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Tuberculosis tertiary prevention
An essay on tuberculosis
Background of tuberculosis
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Tuberculosis
Introduction
Tuberculosis (TB) is an ancient disease, with evidence found in human remains dating back over 9000 years, to the Neolithic era. 1 It was identified and described by Hippocrates as early as 460BC, and continued to be documented in such places as ancient Rome, Egypt, India and China. 2 3 4 5
The disease can be caused by different mycobacterium such as Mycobacterium bovis, M. africanum, M. canettii, M. microti, and most commonly, M. tuberculosis; although the five are highly similar and are together termed the Mycobacterium tuberculosis complex (MTBC). Recently, two additional organisms. Mycobacterium pinnipedii and Mycobacterium caprae have also been implicated with the disease in humans. 6, 7 Members of the MTBC are gram-positive, long, rod-shaped bacterium with unique characteristics such as an exceptionally slow growth rate and a high content of lipids in their cell wall which provide protection against degradation and may account for their persistent survival in the environment even after the death of a host. 8
Active tuberculosis only develops in about 10% of infected persons, remaining dormant in the rest; although the latent infection may later progress to active disease years later, especially in immune-compromised individuals. 9 Infection by MTBC may involve any organ of the body, but clinical presentation is most common in the lungs (pulmonary TB). General symptoms include fever, loss of appetite, weight loss, fatigue and severe cough with bloody sputum (hemoptysis) which may lead to death if untreated. 10 Mortality rates without treatment are high: in a study of natural history of TB in HIV-negative patients, 70% died within 10 years. 11 Tuberculosis remains a major health problem in the world...
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...as better ventilation, negative pressure rooms and the use of UV light for disinfection, nosocomial transmissions continue to post a problem possibly because they are iatrogenic and cases may be missed due to underdiagnosis. 16
Infectiousness
Infection rates of TB are high, especially when in frequent or close contact with individuals with active TB. One study estimates an infection rate of about 22% and a diagnosis with positive sputum smear is the strongest indicator of infectiousness. 19 However, contrary to common belief, sputum smear-negative patients are also infectious, with a study in San Francisco attributing 17% of transmissions to such cases. 20
Researchers have also identified a list of other factors associated with TB transmission such as environmental, organism and host factors, but these unfortunately, are outside the scope of the present paper. 16
Before discussing how disease has shaped history and altered cultures, it is important to understand how they themselves have developed and changed throughout history. Disease, in the broadest definition of the word, has been present since the beginning of humanity. Even ...
Ventilator Associated Pneumonia (VAP) is a very common hospital acquired infection, especially in pediatric intensive care units, ranking as the second most common (Foglia, Meier, & Elward, 2007). It is defined as pneumonia that develops 48 hours or more after mechanical ventilation begins. A VAP is diagnosed when new or increase infiltrate shows on chest radiograph and two or more of the following, a fever of >38.3C, leukocytosis of >12x10 9 /mL, and purulent tracheobronchial secretions (Koenig & Truwit, 2006). VAP occurs when the lower respiratory tract that is sterile is introduced microorganisms are introduced to the lower respiratory tract and parenchyma of the lung by aspiration of secretions, migration of aerodigestive tract, or by contaminated equipment or medications (Amanullah & Posner, 2013). VAP occurs in approximately 22.7% of patients who are receiving mechanical ventilation in PICUs (Tablan, Anderson, Besser, Bridges, & Hajjeh, 2004). The outcomes of VAP are not beneficial for the patient or healthcare organization. VAP adds to increase healthcare cost per episode of between $30,000 and $40,000 (Foglia et al., 2007) (Craven & Hjalmarson, 2010). This infection is also associated with increase length of stay, morbidity and high crude mortality rates of 20-50% (Foglia et al., 2007)(Craven & Hjalmarson, 2010). Currently, the PICU has implemented all of the parts of the VARI bundle except the daily discussion of readiness to extubate. The VARI bundle currently includes, head of the bed greater then or equal to 30 degrees, use oral antiseptic (chlorhexidine) each morning, mouth care every 2 hours, etc. In the PICU at children’s, the rates for VAP have decreased since the implementation of safety ro...
