Epidemiology and Communicable Diseases

Epidemiology and Communicable Diseases

Bacteria or viruses usually cause communicable diseases through the air, insect bites, blood products, bodily fluids, or contaminated surfaces. Many communicable diseases must be reported to appropriate government agencies or health departments when there is an outbreak. Reporting communicable diseases outbreak helps the involved agencies and health departments to implement various strategies for addressing the diseases. This is because there are other risk factors related to infectious diseases, and they can only be prevented when a disease is controlled immediately after the announcement of an outbreak. Examples of communicable diseases include tuberculosis, chickenpox, influenza, hepatitis, mononucleosis, HIV, polio, measles, and Ebola. This paper aims to discuss various concepts related to tuberculosis as an infectious disease. It describes the causes, symptoms, mode of transmission, complications, demographic interests, reporting, and social determinants of tuberculosis. It also discusses the epidemiologic triangle and the role of community health nurses in addressing tuberculosis. The paper also discusses WHO's role in tuberculosis control. The last section discusses the global implication of tuberculosis and how various countries address the disease.

Tuberculosis

Tuberculosis is a contagious disease caused by Mycobacterium tuberculosis bacteria transferred from one person to another via the air. The bacteria commonly affects the lungs, but it can also affect other body parts, such as the spine, kidneys, and brain. The symptoms of tuberculosis include night sweats, fever, weight loss, weakness, chest pain, and coughing. Other symptoms usually depend on the part of the body affected by the disease. For example, the patient may experience severe headaches if tuberculosis has affected the brain. Tuberculosis is transmitted when a person with the disease speaks, sneezes, or coughs (NHS, 2019). That patient releases tuberculosis bacteria in the air, which enter another person’s body when breathing in. individuals who get infected after breathing in tuberculosis bacteria get latent tuberculosis infection.

There are various complications related to tuberculosis disease. They include heart disorders, kidney and liver problems, brain damage, joint damage, and spinal pain. Therefore, the disease requires immediate treatment after it has been diagnosed. Tuberculosis is normally treated by taking antibiotics for several months, depending on the type of tuberculosis. Patients with extrapulmonary tuberculosis are treated using a combination of antibiotics and corticosteroids (NHS, 2019). An example of a corticosteroid is prednisolone which reduces swelling, especially in patients whose membrane part of the brain has been affected. 

Tuberculosis is still a major concern in many countries. Tuberculosis deaths were at 1.2 million in 2019 and 1.3 million in 2020 worldwide, according to WHO (WHO, 2021). In 2018, the Center for Disease Control (CDC) reported that approximately ten million people were diagnosed with tuberculosis globally. Among the total number of tuberculosis patient cases reported that year, 862000 were HIV positive. However, the incidence and prevalence of tuberculosis have declined in many countries, especially the developed counties such as the United Kingdom and the United States (MacNeil, 2020). For instance, the Word Health Organization reported that tuberculosis incidence reduced by 95% in 2020 compared to cases reported in 2015 globally (MacNeil, 2020). Controlling tuberculosis has been effective because it is a reportable disease. A tuberculosis case must be reported within 24 hours to the Health Department or Local Health Authority.

Social Determinants of Tuberculosis

The first social determinant of tuberculosis is shelter. Individuals who live in marginalized societies have temporary accommodation, and others are homeless. These include families and individuals in the treatment of drug issues and those released from prisons. In low-income and high-income countries, homeless individuals are at a high risk of getting tuberculosis. They are exposed to tuberculosis bacteria in hostels or places where homeless individuals gather to socialize or sleep. Generally, homeless people do not seek healthcare services when they experience tuberculosis-related symptoms (Duarte et al., 2018). They assume that their health condition is a result of their lifestyle.

Poverty is the second determinant factor of tuberculosis. This is because poor individuals are more likely to work and live in overcrowded and poorly ventilated places, ideal conditions for spreading tuberculosis bacteria. Also, poor people usually develop malnutrition-related diseases, and it becomes challenging to resist tuberculosis infection. In addition, most poor people do not access healthcare services to diagnose and treat tuberculosis because of the associated costs of treating the disease, like changing nutrition and traveling to healthcare facilities (Duarte et al., 2018). Therefore, one untreated person can easily transmit tuberculosis bacteria to other individuals.

Another social determinant of tuberculosis includes barriers to access to healthcare facilities. Many patients do not seek tuberculosis treatments from qualified healthcare providers. Some barriers that prevent individuals from accessing healthcare services include stigma, poverty, lack of awareness, and poor health systems. Others usually visit healthcare facilities when the disease has already advanced to more complicated stages to offer treatment (Duarte et al., 2018). Failure to seek healthcare services from qualified physicians affects a patient’s health and other people’s health because the disease is easily transmitted from one person to another.

Epidemiologic Triangle of Tuberculosis

The epidemiological model of tuberculosis can be used to understand tuberculosis risk factors. Man is the tuberculosis host because of some factors. An example of those factors is health risks behaviors such as smoking. Tobacco smoking usually increases the risks of transmitting tuberculosis. Alcohol intake puts individuals at risk of getting infected with tuberculosis. Excessive consumption of alcohol can lead to immunity failure hence making a person more vulnerable to tuberculosis. However, there is a limited association between alcohol intake and tuberculosis. Patients with diabetes also contract tuberculosis easily, especially in low-income countries (Khan, 2018). This is because diabetes affects the patients’ immune system, making it easy to contract other infections such as tuberculosis.

