Epidemiological Studies of Tuberculosis Qualitative Research

Introduction

Tuberculosis is a contagious disease, which mainly affects pulmonary system, but can affect kidneys, brain, and bones. The causative agent of tuberculosis is a bacterium called Mycobacterium tuberculosis. Tuberculosis is among the leading causes of deaths globally because it is an infectious disease, which spreads through the air.

Epidemiological studies have revealed that tuberculosis is prevalent among people living with HIV/AIDS in low-income countries because of compromised immune system and poor accessibility to healthcare services (Pang et al., 2014; Pawlowski et al., 2012). The revelation implies that immune system and accessibility of healthcare services play an important role in prevention of tuberculosis.

World Health Organization (2014) reports that tuberculosis 9 million people contracted tuberculosis in 2013 out of which 1.5 million people died (360,000 living with HIV/AIDS). These statistics indicate that tuberculosis is the leading cause of deaths globally and is prevalent among people with HIV/AIDS in epidemic regions, such as low-income countries. In this view, the essay examines global epidemiology of tuberculosis in epidemic regions such as the United States, Sub-Saharan Africa, and Asia.

Epidemiology

The United States

The prevalence rate of tuberculosis in the United States is the lowest when compared to the prevalence rates in Sub-Saharan Africa and Asia. According to Centers for Disease Control and Prevention (2011), 10,528 cases of tuberculosis occurred in 2011, which amount to an incidence rate of 3.4 cases in every 100,000 persons.

Epidemiological statistics indicate that tuberculosis is prevalent in states such as Alaska, District of Columbia, and Hawaii for they have incidence rates of 9.3, 9.1, and 8.9 respectively (Centers for Disease Control and Prevention, 2011; Pawlowski et al., 2012). The epidemiological statistics, therefore, indicate that prevalence of tuberculosis varies from one state to another with Alaska, District of Columbia, and Hawaii having the highest incidence rates.

In the United States, there is disproportionate prevalence of tuberculosis according to race. According to the report of Centers for Disease Control and Prevention (2011), the incidences rates of American Asians, African Americans, and White Americans are 20.9, 6.3, and 0.8 respectively.

Epidemiological study undertaken to establish the prevalence of tuberculosis among American Indians shows that their mortality rate is 5 times that of national average (Pang et al., 2014). The incidence rates of tuberculosis among African Americans are considerably higher than that of White Americans owing to poverty (Hotez, 2008). Place of birth determine predisposition to tuberculosis in the United States.

Other epidemiological studies have indicates that children of foreign parents and foreigners have higher incidences of tuberculosis when compared the children of Americans and Americans (Pang et al., 2014). Regarding co-infections, World Health Organization (2014) holds that HIV/AIDS contributes to the occurrence of tuberculosis. Hence, it is evident that the prevalence of tuberculosis in the United States varies according to race, place of birth, HIV/AIDS.

Sub-Saharan Africa

The prevalence of tuberculosis in Sub-Saharan Africa is very high because it has predisposing factors such as HIV/AIDS and poverty. Countries in Sub-Saharan Africa such as Congo, Kenya, Uganda, Tanzania, Nigeria, Zambia, Liberia, and Mali, amongst other have high incidences of tuberculosis.

Mboowa (2014) states that the incidence rate of tuberculosis is 255 cases in every 100,000 people in Sub-Saharan Africa because it has about 70% of all cases of HIV/AIDS globally. The prevalence of HIV/AIDS cases in Sub-Saharan Africa implies that a significant number of people have compromised immune system, which predispose them to tuberculosis.

A study done to reveal the association of tuberculosis and HIV/AIDS indicates that 50% of people living with HIV/AIDS, who are infected with Mycobacterium tuberculosis, develop tuberculosis in their lifetime (Adeiza, Abba, & Okpapi, 2014). Such a revelation indicates that HIV/AIDS is a major predisposing factor of tuberculosis in Sub-Saharan Africa.

The incidences of tuberculosis are very high in Sub-Saharan Africa because of poverty, ignorance, and human activities. Barter, Agboola, Murray, and Barnighausen (2012) explain that conditions associated with poverty such as poor nutrition, overcrowding, and inaccessibility of healthcare services are responsible for the occurrence of tuberculosis in Sub-Saharan Africa.