Epidemiology of VAP Hunter, Annadurai and Rothwell defines ventialtor-associated pneumonia as nosocomial pneumonia occurring in patients receiving more than 48 hours of mechanical ventilation via tracheal or trascheotomy tube. It is commonly classified as either early onset (occurring within 96 hours of start of mechanical ventilation) or late onset (>96 hours after start of mechanical ventilation. A ventilator is a machine that is used to help a patient breathe by giving oxygen through an endotracheal tube, which is a tube placed in a patient’s mouth or nose, or through a tracheostomy, which is a surgical opening created trough the trachea in front of the neck. Infection may occur if bacteria or virus enters the tube into the lungs or airways by manual manipulation of the ventilator tubing. Ventilator-associated pneumonia accounts for 80% of hospital-acquired pneumonia, 8-28% of incubate... ...
A low-grade fever, weight loss, lethargy, night sweats, respiratory congestion, cough, and hemoptysis, are symptoms indicative of Tuberculosis. A positive skin test, abnormal chest x-ray and a positive sputum culture are indicators of Tuberculosis. Tuberculosis is transmitted by inhalation of respiratory droplets containing bacteria. This excerpt depicts tuberculosis and its history and prevalence.
Signs and Symptoms of Active Tuberculosis Mycobacterium tuberculosis (MT) is a slender, rod-shaped, aerobic bacillus which causes tuberculosis. Tuberculosis (TB) is an airborn infection which is transmitted via inhaling droplet nuclei circulating in the air. These droplets are expelled from the respiratory secretion of people who have active TB through coughing, sneezing, and talking (Porth, 2011). Some bacilli stay in the upper airway and are swept out by mucus-secreting goblet cells and cilia on the surface of the airway.
The rail market continued to grow and by the 1860’s all major cities within the United States were connected by rail. The main diseases that showed the most virulence during the time were cholera, yellow fever and consumption, now known as tuberculosis. The 9th census mortality data showed that 1 out 7 deaths from disease were caused by tuberculosis and 1 out of 24 disease deaths were resulting from cholera. . Until the 1870s the general consensus of the spread of disease through population was still the primitive idea that it came from the individual and not specifically the pathogen.... ... middle of paper ... ...
Tuberculosis as (TB) is caused by Mycobacterium tuberculosis. It is slow growing bacteria that thrive in areas of the body that are rich in blood and oxygen, such as the lungs. Tuberculosis develops when Mycobacterium tuberculosis bacteria are inhaled into the lungs. The infection usually stays in the lungs, but the bacteria can travel through the bloodstream to other parts of the body.
Hepatitis is the inflammation or swelling of the liver. The inflammation can happen from different injuries or viral forms of a disease. People who experience hepatitis have the symptoms of malaise, nausea, vomiting, loss of appetite, fever and jaundice. There are six known forms of Hepatitis which are Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, Hepatitis E and Hepatitis G. The presence of hepatitis in the body can be very risky and cause severe death if not taken care of. Hepatitis is a severe issue that affect many people around the world like third world countries and cross contamination can occur mainly in health care places due to the exposure of patients with the disease and accidents handling blood or instruments, Hepatitis A,B,C,D,E and G are distinct diseases that differ in transmission and vaccines to prevent them or cure them.
One of the first steps to treating Tuberculosis is identifying which form has developed in the body. The two forms that could progress in the body are latent Tuberculosis infection and active Tuberculosis infection (CDC, Morbidity and Mortality Weekly Reports). Latent Tuberculosis is the dormant form of the bacteria, meaning that it is inactive and doesn?t cause an infectious reaction in the body. Even if the latent form enters the body, treatment should be sought (CDC, Morbidity and Mortality Weekly Reports). Latent Tuberculosis can become active Tuberculosis easily though, especially if the immune system is compromised by another infection, like HIV (CDC, Morbidity and Mortality Weekly Reports). Active Tuberculosis infects the body immediately. Symptoms show in the body meaning the bacteria is effecting the cells of the body. Identifying the form is important because treatment is dependent upon it. Testing for TB involves a skin test, usually within seven work-days of contact with the bacteria. Without knowing what is in the body, the drugs won?t be as effective and might even cause drug-resistance.
