Culture And Disease: Pulmonary Tuberculosis

Culture and Disease Paper: Pulmonary Tuberculosis

Introduction to Health and Disease/HCS 245

July 28, 2013

Professor

Culture and Disease Paper: Pulmonary Tuberculosis Tuberculosis is an infectious bacterial disease that usually attacks the lungs. It is considered a challenging disease to diagnose, treat, and control. Tuberculosis is caused by a bacterium called Mycobacterium tuberculosis and is usually referred to as TB. If it is not treated properly, tuberculosis can be fatal. In the United States, tuberculosis is most common in African Americans. According to the CDC (2013), “In 2011, TB disease was reported in 1533 non-Hispanic blacks in the United States, accounting for
23% of all people reported with TB nationally and among U.S. born people reported with TB disease, 39% were non-Hispanic blacks.” Even though TB rates among African Americans have decreased considerably over the last decade, it is still considered substantially higher than any other infected population. Therefore, it is an important priority for control and prevention efforts to be targeted at the African American population. African Americans are more vulnerable to this disease because of a variety of different challenges. Some challenges include the duration of treatment, poverty, limited access to health care, unemployment, housing, transportation, language and cultural barriers, and the most serious challenge is those also infected with HIV. People with HIV have a weakened immune system and are less likely to fight off any infection, including tuberculosis. According to the CDC (2013), “Blacks have the most severe burden of HIV of all racial and ethnic groups in the United States. Compared with other races and ethnicities, Blacks account for a higher proportion of HIV infections at all stages of disease—from new infections to deaths. Blacks accounted for an estimated 44% of all new HIV infections among adults and adolescents (aged 13 years or older) in 2010, despite representing only 12% to 14% of the U.S. population.” When considering the damage of HIV and tuberculosis on one individual, without treatment, life expectancy is shortened tremendously (CDC, 2013). Tuberculosis is an airborne disease transmitted through air droplets when an actively infected person speaks, coughs, or sings. People nearby may become infected by breathing in the bacteria. Tuberculosis becomes active if the body’s immune system is unable to fight off the infection. When TB becomes active, it is considered to be TB disease. This is considered dangerous because some people do not show symptoms immediately. People they spend time with may become affected. Once symptoms begin, it will start off with a cough that lasts more than three weeks. Other symptoms will include pain in the chest area, coughing up blood or blood tinged phlegm, weakness, fatigue, weight loss, no appetite, chills, fever and night sweats (CDC, 2013). There are a variety of different methods for controlling the spread of TB disease.
In the health care setting, hospitals have a TB infection control plan as part of their general infection control program designed to ensure prompt detection of infectious patients, airborne precautions, and treatment for those who are suspected or diagnosed with tuberculosis. The first priority would be to limit the amount of people that could be exposed to the infected person. The next step would be to place the infected person into a negative pressure room, allowing to control the environment for which the infected person is kept. The next step would be to use personal protective equipment that protects the respiratory tract from the airborne droplets. This is determined by a fit test and is very important to make sure the health care workers understand how to properly run any equipment that might be involved. In a home setting, it is important to stay home so others are not infected, ventilate the room, wear a mask, and cover the mouth when sneezing, coughing, or speaking. It is best to be alone until medication has been started and a medical provider says it is acceptable to be around other individuals (CDC,
2013). According to the World Health Organization (2013), the recommendation of the DOTS approach is a high priority to meet the ongoing and new challenges of the tuberculosis disease.
DOTS stands for Directly Observed Treatment, Short-coursed. This approach includes five components and remains at the heart of their Stop TB Strategy. The first component is ensuring political commitment with adequate funding. As the first step this is essential for the amount of resources that would need to be involved. This process will take manpower and funding. The second component includes case detection using bacteriology for diagnosis. This element also requires a strengthened laboratory network. An important aspect of this component would include properly trained individuals capable of following strict guidelines. The third component covers standardized treatment across the country that is supervised and patient support. This component is very important because the direct observation of therapy helps prevent drug resistance. The fourth component is making sure there is a supply of the effective drugs readily available for treatment options. This element also includes that all drugs used to treat tuberculosis will be given at no charge to the infected TB patient. The fifth and last component is monitoring and evaluating the system. Establishing reliable communication is key in this project. This step would also include the tuberculosis planning and budgeting tool, reporting
systems, and online training (World Health Organization, 2013). According to the Kansas Department of Health and Environment (2011), “A new regimen, referred to as the 12 dose regimen, represents a major advancement in preventing future cases of TB disease and puts us closer to our goal of TB elimination. The 12 dose regimen is a combination regimen of isoniazid and rifapentine given in 12-once weekly doses under directly observed therapy (DOT).” The Stop TB in the African American Community Summit was introduced to raise awareness about the tuberculosis disease and how it is associated in the African-American community. This community health promotion creates links and networks that will lead to ongoing activities and strategies to decrease TB in the African–American community (CDC, 2013). Tuberculosis treatment is complicated and consists of a lengthy process. The only cure is to stick to the agreed treatment plan and finish all the medications given. It is important to remember that even though the number of TB cases has dropped tremendously in the United States, tuberculosis is still a fatal disease that needs to be taken seriously. The main goal is to remember that tuberculosis is a curable and preventable disease and by promoting research and having treatment options readily available, we can eliminate tuberculosis altogether.

References
Centers for Disease Control and Prevention. (2013). Tuberculosis (TB). Retrieved from http://www.cdc.gov/tb/
Kansas Department of Health and Environment. (2011). KDHE Receives New CDC Recommendations for TB Treatment. Retrieved from http://www.kspace.org/bitstream/1984/20913/1/12-8-11KDHE+News+Release+-+KDHE+Receives+New+CDC+Recommendations+for+TB+Treatment.pdf
World Health Organization. (2013). Tuberculosis (TB):Pursue high quality DOTS expansion and enhancement. Retrieved from http://www.who.int/tb/dots/en/