Epidemiology: Tuberculosis

Tuberculosis (TB) is one of airborne communicable diseases; it is also called Koch’s disease. This disease does not have major incidence, and prevalence rates to that can necessitate an immediate action of healthcare system. For instance, TB affects fewer Hispanics, and no mortalities have been reported among them so far for the past year. However, for the few people affects by it, TB has severe symptoms that can result in adverse complications. Therefore, healthcare providers, particularly community health nurses, must identify the appropriate treatment and effective ways of preventing tuberculosis from spreading. The following analysis focuses on the causes of TB, its manifestations, mode of spread, its complications, and management; it further analyzes TB epidemiology, its health determinants, and examines the role of community health nurses in managing TB and the National Tuberculosis Controllers Association in reducing the prevalence of this disease.

Disease Description

Causes

The bacterium that causes TB originates from the Mycobacterium family. Thus, such bacteria as Mycobacterium Bovis and Mycobacterium Avium can cause this disease (Allen et al., 2015). However, Mycobacterium tuberculosis is the most prevalent one, and it causes the majority of cases of TB (Allen et al., 2015). Allen et al. (2015) further argue that while there is enough information regarding the etiology of TB and the defense mechanism, the disease continues to infect other people due to ineffective prevention strategies. Therefore, current efforts to understand the causes of TB in various patients can result in significant steps towards its prevention.

Symptoms

Patients with tuberculosis have various clinical manifestations. Thus, Akessa, Tadesse, and Abebe (2015) ascertain that most TB patients present with a cough. Moreover, this cough can be accompanied by blood, further resulting in chest pain and pain when breathing. Patients with TB can also experience unexplained weight loss, dyspnea, fever, anorexia, night sweats, and weakness (Akessa, Tadesse, & Abebe, 2015). Additionally, fatigue and loss of appetite are common in TB patients (Akessa, Tadesse, & Abebe, 2015). Finally, as TB progresses, patients can develop increased dyspnea, hemoptysis, extreme loss of weight, and enlargement of lymph nodes. Therefore, the disease needs an early management to prevent the symptoms from worsening.

Mode of Transmission

The transmission of TB occurs through the air as infected individuals spread it to others by droplet infection. Specifically, when a host has pulmonary TB, they cough sputum that is heavily infected with the bacteria into the air. Many people are exposed to TB bacteria through the droplets, but few of them develop the infection. Thus, Allen et al. (2015) offer a reason for this occurrence and explain that many individuals have acquired natural immunity against the disease, which enables an effective prevention from it. Additionally, suppression of the immunity by age or HIV infection might cause an individual to contract the disease and develop the associated clinical symptoms (Allen et al., 2015). Crowded areas, smoking, and unsanitary environment can also predispose people to TB. Therefore, healthcare providers must identify these modes of transmission to initiate proper prevention strategies.

Complications

The progression of TB can result in serious complications if infected individuals do not seek early treatment. Thus, lungs are most prone to complications due to their high oxygen content, and their damage contributes to increased mortality and morbidity among patients (Allen et al., 2015). Furthermore, TB can infect the heart and result in cardiac failure. Therefore, patients with tuberculosis that has resulted in heart failure complications can also present with heart failure symptoms, including edema and dyspnea. Patients can also suffer from back pains and paraplegia due to the effect that the disease has on the spine. Additionally, the involvement of the spine indicates that infection can also affect the meninges, thus resulting in meningitis, which could cause headaches and psychological problems. Moreover, infection might also affect other organs such as the liver and kidneys. Therefore, a prompt treatment of this disease in its early stages is crucial for the prevention of complications.

Treatment

TB requires more time to treat as opposed to other bacterial infections. Thus, D’Ambrosio et al. (2015) provide guidelines, indicating that Ethambutol, Rifampicin, Isoniazid, and Pyrazinamide are effective drugs to manage this disease. Moreover, the combination of Isoniazid-Ethambutol can treat the disease efficiently (D’Ambrosio et al., 2015). These medicines work by killing the Mycobacterium within a short time. Additionally, current research continues to explore other methods of treating this disease. Therefore, as nurses utilize current protocols, they must also analyze research evidence on effective approaches to treating the disease.

