Immune Response To Mycobacterium Tuberculosis

CRITICAL REVIEW

Table of Contents
How does host immune status-...................................................................................................3
Immune response to Mycobacterium tuberculosis- ...................................................................3
Host and environmental factors (Risk components)...................................................................4
Potential policy response to prevent acquisition and spread of Tuberculosis.............................5
CONCLUSION ...............................................................................................................................5

INTRODUCTION
The most difficult problem that whole world is facing now days is TB. Many people is
affected by this problem. Tuberculosis comes under an infectious disease which mainly affects
lungs. Tuberculosis is that infection which come under second highest killer, all over the world.
As per the research it had been find that 1.8 million people died in 2015 and 10.4 million
people falling ill. Also World Health Organization(WHO) finds a estimate that 9 million people
getting sick with TB. TB becomes top 3 causes for the death of women who comes between the
age of 15 to 44. The symptoms which generally finds during TB are like cough, fever, night
sweats, weight loss, etc. And the most negative impact of TB is that, it is that infection which can
be transfer to other who comes under the contact of the person who is already infected by TB.
The thing which is in TB is airborne pathogen which means it contains that bacteria which cause
TB and can spread this infection through air from one person to other person.(Marshall, 1993)
Doctor gives a distinction to TB by dividing it into two kinds:
Latent TB – In this bacteria is in body only but they are in inactive mode or state. When they are
inactive they do not cause any symptoms and also they are not contagious, but there is not
hundred percent surety that they will remain inactive they can also become active.
Active TB – In this bacteria may cause symptoms and they can also be transfer from one person
to other. (Udwadia, and et.al., 2012)
It is also find that one-third of world's population are having latent TB. And there is 10
percent chance in activeness of latent TB. Latent TB becomes danger for those people who are
having compromised immune system. In compromised immune system people generally lives
with infection like HIV, or the people who are having smoking habits.
Their is no age group that TB will affects particularly this age group, it can affects person
of any age group. There is also no specification that on this part of world will be affected by TB,
it can affect any part of world, but mostly TB affects people who are young adults and living in
developing countries. In 2012, it was founded that 80 percent of TB was mostly in 22 countries.
As earlier discussed that TB gives early warning in which sickness, weight loss, night sweats,
comes under, and the most important thing which gives great symptoms is severe cough that is
affecting person from last three weeks. If there is no precautions taken of TB then it can also
spread to the different parts of body like, it can affect bones, brain, liver, kidneys and heart.

It can be diagnose by doctor, as doctor use stethoscope for listening lungs and also check
is there any swelling on lymph nodes, and also doctor ask patient that either patient is having any
medical history. The mostly used test for diagnosing TB is skin test.
Multidrug-resistant tuberculosis(MDR)
MDR TB is that which does not react to isoniazid and rifampicin which are the most anti-TB
drugs. The main two reason behind MDR resistance is regularly emerging and extending are
person to person transference and other is mismanagement of TB's treatment. In some of the
countries treatment of MDR-TB is becoming very hard and difficult, as treatment of TB is quite
expensive, and also the medicines which are recommended during TB are not easily available.
Extensively drug-resistant tuberculosis(XDR TB)
XDR TB is that form of TB which is caused by bacteria which are unaffected to some of the
most powerful anti-TB drugs. XDR mostly referred as broadly drug resistant TB. In 2017 World
Health Organization has find that this TB has mostly affected regions like Europe, Africa,
Eastern Mediterranean, South-East Asia, etc.
Latent TB infection and TB Disease-
The cursed bacteria which is the only known cause of TB is spreading in air and infecting many
personalities as it spreads from one person who has TB speaks coughs or sings bacteria is
released in the atmosphere and when another person breathes they catches it. There are two types
of TB one is latent infection and another one is TB disease.
Symptoms of TB- (World Health Organization, 2013)
When a cough that is bad and which lasts for 3 or more weeks then a person must consult a
doctor chances are that he or she already has TB. At the time of severe coughing a person will
also feel pain in the chest at any interval of day. At the time of coughing, when a person squirts
blood from his mouth which is mucus that comes from very deep inside of the lungs. When this
situation happens with a person it is confirmed that it is TB. There are others symptoms such as
when a person suffers from weakness or tiredness, loosing weight without any reason, reduction
in appetite, feeling chills from fever or at the time of sleeping he or she sweats at night. This
disease also brings complication in the life of a person such as it can cause permanent lung
damage if it is not treated on time and can spread to other parts of body. Sometimes it is difficult
to diagnose the disease because of slow progression and it is advanced before even the treatment
has begun.

