Tuberculosis Communicable disease: Tuberculosis

Tuberculosis is a widespread, lethal, and infectious/transmittable disease caused by Mycobacterium tuberculosis. This bacterial infection usually begins in the form of innumerable strains of mycobacteria. In the past, tuberculosis was also termed as Phthisis or Phthisis pulmonalis. Its short form is known worldwide to be TB, or MTB. Stereotypically, tuberculosis is a lung infection that attacks the lungs; however, it can as well affect the other parts of the body. It can spread through the bloodstream and the lymph nodes to any other part of the human body. TB spreads through the air when affected individuals who have the infection in an active stage sneeze, coughs, or transmits any other respiratory fluid through the air to a non-infected person (Al Jahdali, Menzies & Al Otaibi, 2011). When individuals with active pulmonary TB sing, sneezes, spit, or cough; they emit infectious aerosol droplets, which are about 0.5 to 5 µm in diameter. A single droplet is enough to transmit this disease since the dose of tuberculosis infection is extremely low (inhalation of more than 5 bacteria may lead to an infection). Most of the TB infections are latent and asymptomatic, but approximately three of the ten latent symptoms may eventually advance into an active disease which, if not treated in time, may kill up to 55% and above of the TB infected persons.

The majority of those infected by tuberculosis under no circumstance develop symptoms since the bacteria may live in their inactive form within the human body for quite good time duration. Nevertheless, if the immune system weakens, as in elderly adults or people living with HIV, the tuberculosis bacteria may rapidly develop to become active within a short duration. In their active stage, tuberculosis bacteria cause destruction and death to the infected organ tissues. If left untreated for a long time, tuberculosis disease may be fatal to human life. The typical symptoms of active tuberculosis infection may include fever, chronic cough with blood-stained sputum, weight loss, and night sweat. Al Jahdali, Menzies, and Al Otaibi (2011) elicits that tuberculosis may infect any other body part, though it commonly affects the lungs, a condition commonly referred to as pulmonary tuberculosis. When the TB bacteria develop externally (outside the lungs), they lead to extra-pulmonary tuberculosis, which may also coexist concurrently with the pulmonary TB. Therefore, the overall signs and symptoms of tuberculosis are chills, fever, and loss of appetite, night sweats, fatigue, and weight loss. In many cases, finger clubbing may occur.

In pulmonary tuberculosis, the symptoms may involve prolonged coughs and chest pain. Occasionally, the infected individuals may cough out blood-stained sputum and in rare occasions, TB infection may erode into the pulmonary artery, causing an immense bleeding, a condition termed Rasmussen's aneurysm. TB may develop into a chronic illness and result into a wide-ranging scarring within the upper lobes of the human lungs (Gerald, Wang & Elwood, 2008). On the other hand, extra-pulmonary tuberculosis spreads outside the lungs, leading to other forms of TB. The notable sites commonly affected by the extra-pulmonary infections include pleura, the lymphatic system, the central nervous system, the bones and joints, and the genitourinary system. In rare cases, the bursting of the tubercular abscess through the skin may result into tuberculous-ulcers.

The most common and worldwide known cause of tuberculosis is the Mycobacterium tuberculosis; a bacterium that is small, non-motile, and bacillus. This bacterium is capable of undergoing cell-divisions every 15 to 20 hours. Gerald, Wang and Elwood, (2008) reveal that MTB is capable of surviving in dry environment for weeks, and can withstand weak disinfectants for some duration. By nature, the bacteria only grow within the living cells of a host organism before transfusion to another host. MTBC (M. tuberculosis complex) encompasses four other mycobacteria causing TB. They include M. canetti, M. africanum, M. bovis, and M. microti. The other recognized pathogenic mycobacteria are M. avium, M. leprae, and M. kansasii (Al Jahdali, Menzies & Al Otaibi, 2011). Further to the infections by these bacteria, a number of risk factors may make many people be more susceptible to tuberculosis infections. One of the most commonly and globally known risk factor is the condition or infection by HIV. This risk factor is particularly a great problem to the Sub-Saharan Africa where the rates of HIV positivity are extremely high. The other known risk factors include drug abuse, such as cigarette smoking and alcoholism, overcrowding, malnutrition, and infection by diabetes mellitus.