Incidence, Prevalence or Morbidity, and Mortality of TB Among Hispanics in Florida

This section examines the characteristics of TB among the Hispanics in Florida. As presented by the findings of the US Census Bureau (2017), 4.2 million Hispanics live in Florida, and Florida Department Health (2017) states that only 167 of them were infected with TB in 2016. Therefore, the incidence of TB among Hispanics in the County of Florida is 167/4.2 million, which amounts to 0.00004. Thus, the incidence rate is 4 cases per 100,000 people. Current and reliable information regarding the mortality of TB among Hispanics in Florida does not exist. Notably, the disease is not prevalent, but the symptoms can necessitate the need for its proper treatment and prevention.

Determinants of Health

Various factors contribute to the development of TB. The determinants of health are factors that can facilitate the distribution of illness, and they include socioeconomic and physical environment and individual characteristics. In this case, poverty is one of the socioeconomic factors. According to Sulis, Roggi, Matteelli, and Raviglione (2014), poverty can lead to overcrowding due to inadequate housing, thus facilitating the spread of mycobacterium from one individual to another. At the same time, the physical environment of people that causes overcrowding, for example, in prisons and during mass gatherings can lead to the spread of TB (Sulis et al., 2014). Moreover, some social factors, such as smoking and abusing drugs, can cause TB as well, but the exact mechanism of TB development due to these factors is unknown (Sulis et al., 2014). Regarding individual characteristics, Allen et al. (2015) contend that people with a suppressed immune system are at a high risk of getting TB. More specifically, people with HIV/AIDS and other diseases that suppress the immune system, such as diabetes mellitus and cancer, do not have adequate defense mechanisms against the Mycobacterium, which puts them at a higher risk of contracting TB. Finally, the bacterium can also infect healthcare workers whose physical environment presupposes a contact with patients, infected with TB. A proper understanding of these factors can help the healthcare system to formulate ways of preventing the development of this disease or its complications.

Epidemiologic Triangle

The epidemiologic triangle describes the way an individual becomes ill. According to Gulis and Fujino (2015), the epidemiologic triangle contains the host of the disease, the agent, and the environment, in which they interact, to guarantee the infection of the susceptible host. In this case, Mycobacterium tuberculosis is the agent, while the person suffering from TB is the host. The environment is the surroundings, where the susceptible host and the original host interact, thus causing the infection (See Appendix). The figure in the Appendix signifies that if the environment supports the Mycobacterium, it thrives and further causes the infection. For instance, a person with a weak immune system can get the bacterium and further develop the infection. An unfavorable environment, such as a person with a stable immune system, can result in the death of the bacterium, and thus, the person might not get the infection.

Role of Community Health Nurse

The progression of TB results in adverse symptoms and serious complications. For that reason, Mnisi, Peu, and Meyer (2012) ascertain that community health nurses must develop strategies for delivering proper pharmacologic and non-pharmacologic management. The primary role of a community health nurse is to participate in a research to understand the prevalence of TB in various areas (Mnisi, Peu, & Meyer, 2012). Additionally, the role of community health nurse lies in working with other healthcare providers and community members to identify factors, contributing to TB and then develop prevention strategies (Mnisi, Peu, & Meyer, 2012). This collaboration can further enhance secondary role of community health nurses, which is diagnosing and treating TB as well as educating the community members on prevention strategies of TB such as living in a clean and spacious environment. The tertiary management includes the management of the cases of advanced TB through proper drug administration and symptom modification. The implementation of these functions can lead to proper treatment and prevention of TB.

National Tuberculosis Controllers Association

The National Tuberculosis Controllers Association (NTCA) (2017) facilitates efforts towards the elimination of TB by advocating laws and policies to control the disease. NTCAs mission is to ensure a TB-free world by working with other parties, involved in the elimination of TB. Additionally, NTCA (2017) indicates that it supports all organizations and other agencies, involved in treating and preventing TB. This organization is useful as it can guarantee a significant reduction in the cases of TB due to the collaborative efforts of all stakeholders involved.

Conclusion

An analysis of TB pathophysiology and treatment can help healthcare providers to identify the ways of managing the symptoms and preventing further complications. For instance, various researchers have found that the Mycobacterium spreads through the air and anybody is susceptible to it. Additionally, TB affects people selectively, and it causes severe symptoms that can progress to fatal complications without a proper treatment. Therefore, community health nurses should identify the ways of treating this disease in its early stages to improve the quality of life of their patients. Most importantly, the community health nurses can consider enhancing prevention strategies among people with compromised immune systems to help preventing the spread of the disease significantly. Finally, the National Tuberculosis Controllers Association is crucial in managing this disease, and it must collaborate with various healthcare providers to help in managing TB.

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