Tuberculosis: causes, effects, and international prevention strategies

Tuberculosis: Causes, Effects, Symptoms and Prevention Measures

Bacterial infections range from mild skin infections to more complicated diseases such as tuberculosis and bubonic plague. Advanced antibiotics, vaccines, and improved sanitation have over the years caused significant reductions in the mortality rates resulting from bacterial infections. Cases of resurgence have, however, been reported in some instances as a result of the evolution of strains that are resistant to antibiotics. Tuberculosis comes about when disease-causing bacteria induce sensitivity into the host's antigenic system (Clark 181). This text examines the costs imposed by TB on an individual and the economy and how the incidence of TB can be controlled. It hypothesizes that the control of TB is not a one-nation affair; in order to effectively combat TB within its borders, a nation must work hand in hand with other nations.

Tuberculosis (TB)

TB was once thought to be headed for extinction. Recent statistics, however, depict that this is not about to happen anytime soon. The disease has, in recent years, been affecting more people, especially in large, densely-populated town centers around the globe (Clark 181). Deadlier forms of the disease "have arisen in immunocompromised individuals, such as those with AIDS, or patients being treated with immunosuppressive drugs in connection with organ transplantation," a trend that has seen TB go up the ranks to become one of the most dreaded diseases, and a major cause of death in the world today (Clark 181).

TB in humans exists either in the latent or in the active form. In the latent form, the TB-causing bacterium is inhaled but the immune system is able to inhibit its growth, such that the host is in no position to spread the same to others and shows no symptoms, but still runs the risk of developing the active form of the disease if diagnosis and treatment are not advanced (Queensland Health). However, it is the active form of TB, which is deadlier and has more disastrous effects on both self and others that forms the basis of the text. In this form, the immune system is not strong enough to stop bacterial activity; the bacteria get active, and multiply, weakening the host's body and increasing its ability to spread the bacteria to others (CDC).

Causative Agent

The Mycobacterium Tuberculosis bacterium is responsible for causing TB in humans, whereas the M. avium and the M.bovis are more prevalent in animals (Queensland Health). M. Tuberculosis is a slow-growing thin, large bacillus, with an almost impermeable cell wall made of the wax-like mycolic acid (CDC). Although the lungs are the most common target, the tuberculosis bacterium can infect almost any part of the human body including the brain, spine, and the kidney.

History

Pulmonary TB was first reported between 688 and 626 BC as a disease with symptoms such as frequent coughs, thick bloody sputum, flute-like breathing, chills and sweats, diarrhea and heart disturbance (Kaye and Frieden 52). Prior to this, signs of M. bovis bacterial infection had been observed in cows. It is widely believed that M. tuberculosis developed from the M. bovis strain and adapted itself to the human system when cattle farming began between 8000 and 4000 AD (Kaye and Frieden 53). Science, in the seventeenth and eighteenth centuries, demonstrated that there were observed physical changes in the lungs of an infected person, but it was not until the end of the 19th century that scientist Robert Koch brought TB to light and proved that it was caused by the M. tuberculosis bacterium which was easily spread through the air (Kaye and Frieden 53). The incidences of death resulting from the same were not as high then, mainly because immunity-weakening conditions such as diabetes, AIDS, and organ transplant complications had not come to light.

Epidemiology

Statistics show that a "third of the world's population is infected with TB" (CDC). Approximately 9 million new infections and more than 1.3 million TB-related deaths were reported in 2012 alone, most of which were HIV cases. Today, TB is the world's leading killer of people infected with AIDS (CDC). The U.S., in 2012, reported 9,945 cases of active TB, representing a rate of 4 per every 100,000 persons (CDC). This is worrying, considering that it takes just one droplet of infected sputum to infect an individual of sound health with TB (Queensland Health).

Prevention and Treatment

The treatment of active TB takes the form of a series of antibiotics, some of which are meant to kill, and others to prevent the bacteria from becoming drug-resistant (Kaye and Frieden 53). The most common of these antibiotics are pyrazinamide, ethambutol, rifampin, and isoniazid (CDC). Most patients feel better within the first month of treatment and are then tempted to skip doses or quit medication. This trend explains why cases of drug-resistant TB are on the rise (Kaye and Frieden 53). Directly Observed Therapy (DOT) is an effective way of ensuring that a TB patient follows the physician's prescription to the latter. Moreover, surgery can be used to treat TB, especially if medication proves ineffective (CDC). The two procedures of corrective surgery commonly used include; i) pneumothorax -- introducing air into the chest so as to make the lungs collapse, and ii) thoracoplasty - the removal of diseased ribs or lungs (CDC).

Different preventive measures have been taken by different countries to reduce the chances of healthy individuals contracting TB. In the U.S., such measures include isolation, air filtration and the enactment of legislation requiring prisons, hospitals, and other social interaction zones to comply with tight ventilation standards (CDC). Additionally, the Bacillus Camille Guerin (BCG) vaccine has been adopted to safeguard against the spread of some types of TB (CDC). The vaccine works by strengthening the immune systems of first-time TB patients and thus lessening the likelihood of them developing any serious TB-related complications - it has been found to be more effective when administered to infants, than to adults (CDC).

Political, Economic, and Social Issues

TB imposes serious economic and social problems on an economy; 80% of those affected are aged between 15 and 49, a bracket that represents the highest economic potential of a nation (Kaye and Frieden 59). Moreover, a large proportion of this does not get diagnosed in time and, due to this, stands to lose not less than a year of work to treatment (Kaye and Frieden 59). A TB pandemic between 1992 and 1996 in New York cost the city a mind-boggling $700 billion which would have otherwise been put to more productive income-generating activities (Kaye and Frieden 59). The country spends millions of dollars on the purchase of TB drugs as well as the enforcement of TB-controlling legislation and policy (Kaye and Frieden 59). In the U.S., the rates of TB infection are highest among minority groups because of socio-economic differences - including high unemployment rates, poor living conditions, and low sustainable income levels (Kaye and Frieden 60). Developing countries have high incidence rates for more or less the same reasons. The U.S. opens its doors to millions of refugees from these countries and thousands of Americans travel to these high-risk nations annually. The risk of contraction and the associated costs, therefore, remain extremely high and almost unavoidable. The only way to change the course is to effectively control TB worldwide.

Conclusion

TB imposes a myriad of negative effects on its victims and the economy as a whole. Despite the fact that the incidence rate has been on the decline in the U.S., the nation still faces high risk brought about by the daily interactions between its people and those from high-risk nations -- particularly in the developing world. In the final analysis, therefore, the only way to combat TB is by joining hands with international stakeholders to fight the same worldwide.