A good number of health researches and health records (Al Jahdali, Menzies & Al Otaibi, 2011) reveal their thoughts that approximately one third of the world's population has been infected by MTB. The infection occurs in about one percent of the population every year. For instance, in...

In 2010, there was an estimation of more than 1.5 million TB related deaths and over 8.5 million new cases mostly occurring within the developing countries. This elicited a decreased number of tuberculosis cases since 2002. Tuberculosis infection distribution has never been uniform across the entire globe; approximately 85% of the affected population has been from African and Asian countries. Therefore, only about 10-15% of the population that tests positive in tuberculin tests comes from the developed countries; the United States contributing to approximately 5% of the population.
The diagnosis of latent tuberculosis depends on the TST (tuberculin skin test), pus test, tissue biopsy, sputum test and/or blood test. However, TB treatment is very challenging and requires a long-term administration of multiple antibiotics. As well, social contacts are treatable though screening. There is a rising problem of antibiotic resistance in this treatment, a condition known asmultiple drug-resistant-tuberculosis (MDR-TB). Prevention thereby relies on the vaccination with Bacillus Calmette -- Guerin (BCG) vaccine alongside the screening programs (Gerald, Wang & Elwood, 2008).

Epidemiologic triangle is a tool consisting of agents, hosts, and the environments of a developing disease causing organism. It explains the spread of a given disease through a community by identifying points of intervention in order to prevent further transmissions, and is useful in guiding the epidemiologic investigations. In this communicable disease, the agent is Mycobacterium tuberculosis; an acid profligate aerobic rod reproducing slowly, hypersensitive to both ultraviolet light and heat. According to Al Jahdali, Menzies and Al Otaibi (2011), this bacterium commonly and primarily affects the organs of the respiratory system, especially the lungs. However, MTB may also have effects to the lymph nodes, pericardium, intestines, kidneys, bones, reproductive organs, and the joints. The infectious disease agent (Mycobacterium tuberculosis) easily spreads to the host (susceptible humans) thru respiratory exposures within public gatherings, or communal settings (environment).

Several factors may combine to affect an individual's or a community's health. The enclosing environment and people's circumstances within that environment determine their health. Factors such as the state of environment, genetics, level of education, income, and relationships with family and friends all impact on people's health (Gerald, Wang & Elwood, 2008). These factors may be summarized into three basic categories: (i) economic and social environment, (ii) the physical environment, and (iii) an individual's behavior and characteristics. Poor social status, low income, and poor education are associated with poor health. This may encourage the development of tuberculosis within a given society since there will be a lack of disease knowledge and low income, which cannot aid the programs of prevention and treatment of TB. Within the physical environment, poor sanitation, unsafe water for drinking and domestic use, unclean air to breath, and unhealthy workplaces may lead to easy development and transmission of MTB.

Community health nurses are the principal healthcare providers who work within an extended nursing role in compliance with other healthcare professionals to provide better health services to a community. They offer public, communal, and home-care health services through the provision of treatment, emergency services, as well as crisis management. Community health nurses coordinate all-inclusive community healthcare programs according to the health standards in order to prevent, protect or reduce the prevalence of communicable diseases, disability, or death to all members of the community. They synchronize admission and transfer of patients to the health facilities, collect and record patients' information. Moreover, community health nurses maintain records/data pertaining to the clients and administrative data via legal guidelines, and within a concise, confidential and accurate manner.

WHO (world health organization) is a universal association that serves to find the best and most appropriate solutions to health issues/problems. In 1993, WHO affirmed TB as a global health emergency and by 2006, the "Stop TB Partnership established a "Global Plan for Stopping Tuberculosis." This partnership aimed at saving approximately 14 million live by 2015. In 2011 WHO issued guidelines on MDR-TB treatment (a multi-drug resistance treatment). WHO recommended an optional treatment of MDR-TB using a blend of standard anti-TB antibiotics. To supplement this guidance, in 2013, WHO issued additional interim policy guidance on the application of bed-aquiline on MDR-TB treatment. This proves how determined this organization is, in the prevention and treatment of tuberculosis disease.