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Global Health Issue: Tuberculosis

Tuberculosis; commonly referred to as TB, is an infection mostly affecting the lungs and which arises from the Mycobacterium tuberculosis (MTb) bacteria (Getahun et al., 2015). TB is contagious and thus can be spread by breathing infected air. According to the World Health Organization (WHO); in 2017, globally, 10 million people suffered from TB with 1.6 million succumbing. TB is one of the top 10 causes of death globally. 9,105 cases of TB translating to 2.8 cases per 100,000 persons were reported in the US in 2017. Examining the symptoms and care strategies for TB can aid in reducing the TB cases and related deaths.

Some of the risk/contributing factors for TB include proximity to an infected person, the presence of immunosuppressive conditions, age, malnutrition, tobacco smoke, and alcohol among others (Mayo Clinic, 2019). Close contact with infectious cases contributes to a healthy person being infected. Additionally, according to Getahun et al. (2015), immunosuppressive conditions such as HIV weaken the immune system and make individuals susceptible to TB. Smoking and alcohol intake are also some of the contributing factors of TB as those who smoke and take alcohol have a higher prevalence of TB than those who do not.

TB can be prevented using various strategies and approaches. One of those is identifying those with the condition and treating them with relevant drugs. Additionally, ensuring that people with latent TB are treated can prevent it from developing into infectious TB (Mayo Clinic, 2019). Infection control should also be made in settings such as prisons and hospitals to curb its spread (Dheda et al., 2014). Notably, a TB vaccine works in preventing TV spread among children. Moreover, milk pasteurization has been found to be effective in preventing humans from getting bovine TB.

The presence of TB in an individual manifest itself in coughs which last for more than three weeks coughs riddled with blood, and unintentional body weight loss (Mayo Clinic, 2019). Additionally, TB patients experience pest chains and pain when breathing and coughing. Fatigue, fever, chills, loss of appetite and night sweats are some of the other symptoms of TB. However, TB can also affect the kidneys, brain, and the spinal code. When the spine is affected by TB, an individual may experience persistent back pains (Getahun et al., 2015). However, TB affecting the kidneys will manifest itself via blood spots in the urine.

TB can be diagnosed using sputum tests, imaging tests, blood tests, and skin tests. Sputum tests are done when the results of an X-ray show some of the signs of TB. In such a case, samples of the sputum will be taken and tested for the TB bacteria. Imaging tests involve taking a chest X-ray or a CT scan to reveal any signs in the lungs. However, Dheda et al. (2014) assert that blood tests are used in either confirming or ruling out latent or active TB. Moreover, skin tests are done by a healthcare professional checking any swelling in the arm for TB infection. However, such tests are imperfect.

                Advanced Practice Nurses (APNs) have an instrumental role to play in the support of patients who have been diagnosed with TB. One of their roles is identifying any active TB and isolating those affected so that it does not spread. Additionally, the APNs can help patients with TB in adhering to their medications (Dheda et al., 2014). The management strategies for TB include identifying high-risk populations, implementing approaches for finding active TB cases, and ensuring that supervised and supported treatment is provided.

The medications for TB will depend on whether active or latent as well as the parts of the body affected. For instance, those with meningeal TB should receive a 12-month treatment regime of isoniazid and rifampicin (Mayo Clinic, 2019). Additionally, pyrazinamide and ethambutol should be given in the first two months of those 12. According to Getahun et al. (2015), the bacteria which causes TB, MTb, can be suppressed using second-line drugs such as aminoglycosides streptomycin, quinolones ciprofloxacin, and amikacin.

                Since TB treatment regimen lasts for around 12 months, follow up care is needed to evaluate whether the patients adhere to the medications and whether the symptoms have begun to disappear. As such, routine monitoring of the manner in which the patients take the drugs is needed. For those with multidrug-resistant TB, a follow-up for 2 years after completion of treatment is necessary (Dheda et al., 2014). Follow-up ensures that the symptoms do not relapse and that any need for follow-up medications is identified.

In conclusion, TB is one of the top 10 leading causing of death in the world. Caused by MTb, TB’s risk factors include proximity to an infected person, smoking, and alcohol intake. Pain while coughing and breathing, weight loss, and coughs with blood spots are some of the signs and symptoms of TB. The diagnosis of the condition can be done via blood tests, sputum tests, and x-ray scans. APNs have a role in ensuring medication adherence for TB patients. Elsewhere, the pharmacological treatments of TB consist of 12-month drug regimen of isoniazid, rifampicin, pyrazinamide, and ethambutol. Follow-up care during treatment is vital to ensure medication adherence and avoid a relapse of the symptoms.