Poor nutrition reduces immunity of the body, while overcrowding promotes the spread of tuberculosis because it is an infectious disease. Moreover, inaccessibility to healthcare services implies people do not perform early diagnosis and treatment. According to Bain et al. (2012), ignorance, illiteracy, corruption, and big family size are social factors that predispose Africans to tuberculosis.

Human activities, such as mining also contribute to the occurrence of tuberculosis. Stuckler, Basu, McKee, and Lurie (2011) state that 10% increase in mining activities cause an increase in the incidence rates of tuberculosis by 0.7%. Therefore, high incidences of tuberculosis in Sub-Saharan African emanate from poverty, ignorance, and mining activities.

Asia

Asian countries that have the high incidence rates of new cases of tuberculosis are Bangladesh, India, China, Philippines, and Pakistan. In the Asian region, South-East Asia has high incidences of tuberculosis. According to Nair, Wares, and Sahu (2010), 4.9 million cases of tuberculosis are present in South-East Asia. Tuberculosis is prevalent among young adults, and thus, affecting their economic contribution in the society.

Verma and Mahajan (2007) state that 40% of global cases of tuberculosis and 18% global cases of HIV/AIDS are present in South-East Asia. India has 1.8 million cases of tuberculosis and 2.5 million cases of HIV/AIDS (Sandhu, 2011). These epidemiological statistics indicate that HIV/AIDS a major predisposing factor of tuberculosis, just like in the case of the United States and Sub-Saharan Africa.

Other predisposing factors of tuberculosis in Asia are poverty and inaccessibility of healthcare services. The conditions make people to have poor nutrition and live in slums where overcrowding occurs, and thus, promote the spread of tuberculosis among people.

Cambodia is the poorest country in Asia with an incidence rate of 495 cases of tuberculosis in every 100,000 people (Wu, & Dalal, 2012). Countries such as India and Indonesia also experience high incidence rates of tuberculosis owing to their poverty level. The poor do not only live in poor conditions but also they do not access healthcare services. According to Shen et al.

(2009), China has 1.31 million cases of tuberculosis, which are associated with HIV, smoking, alcohol, poverty, and inaccessibility of healthcare services. The epidemiological studies of Asia show that the tuberculosis is prevalent among the poor and people living with HIV/AIDS.

Conclusion

The epidemiological studies of indicate that the prevalence of tuberculosis in the United States, Sub-Saharan Africa, and Asia varies due to a number of factors. In the United States, the major predisposing factors of tuberculosis are race and HIV/AIDS.

However, in Sub-Saharan Africa and Asia, HIV/AIDS and poverty are major predisposing factors. Therefore, comparative analysis of the epidemiological studies indicates that social determinants of health are responsible for the disproportionate occurrence of tuberculosis in the three geographical regions.

Questions

1. When do healthcare providers report the occurrence of tuberculosis?
2. Explain how the spread of tuberculosis occurs among people?
3. How long does it take for tuberculosis infection to manifest signs and symptoms?
4. Discuss pathogenesis and pathophysiology of tuberculosis in people living with HIV/AIDS?
5. Describe the effective measures that are applicable in the prevention and control of tuberculosis?
6. Describe how poverty contributes to the occurrence of tuberculosis in Sub-Saharan Africa?
7. How does HIV/AID predispose people to tuberculosis?
8. What is the meaning of direct observed therapy in the treatment of patients with tuberculosis?
9. Name the available methods of diagnosing tuberculosis?
10. What are the types of medications that are applicable in the treatment of tuberculosis?
11. Explain why patient with tuberculosis take different medications for different durations?
12. What are the common side effects associated with medications used in treatment of tuberculosis?
13. When do patients with pulmonary tuberculosis perform their duties normally?
14. Explain the difference between latent tuberculosis and active tuberculosis.
15. Differentiate between prolonged exposure and close exposure in the spread of tuberculosis?
16. What are the incidence rates of tuberculosis in the United States, Sub-Saharan Africa, and Asia?
17. What are the measures that World Health Organization advocates in the prevention and control of tuberculosis?
18. Describe how healthcare providers can protect themselves from contracting tuberculosis from patients they are treating?
19. What are the appropriate tests that people undergo before commencing medications for latent tuberculosis?
20. What are the factors that contribute to the recurrence of tuberculosis after treatment?

References

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Barter, D., Agboola, S., Murray, M., & Barnighausen, T. (2012). Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa: A systematic review. BMC Public Health, 12(980), 1-22.

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