Epidemiology of Tuberculosis: Causes, Risk Factors, and Prevention

This document provides an in-depth analysis of the epidemiology of tuberculosis, including its causes, risk factors, and preventive measures. It explores the impact of social and economic factors on the spread of the disease and evaluates the policies and programs implemented to control tuberculosis. The document also highlights the importance of addressing social determinants and raising awareness among vulnerable populations.

Epidemiology of tuberculosis

Table of Contents
Abstract ...........................................................................................................................................1
Background......................................................................................................................................1
Critically analysis on causal relationships associated with tuberculosis...................................1
Epidemiology triangle for tuberculosis with critical analysis on the risk factors that are
associated with Tuberculosis and preventive procedures...........................................................2
Critical examination of the factors which affect human body and evaluation of social and
public health policies for tuberculosis disease control................................................................3
Evaluation of prevention and effect of policy that changes upon the delivery of health and
social care services......................................................................................................................5
Conclusion ....................................................................................................................................10
REFERENCES..............................................................................................................................11

Abstract
Epidemiology refers to that branch of medical science which mainly deals with
distribution, incidences and procedures to control the wide-spreading diseases (Mogashoa and et.
al., 2019). By describing progression or history of diseases, procedures for treatment and
prevention of same, can be made. Focusing on distribution and determinants of frequency of a
disease, i.e. Tuberculosis it has been analysed through this report that it is one of the most severe
communicable disease that affects a million of people and causes death as well. However, many
interventions have been taken yet to reduce and control this disease, but still people especially
living in areas of unhygienic and underdeveloped areas, are at higher risk of tuberculosis.
Background
Critically analysis on causal relationships associated with tuberculosis
Tuberculosis (TB) is considered as one of the major public health concern at worldwide
level, where a number of people are affected by this disease and some leads to death also
(Senghore, M. and et. al., 2018). It is mainly caused due to poverty, malnutrition and poverty
among population, under which people live at socially backward classes are mostly come in
contact with this communicable disease. TB mortality rates and highest incidence of this disease
are also seen within developed countries like The United Kingdom, especially in less developed
and low income areas, where people are living the vulnerable life due to less income
opportunities (Pai and Memish, 2019). These are also taken as settings, under which
immigration, social inequalities, drug and alcoholic consumption, including HIV infection are
coexists, so, all factors are strongly associated with this specific disease. As per World Health
Organisation report, TB is one of the leading disease that causes death due to a single infectious
agent. In 2017, it has been estimated that ten million incident has found of TB cases, where 1.6
million deaths occurred. This has represented the reductions of 1.8% and 3.9% as compared to
previous year i.e. 2016 (Global Epidemiology of Tuberculosis and Progress Toward Achieving
Global Targets — 2017. 2019).
Epidemiology triangle for tuberculosis with critical analysis on the risk factors that are
associated with Tuberculosis and preventive procedures
As the information given by The Centres for Disease Control and Prevention (CDC)
where it has been defined that epidemic is said to be the occurrence of more cases of disease,
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injury, or other health condition, which is specifically taking place then the expected elements
over a given section or among a specific group of persons during a specific period (Conlan and
Wood, 2018). Specifically, if it is talked about epidemiologic triangle then it is one of the crucial
invaluable tool, that consists of three different elements and these are: host, agent along with the
environment (Guthrie and et. al., 2018). In present context, epidemiology triangle for
tuberculosis is presented underneath:
(Sources : Introduction to Epidemiology, 2019)
Agent : Particularly, if it is talked in scientific term, then the agent for tuberculosis are
the TB microorganisms, which mainly cause illness or the disease (Lee and et. al., 2018). Here, it
can be said that agent might be of any sort of form like causative agent for tuberculosis, fungus,
bacteria, virus or the parasite as well.
Host : Second but the important most element, because host specifically gets infected by
the agent i.e. causative. Specifically, it is said that a host specifically don't particularly would get
sick until and unless if it gets attacked by an agent (von Unger, Scott and Odukoya, 2019). In
terms of tuberculosis, poor nutrition, concurrent disease and low immunity are said to be some of
the elements within host, which could effectively be directed as carriers for an agent without
displaying any outward symptoms of tuberculosis.
