Disease Control and Education Plan

Answer

Disease Control and Education Plan

            Tuberculosis (TB) is a progressive and chronic Mycobacterium tuberculosis infection that is characterized by a period of latency after the initial infection. TB primarily affects the lungs and symptoms include weight loss, fever, a productive cough, and malaise. The disease is diagnosed by sputum culture and smear and rapid molecular-based diagnostic tests. Treatment with multiple anti-mycobacterial agents is often given for a minimum of six months (Tierney & Nardell, 2018).  Public awareness and improved knowledge of the disease may improve surveillance, diagnosis, and treatment of cases; which may in turn reduce transmission. This report provides a public education and disease control plan for Tuberculosis.

Objectives

1. To increase public understanding of the causes and symptoms of TB.
2. To educate the public about transmission, prevention, and control of TB infection.
3. To educate the public on strategies and interventions for detecting TB infections and treating active infections.

Goals

1. To improve public understanding of the disease, its transmission, control, and management of TB patients
2. To reduce transmission of TB through timely detection and treatment of cases; supported by public awareness of the disease.

Epidemiological Data

10. tuberculosis has an ancient origin. It has devastated human beings for more than 70,000 years. Currently, it has infected about 2 billion people all over the world with about 10.4 million new cases per year (Barberis et al., 2017). Similarly, Raviglione and Sulis (2016), estimate that there are approximately 9.6 million new cases of the disease and 1.5 million TB-associated deaths per year. In 2019, there were 8,920 provisional reported cases of TB compared to 9,025 reported cases of TB in 2018 in the U.S. The rate of provisional reported cases was 2.7 per a 100,000 population. A total of 60 jurisdictions, including US territories, cities, and states report TB associated data to the Centers for Disease Control and Prevention (CDC). About 13 million people are estimated to be living with latent TB in the U.S. (CDC, 2019).

Outbreaks and Mitigation Measures

There are no documented historical outbreaks of TB in my community; however, records of regional outbreaks of the disease exist. The disease is predicted to have infected about 3 million human hominids in East Africa approximately 15,000 to 20,000 years ago. Another documented TB epidemic occurred in Western Europe in the 18^th Century with a mortality rate of about 900 deaths per 100,000 people per annum (Barberis et al., 2017). There have been recent outbreaks of tuberculosis in the United States. TB outbreak is defined as detection of a minimum of three cases of the infection, which are related by transmission as suggested by epidemiologic linkages and routine genotyping. Outbreaks of TB in the U.S. are an ongoing problem, which hinders efforts to eliminate it. Between 2009 and 2015, 21 outbreaks of TB were witnessed in the U.S. and involved 457 patients. Of these, 79% (363) were born in the U.S., 11% (51), were aged more than 15 years and 80% were male and 20% female. Methods that were used to handle and control recent cases of the disease in 2019 in the U.S. include utilization of labor-intensive and costly activities including active case finding and implementation of large-scale treatment interventions. These interventions should be continued for an elongated period of time to interrupt transmission (Mindra et al., 2017).  

Initiatives Taken by Government Departments to Mitigate Impact of the Disease

            One of the initiatives is cooperation of the CDC with partners in departments and local departments in surveillance of the disease, diagnosis, and timely treatment of cases. There are increased efforts to detect and treat latent TB infections among high-risk populations. High-risk populations include the African-American communities, Latinos, Asian Communities, HIV patients, children under the age of 15 years, people in correctional facilities, the homeless, and pregnant women (CDC, 2019). The other strategy is evidence-based testing and diagnosis of TB. Diagnosed cases, whether latent or active, are then treated appropriately. Patients are educated about adverse events of each drug in the prescribed regimen to improve adherence (CDC, 2019).

Suggestions for Reducing Health Risks

            The first suggestion is that social determinants of health should be addressed through an interdisciplinary and multi-sectorial collaboration. This is because socially excluded and poorest groups carry the largest burden of the disease. The strategies can include measures for promoting poverty reduction and targeted interventions for addressing healthcare needs of high-risk populations (Raviglione & Sulis, 2016). The second suggestion is educating the public to improve diagnosis and medication adherence. Improved medical adherence can reduce the risk of emergence of multidrug resistant M. tuberculosis strains. The other suggestion is to advocate for governmental and non-governmental organizations collaboration in research on TB new drugs, diagnostics, and vaccines. This intervention may improve detection, prevention, diagnosis, and treatment of the disease. In addition, antiretroviral therapy for people living with HIV should be scaled up. HIV is considered as the strongest risk factor for the disease. TB increases HIV-related deaths (Raviglione & Sulis, 2016). 

Etiology and Pathophysiology of TB

            TB is caused by M. tuberculosis that is spread via aerosolized droplets, contagions, and dried-out residuals of droplets. Infected patients will manifest with signs and symptoms such as chest pains, sputum production, sputum may at times have blood, loss of appetite, fever, weight loss, night sweats, and fatigue (World Health Organization (WHO), 2019). Tests for detecting TB in the body include a positive TB skin test and/or a positive blood test. Other tests such as chest X-ray may be used to demonstrate the infection of the lungs. In addition, a sputum sample may be taken for culture. X-ray may demonstrate respiratory colonization by the M. tuberculosis. Culture in appropriate may lead to identification of M. tuberculosis and hence, confirmation of that the respiratory disease is caused by the pathogen (CDC, 2019).

Suggested Measures for Preventing Outbreak of the Disease

            Suggested measures for preventing the outbreak of the disease include triaging of patients with TB signs and symptoms to reduce the risk of transmission to persons attending healthcare facilities, healthcare workers, and exposed persons at high risk of being infected. The other measure is system change. System change includes improvement of infrastructure at the point of care and equipment availability to facilitate best practice; training and education of healthcare workers; monitoring of outcomes, practices, and processes; improved communication; provision of timely communication, and culture change via fostering of a safety climate (WHO, 2019). The other measure is respiratory isolation/ separation for those who demonstrate symptoms or presumed to be infected with TB to reduce the risk of transmission. In addition, there should prompt treatment of TB cases to reduce transmission. On the other hand, the public needs to be educated about respiratory hygiene, for instance, on cough etiquette, to reduce transmission. Upper-rooms in hospitals should receive germicidal ultraviolet systems to reduce transmission (WHO, 2019).