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Causes, Symptoms, Transmission, and Complications
Tuberculosis (TB) is an infectious disease that is caused by a rod-shaped bacterium. The bacterium is referred to as Mycobacterium tuberculosis. TB occurs in different forms, the type responsible for most infections is the pulmonary TB. According to CDC (2014), it is responsible for approximately 85% of the infections. In addition, the signs and symptoms of pulmonary TB may occur before the diagnoses of the other types of TB. The main symptoms include recurring fever, persistent cough that may last for weeks, hemoptysis, chest pain, fatigue and loss of weight (Oliveira et al., 2012). TB is normally spread through the air. This implies that the Mycobacterium tuberculosis particles are transmitted by airborne. The particles are called nuclei, and their measurement ranges from 1-5 microns in diameter (CDC 2014). Oliveira (2012) states that the droplets nuclei are generated and passed to the air when a person suffering from pulmonary TB sneezes, coughs, shouts, and or sings (p. 2148). The participles can stay in the air for some hours (Oliveira, 2012). Thus, people exposed to the conditions are likely to be infected.
Complications
The effects of the TB infections differ depending on the person and the level of exposure. As a result, some people may not develop complications. However, other people may have mild to severe complications, which may lead the damage of vital body organs such as lungs. Other complications include cardiac tamponade, meningitis, and malfunction of kidney and liver.
Treatment
The overall objective of the treatment of tuberculosis is to alleviate the suffering it causes to the infected person and to reduce the transmission of the Mycobacterium tuberculosis to other people. The treatment benefits the individual and the community. In addition, the treatment should include the clinical and social issues. The treatment of TB is influenced by different factors. One of the main factors is the type of TB and secondly is the sensitivity of Mycobacterium tuberculosis. Treatment is pharmacological, and it entails the use of different regimes. CDC (2012) recommends four regimes. The selection of the schedules is based on the type of TB and the overall health status of the patient.
Incidence, Prevalence, and Mortality
In the United States, the incidence rate in 2014 was 2.96%. The incidence rate varied depending on different categories of people. For example, the incidence rate for foreign-born persons was 13 times greater than for US-born citizens. The total number of people who died of TB was 555 in 2013. The prevalence of TB in the US varies depending on ethnic orientation. Among the whites, it is 0.6 cases per 100, 000 persons (CDC, 2014).
Determinants of Heath
The determinants of health include the social, personal, environmental, and economic factors that influence health status (Hargreaves et al., 2011). The interrelationships among the factors determine the health of an individual or population. According to Hargreaves et al. (2011), the determinants fall under broad categories of social, health services, individual behavior, policy making, and biological and genetic factors. The social determinants directly linked to the environment in which people or population live, work and age. The social and physical environment determinants influence the health outcome. For example, people in overcrowded areas are likely to have a higher prevalence of TB compared with people with better living conditions.
Health determinants relate to the access of health services. Hargreaves et al. (2011) pointed that limited access or lack of access to health services influences the health of an individual. For example, people who lack funds to go for regular medical checkups may not engage in preventive care. In relation to TB, the lack of health services results in delays in receiving the right care and hence the spread of Mycobacterium tuberculosis. Individual behaviors also influence the health outcome. According to Hargreaves et al. (2011), individual behavior plays an important role in the preventive care. For instance, cautious behavior and regular screening for TB is required especially for the HIV-positive patients and people leaving in regions with high prevalence of TB.
Biological and genetic factors relate to how a disease affects specific population more than the others. This is normally due to inherent biological traits that make a person or population more susceptible. Examples of the biological and genetic factors include age, sex, and HIV status. In relation to TB, HIV-positive patients are exposed to increased risk of being infected with TB.
Epidemiologic Triangle
There are different models of disease causation. One of the models is the epidemiologic model, which is composed of the agent, host, and environment. This implies that disease results from the interaction of the three factors. For a disease to be passed from the agent to the host, there must be a shift in balance in the three components. In relation to TB, the agent is the Mycobacterium tuberculosis, the host is the individual while the environment is the medium of transmission such as the air. The Mycobacterium tuberculosis exists only in humans. In order the bacterium to cause infection, it has to be in sufficient amounts in which the host passes it to the environment. If the host has high opportunities for exposure such as susceptibility due to social and environmental factors, the balance will favor infection. On the other hand, the environment represents the extrinsic factors that provide the opportunity for exposure. For example, a crowded environment, poor socioeconomic standards and lack of health services will lead to the infection.
Role of the Community Health Nurse
The community nurse plays a critical role in the prevention and treatment of TB. The nurses can be involved in the screening of populations in order to identify the patients, who need to be examined, i.e. identification of cases. The nurses should also develop a communication system in which the identified patients are referred to the right health facilities to start the treatment. In addition, the community nurses should compile data on the prevalence and incidence rates in the areas of their work. According to Oblitas et al. (2010), analysis of the data helps in determining the communities that are more susceptible. This data can be used in the policy formulation and the design of the intervention programs. According to CDC (2012) TB develops resistance to drugs if the right treatment schedule is not followed. This has a great implication for the patient, the community, and the government. It leads to multidrug resistance (MDR) TB, which is difficult and expensive to treat. Thus, the nurse should do follow-ups in order to ensure that patients are using drugs as advised.
National Agency that Addresses TB
In the United States, CDC plays a great role in the prevention and resolving the TB. CDC is involved in research and monitoring the trends of TB. For example, CDC developed a strategic plan to eliminate TB in the US in 1989 and outlined the actions necessary to achieve the goal. However, factors such as HIV, MDR-TB and increased immigration of people from countries where TB was common hindered the elimination.
References
CDC. (2012). Principles of epidemiology in public health practice: An Introduction to applied epidemiology and biostatistics. Web.
CDC. (2014). Fact sheet: Trends in tuberculosis, 2014. Web.
Hargreaves, J., Boccia, D., Evans, C., Adato, M., Petticrew, M., & Porter, J. (2011). The social determinants of tuberculosis: From evidence to action. American Journal of Public Health, 101(4), 654-662.
Oblitas, F., Loncharich, N., Salazar, M., David, H., Silva, I., & Velásquez, D. (2011). Nursing s role in tuberculosis control: a discussion from the perspective of equity. Revista Latino-Americana Enfermagem, 18(1), 130-138.
Oliveira, I., Jesus, G., Pinto, P., Balderrama, P., Cury, M., & Vendramini, S. (2012). Tuberculosis control: Evaluation of the nursing team on the framework of health services. Journal of Nursing, 6(9), 2145-2153.
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