The agent that causes tuberculosis is Mycobacterium tuberculosis, non-motile, aerobic, Gram-positive, and acids-fast. Regarding the environment, some factors are associated with the transmission of tuberculosis. The first factor is socioeconomic status, where the gap between poor and rich contributes to unequal access to healthcare facilities for tuberculosis treatment. Closed living settings also contribute to the spread of tuberculosis. The disease effectively spreads in poorly ventilated places, such as prisons. In addition, the humanitarian and emergency crisis is an environmental factor that contributes to the spread of tuberculosis (Khan, 2018). For example, some natural disasters like flooding prevent individuals from accessing healthcare facilities for treatment services.

There are some special considerations for the schools in addressing tuberculosis as a contagious disease. Recently, education and health departments have implemented various strategies for tuberculosis control in schools. Some schools have implemented one strategy to carry out tuberculosis screening when enrolling new students in schools. Second, some schools, especially in developed countries such as the United Kingdom and the United States, have established effective communication channels among local CDCs, health facilities, and schools. This ensures an effective exchange of information hence making it easier to report and register tuberculosis cases. Finally, schools have also introduced tuberculosis health education to control disease transmission (Chen et al., 2021). This creates tuberculosis awareness among parents and students, making it easy to identify and prevent tuberculosis.

The Role of a Community Health Nurse

The first role of a community health nurse is case finding. A nurse should first identify tuberculosis cases before the disease is diagnosed and treated. A nurse can easily find tuberculosis cases in healthcare facilities where individuals with tuberculosis seek health care facilities. (CDC, 2022). Household case finding is another case-finding approach implemented by community health nurses. They find out whether a person who has been diagnosed with tuberculosis lives with individuals who are more vulnerable to the disease, especially young children and HIV patients. Nurses also play the role of reporting confirmed or reported tuberculosis cases to health departments and government agencies. Each report contains the patient’s name, age, sex, address, and diagnosed disease.

Another role of a community health nurse is collecting and analyzing tuberculosis data. Data is collected in healthcare facilities and analyzed to determine how the disease has affected individuals. Therefore, it becomes easy to implement efficient and effective strategies for controlling the disease. To obtain positive results, healthcare facilities should complete and accurate data because that data is used for analysis. The last role of a community health nurse is following up with the patient after treatment (CDC, 2022). For example, patients with drug-resistant tuberculosis may need to be followed up because they might have developed parenchymal lung damage.

It is also worth pointing out that nurses cannot provide effective healthcare services without demographic data. Demographic data is essential because it helps nurses determine the most effective treatment for tuberculosis patients by considering age, ethnicity, and medical history. Also, ethnicity and race data help healthcare providers to improve care quality for all individuals (Harries et al., 2020). It is easy to identify populations that do not achieve adequate intervention to prevent and control tuberculosis.

World Health Organization

The World Health Organization is recognized for its efforts to tackle numerous tuberculosis-related difficulties in order to minimize the damage caused by the illness. The organization had a goal of minimizing tuberculosis before the end of 2035 (Harding, 2020). One of the strategies that have been implemented is to prevent and control tuberculosis infection in setting where tuberculosis can be easily transmitted, such as healthcare facilities, prisons, and schools. The organization also recommended that patients diagnosed with tuberculosis be separated from other individuals to reduce disease transmission. This is because tuberculosis can be transmitted from one person to another, especially in overcrowded or poorly ventilated places. The World Health Organization has also provided guidelines for respiratory hygiene for individuals who have been diagnosed with tuberculosis. One of the guidelines is coughing etiquette to prevent transmission of the disease to individuals attending to the patient.

Global Implication of Tuberculosis  

In 2018, the Centre for Disease Control reported that about 1.5 billion individuals were diagnosed with tuberculosis. In addition, it is the leading transmitted disease killer where approximately 1.5 million people die every year. Also, tuberculosis can resist treatment drugs, especially when drugs are mismanaged or misused (CDC, 2019). This is because tuberculosis drugs are taken for a minimum of six months, and some patients do not complete the prescribed dosage. Various countries have implemented various strategies for addressing the disease. For example, Nigeria is the leading country that reports many tuberculosis cases every year (Ogbuabor & Onwujekwe, 2019). Some of the methods employed to combat the consequences of disease are restricting and preventing disease transmission. Also, the United States and other countries like England and Wales in the United Kingdom have strengthened the lab network to ensure that tuberculosis is identified at early stages for effective control. It is also worth mentioning that tuberculosis is endemic to some patients, especially those with HIV. HIV affects their immune system, and they become vulnerable to tuberculosis. The disease is also endemic in certain areas, such as prisons, where individuals are congested, and it creates an ideal condition for the transmission of the disease.

Conclusion

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis bacteria spread from one individual to another through the air. The symptoms of tuberculosis include night sweats, fever, weight loss, weakness, chest pain, and coughing. Other symptoms usually depend on the part of the body affected by the disease. The social determinants of the disease are shelter, poverty, and barriers to accessing health care. Man is the tuberculosis host, and Mycobacterium tuberculosis is the agent that causes tuberculosis. The environmental factors related to the disease include social-economic factors, closed living settings, and humanitarian and emergency crises. Schools’ special considerations in addressing tuberculosis include tuberculosis screening, establishing effective communication channels, and tuberculosis health education. Nurses also play a significant role in finding, collecting, and analyzing data. They use demographic data to accomplish all those activities. The World Health Organization has a major role in addressing several tuberculosis-related problems in order to reduce the disease's influence. The global implication of tuberculosis is that it is the leading infectious killer disease and mostly affects individuals who are HIV positive. 

References

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