Epidemiology and Nursing Research.

Epidemiology and Public Health

Epidemiology is the study of the trends, causes, and consequences of specific diseases as determined by populations. It is one of the most important aspects of public health. The epidemiologist strives to comprehend and design statistical data analysis for clinical research and public health. The majority of these diseases are communicable, such as chickenpox, tuberculosis, Ebola, influenza, polio, and Hepatitis B. This study will apply epidemiology and nursing research approaches to Tuberculosis as an important communicable illness over the years. Tuberculosis is a communicable disease that is faced on a worldwide demographic, and a ninth leading cause of death worldwide. (WHO, 2017). Therefore, being a pivotal disease to research on and analyses it to them extensively. Most of these conditions are caused by various infectious agents. In the case of Tuberculosis, it is caused by a single infectious agent known as Mycobacterium tuberculosis. It is spread through the air from a person who is infected through the mode of transmission majorly being Coughing, sneezing, spitting, and even talking or laughing. (McIntosh, 2017).

Types of Tuberculosis

There are two types of TB; Latent TB and active TB. Active Tuberculosis has the following symptoms. The most common symptom being coughing, sometimes with mucus and later on with blood. Chills, Fatigue, fever, loss of weight, loss of appetite and night sweats are among the primary symptoms. (McIntosh, 2017). However, there are no signs and symptoms associated with the inactive or latent TB. The complication of this disease is that it may end up infecting the Kidney, Lymph nodes, bone joints and lungs as the vital organ where TB occurs. (Med broadcast).

Tuberculosis Treatment

Tuberculosis is a curable disease. It involves taking antibiotics for several months. If it's fatal and not treated, it leads to death and if treatment is not complete. The therapy usually of Two antibiotics the (Isoniazid and Rifampicin) For six months however in the first two months of six months two additional antibiotics, (Pyrazinamide and Ethambutol). One may feel better after few weeks, but it is advisable to complete the treatment. However, if you skip a dose, the TB infection may become resistant to antibiotics. (Nhs.Gov. Uk)

Mortality and Morbidity of Tuberculosis

Mortality is a measure of the number of deaths in a given population. Tuberculosis is one of the top ten causes of deaths worldwide. The mortality rate depends on the demographic areas. From the facts, 1.3 million people have died in 2016 due to TB illness. In which 95% of these deaths account to the low and middle-income countries. While the following nations account for 64% of mortality rate, India, China, Indonesia, Philippines, Pakistan, Nigeria and South Africa. While smoking attributes to 8% mortality rate, among the tuberculosis patients. (WHO, 2017). However, TB mortality is falling about 3% per year.

Morbidity is the rate or incidence of getting diseases in a population. The morbidity rate stands at a percentage of per year. TB Incidence is the number of new cases of the disease in a community during a specified period usually a year. (Ij, 2017). There are about 10.4 million new TB cases reported worldwide as per in 2016 WHO statistics. TB prevalence is the number of people in a population who are living with the Tuberculosis. Yes, tuberculosis is a reportable disease. The disease is reported at each time they occur it helps to produce an estimate of TB statistics for each country and support in ways to curb the epidemic. Tuberculosis is a reportable disease to the local health officer and later the department of health and social services. The unit has the responsibility to control tuberculosis within designated jurisdictions and to maintain the disease and the registers. (CDC, 2017)

Determinants of Health

There are various determinants of health in the society. Many actors affect the health of individuals and communities. These factors contribute adversely to the development of this disease. There are three major determinants of health. First, the social factors that include, the social and physical environment. It consists of the level of income and social status that depicts how higher income and social status is highly associated with better health and living standards as compared to low-income families especially in low income and middle countries. Thus, being vulnerable to this disease at high margin due to lack of health facilities, good transport, better housing facilities which pose a significant threat to their health. Physical environment. Which includes clean air, healthy working places, how is the employment and working conditions? Are people well educated since low education levels are linked with poor health and so. (Harris et al., 2010).

Secondly, the person’s characteristics and behavior. We all know that personal expression plays a role in health outcomes such as substance abuse, diet, and physical activity. Thus, positive changes in one’s practice can reduce the occurrence of TB disease (WHO, 2017). Lastly, Health services. Access to health services which are of quality has a positive impact on one’s health. Lack of access or limited access to health facilities affects individuals’ health. It may be due to high costs, lack of insurance cover, unavailability of services. Which leads to treatment of TB. And hence increasing the mortality and incidence of TB.

