Tuberculosis (TB) is an infectious disease that affects the lungs and that is caused by a strain of bacterium knows as Mycobacterium tuberculosis. Primarily, it affects the lungs even though it can spread to other parts of the body including the brain, lungs, and the liver. There are two types of TB namely, latent and active TB. In latent TB, the bacterium remains in the host in an inactive state that cannot cause infection. CDC estimates that more than 2 billion people have this type of TB. People with active TB show symptoms of the disease because the bacterium resides in the body in an active and infectious state.
Description of the Disease
Cause and Transmission
As mentioned earlier, TB is caused by Mycobacterium tuberculosis that is usually spread through the air (Cobbett, 2014). Therefore, TB is an airborne disease. It is transmitted when an infected person talks, sneezes, coughs, or spits. TB is contagious. However, getting infected is difficult especially from a stranger.
Symptoms
Symptoms of TB include chronic coughing, fatigue, chills, night sweats, fever, loss of appetite, and loss of weight (Raviglione, 2016). TB primarily affects the lungs. However, it can spread to other parts of the body through the bloodstream and cause different symptoms.
Complications
TB can cause serious complications if it spreads to other parts of the body including the brain, the liver and kidneys, the heart, and bones. Infections of the bones cause pain and joint destruction, infection of the brain causes meningitis, and infection of the liver and kidney impairs the proper filtering of waste material (Raviglione, 2016). A condition called cardiac tamponade results from the heart’s infection with TB. Other complications associated with TB include spinal pain, heart disorders, and back pain and stiffness (Cobbett, 2014).
Treatment
The treatment for TB depends on whether the patient has latent or active TB. Latent Tb is treated using three main drugs namely isoniazid, rifapentine, and rifadin (McHugh, 2013). These drugs are administered in four different schedules as recommended by the physician. On the other hand, active TB is treated using isoniazid, rifadin, pyrazinamide, and ethambutol (McHugh, 2013).
Demographic of interest
According to CDC, at least 30% of the world’s population has contracted TB either in the latent or active state (Raviglione, 2016). New infections occur in approximately 1% of the world population each year even though about 90% of the cases are latent. The World Health Organization (WHO) lists TB as the second most deadly infectious disease that causes most deaths annually (Raviglione, 2016). The prevalence of the disease varies with age. For instance, in Africa, it mainly affects young people while in the United States it affects older people.
Determinants of Health
Determinants of health are factors that influence the likelihood of individuals staying healthy or contracting diseases. Categories of determinants of health include health services, biology and genetics, social factors, and individual behavior.
Poverty
Poverty is a major determinant of TB because poor living conditions increase the risk of infection. For instance, crowded and poorly ventilated living and working conditions enhance the transmission of TB. Poverty is also associated with TB’s risk factors that include undernutrition, poor general health knowledge, and lack of empowerment (Raviglione, 2016). Studies have shown that poverty alleviation lowers the prevalence of TB transmission. In addition, it lowers the risk of the disease’s progression after infection.
Policies
Policy-making is an important determinant of tuberculosis. The most effective social, economic, and public health policies promote healthy diets and lifestyles, reduce food insecurity, promote poverty reduction, and improve living and working conditions (Raviglione, 2016). In addition, effective policies address the health and financial situations of low-income families and improve living conditions in congregate settings such as hospitals and correctional facilities.
Health services
Access to health services can impact the development of TB because early diagnosis and treatment is important. Factors that decrease access to health services include poverty, high cost, lack of availability, and lack of insurance cover (Raviglione, 2016). Access to medical care is important because the development of TB can be averted through early diagnosis and treatment.
Individual Behaviors
Individual behaviors such as tobacco use and substance abuse influence the development of TB. Drug use and alcohol abuse weakens the immune system and increases the progression of the disease after infection (Raviglione, 2016). In addition, they increase the body’s vulnerability to TB. Studies have shown that tobacco use increases the risk of contracting TB.
The Epidemiologic Triangle
The epidemiologic triangle is a model of infectious disease causation that comprises three aspects namely, an agent, a host, and the environment. The triad represents the interactions between a causative agent and a host.
Agent
The agent for TB is an intracellular parasitic bacterium known as Mycobacterium tuberculosis. The bacterium is slow growing and aerobic, and is transmitted from infected to healthy individuals through respiratory droplets released through coughs, sneezes, and spits (Raviglione, 2016).
Host
Mycobacteria are found in large quantities in soil and water. However, Mycobacterium tuberculosis is primarily found in human beings (Raviglione, 2016). The microorganism thrives in humans with weakened immune systems.
Environment
The main environmental factors that influence the development of TB include living and working conditions, malnutrition, tobacco use, and excessive alcohol use. Indoor air pollution, poor ventilation, and overcrowded living conditions increase the risk of infection (Raviglione, 2016).
Role of Community Health Nurse
Community health nurses play key roles in the prevention and management of tuberculosis. First, they identify tuberculosis symptoms and isolate infectious patients form the rest of the population (Raviglione, 2016). Nurses posses the knowledge and skills to pick up subtle clues and evaluate the presence of risk factors that could point toward TB infection. In that regard, it is important for community health nurses to be competent in detecting and providing quality health care. Second, they provide health education to communities and families on tuberculosis risk factors, symptoms, complications, prevention and treatment (Raviglione, 2016). Health education on TB prevention is the most important aspect of management. Third, community health nurses collect data, analyze it, and prepare reports on the prevalence, incidence, and effects of TB in communities (Raviglione, 2016). Moreover, they monitor the effectiveness of various treatment schedules. One of the most important aspects of TB prevention is research. In that regard, it is important for community health nurses to participate in research at all levels. Research is one of the most critical components of community nursing. Therefore, community nurses should design, implement, and evaluate outreach programs in communities that focus on the detection and treatment of TB patients (Raviglione, 2016).
National Tuberculosis Controllers Association
The National Tuberculosis Controllers Association (NTCA) is a nonprofit organization founded in 1995 to combat tuberculosis. It was created with guidance from the Centers for disease Control and Prevention. The organization’s mission is to enhance public health by championing the elimination of tuberculosis in the United States by applying the concerted efforts of state, local, and territorial initiatives. NTCA contributes to resolving and reducing the impact of TB by counseling agencies, organizations, and task forces on issues related to TB prevention, collaborating with organizations to promote TB control, and advocating for policies and laws that promote TB elimination. NTCA also supports other organizations and agencies that are involved in programs that focus on Tb control and elimination. Finally, it collaborates with organizations and agencies that fight TB including Stop TB USA, Results International, the American Lung Association, and the Association of Public Health Laboratories.
Conclusion
Tuberculosis is an infectious disease that is caused by the bacterium Mycobacterium tuberculosis. Symptoms include chronic coughing, fever, chills, loss of appetite, and loss of weight. Treatment depends on whether a patient has latent or active TB. It is important for patients to complete their treatment plans regardless of whether symptoms go away after a few days or weeks. Common complications include meningitis, heart disorders, liver and kidney problems, and spinal pain and joint destruction. The efforts of organizations such as CDC, WHO, and NTCA have lowered the incidence and prevalence of TB in the US and the world.
References
Cobbett, L. (2014). The causes of tuberculosis. London, England: Cambridge University Press.
McHugh, T. D. (2013). Tuberculosis: Diagnosis and treatment. New York, NY: CABI.
Raviglione, M. C. (2016). Tuberculosis: The essentials (4th ed). New York, NY: CRC Press.