Treatment For TB Disease-
It has been proven that if the treatment and diagnosis are done at an early stage outcome of the
disease won't last long. Early treatment gives a good and fast recovery. For getting the treatment
for TB a person needs to be admitted into a hospital with close monitoring by doctors to analyse
the progress of disease. (Tuberculosis Prevention Trial, 1980.) In the hospital patient will be
individually monitored by the doctors and get a proper care according to the stage of the disease.
(Trial, 1979) Doctors gives various and suitable antibiotics according to the disease so that
infection and disease can be treated. Doctors vary the duration and process of treatment
according to the patient. At the time of treatment different and a lot of type of pills are required
for just a day. (Snider Jr, and Roper, 1992.) If people ignores or avoid them the bacteria can
grow and will be much more difficult heal it than before and after that medicines will no longer
work. Treatment of long time is needed if someone requires resistant drugs with various and
several antibiotics. In the first few weeks of treatment disease sometimes doctor recommend
steroids to their patients. Full course of treatment is essential for patients so that the bacteria and
TB does not grow back and with ability of resistance to antibiotics. Medicines which are used for
treatment of TB have various side effects which includes changing of vision of a person,
unexpected rashes, colour of urine and tears changes to orange or brown and it can lead to
inflammation of liver. Disease of TB can be treated by taking various types of medicines. The
treatment can go up to duration of 6 months to 9 months. These drugs are given on a
combination which reduces the risk of resistance of developing from antibiotic.
Role of agent and contribution on individual health-
Currently United States Food and Drug Administration have approved these 10 drugs for
the treatment of TB. There are several TB agents, first line TB agents includes- (Flynn, and
Chan, 2001)
Isoniazid(INH), Rifampin(RIF), Ethambutol(EMB), Pyrazinamide(PZA)
Prevention from TB- This disease is preventable even to those who have already been infected
and exposed. By skin testing TB can be prevented which can save a large amount of population
who may have already been infected such as workers who are working in hospitals and day care
facilities. If the first test has came out as negative then patient must apply for skin test as soon as
possible. (Program, 2001) When the test come out with positive results it means the patient have
already been infected or come into contact with the bacteria. At that stage TB is not contagious

and a patient must be in contact with a doctor. If treatment is done at an early stage it will be
beneficial for others as well as for patient as it won't spread to others and others will never come
into contact with that bacteria. Some countries where large no. of people gets diagnosed with
these disease of TB. They have started giving a BCG vaccine which is a preventive measure for
general public so that people don't get infected or exposed to this disease. One limitation of this
disease is the effectiveness of this vaccine which is used for prevention is limited to less factors
causing it. Doctors of those countries advise to people that even after getting the vaccine people
must get a skin test as a precautionary method for them.
People can join support groups to reduce the stress or illness and ease up from their routine as
sharing helps them feel good. (Trial, 1980)
How does host immune status-
Tuberculosis is one of the world's deadliest communicable disease (Stockbridge, Miller
and Ho, 2018). It is still the subject of public health concern in most of the countries, globally in
2014 9.6 million people developed tuberculosis and almost 1.5 million died from this disease. As
per the view of Ngwenya, Gumede and Seeley, (2018) stated that Tuberculosis is primarily a
disease of the lunge and the dissemination is dependent on the productive function of critical
organ.
Immune response to Mycobacterium tuberculosis-
Tuberculosis highly caused by Mycobactirium tuberculosis infection. This is disease that
is responsible for approximately 10.0 million incident cases of TB. There are many parameters as
socio-economic factors, HIV and co-infection and genetic predisposition of the host influence
the susceptibility of disease. In contrary to Cho, (2018) stated that the development of
tuberculosis in human can be defined as two stage process. At the early stage person may
exposed to an infectious case, this first becomes the infected. After years it may turned into the
disease that depends on the variety of components and this is also inclusive of physiologic
mechanisms. In contrary to Go and Yoo, (2018) stated that the risk of becoming infected can be
recognised with help of three components as the infectivity of source case, the intensity of
susceptible individual exposure to case and susceptibility of exposed person to infection. There
are number of the components that that highly influenced the risk of mycobacterial infection and
this is inclusive of age, crowding, sex, socio-economic conditions, human immunodeficiency

virus infection and ethnic group etc. Therefore, the patients infected with the mycobacterium
tuberculosis, the disease can develop at any time through the infection as latent and exogenous
infection. As per the view of Migliori and Global Tuberculosis Network, (2018) stated that the
time interval of the disease can ranges from few weeks to lifetime. Henceforth, the risk of
developing disease after infection is highly dependent on the age and time factor.
As per the view of Lange, Aarnoutse and Duarte, (2019) stated that when M.
tuberculosis infects a individual then it first attacks the lungs and response to the immune cells.
However, the response by the macrophages is inclusive if the four differed proteins called as
inflammasome. In contrary to stated that inflammasome role is to prepare the certain immunity
proteins within the macrophages that termed out as interleukins. At the the time when M.
tuberculosis infects the lungs from the macrophages are comes within the first line of the
defense. Additionally, the substantial amount of clinical experience shows that host immunity
plays the vital role in the host pathogen interaction happens in individual exposed to M.
tuberculosis. As per the view of Raviglione, (2018) stated that substantial amount of the
experience of clinical shows that host community plays vital role in the host-pathogen interaction
indicates in an individual exposed to M. tuberculosis. According to the view of Lange, Aarnoutse
and Duarte, (2019) stated that understating the factors of host response at the basic level is
likely to lead and enhance better understanding of the pathogenesis of the tuberculosis within the
human being. Once the organism of this disease took entry in body and made their way into the
lunge, have four potential fates. Thus, it completely effectively and kills all bacilli, this aids to
reduce the chance of developing tuberculosis in the future.
Host and environmental factors (Risk components)
The risk of the progression from exposure to the tuberculosis bacilli to the development
of the active disease and that can be mainly governed at the two stages of the risk components as
exogenous and endogenous. As per the view of Lange, Aarnoutse and Duarte, (2019) stated that
exogenous plays the vital role within accentuating the progression from the exposure to the
infection, the bacillary load in the sputum and proximity of an individual to an infectious. On
the other hand, endogenous components leads towards the progression from infection and this
activates the TB disease.
There are various risk components that leads to impact the human body and turned to
tuberculosis disease and these as human immunodeficiency virus, malnutrition and young age.

