Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.
Communicable Disease Selection
Epidemiology Paper Requirements
Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
Describe the social determinants of health and explain how those factors contribute to the development of this disease.
Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.
A minimum of three peer-reviewed or professional references is required.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Tuberculosis (TB) is a contagious infection that affects the lungs. Tuberculosis is caused by mycobacterium tuberculosis. The bacterium passes from one person to another in the form of microscopic droplets discharged into the air through. TB bacteria can affect the spine, brain, and kidney. TB has been a rare disease until 1985 when it is started increasing due to the emergence of HIV. HIV makes the body’s immune system weak such that the body is unable to defend itself from the TB bacterium.
Causes of Tuberculosis
Various risk factors cause TB. Individuals may develop TB soon after infection. Some people get affected when their body immune system becomes weak due to other medical conditions. People who are most likely to be affected by TB are those who had a recent TB infection and those with the weak immune system. A person can also be infected if they are in close contact with infected individuals, migrants from countries with high risks of TB, and working in areas that are subject to high risk of TB such as health facilities, rehabilitation facilities, and HIV infected people residential homes.
Symptoms of Tuberculosis
TB Symptoms are categorized into two distinctions, which include latent TB and active TB. In latent TB, the bacterium remains inactive in the body due to the healthy immune system of the individual. Latent TB should be treated to help in controlling the spread of TB. Active TB means that the bacterium is active in the body and that the infected individual can spread to others. Active TB can be activated in the body a few weeks after infection or years later.
Active TB symptoms include fever, coughing that continues up to three weeks or more fatigue, and coughing up blood. Loss of appetite, night sweats, chills, fatigue, and unintentional weight loss are also symptoms of TB. The TB symptoms also vary depending on the infected organ. The TB of the spine may cause a backache, and the TB of the kidney causes bloody urine.
Tuberculosis Mode of Transmission
Transmission of TB occurs through the air when an untreated individual with the bacteria coughs, speaks, laughs, or sings. The crowd of people nearby may become infected at inhalation of the bacteria. The bacterium then settles in the lungs, where it starts to develop. The bacterium then moves through the blood to other body parts such as the spine, kidney, and the brain. Individuals who are at high risk of TB infection are those who spend most of the time with the already infected persons.
However, TB cannot be spread through a handshake, kissing, sharing meals, toothbrushes, bedding, or toilet seats. Patients who are on medication for at least two weeks are not contagious.
Complications of Tuberculosis
Untreated tuberculosis can be fatal and hence, result in various complications. The most common complication is the spine pain, which has back pain and stiffness symptoms (Judith & Diane, 2019). Tuberculosis arthritis causes damaged joints, which affects the hips and the knees. Meningitis is also a complication that causes alternating headaches that take place for weeks and can cause mental alteration as well.
TB can also impair the kidney and liver functions, which involves the filtering of impurities through the bloodstream. Cardiac Tamponade is also a TB complication. It affects the surrounding heart tissues, resulting in soreness and fluid collections that may obstruct the heart’s capacity to pump efficiently.
TB treatment method is determined after the physician has diagnosed the patient. The diagnoses include a blood test that is used to validate or rule out latent TB or active TB. A blood test is helpful if the individual is at high risk of TB, but can be ineffective if one recently had received a BCG vaccination. The skin test is also used, but it can be wrong, especially when some individuals don’t react to the test.
False-negative results may also occur when the TB bacterium has not reached the immune system. The imaging test can be done if the skin test was positive. The doctor may then order a chest x-ray or a CT scan. A positive chest X-ray may require the doctor to test a sample of the sputum. Sputum samples help to identify the drug-resistant strain of TB.
TB treatment takes longer, unlike other kinds of diseases. Patients with active tuberculosis are required to take medication for six to nine months. The type of drug and treatment duration depends on age, overall health, infected body location, and drug resistance possibilities. The most common TB medicines include pyrazinamide, Rifampin, Ethambutol, and isoniazid. Latent TB patients are required to take one or two tablets while those with active TB take several drugs at once.
Drug-resistant TB patients receive several antibiotics and injectional medications. These medications are used for 20 to 30 months. It is important to note that TB medications are unlikely to have side effects. If they occur, they can be fatal, and highly harmful to the liver, and any identified side effect should be reported to the doctor immediately. The side effects may include jaundice, loss of appetite, dark urine, nausea and vomiting, and a causeless fever that may last for three days or more.
