Tuberculosis Epidemiology: Global Public Health Implications and Strategies

Tuberculosis (TB) is one of the most widespread infectious diseases all over the world. More than 95% of TB deaths happen in low- and middle-income countries (Tuberculosis, 2016). However, wealthy regions are not secure. In 2012, Mycobacterium tuberculosis Beijing outbreak occurred in France.

Summary of the Article

The article “Mycobacterium tuberculosis Beijing outbreak in a school in Marseille, France, 2012” concentrates on the case of pulmonary tuberculosis at a technical college (Golesi, Brignatz, Bellenfant, Raoult, & Drancourt, 2013). As the authors underline, it was a rare genotype that had a global distribution.

To begin with, the outbreak description is given. Case 1 was registered in January 2012: it was a 20-year-old male attending the technical school. In June, a college teacher was diagnosed with pulmonary TB: he presented typical symptoms, such as weight loss, fever, and a cough that he had for the previous six months. First-line drug combination therapy was given favorably, but in early July another student (Case 3) presented TB symptoms; the diagnosis was confirmed.

The authors report on the process of contact tracing. Under the investigation, interferon gamma release assays were used on 334 persons including students and the staff of the college. As a result, subclinical pulmonary TB was detected in two students (Case 4 and Case 5) from the same class as Case 3. The hypothesis was formulated: the teacher was the source case. Because his clinical signs were considered the consequences of chronic obstructive pulmonary disease secondary to heavy smoking, there was no early TB identification (Golesi et al., 2013). He continued giving lessons. However, Case 1 did not have direct contact with the teacher.

Further, laboratory investigations are represented. As the molecular testing verified, it was Mycobacterium tuberculosis without mutations associated with rifampicin resistance. According to susceptibility testing, the culture showed no resistance to all first-line antimycobacterials (Golesi et al., 2013). Then, a Beijing genotype for the collected isolates was identified with real-time PCR genotyping. Finally, multispacer sequence-typing attested a genotype MST72 in each case.

In conclusion, the authors state the significance of contact tracing and laboratory investigation. It is vital to improve the early detection of TB. Schools must be integrated to surveillance systems for tuberculosis in France (Golesi et al., 2013).

Epidemiologic Triangle

Considering a communicable or infectious disease, one should pay attention to the following elements: causal agents, susceptible persons, and environmental factors. The relationship among them is stable. Using the example of tuberculosis, it is probable to describe the connection as a triangle since all elements are intertwined.

Causal, or causative, agents are those bacteria, viruses, fungi, parasites that trigger diseases. Caused by bacteria Mycobacterium tuberculosis that most frequently affect lungs, the disease is transmitted through air droplets when people with lung tuberculosis sneeze, cough, or spit (Tuberculosis, 2016). Susceptible persons (hosts) are notable for little resistance against a certain causal agent. Hosts are likely to contract a disease because their immune system is weak. As for the third component, environment, it is a complex of external conditions in which causal agents and susceptible persons are brought together. In the context of tuberculosis, the key risk factors include HIV, malnutrition, diabetes, and smoking. Reportedly, one-third of the world’s population has a latent form of TB, but they do not transmit the disease (Tuberculosis, 2016). The outcome depends on the environment: under unfavorable conditions, a person will soon have an active form of tuberculosis.

Role of the BSN Nurse

Nowadays, there is no doubt that nurses play a prominent role. First of all, they provide direct TB patient care: it is a nurse who regularly contacts with a patient and performs the required treatment. It is necessary for a nurse to identify potential side-effects of treatment and monitor patients’ condition. Moreover, nurses provide education to patients and their family and support them. In relation to tuberculosis Beijing outbreak, is was the matter of primary importance: not only adults but also younger patients were involved. Finally, preventative measures are also significant: nurses perform TB testing, identify possible TB cases, and educate the public.

Health Protection Strategies

In general terms, health protection strategies may be subdivided into clinical and economic measures. In the first case, drug-susceptible TB disease is usually treated with a standard six months course of 4 antimicrobial drugs: rifampicin, isoniazid, pyrazinamide, and ethambutol. (Tuberculosis, 2016). This strategy was implemented in Marseille. Tuberculosis is curable if patients are provided with medicaments and take them as health workers instruct. Economic measures refer to the developing countries: since poverty and overcrowded living conditions account for TB outbreaks, it is urgent to enhance the quality of life and provide accessible medical care for everybody. In this context, World Health Organization pursues several core functions and emphasizes that partnership should become the fundamental principle.

Conclusion

All in all, tuberculosis is far from becoming a disease of the past. Any region may suffer from infectious or communicable disease outbreak as it happened at the technical college in Marseille. Under such circumstances, the role of nurses is pivotal: they provide direct TB patient care, take preventative measures, and educate people. To defeat TB, it is necessary to combine proper medical treatment and economic measures aimed at economic upturn all over the globe.

References

Golesi, F., Brignatz, J., Bellenfant, M., Raoult, D., & Drancourt, M. (2013). Mycobacterium tuberculosis Beijing outbreak in a school in Marseille, France, 2012. Eurosurveillance, 18(2), 1-2.

Tuberculosis. (2016). Web.

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StudyCorgi. "Tuberculosis Epidemiology: Global Public Health Implications and Strategies." October 20, 2020. https://studycorgi.com/tuberculosis-epidemiology-in-global-public-health/.

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StudyCorgi. 2020. "Tuberculosis Epidemiology: Global Public Health Implications and Strategies." October 20, 2020. https://studycorgi.com/tuberculosis-epidemiology-in-global-public-health/.

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