Essay about tuberculosis
The primary site of infection in the lungs in the lungs is called the Ghon focus, and is generally located in either the upper part of the lower lobe, or the lower part of the upper lobe. Simon foci may also be present. Further spread is through the bloodstream to other tissues and organs where secondary TB lesions can develop in other parts of the lung particularly the apex of the upper lobes , peripheral lymph nodes, kidneys, brain and bone.
All parts of the body can be affected by the disease, though it rarely affects the heart, skeletal muscles, pancreas and thyroid.
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Tuberculosis is classified as one of the granulomatous inflammatory conditions. Macrophages, T lymphocytes, B lymphocytes, and fibroblasts are among the cells that aggregate to form granulomas, with lymphocytes surrounding the infected macrophages. The granuloma prevents dissemination of the mycobacteria and provides a local environment for interaction of cells of the immune system.
Bacteria inside the granuloma can be dormant, resulting in a latent infection. Another feature of the granulomas of human tuberculosis is the development of abnormal cell death necrosis in the center of the tubercles. To the naked eye this has the texture of soft white cheese and is termed caseous necrosis.
Diagnosis may be made using imaging. X-rays or scans o tuberculin skin test. Medical history Physical examination Chest X-ray Microbiological smears Cultures It may also include a tuberculin skin test, a serological test.
Mycobacterium Tuberculosis: An Academic Essay Sample
New TB tests have been developed that are fast and accurate. These include polymerase chain reaction assays for the detection of bacterial DNA. One such molecular diagnostics test gives result in minutes and is currently being offered to low-and-middle-income countries at a discount with support from WHO and the Bill and Melinda Gates Foundation. This test yields results in 2. Mantoux tuberculin skin tests are often used for routine screening of high risk individuals. Currently, latent infection is diagnosed in a non-immunized person by a tuberculin skin test, which yields a delayed hypersensitivity type response to an extract made from Mycobacterium tuberculosis.
If TB is in an active state, an antibiotic called isoniazid, INH is prescribed for six to twelve months. INH is not prescribed to pregnant women, and it can cause side effects such as liver damage and peripheral neuropathy. It is also not uncommon for TB patients to receive streptomycin if the disease is extensive. Drugs therapies for TB may last many months or even years.
If a patient has a drug-resistant strain of TB, several drugs in addition to the main four are usually required. In addition, treatment is generally much longer and can require surgery to remove damage lung tissue. The largest barrier to successful treatment is the patients tend to stop taking their medicines because they begin to feel better. It is important to finish medications in order to completely eradicate the TB bacteria from the body.
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Risk Factors. There are number factors that make people more susceptible to TB infections. Tuberculosis is closely linked to both overcrowding and malnutrition making it one of the principal diseases of poverty. Chronic lung disease is a risk by two to four times and silicosis increasing the risk about 30 fold. Other disease states that increase the risk of developing tuberculosis include alcoholism and diabetes mellitus threefold increase. Certain medications such as corticosteroids and infliximab an anti-a TNF monoclonal antibody are becoming increasingly important risk factors, especially in the developed world.
There is also a genetic susceptibility for which overall importance is still undefined.
Tuberculosis is spread from person to person through tiny droplets of infected sputum that travel through the air. If an infected person coughs, sneezes, shouts, or spits, bacteria can enter the air and come into contact with uninfected people who breathe the bacteria into their lungs. The World Health Organization has achieved some success with improved treatment success and a small decrease in case numbers.
There is a vaccine available for tuberculosis called BCG vaccine that is used in several parts of the world where TB is common. However the immunity that it induces decreases after about ten years. Better methods of preventing tuberculosis or TB relapses include eating a healthful diet that takes care of your immune system, getting a TB test regularly if you work or live in a high risk environment, and fishing TB medications.
To prevent transmitting the disease to others if you are infected, stay home, cover your mouth, and ensure proper ventilation. Progression from TB infection to TB disease occurs when the TB bacilli overcome the immune system defenses and begin to multiply. In primary TB disease of cases this occurs soon after infection. However, in the majority of cases, a latent infection occurs that has no obvious symptoms.
The risk of reactivation increases with immunosuppression, such as that caused by infection with HIV. In , case rates varied from less than 1. Reported cases of tuberculosis, — Some metropolitan statistical areas have even higher rates. For example, in , case rates per , population were In , the case rate in central Harlem was Individuals from Mexico, the Philippines, and Vietnam accounted for nearly half 45 percent of these cases, with other countries accounting for the remainder.
The resurgence of tuberculosis in the mids and early s also affected health care workers and others employed in settings that served patients, inmates, or clients with tuberculosis. A number of high-profile outbreaks of tuberculosis—including cases of multidrug-resistant disease—were documented in hospitals, nursing homes, prisons, homeless shelters, and other settings see, e.
Most such outbreaks have been linked to lapses in infection control practices, delays in diagnosis and treatment of infectious individuals, and the presence of high-risk populations including people with HIV infection or AIDS and recent immigrants from countries with high rates of tuberculosis. In , of the 16, cases of tuberculosis for which occupational data were reported Such individuals accounted for less than 5 percent of the total workforce BLS a, b. Health care workers accounted for about 2.
