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There are numerous challenges the healthcare system faces today. Despite multiple attempts to eliminate the most dangerous diseases and improve the epidemiologic situation, there are many illnesses or other health issues that deteriorate the health of the nation and result in the appearance of critical problems. For this reason, one of the primary purposes of modern health workers is the introduction of methods that could help to enhance the situation and significantly reduce potential threats. However, this task becomes impossible without a comprehensive investigation of the main factors that impact peoples health. The aim of this paper is the in-depth analysis of the current state of tuberculosis (TB), its spread, morbidity rates, epidemiologic situation, and future perspectives. The relevance of the study comes from the fact that TB remains one of the most wide-spread communicable diseases which have a critical impact on a persons health. That is why the analysis of the problems most significant aspects acquires the top priority for researchers who try to alter the situation.
Definition of the Health Problem
Tuberculosis is a severe infectious disease caused by the bacterium Mycobacterium tuberculosis which mainly affects the lungs (CDC, 2015). However, in some instances, it could also affect other parts of the body (WHO, 2016). For a bigger part of history, the disease remained fatal and killed patients. Today, there is a complex and expensive treatment that results in complete recovery. Thus, there is a tendency towards the further spread of the disease and deterioration of the situation.
As it has already been stated, the disease is caused by the MTB which is spread through the air. Humid, dark, and poorly ventilated areas are favorable for its development. The issue is complicated by the fact that most infections do not have symptoms and are called latent tuberculosis (WHO, 2017). However, 10% of latent infections could enter the active stage which if left untreated results in extremely high morbidity rates (WHO, 2017). A chronic cough, often with blood, fever, night sweats, and body loss are the classic symptoms that evidence active TB. Therefore, its diagnosing rests on using chest X-rays, microscopic examination of body fluids, tuberculin skin, and blood tests (WHO, 2017). Regarding the type of the disease, its treatment includes different antibiotics as the MTB is vulnerable to them.
Therefore, the critical character of the problem is evidenced by high morbidity rates among patients suffering from active TB which remains untreated. According to the statistics suggested by the World Health Organization (WHO) (2017), the disease is one of the top 10 causes of death worldwide. This fact demonstrates the high topicality of the problem for all regions regardless of their development and economic status. WHO (2017) also reports that “in 2015, 10.4 million people fell ill with TB and 1.8 million died from the disease” (para. 5). Over 95% of deaths occurred in countries with a low level of income and poor living conditions (WHO, 2017). As for the USA, the Centers for Disease Control and Prevention (n.d.) state that 9,557 cases of TB were reported in 2015. These facts prove the critical character of the problem and introduce the need for immediate intervention to improve the situation and assist people in their recovery.
Summarization of Data
The main causative agent of tuberculosis is the MTB bacteria that emerged as a human pathogen in Africa (Abdul-Aziz, Elhassan, Abdulsalam, Mohammed, & Hamid, 2013). Recent epidemiological investigations state that different phylogenetic lineages of MTB might adapt to diverse human populations and become more successful in terms of their spread (Niemi, 2014). In other words, the pathogen evolves and correlates with the hypo-inflammatory phenotype in macrophages (Gagneux, 2012). That is why it becomes extremely virulent for humans. The infectious dose contains 1-200 bacilli (Gagneux, 2012). After a person becomes ill, the host might develop as primary infection immediately, or remain latent for a certain period. Usually, the MTB travels to the lungs and stops in the alveoli. The body starts to attack the disease by macrophages that try to disassemble the bacteria; however, not all cells could be destroyed. On the contrary, the disease uses macrophages to feed and increase the bacteria population (Niemi, 2014). For this reason, the body is not able to destroy the foreign organism and fails to recover.
It is known that TB evolves better in the humid and dark environment. However, several factors promote fast growth. First, patients with a weak immune system become more vulnerable to tuberculosis. That is why HIV positive people demonstrate disastrous statistics. WHO (2017) states that the disease is the primary cause of death of HIV positive people in 2015 (35% of HIV deaths were due to TB). Therefore, diabetes also results in numerous complications in patients with the disease. Their immune system is not able to resist TB. Thus, some other contributory factors create beneficial conditions for the illness’s development. These are smoking, alcoholism, and starvation. For instance, in poor countries, TB is one of the most significant health problems that threaten various populations (WHO, 2017).
A significant scale of the problem is also evidenced by the fact that about 1 million children became ill with TB in 2015 (WHO, n.d.). 170000 of them died (WHO, n.d.). It means that despite all attempts to protect juveniles from various diseases, they still suffer from tuberculosis. Moreover, the majority of these children live in extreme poverty and horrible conditions. Another important fact is that about 500000 people acquired multi-resistant TB which does not respond to antibiotics and demands a specific approach (WHO, 2016). The introduction of new combinations of antibiotics is needed to solve the problem and treat people with MDR-TB.
Numerous investigations of the issue suggest several reasons for the increased topicality of the problem. Even though TB incidence has fallen by 1,5% per year during the last decade, there is a critical need to increase the gradual decline to reach the goal outlined by the global anti-TB strategy (CDC, 2015). However, the extreme poverty of some areas in India, Indonesia, China, Pakistan, and South Africa makes the given goal almost impossible. The complexity of the problem preconditions the need for the approach that touches upon all relevant factors. For this reason, TB is not only a health problem. Numerous social factors promote the deterioration of the epidemiologic situation. Researchers believe that along with the drug treatment the radical alteration of living conditions is one of the crucial aspects of struggling against the disease (Gagneux, 2012). Moreover, regarding the fact that HIV positive and diabetic patients are more vulnerable to tuberculosis, the spread of these diseases also deteriorates the situation. The combination of these points contributes to poor outcomes and the evolution of TB. That is why the current catastrophic situation should be associated with the global tendency towards the worsening of the epidemiological environment.
Thus the further epidemiology research should be focused on several factors. As it has already been stated, some patients acquire multi-resistant TB which demands specific treatment as the traditional one becomes inefficient. That is why the main aspects that precondition the appearance of this form of the disease should be studied. Moreover, the bacteria causing TB is known for its ability to evolve and adapt to new conditions. It means that new more resistant forms might appear. Their research is crucial for the improved understanding of the illness, its roots, and new mechanisms that might impact patients.
Altogether, TB remains one of the most topical health problems of the modern age. Even though the use of antibiotics demonstrates positive results and about 49 million people were saved due to the appropriate treatment (WHO, n.d.), it remains one of the primary causes of death, especially among patients suffering from HIV because of their weak immune system. Tuberculosis has a set of specific values that precondition its extremely virulent and pathogenic character. It evolves faster in humid and dark environments. For this reason, poor countries become vulnerable. About 95% of TB deaths were admitted in low and middle-income states. That is why the need for further research is evident. It should be aimed at the elaboration of new approaches in struggling against TB and the creation of new more efficient treatments for patients with MDR-TB.
Abdul-Aziz, A., Elhassan, M., Abdulsalam, S., Mohammed, E., & Hamid, M. (2013). Multi-drug resistance tuberculosis (MDR-TB) in Kassala State, Eastern Sudan. Tropical Doctor, 43(2), 66-70. Web.
Centers for Disease Control and Prevention (CDC). (n.d.). Data and statistics. Web.
Centers for Disease Control and Prevention (CDC). (2015). Reported tuberculosis in the United States, 2015. Web.
Gagneux, S. (2012). Host–pathogen coevolution in human tuberculosis. Philosophical Transactions of the Royal Society B: Biological Sciences, 367(1590), 850-859. Web.
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