This will paper discuss one of the deadly disease in the world call Tuberculosis (TB). The goal is to prevent the disease and prevent the spread of the disease from the teaching that the community health nurse will provide. An individual can die if TB is left untreated.
Tuberculosis (TB) is an infection caused by a bacteria called Mycobacterium Tuberculosis. This respiratory disease that in most common in the lungs. (World Health Organization, 2014). Other parts of the body are affected by TB is the brain which causes tuberculosis meningitis, genitourinary TB, gastrointestinal TB, tuberculosis lymphadenitis, cutaneous TB, Uterus ovarian TB and Osteo articular skeletal bone and joint TB(articles base, 2008). It is curable and preventable. TB is contagious and is transmitted through the air from a person with the active respiratory disease and then another person inhale this infectious droplet.
Active TB symptom from the lung are coughing, and with bloody sputum present sometimes, weakness, chest pain, fever, weight loss and night sweats. Once the germs enter the air it takes only a few of them to infect another person (World Health Organization, 2014). People with active TB usually have positive TB skin test and blood test. The chest x-ray is usually positive and positive sputum culture (Centered for Disease Control and Prevention, 2012).
Another form of TB is called Latent TB infection. This TB have bacteria that can lay dormant in a person body and not make them sick. The individual with this TB are without symptom and are not infected and therefore not able to transmit this disease to someone else. But if the bacteria become active and multiply, then a person will develop the TB disease. Also if the immune system is weak and the person is not able to fight off the infection, the individual will develop the active disease, become sick and spread the bacteria to others. There are lots of people with Latent TB that never develop the infectious TB disease.
About 5 to 10 percent of these people will develop the TB disease at some time of their life. Usually a TB skin test or blood test will show the TB infection, but the chest x-ray and sputum culture is normal. . People with HIV/AIDS are at greater risk for developing TB due to a weak immune system (Centered for Disease Control and Prevention, 2012).
Treatment for Active Tuberculosis and Latent Tuberculosis
Active TB treatment consist multiple antibiotic being given simultaneously for at least six month to cure the disease. The regimen is four antibiotic for the first two months and then decreased to two antibiotics for the last two months. Most of the antibiotics are given in pill form. The antibiotics of choice are listed in generic form as follow, ethambutol, Isoniazid, pyrazinamide, rifampin, cycloserine, ethionamide, levofloxacin, moxifloxacin, para- aminosalicylic acid, and streptomycin. Sometimes steroids medication are used if inflammation is present. But the medicine has to be taken as prescribed. If doses of medication are missed this can cause a delay in curing the disease. (Everyday health, 2014). The Latent TB treatment consist of the antibiotic isoniazid for six to twelve months to prevent the TB disease from progressing to an active status for most people.
But also taking a mixture of two antibiotics for 3 months is a good way to treat latent TB, but a health care provider has to monitor the person taking the medication in order to prevent the latent TB from becoming active due to a person missing medications (Everyday Health, 2014). “There are special treatment recommendations for people with HIV and TB, people with drug resistant TB, children with active TB and pregnant women with active TB” (Everyday Health, 2014).
Complications of TB Treatment
A person lung can become permanently damage if the treatment are not started early. Difficulty in breathing can developed, the infection can travel to other organs in the body and also the infectious disease can developed a resistance to the medications. A person not taking their medicine as prescribe can cause a resistance to the medications and make the disease tougher to cure (Rodriquez, 2014). There has been an escalation in the resistance of TB drugs that has been used for years. This resistance has affected every country that has been surveyed. Multidrug-resistant tuberculosis (MDR-TB) happens when the top two medication, Isoniazid and Rifampicin are taken and the bacteria does not respond to medication. The main reason for MDR-TB is in the wrong form of treatment or the drug is not used correctly and often the drug is of poor quality. It is treatable and curable but is more expensive. When the extensive chemotherapy is used in the treatment of MDR-TB, it takes up to two years to treat the disease and can cause a severe reaction in a person (World Health Organization, 2014).
Tuberculosis can be misdiagnosed because the symptoms may be the same symptoms of other diseases. It is vital to take a good health history and physical examination. Taking a blood test and Tuberculin skin test can determine if the person has been infected or exposed to active TB. A chest X-ray is needed to see lesions on the lungs that is caused by tuberculosis. A sputum sample is obtained to confirm the present of the TB bacteria (Centered for Disease Control and Prevention, 2012). Some people has to be admitted into the hospital and placed in a special room that filters out TB bacteria out of the air. This will prevent health care workers and other people in the hospital from contracting the TB infection. It is likely that a person is not to leave the room until 3 sputum samples are obtained and shows that a person can no longer spread the infection (Everyday Health, 2014). Also the side effect of the strong drugs use has to be monitor. Some drugs can cause the liver to become inflamed, kidney and nerve damage and changes in vision. Death can occur if TB is not treated and cured (Rodriquez, 2014).
