Description of Tuberculosis
Tuberculosis is a highly infectious disease that results from an infection with the bacteria Mycobacterium tuberculosis which mainly affects the lungs. Some of the general signs of tuberculosis include night sweats, weight loss, and other signs that are common to bacterial infection. When tuberculosis affects the lungs, it leads to chest pain as well as a persistent, productive cough and hemoptysis. Extrapulmonary tuberculosis results in symptoms that are characteristic of the organ that has been affected. For example, when tuberculosis affects the spine, it causes back pain while tuberculosis that affects the kidneys leads to hematuria.
The transmission of tuberculosis takes place through the inhalation of airborne particles that contain the bacteria Mycobacterium tuberculosis. The primary source of the bacteria is the sputum emanating from the larynx or the lungs of untreated tuberculosis patients.
During the treatment of tuberculosis, the first step is to isolate the patients in a room with negative pressure. Patients are put on a “four-drug regimen which comprises of isoniazid, rifampicin, pyrazinamide as well as ethambutol” for a period of two months (Zumla, Raviglione, Hafner, & Reyn, 2013). The patient is then put on isoniazid and rifampin for a period of four more months. If after six months the patient is still culture-positive, the medication is continued for another two months.
Untreated tuberculosis results in multiple complications that manifest themselves based on the organ that is affected. Tuberculosis can result in damage to body joints especially the hip joint and the knee joint as a result of arthritis. Tuberculosis also causes meningitis which is a fatal condition accompanied by severe damage to the brain. When tuberculosis affects the kidney, it causes impaired kidney functions that may also lead to kidney failure. Tuberculosis also affects the pericardium leading to accumulation of fluids in the pericardial as well as impaired heart function.
Demographics of Tuberculosis
The prevalence rate of tuberculosis is around 9,588 persons around the country. The incidence rate for tuberculosis is around “3.0 cases per a population of 100,000 individuals” (Alami et al., 2014). The incidence rate is notably thirteen times higher among persons who are born outside the United States as compared to other individuals. There is a minimal mortality rate as a result of tuberculosis which accounts for about eleven deaths per year. The “morbidity rate as a result of tuberculosis is about 0.1 per 100,000 individuals” annually (Alami et al., 2014).
Health Determinants in Tuberculosis
Health determinants can fall into socioeconomic factors, environmental factors as well as individual characteristics. Persons who have low income are more susceptible to diseases. There is increased level of diseases among persons of low education. According to Zumla et al. (2013), the environment also plays a significant role in health and diseases given that most diseases have water or air as their causal factors. Social activities such as cultures and traditions are also important in the disease process. An individual’s genetic composition determines to a large extent the predisposition to most diseases. Access to healthcare services is also important in the determination of an individual’s health (Zumla et al., 2013).
Persons who have low income are more predisposed to tuberculosis as they do not have access to proper housing. There is also the increased risk as a result of lack of access to appropriate healthcare due to the costs associated with healthcare service provision. Tuberculosis is also high among persons who have low education levels as they lack the knowledge on how to prevent tuberculosis infection as well as how to prevent its spread (Zumla et al., 2013). Persons who have low education have an increased risk given the fact that they are at times not aware of the right time to seek treatment or even the signs and symptoms that should prompt decision to seek medical attention. Given that tuberculosis is airborne the transmission occurs quickly in an enclosed environment. There is no significant relationship between tuberculosis and the genetic composition of an individual. However, other unique characteristics such as the immunity level of a person determine their susceptibility to tuberculosis.
Epidemiological Triangle
Mycobacterium tuberculosis has enhanced invasiveness given its airborne characteristic. The bacterium also has an increased pathogenicity given its ability to remain latent in the body for a long duration of time and cause disease later. Zumla et al., (2013) indicate that Mycobacterium tuberculosis as an agent has a relatively high resistance that makes it survive in harsh climates and remain potent in the outside environment. The body does not have the ability to prevent the spread, as well as the growth of the bacteria from the initial infection.
The host factors in the causation of tuberculosis disease relate to the immunity and defensive mechanism of the host. When the host has decreased immunity, there is a higher chance for tuberculosis to progress from the latent disease to active disease stage. The host can be conferred with artificial immunity by the use of vaccines to increase the chance of fighting tuberculosis.
The environment is significant in the disease process of tuberculosis. Some of the environmental factors that tend to accelerate the disease process include poorly ventilated areas. An environment that is overcrowded also increases the chance of contracting tuberculosis. Zumla et al., (2013) argue that other environmental factors such as poor sanitation are also responsible for increasing the chances of contracting tuberculosis.
Role of the Community Health Nurse
Community health nurses are responsible for finding tuberculosis cases in the community. Finding tuberculosis cases could be done by making household contacts aside from outpatient diagnosis. Community health nurses also assemble tuberculosis screening campaigns and lead an interdisciplinary team to conduct screening in the community (Stanhope & Lancaster, 2011). When tuberculosis patients default their medication, it is the responsibility of the community health nurse to call or visit the patients in their homes. The community health nurse encourages the patient to resume treatment.
The community health nurses are held responsible for collecting tuberculosis data in the outpatient clinic. The data also includes the outcome of the screening campaigns as well as that of tracing tuberculosis patients. Stanhope and Lancaster (2011), states that the nurses also play a significant role in the analysis of the tuberculosis data in order to guide the management and approaches towards tuberculosis. Community health nurses also prepare a report on the activities regarding tuberculosis. The report focuses on different issues such as tuberculosis campaigns and the results of patient follow-up.
Tuberculosis Organization
One of the organizations involved in the fight against tuberculosis is the National Tuberculosis Controllers Association (NTCA). NTCA aims to advance activities that will eliminate tuberculosis through the efforts of the state and other related programs. NTCA provides a collective voice that represents all tuberculosis controllers as they attempt to present their views. The organization assists tuberculosis controllers to overcome barriers that are a result of state activities. The aim of reducing state controls is to ensure that there is a speedy response to tuberculosis activities. NTCA also advocates for policies that foster tuberculosis control both at the national and local levels. The organization also acts to eliminate territorial barriers and as such enhance the creation of policies and laws that foster the fight against tuberculosis.
References
Alami, N., Yuen, C., Miramontes, R., Pratt, R., Price., S., & Navin, T. (2014). Trends in tuberculosis — United States, 2013. Morbidity and Mortality Weekly, 63(11), 229-252.
Stanhope, M., & Lancaster, J. (2011). Public health nursing: Population-centered care in the community. St. Louis, MO: Mosby.
Zumla, A., Raviglione, M., Hafner, R., & Reyn, F. (2013). Tuberculosis. New England Journal of Medicine, 368, 745-755.