Epidemiologic Triangle

An epidemiologic triangle is a tool that is used to help understand the infectious disease. It majorly explains the organism causing illness and the conditions that allow it to reproduce and spread. The significant points of the triangle are the Host, Agent, and Environment. (Engard, 2017). It is also known as an epidemiologic triad. The Agent pillar tries to identify the agents and its characteristics such as infective dose and infection routes, pathogenicity, survival on different conditions, life cycle, transmission pathways. From this Tuberculosis, the agent is Mycobacterium tuberculosis.

Mycobacterium Tuberculosis

It is an acid based aerobic rod. Being an Aerobic Rod, it reproduces slowly and so much sense of heat and ultraviolet. Affecting mostly the lungs and later to other organs as discussed. (The Merk manual, 2010). It is transmitted through airborne having its infectious routes being coughing, sneezing and laughing. If it can stay in the atmosphere and later inhaled it can cause infection, but it is so prevalent on the family member and coworkers. (Reicher et al., 2002).

Host and Environment

The host pillar identifies all the characteristics of all hosts if they are definitive, intermediate, reservoir or paratenic. The features may include both intrinsic and extrinsic factors. This infectious agent (Mycobacterium tuberculosis) is susceptible to a human who is the host majorly the respiratory system. It is most prevalently to the impaired hosts such as diabetes mellitus, cancer, and HIV /AIDs have high chances of getting TB. However, the free host can be infected if it is exposed continuously to the infectious agent.

The last pillar seeks to characterize the abiotic and biotic and socioeconomic environments for the agent and host and interrelates them. (Nganwa et al., 20). The environment affects the organism which is the causative agent such as ethical, cultural minority, immigrants, homeless, overcrowded housing, prisons cells and such. If the density of the bacterium is high, there is a likelihood of more infections of tuberculosis. (Smeltzer et al., 303). Yes, there is a particular consideration for specific groups and communities especially the immune impaired, doctors and nurses and to the general public that is working under best conditions of survival of the causative agent.

Role of Community Health Nurse

Community health nurse has various roles in his/her jurisdiction. Apart from their dominant task to take care of healthy and sick, they play significant roles in case finding, reporting, and data analysis among others. Community health nurses are entitled to ensure the following as their roles; Make sure the TB patients treatment has no interruption, or there is no skip of doses. Monitor the side effects from the treatment of the patient and quickly help out as needed. Patient health is the ultimate role of every nurse; Therefore, they have to ensure gradual patients improvement always through completion of correct treatment of antibiotics. Providing counseling and support for the patient and to their families is also a responsibility that should be carried carefully. (Christine,48)

A nurse is involved in case finding where can identify the patients with TB. After they initiate plans and records on how to manage these people with the infectious disease. At this stage, the nurse communicates with the health providers and hospital infection control practitioner by notifying them of the TB incidences. The community health nurses are required to collect data or make an assessment of all the patients to ensure a proper hospitalization and diagnosis of the patient. It may include obtaining the demographic information. Then through the analysis of the extent of the TB illness from the findings and lab analyses and creating a baseline. Lastly, the follow up is ensuring how well are the patients taking medication. How is the hospitalization and review of the medical history of the patients through clinical response to treatment?

World Health Organization (WHO)

WHO is one of an organization that is more concerned in the detection of the communicable diseases. Tuberculosis is one of the major infectious diseases of concern among the population. World Health Organization works with various national government to put in place different measures to curb the morbidity and the mortality rates of this disease. WHO is committed to disease prevention and health promotion. Some of the primary prevention of this communicable disease being improving health by changing the impact of social and economic determinants of health and providing education on behavioral and medical health risk ascertained through contraction of the disease. The increase in oral and dental hygiene education and provision of services such as immunization and vaccination of children. The vaccination and post-exposure prophylaxis to people exposed to the risk of communicable disease such as tuberculosis.

