Causes
Bacteria, which lives in the soil is the main cause of tuberculosis. It spreads to humans through a mechanism, which involves breathing the dusty air where the bacteria are present. Further, breathing the air coughed out by an infected person or by drinking milk from an infected cow can cause infection of the disease.
Symptoms
A common symptom of TB is the presence of a productive cough that can last more than two weeks. Other respiratory symptoms, which include chest pains, shortness of breath and haemoptysis accompanies the productive cough (World Health Organization, 2010). Additional symptoms include weight loss, night sweats, fatigue, coughing up blood and loss of appetite (World Health Organization, 2010).
Mode of Transmission
Several modes of transmission are present. One of the modes of transmission is by breathing the air released or coughed up by a person infected with tuberculosis (Brown and Inhorn, 2013). Secondly, intimate contact and touch with an infected person is also another mode of transmission. Further, transmission of tuberculosis can be through contact with food that an infected person has touched and coming into contact with utensils such as glasses, forks and plates used by infected person (Brown and Inhorn, 2013).
Complications
Common complications of tuberculosis include miliary disease, disseminated tuberculosis and tubercular meningitis (Parija, 2009). According to Parija (2009), other complications include pleural effusion and pneumothorax. Complications in the small intestines include intestinal perforation obstruction and malabsorption. In the renal area, complications include hydronephrosis and autonephrectomy.
Treatment
Treatment of tuberculosis is essential to prevent death and reduce transmission of tuberculosis. Furthermore, treatment prevents development of drug resistance, cures and restores quality of life in a patient. Several anti-tuberculosis drugs are available. These drugs include Isonazid, Rifampicin, Pyrazinamide, Ethambutol and Streptomycin. Provision of these drugs is in dosages based on the age and body weight of the patient.
Demographic of Interest (mortality, morbidity, incidence, and prevalence)
Tuberculosis occurs on a global scale. According to Webber (2009), countries with low prevalence have less than 10% of the children under the age of 15 with a positive tuberculin test. These are countries in Western Europe and North America. High rates of tuberculosis are common in Africa, Asia and South America. The mortality rates in the United States are highest in older age groups (Nelson and Williams, 2014). This high mortality in older individuals is because of the fact that the older individuals were born during a period of higher risk of infection of tuberculosis. The incidence and prevalence rates of tuberculosis differ in different parts of the world. For instance, the South Asia Region has the highest number (3,200,000) of tuberculosis cases in the WHO (World Health Organization) regions (Nelson and Williams, 2014). The per capita rate of tuberculosis is highest in Africa region with 276 cases per 100,000 reported in 2010 (Nelson and Williams, 2014). The South East Asia region and the Africa Region account for nearly 70 percent of tuberculosis infections.
Determinants of Health
Social Environment
Social factors that influence the development of tuberculosis include relationships with family and friends, neighbors and workplace colleagues. A social environment has access to facilities such as public parks, social institutions such as schools and recreational facilities. Social environment influences how people live (Hickey, and Brosnan, 2012). Because of certain economic conditions such as poverty, people may tend to live in crowded conditions that tend to increase the risk of transmission of tuberculosis (Hickey, and Brosnan, 2012). Lack of access to health resources may prevent people from accessing screening resources for tuberculosis infection. In social institutions such as correctional facilities and workplaces, individuals are at high risk, as they tend to congregate together (Hickey, and Brosnan, 2012).
Lifestyle
Lifestyle factors may include risky behaviors such as tobacco smoking, drug abuse, alcohol, poor diet and lack of physical activity. Individuals with these risky behaviors have an increased risk of infection of tuberculosis (Hickey, and Brosnan, 2012).
Biology and Genetics
Physical and health problems influence the rate of infection. In older individuals, infection increases because of the aging of cells, as most of the cells have aged and lack the capacity to function at their full potential. HIV weakens the immune system and this tends to increase the rate of tuberculosis infection (Hickey, and Brosnan, 2012).
Epidemiologic Triangle
The use of the epidemiological triangle is to provide an understanding of the cause of a disease based on the interaction of several factors. These factors include host, agents and the environment.
Agents of Tuberculosis
The agent present for infection of tuberculosis to occur is bacteria. Treatment of bacteria is possible using antibiotics. The emergence of bacteria strains that are resistance to antibiotics proves to be a challenge towards the treatment of tuberculosis.
Host
For the infection of tuberculosis to develop, the agent, which in this case is bacteria, must have the ability to infect a host (Ivanov and Blue, 2007). The host’s ability to fight off infection determines the degree of infection. For instance, in a human host with reduced immune system, tuberculosis infection will occur rapidly and may result to death, as is the case in HIV infected individuals (Ivanov and Blue, 2007).
Environment
Environmental factors such as poverty, drug use, homelessness increase the risk of infection of individuals to tuberculosis. The environment influences both the agent and the host. Community resources and access to health and social services are factors that influence the rate of spread of tuberculosis (Friis, and Sellers, 2014).
Role of the Community Health Nurse
A community health nurse will be responsible for educating clients regarding medications, dosages and the likely side effects that may result from the tuberculosis medication. According to (Maurer, and Smith, 2013), a community health nurse ensures documentation of the effectiveness of treatment and conducts a risk assessment of rate the rate of infection of the disease. The community health nurse will be responsible for providing screening services. Additionally, the community health nurse is actively involved in the dissemination of information to the public and ensures provision of follow-up care to the tuberculosis patients.
National Agency
A national agency that addresses tuberculosis is the National Tuberculosis Controllers Association (NTCA). This agency develops a collective voice for tuberculosis control and elimination. Additionally, it advocates for policies and laws that will progress tuberculosis control and elimination at state and local levels in the country. The CDC is another organization that addresses the problem of tuberculosis. It ensures this by increasing access to tuberculosis drugs and collaborating with other government agencies and partners to improve infection control measures. Additionally, the CDC provides training and support to healthcare providers to promote correct diagnosis and proper treatment, which helps to prevents drug resistance.
References
Brown, P. J., & Inhorn, M. C. (2013). The anthropology of infectious disease: international
Health perspectives. Amsterdam: Routledge.
Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice. Burlington, Mass: Jones & Bartlett Learning.
Hickey, J. V., & Brosnan, C. A. (2012). Evaluation of health care quality in advanced practice nursing. New York: Springer Pub. Co.
Ivanov, L. L., & Blue, C. L. (2007). Public health nursing: Leadership, policy, & practice. Australia: Delmar Cengage Delmar.
Maurer, F. A., & Smith, C. M. (2013). Community/public health nursing practice: Health for families and populations. St. Louis, Mo: Elsevier/Saunders.
Nelson, K. E., & Williams, C. M. (2014). Infectious disease epidemiology: Theory and practice. Burlington, MA: Jones & Bartlett Learning.
Parija. (2009). Textbook of Microbiology & Immunology. New Delhi: Elsevier India.
Webber, R. (2009). Communicable disease epidemiology and control: A global perspective. Wallingford, Oxfordshire: Cabi.
World Health Organization., & Stop TB Initiative (World Health Organization). (2010). The treatment of tuberculosis: Guidelines. Geneva: World Health Organization.