Environment: These are said to be some of the outside elements would directly get
affected where it is also been considered as an epidemiologic outbreak, which mainly or
collectively linked with or referred to particularly the environment (Introduction to
Epidemiology, 2019). If it is talked about Tuberculosis, nature incorporates any components that
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Illustration 1: Introduction to Epidemiology

influence the spread of the ailment yet are not legitimately a piece of the operator or the host
(Gayoso and et. al., 2018). This could be understood with a good example where, temperature in
a given area may influence an operator's capacity to flourish, as might the nature of drinking
water or the availability of satisfactory restorative system.
Critically analysis on the risk factors associated with Tuberculosis:
 If it is critically analysed, then infections like HIV, diabetes mellitus, low body weight,
head or neck cancer, Leukemia, or Hodgkin's disease can be considered as some of the
risk factors in regards to Tuberculosis, which may lead an individual to death as well.
But, on the other side if it is thought in a different way than, it can be said that this
disease can effectively be cured if proper vaccination is being given to individual
(Chambers and et. al., 2018).
 On the other hand, some medical treatments like corticosteroids or certain medications
can effectively be utilised for autoimmune or vasculitic diseases such as rheumatoid
arthritis (Moran and et. al., 2018). But, these may lead an individual to go through some
severe diseases as well. Away with this, silicosis is said to be another risk element, which
stays linked with respiratory condition and this may take place due to inhaling silica dust.
Critical examination of the factors which affect human body and evaluation of social and public
health policies for tuberculosis disease control
There are a number of factors present that affect human body and provide access to agents of
disease to spread virus and affect their health (Khatami and Marais, 2018). To a large extent,
such factors include the living condition, the state surrounding atmosphere, genetics, lifestyle,
level of income and education level, relationships of people with their friends and family ones,
all have the considerable impacts on well-being and health of people (Thrusfield, 2018). Along
with this, accessibility and affordability of health care service also included as factor which
affect human health (Mogashoa and et. al., 2019). The most determinant factors include Social
and Economic Environment; Physical environment; and the individual characteristics of people
and their behaviour. In this regard, context with lives of individual help in determining their
well-being state, therefore, blaming people that for having poor health is considered as
inappropriate. Because people are not likely to be able for directly control the various
determinants of health (Senghore, M. and et. al., 2018).
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As per income and social status of a society, the difference in high and low income people
will easily create a large gap in health status of people. Similarly, less education facilities for
poor people linked with their high stressful condition, with less self-confidence. These people are
also not acknowledged with more about factors that rise the TB agents in their body, like HIV
virus, which contributes the major cause of this disease by destroying the immunity level (Pai
and Memish, 2019). Similarly, physical environment which includes availability of pure and
safer water, hygienic food, safer areas, proper infrastructure leads to good health of people. In
this regard, shortage of any of these factors that are unavailability of safe water and food, as well
as unhygienic living condition, lead to develop the single agent of TB among people, who are
living in such kind of physical environment (Conlan and Wood, 2018). In context with social and
economic environment, having great support of families and societies also linked with good
well-being state of individuals. While if they do not get same then it increases their stress level
and highly affect on mental state of people, under such condition they tend towards alcohol and
abuse activities. This would also affect the health of such people and ultimately they come at
higher risk of mentioned progressive disease (Guthrie and et. al., 2018). Among all these
determinants, genetics is considered as the main key element that actively plays main role in
increasing the chance of TB disease in a person.
Inheritance or genetics plays an important part for determining the lifespan, well-being state
and likelihood of healthiness and development of any certain illnesses within an individual
(Thrusfield, 2018). Here, personal behaviour, lifestyle and coping skills such as balanced or
unbalanced eating habits, active or passive smoking, alcoholic consumptions and how a person
deal with it life’s challenges and stresses, helps in measuring the life-span of good health of
them. In addition to all above determinants, access to health care service for the people who are
belonged to minorities, socially background classes, underdeveloped or less developed areas,
also impact their health (Lee and et. al., 2018). Due to less accessibility of healthcare services,
they are not get access to treatment of basic illness like cough, cholera and others. In this regard,
not getting timely treatment leads to decrease their health and give birth to TB agents (von
Unger, Scott and Odukoya, 2019). Therefore, addressing these social determinants is essential
for prevention of TB disease and implementation of healthcare practices. For this purpose,
bringing awareness among less educated and low income people about the importance of social
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determinants especially of HIV/AIDS, has led to stimulate the growth of communicable diseases
(Khatami and Marais, 2018).
