Patterns and Distribution
Tuberculosis is an infectious disease that occurs when Koch’s bacilli enter the human body. It is caused by microorganisms of the Mycobacterium tuberculosis complex group, which are transmitted by airborne droplets and mainly affect the lungs. The prevalence of the disease is associated with a simple transmission route and a high spread rate. A severe course characterizes the disease due to the breadth of the microorganisms involved.
Data from the Centers for Disease Control gather information on TB cases yearly. According to the CDC, in 2020, the incidence of tuberculosis in South Carolina was less than 67 cases per 100,000 population (Filardo et al., 2022). In 2021, the incidence was already 88 cases, probably because of improved diagnosis of Covid-19 co-infection (Filardo et al., 2022). There has been a decrease in cases since 2010, with a drop from 153 cases to 67 cases (TB Date & statistics, n.d.). Significant differences in incidence were found depending on gender: males were predominantly affected at 71.64% (Filardo et al., 2022). The primary age of the disease was 19-48 years (34%), and only 5% were children under 18 years of age (TB Date & statistics, n.d.). There are no differences by race: there is only a 4-5% difference between African Americans, whites, and Asian Indians. Nevertheless, more than 80% of cases are in non-Hispanic populations (TB Date & statistics, n.d.). The decrease in case of rates from 2019 can hardly be attributed to the presence of Covid-19 because the practice of identifying TB comes with official risk assessments and outside of other diseases.
Recommendations
South Carolina is currently taking steps to improve the epidemiological situation of tuberculosis cases. It is primarily governed by legislation in Title 44 in Chapter 31. The law requires physician and administration reports and bacteriological and pathology laboratory reports. In addition, Article 3 regulates emergency isolation for persons with suspected or confirmed tuberculosis (South Carolina Code of laws unannotated, n.d.). Secondary laboratories provide state-of-the-art analyzers to diagnose active or latent tuberculosis. They use the Bactect MGIT 960 system, a required part of diagnosis and regulated by the Centers for Medicare and Medicaid (Testing for diagnosis of active or latent tuberculosis – CAM 336, 2021). South Carolina currently uses interventions to prevent tuberculosis through prevention and mandatory testing once every four times. The administration should introduce new technologies such as serologic blood tests and improved immunologic tests. In addition, it is recommended that prevention be expanded through changes in treatment management and pharmacotherapy tactics.
Epidemiologic Study Designs
Designs within the studies of epidemiology that are aimed at responding to a hypothesis can range in complexity and can be observed as being on a hierarchy. As such, a less complex and initial design can include clinical observation which would not present a viable response to a hypothesis. A descriptive and case-study design allows for the reduction of variables and a better insight into the functions of a hypothesis but is still flawed as it observes an insulated scenario. Cohort studies and randomized trials are aided by larger sample sizes that allow for new and less biased findings.
Systematic reviews are likely the most successful in proving or disproving hypotheses as they observe phenomena and events that occur on a larger basis, such as regionally, nationally, or even globally. Within epidemiology, a systematic review has the ability to track exposure and outcomes of diseases in varied settings.
References
Filardo, T., Feng, P.-J., Pratt, R. H., Price, S. F., & Self, J. L. (2022). Tuberculosis – United States, 2021. Centers for Disease Control and Prevention: Morbidity and Mortality Week Report, 71(12). Web.
South Carolina Code of laws unannotated. (n.d.). South Carolina Legislature. Web.
TB Date & statistics. (n.d.). South Carolina Department of Health and Environmental Control. Web.
Testing for diagnosis of active or latent tuberculosis – CAM 336. (2021). South Carolina Blues. Web.