Disease Analysis Paper: Tuberculosis

For this disease analysis paper, it will focus on TB. Tuberculosis is a respiratory disease that affects mostly the lungs although there are instances of disseminated TB that affects other body systems ("CDC | TB | Basic TB Facts", 2017). This disease is caused by Mycobacterium tuberculosis and not every victim attacked by this bacterium gets sick thus categorizing the condition into latent TB infection and TB disease. This disease is airborne, and it is frequently transmitted through aerosols when infected people cough or during speaking. The risk factors associated with TB include weak immune status especially those individuals with HIV infection or any other medical condition that lowers the immune system. Regarding the data and statistics of this disease, the CDC has ranked the disease as one of the major global deadliest diseases ("CDC | TB | Basic TB Facts", 2017). According to the CDC data, about 1/3 of the world's population suffer from TB. For the United States data in 2015, about 9,557 TB cases were reported with an incidence rate of three persons per 100,000 individuals. The incidence rate has been stable as from 2013 although there was an increase from 1993 data ("CDC | TB | Data and Statistics", 2017).

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The health disparities associated with the disease include conditions such as immunocompromised individuals. According to healthypeople.gov, (2017), they conducted a disparity overview by comparing race and ethnicity where they examined incidence rate between Asians and the Whites (not Hispanic or Latino). From the statics, the Asians (not Hispanic or Latino) are the leading population when compared with Whites (not Hispanics or Latino) from 2010 through 2013. From the data above, Asians showed a higher incidence rate. The risk factors between the two populations have not been reviewed although they cut across all populations. Another disparity associated with this disease is the vulnerable populations without access to health care services and those living below poverty line. Poverty is associated with malnutrition's which facilitates weak immune system (healthypeople.gov, 2017).

Regarding the prevention strategies for this disease, different measures have been taken in place including complementary and alternative health therapies. One of the preventive strategies is the administration of TB vaccine known as BCG (Bacille, Calmette- Guerin) (Cold, et al., 2017). The vaccine is effective for the young children, but with the adults and immune-compromised, it is less effective. Other alternative measures include avoiding stuff places for long hours with people with active TB, and use of protective measures especially face masks when giving services to TB victims in the health facilities. Additionally, those living with people infected with TB are encouraged to promote complete treatment (Cold, et al., 2017).

Tuberculosis is associated with clinical studies especially those involving drugs and treatment plans and other management strategies. According to Kwon, Jeong, & Koh, (2014), advancements have been made regarding the treatment strategies with the development of new drugs that are effective with shorter durations of treatment. From the clinical trial by Kwon, Jeong, & Koh, (2014), Moxifloxacin and levofloxacin showed a good efficacy for early treatment of multidrug-resistant TB (MDR-TB. The clinical trials showed that linezolid had a better potential of treating refractory MDR-TB. Other drugs analyzed in the study were bedaquilline and delamanid that had a better treatment outcome. The late generation fluoroquinolones along with 1st and 2nd line anti-TB drugs had a better outcome regarding treatment duration and MDR-TB. Other clinical studies have focused on aspects such as pathophysiology of the disease and its management (Kwon, Jeong, & Koh, 2014).

In conclusion, the pathophysiology of TB involves inhalation of infectious droplets that settle in the airways (Knechel, 2009). Most of the bacilli are trapped in the upper respiratory system due to the presence of mucus. Those bacilli that bypass the mucociliary barrier get to the alveoli where the macrophages engulf them. Other cell-mediated defensive mechanisms take part in destroying the bacilli which are actively dividing in macrophages. People with integral cell-mediated immunity enhance formation of granulomas that limit the replication of the bacilli. For less immunocompetent persons, the granuloma formation is limited thus making the necrotic tissue to undergo liquefaction with the fibrous wall losing structural integrity (Knechel, 2009). The bacilli can then be coughed out and get disseminated to other body systems. From then the disease can then present as latent tuberculosis, primary disease, primary progressive TB, or extra-pulmonary TB (Knechel, 2009).

References

CDC | TB | Basic TB Facts. (2017). Cdc.gov. Retrieved 9 June 2017, from https://www.cdc.gov/tb/topic/basics/default.htm

CDC | TB | Data and Statistics. (2017). Cdc.gov. Retrieved 9 June 2017, from https://www.cdc.gov/tb/statistics/default.htm

Cold, F., Health, E., Disease, H., Management, P., Conditions, S., & Problems, S. et al. (2017). Tuberculosis (TB)-Prevention. WebMD. Retrieved 9 June 2017, from http://www.webmd.com/lung/tc/tuberculosis-tb-prevention

Disparities Data Overview IID-29 by Race and Ethnicity | Healthy People 2020.

(2017). Healthypeople.gov. Retrieved 9 June 2017, from https://www.healthypeople.gov/2020/data/disparities/summary/Chart/4698/3

Knechel, N. A. (April 01, 2009). Tuberculosis: Pathophysiology, Clinical Features, and Diagnosis. Critical Care Nurse, 29, 2, 34-43

Kwon, Y. S., Jeong, B. H., & Koh, W. J. (January 01, 2014). Tuberculosis: clinical trials and new drug regimens. Current Opinion in Pulmonary Medicine, 20, 3, 280-6.