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Tuberculosis: Diagnostics, Prevention, and Management

Tuberculosis General Information

Tuberculosis remains a serious problem for modern society. In 2017, it was estimated by World Health Organization as a leading pathology causing death from one infectious agent (Abongo et al., 2020). The disease is indeed a major factor in mortality in low-income and middle-income countries. Tuberculosis is predominantly a disease of homo sapiens, even though it affects animals too. The disorder is caused by Mycobacterium tuberculosis and transmitted via air, contact, food (eating meat or milk of an infected animal), or from an infected mother to her fetus. The most common way of spreading the disease is through the air, after breathing in tubercle bacilli in air droplets coming from a sick person’s speaking, coughing, or sneezing.

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To be able to infect sick others, this person also must have a special destructive form of pulmonary tuberculosis. On the other side, to become infected, a recipient has to have a weak immune system or be immunocompromised. The latter refers to individuals on chemotherapy, with HIV or AIDS, with diabetes mellitus, having transplantation interventions, or drug and alcohol abusers. Decreased level of the immune system predisposes such patients to develop a disease. It was proved that only 10-15% of the population usually develops tuberculosis; others have a latent form after the first contact. The major signs of tuberculosis are cough, fever, hemoptysis, chest pain, fatigue, and weight loss (Stanhope & Lancaster, 2017). Hemoptysis, fatigue, and weight loss are late symptoms of the disease and usually occur after years without treatment.

The Role of a Nurse in Community Health TB Treatment

Nurses play an essential role in tuberculosis prevention and management. Nurses are the ones that learn and implement federal and state programs supporting and treating people with low income and tuberculosis. Nurses can participate in the identification of sick patients and cooperate with other organizations that can help track infected individuals. Nurses also have an important role in social education as they can work with risk populations, infected patients, and young civilians, educating them about the disease. The population should know the major disease signs and their rights. Not all people know they can use state programs and receive full treatment, be tested, and even be hospitalized with serious destructive forms. Nurses participate in screening programs allowing identify the disease in its early stages.

Diagnosis of TB

Another essential nurse’s role is diagnostics and treatment of the patients: doing the screening, reporting the cases, acting prompt with diagnosis establishment, hospitalizing the patient, and developing his treatment plan. It is also essential for nurses to be up-to-date and know the current guidelines for treating multi-resistant bacteria (Shinha et al., 2019). Diagnostics of tuberculosis involve chest X-Ray, sputum smears for acid-fast bacilli, cultures for M. tuberculosis, and tuberculin skin test (TST).

The latter should be done according to the rules, and the results are also dependent on the category of the patient. Mantoux is proven to be the most effective TST; it is usually injected in the forearm subcutaneously at 0.1 ml with five tuberculin units (Stanhope & Lancaster, 2017). The results are estimated within 48-72 hours by measuring the induration. The test can be positive if the induration is 5, 10, or 15 mm. The table on the slide narrates the various positive test results depending on the patient’s history, age, and other factors. If the induration is 5 mm, the result is positive if the patient is immunocompromised or contacted with sick people with TB. The result is positive with 10 mm induration if the patient has comorbidities, injects drugs and has no HIV, was in jail, or if the patient is a child under four years old. For all other individuals older than four years and with no risk factors, the maximum measurement is 15 mm.

Nurses play an essential role in community health regarding the prevention, screening, and treatment of tuberculosis. It is a social disorder that can cause serious consequences for the population. To prevent the worsening of its spread, healthcare workers and volunteers must work together, educate themselves and others to identify tuberculosis in its early stages and provide treatment for all infected citizens.

References

Abongo, T., Ulo, B., & Karanja, S. (2020). Community health volunteers’ contribution to tuberculosis patients notified to National Tuberculosis program through contact investigation in Kenya. BMC Public Health, 20(1184), 1-8. Web.

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Stanhope, M., & Lancaster, J. (2017). Foundations for publication health in community/public health nursing (5th ed.). Mosby.

Sinha, P., Shenoi, S. V., & Friedland, G. H. (2019). Opportunities for community health workers to contribute to global efforts to end tuberculosis. Global Public Health, 15(3), 474-484. Web.

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