Tuberculosis: Epidemiology, Incidence, Prevalence, and Prevention

Tuberculosis
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Tuberculosis
The Epidemiology Triangle
The epidemiology triangle or triad is a scientific tool used by epidemiologists to explain how a disease is spread (Timmreck, 2002). The triangle consists of a host, agent, and the environment. By addressing each of these points, epidemiologists can conduct epidemiologic investigations, therefore, identifying the best intervention to prevent the transmission of the disease (Scholthof, 2007). For tuberculosis (TB), the agent is mycobacterium. The host is the human being and the environment public gatherings, and communal settings (Ciesielski et al., 1991).
Descriptive Epidemiology
Tuberculosis starts in the lungs of a human being but can affect the entire body. Scientific records show that the disease can be traced as far back as 2400 BC (McCray et al., 1997). However, it was in the nineteenth century that a serious outbreak of the disease occurred. In Europe, the disease killed one in every seven persons. As major cities in the United States (U.S.) became overpopulated, the disease spread into the country. Currently, there are more than two billion people who are infected with the disease. In 2007 alone, there were more than 1.5 million deaths as a result of TB (Young et al., 2016). In today’s society, there are even more potential areas for the spread of TB. Still, healthcare workers are applying as much effort to prevent the spread of the fatal disease. In the U.S., the Centres for Disease Control and Prevention (CDC) reported that in 2009, the number of TB cases had reduced by 4.2% (Young et al., 2016). The risk of more infections is now attributed to HIV illnesses, increased immigration from countries with high incidences of TB, and transmission in high-risk settings such as correctional facilities and homeless shelters (Young et al., 2016).
Incidence and Prevalence of The Disease in The United States
According to the CDC, the U.S. is experiencing a decline in the number of TB cases (CDC, 2019). Still, this is not enough to achieve America’s goal as regards to TB, which is absolute elimination of the disease in the twenty-first century. Eliminating the disease requires an interruption of its transmission while also applying efforts to prevent hidden TB infection. As of 2018, the number of TB cases stood at 9,025. This was a 0.7% decrease from 2017 (CDC, 2019). Also, as of 2018, the incidence rate at the national level was 2.8 cases for every 100,000 persons. This was also a decrease of 1.7% from the number recorded in 2017 (CDC, 2019).
The prevalence of TB in the country has also been attributed to drug resistance. According to CDC records, the number of drug-resistant TB cases has remained constant over the last two decades (CDC, 2019). When TB becomes drug-resistant, it means that the drug is not strong enough to kill the mycobacterium. This poses a significant threat to the healthcare sector’s ability to control TB. In 2018, isoniazid (INH) resistance was the most common. It occurred in 605 cases countrywide (CDC, 2019).
Based on a careful analysis, the CDC found that half of all TB cases reported in 2018 were from four states (CDC, 2019). These states included Texas, California, Florida, and New York. Minority populations are the most affected in each of these states and the entire country. The highest growth in incidence rates witnessed in 2018 was among Alaskan natives and American Indians. Among African Americans, the rates dropped significantly by 6.7% the same year (CDC, 2019).
Added risk factors that have been associated with the disease include excessive alcohol use, diabetes, HIV infections, use of non-injectable drugs, homelessness, and correctional settings (CDC, 2019).
Mortality Rates
The most recent data by the CDC shows that the number of deaths related to TB was 515 as of 2017 (CDC, 2019). This was a slight decrease from the 528 deaths recorded in 2016 (CDC, 2019). A careful assessment of the mortality rate as a result of TB showed that it was prevalent among people who were born in countries with high incidence rates (Beavers et al., 2018). For instance, in 2018, a large number of TB related deaths in the country were among people not born in the U.S.
Cohort Study
In their study, Goswami et al. (2012) acknowledge that the treatment of latent TB infections is key to eliminating TB within the U.S. Also, the researchers find that for the treatment to be a success, it needs to be supported by therapeutic regimens. According to Goswami et al. (2012), the effectiveness of therapy, is, however, limited to a patient’s willingness to initiate and complete treatment. Hence, in their study, the scholars aimed at evaluating the geographic, medical, demographic, attitude-based, and behavioural factors associated with treatment initiation and completion among individuals presenting with latent TB infection in a public health clinic (Goswami et al., 2012).
The researchers used data collected through structured interviews, clinic intake forms, administered questionnaires, and national census data (Goswami et al., 2012). All persons above 17 years from the Wake County Health and Human Services Tuberculosis Clinic in Raleigh, North Carolina, were considered for the study. Those registered had to meet the latent TB infection treatment guidelines proposed by the CDC between January 2008 and May 2009. The scholars also took into account the traditional and behavioural factors associated with TB. In addition to this, they included a three-level (high, low, moderate) remedial risk variable based on risk factors for progression and transmission of TB in the analysis. Neighbourhood poverty level and clinic distance were also included in the analysis based on the percentage of residents living below the poverty level. All the variables with a significance level (<0.10)...