The Demographic of Interest
TB is among the top global mortality causes and the leading cause of a single infectious agent rated above HIV. According to the World Health Organization (WHO), 10 million people became ill of TB, while 1.3 million people died in the year 2017 worldwide. Most of the people who died from TB are HIV negative. Through effective diagnosis and treatment, 54 million people have been treated from tuberculosis. Mostly, foreign-born young people are reported to be infected with TB.
Tuberculosis as a Reportable Disease
TB surveillance system has been strengthened in many countries. Reporting TB cases to the health authorities has reduced TB morbidity and mortality rates at a high standard in recent years (Yuri, 2018). Public health services have provided health facilities where the communities can report TB cases. The health facilities have been equipped with skilled health care providers as well as diagnostic and treatment systems that will enable the treatment of TB.
The individuals with the knowledge that anyone has TB should report to the authorized health authority within 24 hours. The clinicians found at the reporting center should report to the TB program department in 24 hours. The TB program department should inform the local board of health in the community within 24 hours.
The laboratories and the administrators in institutions such as schools, youth camps, and childcare centers should also report the infected person to the appropriate authorities within the lawfully given time. Upon receiving the patient, the health record is filed, and the patient is taken through the diagnostic process. Depending on the test result, a healthcare plan is developed to ensure that the patient is appropriately taken care of.
Health Social Determinant and their Contribution to the Development of Tuberculosis
Social determinants of health entail the setting that people live in, work, born, and worship. Age is also a determinant factor of health as it interferes with a wide range of health such as body functions and value of life results and threats. The social determinants of health that influence the development of TB are poverty, access to community-based resources, residential segregation, and social disorder.
Poverty is connected with disorganized and poorly aerated working and living areas that contribute to the direct risk of TB. Poverty is also allied with the typical lack of information due to limited exposure to tuberculosis risk factors. Alleviation of poverty diminishes tuberculosis transmission and the risk of further complications that may lead to chronic illnesses. The healthcare board in the community should pursue the eradication of poverty to ensure that the risk factors of tuberculosis are eliminated.
Various actions can be taken to implement safety, which includes improving the living and the working condition — addressing the social, financial needs, and health condition of the migrants. Encouraging healthy diets and lifestyles will also contribute to the reduction of TB incidences in the community.
Inadequate access to community-based resources leads to severe health implications within the community. TB programs can play a significant role in eliminating infections by engaging the community. Enlightening the population on the risk factors of TB deepens understanding of the contribution of communities and the critical people in which they are most active (Ana, Angus, Renaud, Ross, Diego, 2019)
Residential segregation cause inequality and higher numbers of poverty affected people. Health financial support is not available for the discriminated groups hence, making it difficult for the population involved to access health care for TB. In high poverty areas, there is less economic growth, poor infrastructure, and investors hesitate to develop their business in such areas. As a result, the healthcare expectation for the residents reduces. The communities living in such areas end up having poorer health.
Social disorders prevent people from living their life because of fear of stigmatization. The perceptions of tuberculosis effects in the society are poverty, due to lack of knowledge. Therefore, the victim is likely to be avoided by others. Hence, those affected by tuberculosis may not disclose their status, and if untreated, they affected others as they mingle during various activities. But with understanding and exposure, the majority can be saved from the infection, and TB incidences can reduce at a high rate.
The purpose of the epidemiologic triangle is to study health problems, especially infectious diseases and how they multiply. The epidemiologic triangle of tuberculosis involves three vertices. These are the agent; this is the bacterium known as mycobacterium tuberculosis. There is the host vertex, which refers to the individual who has been infected by TB. The environment is the other vertex, and it entails the external factors that cause TB.
Mycobacterium tuberculosis is the agent factor, and it is transported in communicable airborne particles known as droplet nuclei. The infectious droplet nuclei are generated when the infected person coughs, sneezes, laughs, or speaks and can spread and infect the people in the surrounding. The people who have been infected become the host factors, meaning that they are now the carriers of the TB bacteria.
Environmental vertex entails the risk factors that influence tuberculosis. The environmental factors include the living and the working area, groups of people that have high rates of TB transmission, including homeless people, injection drug users, and HIV infected individuals. Poor sanitation can also attract TB infections.