Write an essay on tuberculosis
In , health care workers accounted for about 9 percent of employed persons and 8 percent of tuberculosis cases among employed persons Amy Curtis, CDC, , personal communication and about 5 percent of the total workforce. As discussed in Chapter 5 , it can be difficult to determine whether tuberculosis in health care and other employed workers is due to workplace or community exposure.
Several health care and correctional workers have died of tuberculosis following documented work-related exposure to the disease Dooley and Tapper, , but no comprehensive mortality figures are available. Most of these workers as well as patients or inmates who died suffered.
Newly reported outbreaks of tuberculosis in health care facilities have dropped off since the mids, but recent outbreaks have been reported in correctional facilities see Chapter 5. Reports on facilities that experienced tuberculosis outbreaks in the late s and early s describe lapses in tuberculosis control measures followed by the implementation of new protective measures, and the subsequent reduction of worker exposures and new infections. In , the U. Congress requested that the National Academy of Sciences undertake a short-term study of occupational tuberculosis P.
Consistent with legislative conference language, the committee focused on three questions:. Are health care and selected other categories of workers at a greater risk of infection, disease, and mortality due to tuberculosis than others in the community within which they reside?
If so, what is the excess risk due to occupational exposure? Can the risk of occupational exposure be quantified for different work environments and different job classifications?
Essay on prevention and control of tuberculosis
What is known about the implementation and effects of the Centers for Disease Control and Prevention CDC guidelines for the prevention of tuberculosis in health care facilities? What will be the likely effects on tuberculosis infection, disease, or mortality of an anticipated Occupational Safety and Health Administration OSHA standard to protect workers from occupational exposure to tuberculosis?
It also did not include an evaluation of the costs or cost-effectiveness of the implementation of a standard.
When the study committee officially began work on April 1, , publication of the rule was expected in July When the committee met for the final time in September , the final standard had not been issued, and its status was uncertain following the change in control of the Executive Branch in January As explained. The rest of this chapter briefly reviews responses to resurgent tuberculosis and proposed strategies for the elimination of tuberculosis in the United States and worldwide.
Essays on Tuberculosis
Chapter 2 provides a basic review of tuberculosis transmission, infection, and disease. Chapter 3 discusses the proposed OSHA rule in the larger context of regulatory and other strategies used to protect worker health and safety. It also examines the statutory, judicial, and administrative frameworks within which the rule was developed. Chapter 5 , 6 , and 7 are organized around the three questions posed to the committee: the extent of occupational exposure to tuberculosis, the effects of the CDC guidelines, and the likely effects of an OSHA rule, respectively.
Appendix B discusses the strengths and limitations of the tuberculin skin test, Appendix C reviews the literature on the occupational risk of tuberculosis, and Appendix D reviews the literature on the effects of workplace tuberculosis control measures. Appendix F reviews issues related to the use of personal respiratory protection devices and programs in health care and other settings.
Appendix G lists the recommendations of another recent IOM report on strategies for the elimination of tuberculosis in the United States, and Appendix H includes brief biographies for members of the committee. The increase in tuberculosis case rates in the mids and early s prompted public health authorities to revive and adapt traditional strategies to prevent and control tuberculosis in the community. Specific federal funding for tuberculosis control programs, which had virtually disappeared in the s, resumed in the s and increased substantially in the s, as shown in Figure IOM, States and some cities and counties began to rebuild programs that had been neglected or dismantled in the s and early s.
A particular focus of federal, state, and community efforts was drug-resistant disease, particularly that related to inappropriate or incomplete treatment. One measure, directly observed therapy, targeted the failure of many with active tuberculosis to complete their full, several-month treatment regimen Addington, ; Chaulk et al. Physician failure to prescribe the appropriate drugs at the appropriate level and frequency for the appropriate period of time is another problem Rao.
Trends in tuberculosis funding CDC, fiscal years — and numbers of tuberculosis cases in the United States in thousands. The development of practice guidelines and physician education programs are partial responses to such treatment errors see Chapter 4 , but physician awareness of and adherence to tuberculosis treatment guidelines remain concerns DeRiemer et al.
Other elements of the attack on drug resistant disease have included faster laboratory identification of drug-resistant strains of the disease Tenover et al. Outbreaks of tuberculosis in several health care and correctional facilities prompted additional actions by public health officials, health care and other managers, and those representing workers in these institutions see Box for a selective chronology. Federal and state investigations of these outbreaks often pointed to lapses in basic infection control protocols including failure to promptly identify and isolate suspected cases and failure to provide, maintain, and properly use negative-pressure isolation rooms designed for patients with infectious tuberculosis.
Beginning in , CDC and other public and private health groups issued guidelines for the prevention and control of workplace transmission of tuberculosis in health care facilities, correctional facilities, and settings that serve homeless people CDC, a,b, a, b, b.
The CDC guidelines for health care facilities were adapted from earlier infection control guidelines.