Thus, uncertain factors as diabetes, indoor air pollution, alcohol and consumption of the drugs,
smoke and tobacco plays the vital role at the both population and individual level. As per the
view of Migliori and Global Tuberculosis Network, (2018) stated that individuals are at the high
risk for progression to TB disease who are suffering from the virus as Human immunodeficiency
virus.
In contrary to stated that biologically, environment components could be involved in
the pathogenesis of the tuberculosis and this has affect on the immune function of an individual
and it also enhances the susceptibility to developing the active PTB. On the other hand, Go and
Yoo, (2018) stated that enhanced level of air pollutants related to impaired lunge function via
aerobic stress can produce redness to the airways and this also enhances the susceptibility to
pathogens. As per the view of Cho, (2018) stated that weakened immune system of an individual
that caused by the HIV infection might promote tuberculosis reactivation.
Potential policy response to prevent acquisition and spread of Tuberculosis
The legal authorities has taken various initiatives to provide education on preventing TB
with help of framing strategies and policies (Stockbridge, Miller and Ho, 2018). Every state
possess general health legal authority that may be framed to control the communicable disease.
Thus, United states produce the laws that aids to prevent from tuberculosis. Henceforth, these
laws and policies are defined as-
Communicable disease control law- With the exercise of health powers, state and local
government of US has promulgated a variety of general and disease specific statutes and
regulation whose main aim is to control the communicable disease. As per the view of
Ngwenya, Gumede and Seeley, (2018) stated that state department of the public health has taken
initiatives to take strict and suppress infectious disease. It is crucial to protect the public health of
the individuals.
Fedral communicable disease control law- The tribal, state and local authorities have extensive
power to prevent and control communicable disease, the fedral authorities is vested as as well
with effective control over the communicable disease. With the Fedral local authoties to regulate
immigration is mainly derived from two claise in the U.S. constitution.
Henceforth, there are three main startegies that has framed for prevention of tuberculosis in the
United States. These are defined as- To identify and treating person who has tuberculosis and to
undertake evaluation for mycobacterium tuberculosis infection and disease by providing

subsequent treatment and to test out the population who are at the high risk for the latent
tuberculosis infection and to provide treatement to those individuals who are infected to prevent
progression to the disease (Role of the Health Department in Tuberculosis Prevention and
Control-Legal and Public Health Considerations, 2017). Henceforth, these are the strategies
that has been framed for undertaking prevention and control of tuberculosis and it is core
responsibility of legal authorities to conduct planning and overall development policy.
Therefore, UK consists of several policies of prevention from TB. These policies are :-
Policy for infection prevention and control – This policy is formed to prevent spreading of
infection of TB. Its main purpose of ensure that patient who are suffering from TB are identified
and effective measures are taken to prevent transmission to others. Moreover, it directs
management to use antibiotics wherever necessary. Also, to create awareness among public
health agencies to take appropriate measure from TB prevention. In case of failure of comply
with policy, relevant legal action is taken.
The health protection regulation (2010)- This policy consists of several duties and
responsibilities for nurse to follow. Here, nurse has to notify officer of local authority in case of
any suspecting person. Also, every info related to patient is to be given such as symptoms, age,
medical history, etc. Alongside it, nature of disease, infection level, circumstances, etc. are
informed. However, there are different sections mentioned in it. The local authority has to issue a
notice within 3 days so that TB infection is prevented. This enables nurse of take appropriate
measure as per regulation.
CONCLUSION
Based on the above report it can be stated that Tuberculosis is defined as infectious
disease that primarily impacts over lungs. Therefore, tuberculosis is one of second biggest killer
disease at the global level. Henceforth, this disease is curable and preventable and can be
compared person to person through the air.
The present report is based on the chosen topic as Tuberculosis. Furthermore, report has
covered the role of agets of this disease and its contribution on the health of individual's body.

Thus, Host and environmental factors has been defined to analyse the risk associated with this
disease. Lastly, study has focuced on Potential policy response to prevent spread of Tuberculosis.

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Online
Role of the Health Department in Tuberculosis Prevention and Control-Legal and Public Health
Considerations. 2017. [Online]Available
through:<https://www.ncbi.nlm.nih.gov/pubmed/28256190>.