Community, Schools, and General Population Special Considerations
The society, learning institutions, and the public are vulnerable environments that are most likely to contract the infection and cause diseases. It is essential that the health authorities and the administrators in charge of developing systems that will help to identify TB cases quickly. Creating awareness through community programs will enable the population to understand the risk factors as well as signs and symptoms that can cause TB.
The school administration should educate the students, teachers, and the workers on TB causes signs and symptoms, and reporting procedures. Screening programs can be developed to help identify both latent and active TB cases hence preventing the spreading of epidemic cases.
The Community Health Nurse
The role of the community health nurse is to provide treatment to patients. The nurse should be competent in identifying various illnesses by assessing the patients noting the multiple symptoms. The community nurse will also identify health cases, which in return, will plan educational community programs enlighten the people on causes and prevention measures. In cases where infectious disease such as TB emerges, the nurse will report to the health board authority of the area within 24 hours.
The nurse will also raise an alert in the community through urgent education assemblies, media, and brochures so that the community can be cautious of the signs and the infected people. Through community awareness, the nurse will be able to reach a significant population and hence, prevent the case from worsening. During the clinic visits, the community nurse will collect health records from individuals who will include their personal information as well as health history.
The nurse will then perform data analysis using health records. Using the records, the nurse will identify the cases that need urgent attention and the development of healthcare plans. Through data records that the nurse will be able to follow up on patients whose cases need healthcare providers close attention and monitor their health progress closely.
Significance of Demographic Data to the Health of the Community
The demographic data is essential in that the nurse will be able to identify the environmental factors that cause health disparity in the community. The data will also help the nurse to advocate for the community. As the healthcare provider, the nurse lias with the local authority and the health policymakers can provide quality and adequate healthcare systems that will sustain the health of the community.
National Agency or Organization That Addresses Tuberculosis and its Contribution
National Tuberculosis Controllers Association (NTCA) was founded with the help of the Centers for Disease Control and Prevention (CDC) Division of Tuberculosis Elimination (DTBE). The role of NTCA is to promote the elimination of TB. NTCA works jointly with the DTBE in joint commissions and developments which involve identifying, implementing, and evaluating funding formulas that are used to eliminate TB.
The organization has contributed to resolving the impact of TB by developing funding programs, correctional facilities. These systems help reduce social factors such used by injection drug groups, and the examination of immigrants and refugees. The organizations also develop systems that help to identify medical risk factors and comorbidities, and currently, NTCA has identified HIV as the dominant medical risk factor. Hence, NTCA has increased clinical resources to ensure effective treatment.
Global Implication of the Disease
The global insinuation of TB is that the disease is a hazard to the local financial systems and the global economy. People with low income have a difficult time taking care of the families as well as funding treatment for TB. TB treatment has become harder, and there is an extreme rate of drug-resistant cases and false diagnoses.
The countries which have a high risk of TB have combined effort with the help of the World Health Organization (WHO) and other health institutions to focus on preventing, detecting, and treating TB. Research and development of health systems that can be used to eliminate TB have also been established, and reduction of mortality and morbidity rate has been evident.
How Other Countries Address TB
Many countries are working towards eliminating TB because if unchecked, it can turn out to be an epidemic that can be reported as a national emergency. When a disease becomes a national emergency, the economy of the countries derails because investors stop traveling both internally and externally.
The countries are establishing health systems that are taken closer to the communities as possible to assist in TB elimination. The communities are encouraged to go for screening even if they cannot detect any signs and symptoms. The testing helps in reducing the incidences and that way the countries are in control.
Is Tuberculosis Endemic to a Particular Area?
Tuberculosis is endemic in many places which are also determined by the environmental factors. The most affected areas are those that are crowded, such as correctional facilities and especially where healthcare resources are limited. Health care facilities are also subject to the disease, especially when there are outbreaks. The outbreaks can also cause those who are visiting the clinic for other conditions to be infected if measures are not taken.
Ana Komparic, Angus Dawson, Renaud F. Boulanger, Ross E. G. Upshur, Diego S. Silva,(2019). A failure in solidarity: Ethical challenges in the development and implementation of new tuberculosis technologies. https://onlinelibrary.wiley.com/doi/full/10.1111/bioe.12554
Judith S. Currier, Diane V. Havlir, (2019). CROI 2019: Complications and Coinfections in HIV Infection. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550358/
Yuri Lee, (2018). Future directions for notifiable diseases: tuberculosis-related laws in the Philippines. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6106835/
Also check: Global Health Issues