However, WHO has more measures to curb this disease by enhancing early detection of tuberculosis and trying to improve their lives through positive health outcomes such as tuberculosis screening programs for detection, Preventive drug therapies and increment of health care facilities and services to the marginalized areas. Counselling and providence of literacy programs and provision of chemo-prophylactic agents to control the uprise of tuberculosis among population is also put in place

Tuberculosis as a Global Disease

Tuberculosis is a global disease. It is referred to as a pandemic. It is because tuberculosis is found in any country and it is one of the top leading infectious causing death disease. From the records, it shows that the WHO has reported of about two billion people have been affected by the infectious agent Mycobacterium tuberculosis. However, the specific incidences are approximately 10.4 million people with TB. And from the figures, only 1.7 million people have died of the disease. The most vulnerable human beings are women children and those with HIV/AIDS. WHO has also reported figures in which are for growth of drug resistance referred to as MDR-TB which is about 490,000 each year. It poses a significant threat to the eradication of the disease. Through such as these effects, the WHO have formulated a Global Tb programme and department a task force ensuring TB impact is measured and treated effectively to save lives. Various countries have put measures to curb this disease through the department of health and the local community health practitioners mostly to the massive burdened TB countries such as India, Indonesia, China, Nigeria, Pakistan and South Africa accounting for 64% of all incidences. However, in 2016 the reported TB cases in the 30 high burden countries are 87%.

Tuberculosis Incidence and Prevalence

Tuberculosis is endemic mostly to the Asian and sub-Saharan countries with a 45% and 25% TB incidence rates. Also, having an annual incidence of several hundred per 100,000 population. Most of the sub-Saharan nations the disease are endemic due to high rates of HIV/AIDS infections and low-income factors that may lead to poor living conditions regarding social and environmental factors, behavioral and health services. Therefore, these two areas being the most affected rates of TB people live.

Conclusion

In conclusion, Tuberculosis is a treatable disease upon early detection at the health facilities. TB is curable by use of the antibiotics for six months. Apparently, if the patients skip the doses, they may end up being a multi-drug resistant TB that may take up to 2 years to health by the use of increased chemotherapies. Tuberculosis is a global disease that causes a lot of deaths per year. It is the initiative of the national and international organization to join hands and help in the realization of vision 2030 of eradicating this killer disease through the various programme and increased hygiene and raising the level of living standards of people.

Works Cited

Brian Engard. Whats Epidemiologic Triangle. River Online University. (2017).

David Nganwa, Tsegaye, Tameru, Gemenchu, Asseged, Zinaida, and Wanda. Applying the epidemiologic problem-oriented approach (EPOA). The epidemiologic triangle. PubMed. (2011). 20-100

Caroline Bunker Rosdahl, Mary T Kowalski. Textbook of Basic Nursing. Philadelphia Lippincott Williams and Wilkins. (2008). p 101-385

CDC. Center for Disease Control Prevention. U.S Department of Health and Human Services. Communicable diseases. (2017)

Christine Bell. The treatment of patients with TB and the role of the nurse. Department of Respiratory Medicine, Manchester Royal Infirmary. (2004) Vol 100 (36), p. 48.

https://www.nursingtimes.net/the-treatment-of-patients-with-tb-and-the-role-of-the-nurse/20413

Harris K, Holden C, Chen M. Information on National Indicators for Social Determinants of Health. National Opinion Research center. (2010).

Ij. Basic statistics. About incidence, prevalence, morbidity, and mortality- Statistics. Department of Health, New York State. (2017).

Https://www.health.ny.gov/diseases/chronic/basicstat.htm

James McIntosh. Tuberculosis: Causes, Symptoms, and Treatments. Reviewed by the University of Illinois-Chicago, School of Medicine. Medical News Today. (2017).

Smeltzer, B., Hinkle, J & Cheever, k. Brunner & Suddarth's textbook of medical-surgical Nursing. 11th ed. Philadelphia Lippincott Williams and Wilkins. (2008). P 255-498

WHO World Health Organization. Tuberculosis. Global Health Observatory(GHO). Data. (2017).

Https://www.who.int/gho/tb/en

WHO. World Health Organization. Tuberculosis. Media center. Tuberculosis Facts sheet. (2017).

Https://www.who.int/gho/tb/en

WHO. World Health Organization. Tuberculosis. The Determinants of Health. Health Impact Assessment (HIA). (2017).

Https://www.who.int/hia/evidence/doh/en

WHO. Health promotion and disease prevention through population-based interventions, including action to address social determinants and health inequity. (2009)

http://www.emro.who.int/about-who/public-health-functions/health-promotion-disease-prevention.html