Preventive Procedures
For prevention of TB agents TPT (Tuberculosis Preventive Treatment) is counted as one of
the implication of public health service, that contributes majorly to control of HIV agents, for
decreasing TB (Gayoso and et. al., 2018). It is most commonly isoniazid treatment, which is
given to those people are at higher risk of progressing of this disease. In UK, as per new data
revealed through Public Health England, it has been evaluated that incidence rate of TB
diagnosed patient was dropped by 38% from last five years in 2017, where 9% was reduced in
2017 alone. Public Health England under this process, has played the main key role in driving
down this mortality and TB diagnosed rates by collaborate with NHS and other health care
organisations (Chambers and et. al., 2018). For this purpose, Government has also implemented
the ‘Collaborative Tuberculosis Strategy for England 2015 to 2020’. This would help in raising
the awareness as well as tackling the Tuberculosis in vulnerable and underdeveloped
populations. Through implementation of this testing for latent TB in areas having with high rates
of determinants, that helps in strengthening surveillance as well as monitoring the progressive
rates also (Moran and et. al., 2018). So, growing consensus of decreasing rates of TB indicates
that this disease is now in much control within middle and low income countries of world, which
due to tuberculosis control programs, early testing of diagnostics, treatment and more.
Evaluation of prevention and effect of policy that changes upon the delivery of health and social
care services
Tuberculosis (TB) is caused by a bacterial pathogen called Mycobacterium tuberculosis
(the TB bacillus). It has been identified that in most of the people tuberculosis affect their lungs,
however almost any organ of human body can be affected by TB such as kidneys, brain and
spine (Mogashoa and et. al., 2019). Infection of TB is basically spread to other through the
medium of airborne route as due to cough there is a release of TB into the air from lungs from an
infected person. TB emerged as a one of the major Public Health threat that further lead towards
cause of death. It is also known as poverty related disease, as it has been duly identify that it
mainly affect poorest as well as most vulnerable population (Senghore, M. and et. al., 2018). It is
an airborne infectious disease that affects living condition of individual in adverse manner. In
order to overcome this disease there are different types of policies and measures that has been
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undertaken by UK Government. There is significant rise in TB control programs by government
that they mainly undertake to overcome this Public Health challenge in best effective manner and
successfully control this disease (Pai and Memish, 2019). Due to the increase in rise of
tuberculosis health department hold the prime responsibility to prevent and control TB in order
to further meet this challenge in a successful manner. There are different types of programs that
has been undertaken such as conduction of Planning and development of formative policies,
identification of persons those who have tuberculosis, proper managing of individuals who are
supposed to have and have this disease provide laboratory as well as diagnostic services,
collection and evaluation of data, offer training and education as to educate individuals to
undertake different type of measures to eliminate this disease (Conlan and Wood, 2018). Along
with is it has been further identified that there are different types of appropriate laws and
regulations that has been undertaken by UK Government to effectively support TB control
activities (Guthrie and et. al., 2018). In this they effectively insured that patient was suffering
from this disease receive proper and appropriate treatment until they are fully cured. In addition
to this, through these activities government ensure that there is adequate and appropriate staff as
to effectively fulfilled TB controls activities. With the help of these policies there is significant
change upon delivery of Health and social care services.
It has been identified that there were over 2,500 new cases of TB in London in the year
2014. Apart from that it has been identified that tuberculosis nearly affect some of the London
marginalised and vulnerable communities and individual and it is mainly linked with health and
deprivation inequality (Lee and et. al., 2018). Thus, in order to significantly prevent and offer
treatment certain programs and policies have been undertaken by UK Government.
