Epidemiology of Tuberculosis: Outbreak, Treatment, and Prognosis

Running head: EPIDEMIOLOGY
Epidemiology
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EPIDEMIOLOGY
Tuberculosis (TB) is a bacterial disease caused by Mycobacterium tuberculosis
(Centre of Disease Control and Prevention [CDC], 2019). The following paper aims to
provide a detailed perspective of outbreak, treatment and prognosis of tuberculosis (TB) in
the U.S and worldwide. Having a proper demographic and prognosis knowledge of TB will
help to promote successful elimination of the contagious disease.
Answer 1
Mycobacterium tuberculosis colonizes but not restricted to lungs. The colonization of
bacteria is also highlighted in the kidneys, brain and spine. Not everyone infected with TB
bacteria develops the disease or become sick. As a result there are two phase of the disease,
one is the latent TB infection (LTBI) and another phase is known of TB disease. If not
reported on time, TB can be fatal (CDC, 2019). Mode of transmission: TB bacteria is a air
borne bacteria and thus the disease can be transmitted from one person to another whenever
the bacteria comes in contact to air for example bacteria expelled in air by the infected person
through sneezing, coughing, speaking, singing and spitting. The TB infection also spreads by
touch like coming in contact with contaminated hands (handshake), sharing of meal, touching
the linens of beds or toilet sheets and kissing. When healthy person breaths in TB bacteria
settle in lungs and starts replicating and move through blood streams in order organs (CDC,
2019). Symptoms: The symptoms of TB vary with the point of colonization of the bacteria.
The bacteria mainly grow inside the lungs (pulmonary TB) and leads to the development of
symptoms like cough (that lasts for 3 weeks), chest pain, coughing of blood or sputum. Other
associated symptoms include fatigue, weight loss, lack of appetite, fever, chills and sweating
at night (CDC, 2019). The complications associated with TB increases when there occurs co-
infection among the person suffering from HIV (Human Immuno Deficiency Virus). People
with HIV are immune-compromised and are more likely to become infected with TB and this

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eventually becomes fatal (CDC, 2019). TB is treated by a combination of several drugs for
duration of 6 to 9 months. There are 10 drugs, which are currently approved by U.S Food and
Drug Administration (FDA) in order to treat TB. The first line of the anti-TB agents that are
approved by FDA include: isoniazid (INH), rifampin (RIF), ethambutol (EMB),
pyrazinamide (PZA) (CDC, 2016). In 2017, 9015 cases of TB were reported in U.S showing
a decrease in rate of occurrence by 1.6% from 2016. A total of 11 states along with District of
Columbia and New York City reported the incidence of TB at a rate of 2.8 cases per 100,000
amounting to 528 deaths. There is an increase from 470 deaths as reported in 2015. The
highest rate of occurrence is in California, Texas, Florida and New York. The main victims of
TB as per the race and ethnicity in USA are the Asians and Black or African Americans
(CDC, 2017). TB is a reportable disease from 1951 until present as per the website of CDC.
It is recommended to report the suspected or confirmed cases of TB within 24 hours to the
local health officer or the state health department. For the laboratory professional who is
conducting the confirmatory test is required to report to the local health department of state
health department. The notifications must be associated with date and results of the test
performed along with the name and the date of birth of the person from whom the specimen
is extracted (CDC, 2012).
Answer 2
Social Determinants of Health (SDH) are defined as conditions, under which the
people are born, live, grow, work and age. The circumstances are modulated by the
distribution of power, money and distribution of resources at the local, national and global
levels. SDH are responsible for the generation of health inequalities or avoidable difference
in the health status of the people from different race, ethnicity, culture or countries. The main
social determinants of health includes employment conditions, social exclusion, public health

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accessibility, gender equity, early development of child, globalization, social support,
addiction, food and transportation (World Health Organization [WHO], 2019). According to
WHO (2018), poverty is one of the powerful determinants behind the development of TB.
Poorly ventilated and overcrowded working and living environment is inter-related with
poverty and cast a significant risk behind the transmission of TB bacterium. Malnourishment
is also an important risk behind the development of TB. Poverty or lack of proper financial
support at home is associated with lack of proper maintenance of healthy diet leading to
malnourishment and subsequent development of TB and the main victims of these are
children who are in their early childhood (WHO, 2019). Sester et al. (2014) are of the opinion
that children who are devoid of proper nutrition during their early years of development
become immuno-compromised, making them vulnerable for the bacterial attack and thereby
increasing the tendency of developing TB. Lack of proper employment opportunity is another
important SDH that leads to the development of TB. Unemployed people are more prone
towards getting affected with substance abuse and depression (WHO, 2019). de Colombani
and Hovhannesyan (2015) stated that substance abuse like marijuana, tobacco and alcohol
increases the vulnerability of developing lung TB. Under depressive condition, people are
prone to become addicted to tobacco smoking increasing the vulnerability of TB
development.
Answer 3
Epidemiologic Triangle is defined as a model developed by scientists in order to
study health problems. The three corners of the triangle or the vertices are: (i) agent or the
micro-organism that is responsible for the disease development; (ii) Host or the organism
harboring the causative agent; (iii) environment or the external factors leading of the disease
transmission (CDC, 2015).