Epidemiology and Communicable Diseases: Tuberculosis
Tuberculosis (TB) is one of the infectious diseases which affect the lungs. Unlike other diseases, this communicable syndrome is caused by more than a single agent. Today, TB is the second leading killer in the world. In fact, a report posted by Mclntosh (2017) on the Medical News Today shows that over 1.8 million people die from the syndrome while 10.4 million falls sick. In the nineteenth century, this epidemic was widespread in North America and Europe until the microbial causes were identified. Because of this discovery, vaccines and drugs were introduced; thus, making people believe that the disease was defeated. In fact, even the UN had predicted that TB would be no more by 2025 (Mclntosh, 2017). However, the situation worsened in the subsequent years leading to the WHO decision to declare it a global emergency. The disease continues to cause havoc among the global population leading to this research.
Description of TB
The TB is a communicable disease caused by different infectious agents. Many health practitioners have distinguished the disease into two based on the TB infections. To this effect, they have classified them into active and latent TB (Debi, Ravisankar, Prasad et al., 2014). Active TB is caused by bacteria with symptoms, which make it possible to be transmitted to others. On the other hand, in latent TB, the infectious agent or bacteria is confined in the body where it remains in an active form. These inactive bacteria show no symptoms; hence making them not contagious. Studies have predicted that about thirty percent of the global population has latent TB and the possibility of the inactive TB becoming active is imminent. The individuals whose immune systems have compromised because of malnutrition, smoking, and HIV are vulnerable (Mclntosh, 2017).
The major cause of this communicable disease is the Mycobacterium tuberculosis complex (Bernando & Roncarati, 2012). This bacterium is unique because it can be spread through the air, especially whenever an individual with the syndrome coughs, talks, laughs, sneezes, and spits. Although this disease is communicable, catching it is never easy because the chance to catch it from a person whose lungs are infected, especially a stranger is difficult. However, a person can contrast it when an individual interacts with workmates and family members. Sometimes the disease can be transmitted through droplets and mucus or saliva when expelled through the air.
Currently, studies are yet to provide symptoms for latent TB because the inactive TB never shows signs of infection (Mclntosh, 2017). Nonetheless, the symptoms may develop gradually but individuals need regular checkups. Although it can affect any organ, the lungs are the most common. The most common symptoms of active TB include a cough, fatigue, weight loss, chest pain, fever, and night sweats. Loss of appetite, chills, and shortness of breath could also be attributed to TB.
When diagnosed with TB, doctors can prescribe proper treatment and prevention measures to the patient. In fact, there are several antibiotics which physicians have recommended to treat TB because of its bacterial infections nature. For patients with TB lung infections, doctors would combine up to 4 antibiotics for at least two months of therapy. The most common antibiotics which doctors prescribe for TB patients include ethambutol, isoniazid, pyrazinamide, and rifampin (Mclntosh, 2017). The complications have also been identified by different studies, especially where the syndrome is never treated swiftly (Debi et al., 2014). Although this contagious disease affects the lungs and spread through the air, it can be spread through blood leading to fatal complications including heart disorders, joint damages, meningitis, kidneys and liver damages, and spinal pain.
Demographic most affected
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TB remains the leading killer disease in the world as reported by WHO in 2018. By 2016, the WHO reported that 10.4 million people were suffering from the scourge. The world lost 1.7 million people to the disease who included about 0.4 million people suffering from HIV. Unfortunately, it has emerged that the majority of the TB death cases are reported in middle- and low-income economies. China, South Africa, Nigeria, Pakistan, Indonesia, and the Philippines are the leading countries in terms of incidences because they account for about 64 percent of the total global infection. The multidrug-resistant TB has become the public health crisis. Today, the incidence of TB is declining at 2 percent annually and WHO predicts the rate would accelerate to about 5 percent by 2020 (WHO, 2017).
Although TB can affect anyone, there are certain groups who are more vulnerable. In the United States, for instance, the foreign-born individuals seem to be affected disproportionately (ALA, 2013). It affects all age groups, but it mostly affects people and young adults residing in the emerging economies. Regarding gender, males were likely to contract the syndrome than male. Nonetheless, in 2011, the incidence reduced by over 50 percent in both genders (ALA, 2013).
The determinants of health affecting TB
Social determinants of health have affected TB as explained by Hargreaves, Boccia, Evans et al. (2011). The growing consensus has indicated that controlling TB in middle- and low-income patients will need significant investments in treatment, diagnostics, and control programs. This falls under the policymaking determinants which will help in improving population health. The social determinants of TB entail the use of practical ideas that would support the efforts to reduce the scourge. The social determinants encompass interventions beyond the health sector including urban planning and social protection; therefore, strengthening TB control (Millet et al., 2013). This shows that the key risk factors would include overcrowding and poor ventilation in communities, homes, and workplaces; hence, exposing healthy individuals to the disease. Studies have also found that hunger, malnutrition, and poverty can increase the severity of clinical results and susceptibility to infection (ODPHP, 2018). In most cases, TB patients who experience severe coughs experience economic and social barriers; thus, delaying appropriate diagnosis leading to stigmatization.
The epidemiologic triad
The epidemiological triad remains the most popular tool that has enhanced explanation of the spread of diseases in communities. The triad consists of different factors including an environment, host, and agent which make it possible for the identification of interventions, transmission and investigate the epidemiology of TB (Bernando & Roncarati, 2012). Mycobacterium tuberculosis is an agent which transmits the disease. The Mycobacterium tuberculosis complex is a rod with the potential of reproducing slowly. The bacterium is hypersensitive to ultraviolet light and heat. Although the disease affects the lungs, it can have an impact on other organs, such as kidneys, reproductive organs, joints, bones, lymph nodes, and intestines (Raviglione & Sulis, 2016). Since 1990, THE TB death rates have declined by over 35 percent despite being the leading infectious killer (WHO, 2017).
The bacterium is spread through airborne droplets, talking, sneezing, and coughing. With smaller droplets in the air left by an infected individual, the healthy person can inhale the infected air. The TB can also be passed from one family member to another than strangers (Raviglione & Sulis, 2016). Mycobacterium tuberculosis is also an agent of the disease because any susceptible person (host) can readily spread it by exposing the respiratory system in an environment or public gathering or communal settings. Other environmental factors which can expose a person to the disease include overcrowded housing, immigrants, homeless, racial minority, prison systems, and impoverished (Bernando & Roncarati, 2012).
Role of the public health nurse
Healthcare workers are some of the healthy individuals whose immune systems can be susceptible to the syndrome. This is because they are exposed to illness in the hospitals and public health facilities. Since the public health nurses handle the TB patients, they are at risk for the disease (Raviglione & Sulis, 2016). Importantly, these professionals are responsible for treating and detecting the actively infected individuals; hence, prevent TB transmission within the clinical setting.
The public health nurses always engage in surveillance and investigation of the disease. During the investigation, the infection control nurses, clinicians, or the pharmacists have the capacity to report cases of active TB cases. This is because early reporting is necessary for controlling and preventing the disease. The nurse has the capacity to collect data from the infected individuals to compare infected patients and the trends. Since health departments conduct contact investigations regularly, the cases of pulmonary TB can be detected and acted upon. The health department through the staff would notify the exposed contacts; thus, allowing the contact to schedule for testing. The health department staff is expected to conduct a follow-up test some months after the last exposure to determine whether the case is active or inactive. Therefore, the health nurse strives to work collectively with the community and care providers.
