Tuberculosis (Term Paper Sample)

Tuberculosis Student's Name Department, School Course Professors’ Name Due Date Tuberculosis Tuberculosis remains a severe and infectious disease that affects all populations worldwide. Schrager et al. (2020) indicate that tuberculosis has killed approximately 1.45 million individuals, whereby 251,000 of the deaths were of those living with HIV. A study by Snow et al. (2020) shows that an estimated 1.8 million teenagers develop tuberculosis (TB) every year around the world, triggering the constant rise in disease prevalence rates. The World Health Organization found that approximately 10.6 million individuals had TB in 2021 (Bagcchi, 2022). These statistics were a significant increase from the 10.1 million people living with TB as of 2021. Bagcchi's 2023 report showed a 3.6% increase in TB incidence rates between 2020 and 2021. The United States (US) has no exemption regarding tuberculosis illness. The TB incidence rates in the US have decreased consistently in a range of 2%-3% in the last twenty years (Deutsch-Feldman, 2021). The CDC (2022) posits that TB cases spiked by 5.9% in the US in 2022 with an increase in incidence rates by 5.5% than in 2021. The public should be aware of the causes, treatment, incidence rates, and other TB variables to help them make informed decisions about TB illness in the US and the world at large. Causative Agent Studies show that bacterium is the leading cause of tuberculosis. According to Herchline and Bronze (2019), Mycobacterium tuberculosis (M.tb), which is a slow-growing, aerobic, and intracellular agent from the Mycobacteriaceae family, is the pathogen that causes TB. Even though it is the main cause of TB, studies indicate that there are other bacteria species like Mycobacterium bovis and Mycobacterium africanum that can also cause tuberculosis (Natarajan et al., 2020). TB bacteria have Gram-positive cell walls with a rod-shaped morphology, that contributes to their long-term survival within the host's lung alveolar macrophage cells. Another systematic analysis found that the M.tb cell wall is waxy with lipid material envelopes that protect it from the host's immune responses (Peloquin & Davies, 2021). Multiple studies show that M.tb has a huge genome diversity of about 4.4 million base pairs that allows it to exist in multiple strains that have varying drug susceptibility profiles, virulence, and transmissibility (Reid et al., 2019; Smith et al., 2020). M.tb's genetic diversity is therefore the main reason for many symptoms of TB in various populations (Reid et al., 2019). Therefore, there is a need for better methods of determining the different strains of TB to help devise practical measures to diagnose and treat patients with the illness. Reservoir Humans are the primary destinations for Mycobacterium tuberculosis. Snow et al. (2020) note that active TB is contagious among untreated persons. M.tb-infected individuals with active disease release it by coughing, sneezing, or speaking (Schrager et al., 2020). Nevertheless, in some patients, the condition could remain latent as M.tb can remain dormant in humans without any signs or symptoms. Inactive TB strains may become active under weakened immunity or being subject to specific medications (Schrager et al., 2020). Despite the overwhelming evidence that humans are the primary reservoirs for TB, recent reports link the bacterium to other animal species. According to Reid et al. (2019), some TB strains affect cattle, which can be passed from cattle to humans. TB spread from cattle to humans occurs when people eat unpasteurized dairy products or when they are in direct contact with infected animals. Tuberculosis can remain latent for an extended period in humans, and this feature makes it persistent and challenging to diagnose for early interventions. Herchline and Bronze (2019) report that dormant TB has non-replicating bacteria in the host cells but can reactivate itself among individuals who have HIV and other chronic infections. Hence, people and cattle are the primary reservoirs for the TB disease. Mode of Transmission Tuberculosis transmission is through air droplets. Schwartz (2020) documents that air is the primary transmission mechanism for TB when individuals inhale aerosolized droplets with M.tb. A person with active bacteria spreads to others close by sneezing, coughing, or speaking. The infectious TB particles are released into the air during speaking or coughing to infect other individuals. The disease can also spread when a person is in prolonged contact with infected individuals. According to Chandra et al. (2022), bacteria concentration exposure duration and environmental ventilation comprise vital factors determining TB transmission rate. Susceptible people are also at a higher risk of getting the bacteria from those infected than the less susceptible ones. The inhaled bacteria reach the cells within the lungs, leading to an infection. Natarajan et