Tuberculosis Infection Disease

Introduction

Tuberculosis is a severe communicable disease that affects the population of the US and people around the globe. The complexity of this condition results in the long treating process involving antibiotics or chemotherapy, and one can be easily infected by breathing in the air that contains the bacteria. This paper aims to evaluate tuberculosis in regards to its primary characteristics and define best practices for nurse practitioners.

Analysis

This condition is caused by Mycobacterium tuberculosis, which are transmitted through a person’s respiratory system. The lungs are affected most commonly, however, other tissues can be damaged as well. According to Bloom et al. (2017), “only about 10 percent of individuals infected with Mtb progress to active TB disease within their lifetime” (p. 233). Due to this, an infected person can display no signs of tuberculosis for years since the disease does not progress and remains latent. The symptoms include coughing that persists for long periods, or that contains blood, lack of appetite and weight loss, fever, and night sweats.

Complications include a variety of adverse health-related issues, including lung damage. Others are bone pain, migraine, malfunction of the kidneys or liver, cardiac tamponade, and problems with vision (Bloom et al., 2017). Also, the medication used to treat tuberculosis can cause significant side effects such as vomiting, jaundice, fever, and others. According to Bloom et al. (2017), treatment involves chemotherapy, which is considered to be the most cost-effective approach. However, antibiotics can be used as well and the patient has to take them for extended periods ranging from 6 to 9 months, depending on the severity of the case. It should be noted that drug-resistant forms of tuberculosis exist, which complicates the treatment process and requires more time for management. Vaccines such as bacille Calmette–Guérin (BCG) are used to prevent the infection and further development of this condition (Bloom et al., 2017). Besides, the approach to treatment depends on the form of the disease – active or latent, which determines the combination of drugs and the longevity of the process.

Demographic Break Down

Due to the fact that tuberculosis is a complex disease that requires lengthy treatment, it is necessary to determine the mortality and morbidity estimates. Mortality from tuberculosis is estimated at 1.3 million deaths globally and is ranked at number 10 among the common causes of death, and the Centers for Disease Control and Prevention estimates that 9,105 incidents were reported in the US in 2017, which indicates the morbidity rates (CDC, 2018; WHO, 2018). In addition, in 2016, 568 deaths were linked to the condition, and mortality is estimated at 42% (WHO, 2019). Prevalence is described by Miramontes et al. (2015) as “1,260 cases annually per million population” (p. e0140881). The authors hypothesize that in the US, about 4,7% of not hospitalized individuals have tuberculosis. It should be noted that the overall trend indicates a decline in the number of infected people and deaths caused by tuberculosis (Miramontez et al., 2015). In addition, Asians, Hispanics, and people born outside of the US had the highest number of cases.

Determinants of Health

Host factors include individuals not affected by the condition, those who were infected but did not display symptoms, and people exposed to the bacteria, and those who have undergone treatment and were cured. Turner et al. (2017) state that a person’s innate and adaptive defense mechanisms determine whether the bacteria can develop into tuberculosis. Agent factors include the presence of airbed bacilli capable of surviving in the external environment (Turner et al., 2017). This enables the infection to impact a person inhaling the affected air. Environmental factors include climate beneficial for the disease, humidity, and temperature that allow the bacteria to develop sufficiently to be found in people’s airways (Turner et al., 2017). Both direct and indirect ways of acquiring this infection exist.

The role of the primary care nurse practitioner in the process of treating tuberculosis is vital. Firstly, the integration of care models using best practices and evidence-based strategies involves direct administering drugs to ensure that individuals do not stop treatment when symptoms disappear (Belknap et al., 2017). The American Association of Nurse Practitioners (AANP) states that the role of primary care is to provide patients with access to high-quality healthcare services (AANP, n.d.). Additionally, it is crucial to educate individuals about severe diseases such as tuberculosis and encourage people to be tested to prevent them from infecting others.

In regards to managing infectious diseases, nurse practitioners should be able to assess symptoms and diagnose individuals using generally accepted techniques. Surveillance should be done in the form of evaluating symptoms and performing blood tests necessary for diagnosis. Primary interventions can be done in the way of preventing the exposure to bacteria, which is especially crucial for family members and friends of the infected. Next, secondary strategies are aimed at treating the condition. Tertiary interventions involve treatment with either antibiotics or chemotherapy, as was described above. It is necessary to monitor the patient for extended periods since the treatment process takes months and should be conducted with adherence to all recommendations. Reporting, data collecting, data analysis is necessary to estimate the exact number of cases and treatment outcomes for tuberculosis. Follow-ups are crucial with this disease because it is essential to ensure that patients adhere to the treatment plan since tuberculosis bacteria can become resistance if not adequately treated.

Conclusion

Overall, tuberculosis affects over a million people globally, however, only 10% of the infected display symptoms. The process that contributes to the development of the condition involves the most susceptible to the bacteria individual, active agent, and environments in which the former can be found. It is crucial for primary care professionals to assess symptoms correctly and use strategies of treatment that ensure adherence to medication to avoid complications.

References

Belknap, R., Holland, D., Feng, P., Millet, J., Caylà, J., & Martinson, N., … TB Trials Consortium iAdhere Study Team. (2017). Self-administered versus directly observed once-weekly Isoniazid and Rifapentine treatment of latent tuberculosis infection. Annals of Internal Medicine, 167(10), 689-698. Web.

Bloom, B. R., Atun, R., Cohen, T., Dye, C., Fraser, H., Gomez, G. B., … Yadav, P. (2017). Tuberculosis. In: K. K. Holmes, S. Bertozzi, B. R. Bloom, & P. Jha (Eds)., Major Infectious Diseases (3rd ed.) (pp. 233-315). Washington, DC: The International Bank for Reconstruction and Development/The World Bank.

Miramontes, R., Hill, A., Yelk Woodruff, R., Lambert, L., Navin, T., Castro, K., & LoBue, P. (2015). Tuberculosis infection in the United States: Prevalence estimates from the National Health and Nutrition Examination Survey, 2011-2012. PLOS ONE, 10(11), e0140881. Web.

AANP. (n.d.) Nurse practitioners in primary care. Web.

CDC. (2018). Take on TB. Web.

WHO. (2019). How many TB cases and deaths are there? Web.

WHO. (2018). Tuberculosis (TB). Web.

Turner, R., Chiu, C., Churchyard, G., Esmail, H., Lewinsohn, D., Gandhi, N., & Fennelly, K. (2017). Tuberculosis infectiousness and host susceptibility. The Journal of Infectious Diseases, 216(6), S636-S643. Web.