Demographics and Health Statistics
“Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent” (World Health Organization, 2014). There were about 8.6 million people in 2012 that contracted TB and 1.3 million deceased from TB. Around 95% of these death happen in the low class and middle class income countries. TB is around the third cause of death in women age 15 to 44. About 530,000 children contracted the TB in 2012 and 74,000 HIV negative children deceased from TB. One fifth of people that has HIV deceased from TB which is the number one killer for them. The Millennium Developmental Goal for 2015 is to overturn the spread of TB, which as of now the number of people contracting TB decreasing each year but very slowly. TB death rate declined by 45% between 1990 and 2012 (World Health Organization, 2014).
Epidemiology Triangle of Tuberculosis
Host Factor of Tuberculosis consist of the age, ethnic background, race, education and economic status. This describe the host or the person that is affected by the disease and what made the individual more acceptable to contact TB. It could be a mixture of many reasons, like chronic illness, weak immune systems or a recurrent TB or other diseases (Maurer & Smith 2009). The Agent Factor of Tuberculosis is a bacteria known as Mycobacterium Tuberculosis that is transmitted through the air from respiratory droplets (World Health Organization, 2014). The Environment contains the air, family, community, public policy, and workplace, economic status, housing population, and culture and health services. All of these can affect the person before and after TB is contracted. The person living in a crowed population is most at risk of being exposed to TB. The family and the community is at risk for receiving and spreading TB. If the public does not have a policy to protect individuals, put them at a high risk. The individual’s is affected by their attitude, health practices, no insurance, and not able to obtain proper health care (Maurer & Smith 2009).
Roles of the Community Health Nurse
The Community Health nurse is responsible for assessing the community for communicable diseases and needs of the community and start the process and report findings to the appropriate person or group. The nurse take on the role as the teacher, educator, and counselor. It is important for the nurse to help prevent the spread of disease and illness in the community by providing education. The health and social needs are to be assessed. The nurse is knowledgeable of infectious diseases and familiar with epidemiologic data in order to assess the needs and problems in a given community. The nursing process must be used with the principles of epidemiology in order to provide the appropriate care.
Educating the community in regard to communicable disease such as the risk factors, prevention and how they are transmitted and importance of good hygiene. Follow-up care is needed to assess and measure the outcome of the community. The nurse should work with other health care worker motivates changes in health behavior in individuals, families, groups, and communities that also include lifestyle in order to promote and maintain health (RN pedia.com, 2014).
Centers for Disease Control and Prevention (CDC) has been dedicated to protecting health and promoting quality of life through the prevention and control of disease, injury, and disability. CDC is always working seven days a week and twenty four hours a day to protect America from health, safety and security threats, both foreign and in the U.S. Whether diseases start at home or in the community, the disease can be chronic or acute, curable or preventable, the CDC fights disease and supports communities and saves patient lives (Centered for Disease Control and Prevention, 2014).
Tuberculosis is a deadly disease. It is preventable and curable. Millions of people contract this disease and millions of people die from this disease yearly. Teaching from the nurse to the community is very important to prevent the disease and prevent the spreading the disease. Nurse are to be knowledgeable themselves of the disease and help in promoting and keeping the community healthy.
World Health Organization. (2014). Tuberculosis (TB). Health Topic. Retrieved from http://www.who.int/topics/tuberculosis/en/ World Health Organization. (2014). Tuberculosis. Fact Sheet. Retrieved from http://www.who.int/mediacentre/factsheets/fs104/en/
Articles base. (2008). Other or Different Types of Tuberculosis? Retrieved from http://www.articlesbase.com/diseases-and-conditions-articles/other-or-different-types-of-tuberculosis-474213.html Centered for Disease Control and Prevention. (2012). The Difference between latent TB infection and The TB disease? Facts Sheets. Retrieved. http://www.cdc.gov/tb/publications/factsheets/general/LTBIandActiveTB.htm
Rodriquez, D. (2014).Monitoring Tuberculosis Treatments. Everyday Health. Retrieving from http://www.everydayhealth.com/tuberculosis/monitoring-tuberculosis-treatment.aspx Everyday Health. (2014). Multiple Drug Therapy for Tuberculosis. Retrieved from
http://www.everydayhealth.com/health-center/multiple-drug-therapy-for-tuberculosis-tb.aspx#hw20716 Maurer, F. A., & Smith, C. M. (2009). Community/Public health nursing practice: Health for families and populations (4thed.). St. Louis, MO: Saunders/Elsevier. RN pedia.com. (2014). Community Health Nurse Roles and Functions. Retrieved from http://www.rnpedia.com/home/notes/community-health-nursing-notes/community-health-nurse-roles-and-functions
Centered for Disease Control and Prevention. (2014). CDC Organization .CDC 24/7: Saving Lives and Protecting Peoples. Retrieved from http://www.cdc.gov/about/organization/cio.htm