al. (2020) argue that TB is infectious but not highly contagious to the extent that any contact with infected individuals does not necessarily lead to infections. Unlike active people, those in the latent stage are not contagious unless they presume the active phase of the disease (Natarajan et al., 2020). Multiple research reports claim that healthcare settings with poor control measures and procedures can accelerate the transmission rate (Chandra et al., Natarajan et al., 2020; 2022; Schwartz, 2020). As such, transmission in care facilities should be controlled by setting effective infection control measures, including good ventilation and adequate spacing. Food and contaminated objects can facilitate transmission, but such incidences are rare. Signs and Symptoms TB signs and symptoms heavily depend on the disease severity and strain type. The classical tuberculosis features include cough, weight loss, night sweats, fatigue, and fever (Herchline & Bronze, 2019). Other signs and symptoms include chest pain and hemoptysis (Herchline & Bronze, 2019). The location of infection within the body also determines the TB signs and symptoms. Difficulties have been encountered in diagnosing dormant tuberculosis because it lacks identifiable features. Most situations that involve latent TB require an interferon-gamma release assay (IGRA) blood test for M.tb bacteria. According to Herchline and Bronze (2019), each TB type displays different symptoms because of the differences in the areas affected. The tuberculosis meningitis symptoms are persistent headache for 2-3 weeks, absent fever or low grade, and subtle mental status changes (Herchline & Bronze, 2019). The disease affects the skeletal with signs and symptoms such as stiffness or back pain, tuberculosis arthritis, and lower extremity paralysis (Herchline & Bronze, 2019). Besides, individuals with genitourinary TB experience dysuria, frequent urination, frank pain, painful scrotal mass in men, and pelvic inflammatory disease-like symptoms (Herchline & Bronze, 2019). Physical scientific examinations among patients living with diabetes have also shown bronchial breath signs and abnormal breath sounds in the regions affected, like the upper lobes (Herchline & Bronze, 2019; Smith et al., 2020). The tissues affected also determine the signs and symptoms among patients living with TB. Patients may develop confusion, coma, neurologic deficit, chorioretinitis, cutaneous lesions, and lymphadenopathy (Schwartz, 2020). Nevertheless, the absence of signs and symptoms does not exclude active tuberculosis. Incubation Period Incubation refers to the time from exposure to the M.tb to when they begin showing symptoms. Colangeli et al. (2020) indicate that TB incubation lasts 2 weeks to 12 weeks. Other research studies argue that the TB incubation period can vary from weeks to years depending on the type of the disease and the organs affected. Smith et al. (2020) point out that the TB incubation period is between 2-10 weeks after infection. Most infected people are never active; hence, dormant TB strains have an incubation period from weeks to many years. Patients with latent TB can later show infection symptoms due to immunosuppression, malnutrition, and aging. Recent study reports illustrate that TB's incubation period among individuals depends on their immune response, the virulence and quantity of M.tb, and the preexisting medical conditions. Substance abuse and chronic diseases like diabetes also reduce the incubation period among TB patients. Individuals suspected of TB should seek medical intervention before the signs and symptoms develop. Peloquin and Davies (2021) suggest that patients need to seek medical intervention when TB is dormant to deter disease progression to an active phase. The strategy will also reduce the risk of disease spread and the development of further complications. Treatment Treatment for TB is mainly comprised of pharmacological interventions taken in 6-9 months. Chandra et al. (2022) reveal that tuberculosis treatment duration changes based on the type of anti-TB prescribed, the frequency of use, and the dose. The CDC (2022) highlights that the initial drugs used for TB treatment are isoniazid, rifampin, pyrazinamide, ethambutol, and E (HRZE). Tuberculosis treatment can be complicated when the bacterium is drug-resistant. According to Smith et al. (2020), drug-resistant TB is complex, and it needs second-line or third-line medications that are more expensive and less effective. The multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) are the most common resistant TB strains (Bagcchi, 2023; Herchline & Bronze, 2019). Several studies suggest that a single new drug should not be used for a failed one but instead, a combination of at least three regimens. Herchline and Bronze (2019) recommend using 4-5 drug combinations of an aminoglycoside, a fluoroquinolone, a thioamide, and a pyrazinamide for resistant strains. Surgical proce...