquired through airborne transmission. Moreover, overcrowding and poor living conditions favor the spread and thriving of TB bacteria (Duarte et al., 2018; Narasimhan et al., 2013).
Furthermore, social stigma about TB is still present even in the healthcare setting, as seen in Sara’s case. Stigma dissuades individuals to seek consult for TB; hence, causing delay in diagnosis, increase in severity and spread of the disease (Waisbord, 2005). It is therefore essential to build awareness first into the healthcare team, then into the community to strengthen strategies towards reduction of TB incidences.
Finally, poor health systems play a key role on the prevalence of TB worldwide. Delays in diagnosis and undertreatment are the two primary outcomes of inadequate facilities and surveillance systems. On this regard, WHO’s current efforts on End TB strategy are geared towards service delivery and financial support on countries with high TB burden (Waisbord, 2005; WHO, 2018).
U.S. Surveillance Systems on TB
The case of Sara shows that community health workers can easily contract TB. In 2015, United States National Tuberculosis Surveillance System estimated that 3.9% of total TB cases were diagnosed from healthc...
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