Application of the Concepts of Epidemiology to a Communicable Disease: Tuberculosis - Essay Example

Application of the concepts of epidemiology and nursing research to a communicable disease: Tuberculosis Introduction In today’s modern world, diseases have become increasingly prevalent among individuals, regardless of their health consciousness and standards of livings. A majority of diseases are caused by spread of communicable diseases, such as Tuberculosis (TB), because of presence of direct and physical contacts with the external environment and people who are suffering from such health issues at large. The modern world is facing huge challenges to overcome such situations and introduce medicines to control or deal with such healthcare concerns. Hence, the main aim of the paper is to discuss the communicable disease of (TB), its causes, symptoms, mode of transmission, along with its treatment among others. The paper would further enumerate the determinants of health, the epidemiological triangle surrounding TB, apart from the host factors, agent factors and the environmental factors associated with the health issue. The paper will further lay emphasis upon the role which can be played by the nurses in the field of healthcare to identify and addresses the issues of TB further intending to reduce the impact of diseases in a considerable manner altogether (Centers for Disease Control and Prevention, 2010). Description of the Communicable Disease TB is caused owing to particular bacteria, which is biologically termed as ‘Mycobacterium tuberculosis’. The study of TB comes under the concept of ‘Epidemiology’ that relates with the study of causes of a disease which further helps in management of any disease. The nursing practices, which defines the role of nurses in treating TB, apart from providing evidences is commonly known as nursing research. The common symptoms of TB include long-lasting cough, fatigue, chest pain and fever among others. TB is transmitted from one person to another usually through cough droplets and air. When an affected person is involved in coughing, singing or sneezing he/she releases the microscopic droplets that enter the lungs of unaffected person through inhalation, which further cause the disease. In case TB is left untreated, it can result in complications such as meningitis, spinal pain, heart disorders, kidney & liver failure among others. TB can be treated by consuming verified medicines that are known to reduce and control the disease. Some of those include ‘Pyrazinamide’, ‘Rifampin’ and ‘Isoniazid’ (Alami, Yuen, Miramontes, Pratt, Price and Navin, 2014). The mortality rates relevant to TB have declined at an approximate of 45% in between the years 1990 to 2013. Most of the nations have noticed a decline in the number of people affected by TB in the last three decades or so. In U.S. an incidence rate of 3.0 cases was recorded in comparison to 1, 00,000 people in 2013, which further depicts a decline of 3.6%, when compared to 2012 figures. The prevalence rates of TB have reduced to an approximate of 41% between the periods ranging 1990-2013 (WHO, 2015). (Source: WHO, 2015) The Determinants of Health in TB and Its Contribution to the Development of TB The determinants of TB and their contributions towards development of the disease have been illustrated in the diagram below. (Source: Hargreaves, Boccia, Evans, Adato, Petticrew & Porter, 2011) From the above diagram, it can be interpreted that there exist several determinants of TB, which play a vital role in its development at various stages of the disease. In the Exposure stage, prevalence of TB within the society, over-crowded workplace and pollution can affect a person. In Infection stage, TB can get attached with the patient, with an increase in the age, urban residency, malnutrition and poverty. In the disease stage, TB is determined on the basis of factors such as influence of diabetes, cancer and migration, apart from smoking, drinking, drug intoxication, race and ethnic group. The disease might also cause owing to lack of ‘Bacille Calmette Guerin’, a type of chemical substance in the body of individuals. Finally, determinants, which results in development of TB in the stage of ‘access to TB care’ are gender barriers, geographic and cultural barriers, absence of social security and weakening healthcare mechanisms among others (Hargreaves, Boccia, Evans, Adato, Petticrew & Porter, 2011). The Epidemiologic Triangle and Its Factors The concept of Epidemiologic Triangle in TB can be understood as a combination of three variables, namely agent factors, host factors and environment factors. The relationship among these factors can result in occurrence of TB among individuals. The elements have been diagrammatized below. (Source: Kebede, 2004) The agent factor can be considered as the actual cause of the disease, as they are the actual infected microbes which get transferred from one person to another. TB is mainly caused due to the transfer of microbes such as Viruses, bacteria and protozoa. Their presence may create an environment for transfer of TB (Kebede, 2004). The next factor, which plays a vital role in causing TB, is ‘Host’, referring to the individuals, who carry TB along with them and are responsible for transferring it to others. Host can be referred to the person who carries the TB infection and bacteria, which may or may not be in his/her knowledge. The final factor in the Epidemiologic Triangle is environment, which can be said as the favorable