TB germs enter the body, the immune system builds a wall around them. While TB
(2014) shed light on two key components for infection control, which includes protecting patients from acquiring infections and protecting health care workers from becoming infected (Curchoe et al., 2014). The techniques that are used to protect patients also provide protection for nurses and other health care workers alike. In order to prevent the spread of infections, it is important for health care workers to be meticulous and attentive when providing care to already vulnerable patients (Curchoe et al., 2014). If a health care worker is aware they may contaminate the surroundings of a patient, they must properly clean, disinfect, and sterilize any contaminated objects in order to reduce or eliminate microorganisms (Curchoe et al., 2014). It is also ideal to change gloves after contact with contaminated secretions and before leaving a patient’s room (Curchoe, 2014). Research suggests that due to standard precaution, gloves must be worn as a single-use item for each invasive procedure, contact with sterile sites, and non-intact skin or mucous membranes (Curchoe et al., 2014). Hence, it is critical that health care workers change gloves during any activity that has been assessed as carrying a risk of exposure to body substances, secretions, excretions, and blood (Curchoe et al.,
Malaria (also called biduoterian fever, blackwater fever, falciparum malaria, plasmodium, Quartan malaria, and tertian malaria) is one of the most infectious and most common diseases in the world. This serious, sometimes-fatal disease is caused by a parasite that is carried by a certain species of mosquito called the Anopheles. It claims more lives every year than any other transmissible disease except tuberculosis. Every year, five hundred million adults and children (around nine percent of the world’s population) contract the disease and of these, one hundred million people die. Children are more susceptible to the disease than adults, and in Africa, where ninety percent of the world’s cases occur and where eighty percent of the cases are treated at home, one in twenty children die of the disease before they reach the age of five. Pregnant women are also more vulnerable to disease and in certain parts of Africa, they are four times as likely to contract the disease and only half as likely to survive it.
Tuberculosis is transmitted by inhalation of aerosols containing the tubercle bacilli. The required inoculum size for infection is usually high, but easily occurs with exposure to a patient who is currently infected. The products of dried aerosols, droplet nuclei, are particularly infectious because they remain in the air for an extended time, and upon inhalation easily move to the alveoli. The severe damage related to infection is caused by the reaction of the host. The tuberculosis infection has two phases, primary and secondary.
Recent research shows that, there are three major means by which infections can be transmitted and they include direct transmission, indirect transmission and airborne transmission (Hinman,Wasserheit and Kamb,1995). Direct transmission occurs when the physical contact between an infected person and s susceptible person takes place (division of public health, 2011). An example is a health care worker who attends to an Ebola patient, without gloves, gown and mask plus forget to wash his or her hand with soap and hot water and or a person having flu without the use of mask or washes his hand after sneezing easily passes the infection to the other through hand shake or surface touch, living the bacteria there for another vulnerable person to also touch if the surface is not disinfected with bleach. Studies makes it clear that, the spreads takes effect when disease-causing microorganisms pass from the infected person to the healthy person through direct physical contact such as touching of blood, body fluids, contact with oral secretion, bites kissing, contact with body lesions and even sexual contact. However, measles and chicken pox are said to be conditions spread by direct
The disease, cholera, is an infection of the intestines, caused by the bacterium Vibrio cholerae. As stated in Microbes and Infections of the Gut, the bacterium is “a Gram-negative, comma- shaped, highly motile organism with a single terminal flagellum” (105). Cholera is characterized by the most significant symptom that presents with the disease, diarrhea, and victims can lose up to twenty liters of body fluids in a day. Cholera can be a serious disease, due to the serious dehydration that can occur, but it is only fatal if treatment is not administered as soon as possible. This research paper includes information on the causes of cholera, symptoms, ways of treatment, studies of treatments, complications that may occur, the tests and diagnosis for cholera, and finally, the ways the cholera bacterium may be transmitted.