internal or external surroundings where an affected person reside or be in (Centers for Disease Control and Prevention, n.d.). The Role of the Community Health Nurse Community Healthcare nurses can play a vital role in reducing the impact or prevalence of TB to a considerable extent. Nurses at the community level can act as change agents in their communities, as they have a significant level of knowledge about the individuals suffering with the disease within the society. In order to adopt and execute a case finding and reporting, a ‘systematic probability sampling’ technique can be used. Furthermore, sampling and reporting can be performed through distribution of questionnaires. The questionnaire distributed among several healthcare communities, facilitated the researcher to gather a comprehensive set of understanding with regard to the individuals affected by TB. The probability sampling enabled the researcher to provide every nurse, a chance to participate in the selection process. The nurses who were registered and had an experience of more than two years were selected for the study and twenty nurses were selected directly in the eventual stage. In the data collection process, questionnaires were allocated among nurses, especially those who were involved in dealing with TB patients. A questionnaire involving 10 questions were given, required to be filled within 30 minutes by the nurses. The questions were generally based upon their presence with patients, their treatment criteria, their responsibilities and medications. Furthermore, the data were also collected within five working days by visiting the healthcare centers (Mnisi, Peu & Meyer, 2012). The Data compiled were evaluated with the help of tools like frequency counts and responses to Likert scale. To evaluate factors such as experience, gender and age groups, summary statistic approach was employed while conducting the research. It was found that the people affected by TB, mostly comprised of the middle-aged people, especially males, who were in direct contact with the unhygienic conditions. Furthermore, the questionnaires were analyzed by comparing them with the actual findings from secondary sources regarding TB. It was observed with the information provided by nurses in questionnaires that a majority of the patients completed their treatment successfully. The nurses further had to conduct specific tasks such as educating the patients, giving them medicines, providing follow up treatment and establishing a positive relationship with the patients towards ensuring proper and systematic interventions. The questionnaire analysis further revealed that most of the people affected by TB were also dealt with health issues of chest pain and poverty-stricken among others. The follow up was made through ensuring that the work of nurses in the community healthcare sector could be improved if certain issues such as nutritional absence and transportation problems are eliminated (Carlsson, Johansson, Eale & Kaboru, 2014). National Agency involved in Addressing TB and Its Contribution to Resolving the Impact of the Disease Several U.S. Government (USG) agencies run specific programs for the control, prevention and treatment of T.B. in U.S. At the worldwide scale, World Health Organization (WHO) is involved in treatment of TB. In U.S one of the major agencies working in the field of TB control is ‘Centers for Disease Control and Prevention’ (CDC), which strives towards controlling and elimination of TB through its global disease intervention plan. The agency is involved in realization of the President’s Emergency Plan for AIDS Relief (PEPFAR) objectives, through reduction in TB mortality rates. CDC is further involved in intensification of the ‘TB laboratory systems’, so that high quality medicines can be produced to fight with TB. The agency has further involved itself in development of ‘Infection Control (IC)’ practices, for restricting TB transmission at large (Centers for Disease Control and Prevention, n.d.). References Alami, N. N., Yuen, C. M., Miramontes, R., Pratt, R., Price, S. F. & Navin, T. R. (2014). Trends in tuberculosis — United States, 2013. Morbidity and Mortality Weekly Report, 63(11), 229-251. Carlsson, M., Johansson, S., Eale, R. B. & Kaboru, B. B. (2014). Nurses’ roles and experiences with enhancing adherence to tuberculosis treatment among patients in Burundi: a qualitative study. Tuberculosis Research and Treatment, 2014, 1-9. Centers for Disease Control and Prevention. (n.d.). CDC’s role in global tuberculosis control. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination, 1-6. Centers for Disease Control and Prevention. (2010). Establishing a holistic framework to reduce inequities in HIV, viral hepatitis, STDs, and tuberculosis in the United States. An NCHHSTP White Paper on Social Determinants of Health, 1-27. Centers for Disease Control and Prevention. (n.d.). Lesson 1 understanding the epidemiologic triangle through infectious disease. Section Diseases, 1-13. Hargreaves, J. R., Boccia, D., Evans, C. A., Adato, M., Petticrew, M., Porter, J. D. H. (2011). The social determinants of tuberculosis: from evidence to action. American Journal of Public Health, 101(4), 654-662. Mnisi, S. D., Peu, M. D. & Meyer, S. M. (2012). Role of community nurses in the prevention of tuberculosis in the Tshwane Health District of Gauteng. Curationis, 35(1), 1-9. WHO. (2015). Global health observatory (GHO) data. Retrieved from http://www.who.int/gho/tb/epidemic/cases_deaths/en/ Read More