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Further it has been identified that many Londoners do not aware with the fact of the
manner through which TB spread (von Unger, Scott and Odukoya, 2019). According to the
figures it has been suggested that there are number of ways through which TB transform to one
person to another as most of the people in UK believe that TB only spread due to coughing.
In order to effectively overcome this challenge there are various policies and measures
that has been undertaken by London’s clinical services. In this, Healthcare providers effectively
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conduct community based TB services in this they provide their services voluntarily and work
flexibly to fulfil needs of patient (Tuberculosis strategy for England 2015-2020. 2019). In
addition with this they ensure that there is safe environment in which they undertake activities
related to medication, mental health support, and assistant with accommodation and further help
patient with expenses like transportation and food to clinics. With the help of these efforts and
policies government of UK treat multiple health issues related with TB (Gayoso and et. al.,
2018). In addition with this, Directly observed therapy (DOT) program has been undertaken by
UK Government, in which a trained support worker visit TB patient in community. In this they
ensure proper course of treatment in best effective manner and fulfil shortage of any resources
and further provide them to patient in time effective manner (Chambers and et. al., 2018). It has
been further identify that TB treatment is mainly a lengthy process and further include different
types of opportunities to deal with (Essential Components of a Tuberculosis Prevention and
Control Program Recommendations of the Advisory Council for the Elimination of Tuberculosis.
1995). The National Institute for health and clinical excellence and the health protection
Agencies independently undertake activities and provide cost-effective services to patient in
order to treat TB patients such as homeless people, illegal immigrants and people those who have
been in Prison (Moran and et. al., 2018).
It has been for the identified that tuberculosis is a major social and health impact that
effectively contributes towards increase in health inequalities and further deprive large base of
population in UK. With each infectious case there is a formative representation of failure of
protecting communities from TB transmission (Khatami and Marais, 2018). Thus, in order to
overcome failure of Public Health system UK ensured application of policies and procedures in
well effective manner. In this regard, Health and social care act 2012 States duty of NHS
England, PHE, NHS England, CCGs in order to effectively reduce these inequalities. There are
different type of TB prevention and control activities that are duly been undertaken by these
health care services in order to offer best effective services to population in UK in cost saving
manner (Thrusfield, 2018). With the implementation of different type of strategies all these,
government in London duly tend towards improving access to services and further ensure early
diagnosis. Further it has been identified that these Organisation ensure improved treatment and
care services with the help of which they effectively provide services to TB patients in UK
Government. They also ensure improved BCG vaccination uptake while systematically
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implementation of new entrant latent that further ensure effective TB screening as to strengthen
and monitor surveillance method (Conlan and Wood, 2018). With this appropriate policy i.e.
deliver TB control is been undertaken as to deliver best Healthcare services in order to protect
individuals in UK. TB control boards effectively conduct their responsibilities and establish clear
set of accountable agreements. In this they effectively plan, oversee, monitor and support each
and every aspect in order to control TB. In addition to this, they ensure best effective clinical and
public health services while ensuring workforce planning as to provide best effective Healthcare
services.
Furthermore, it has been determined that all the relevant Healthcare organisation within
UK effectively ensure consistent utilisation of current National institute for Health and Care
excellence guidelines as to implement and develop plans to address this equality and further
provide services to individuals in UK in well-defined manner (Pai and Memish, 2019). In this
regard, it has been identified that Healthcare organisation duly ensure that they conduct
appropriate TB awareness programmes in local authorities and third sector as to educate people
relating to the manner in which TB transmitted from one person to another (Tuberculosis
prevention and control. 2019). TB control board further undertake different measures to
effectively track outcomes of implementation of these strategies as to determine progress. In this
Intelligence and surveillance function play most important role as to further provide relevant,
appropriate as well as timely information as to further support local decision makers and offer
national picture of progress in well effective manner (Senghore and et. al., 2018). In this a formal
monitoring Framework is been undertaken as to ensure that all the programs have been duly
undertaken in different geographical location in London with clear set of results (Strategy for the
control and elimination of tuberculosis. 2019). Further it has been identified that TB control
board regularly provide progress report to the local authorities such as NHS England, PHE, NHS
England, CCGs in order to evaluate health and wellbeing of individual in UK. Along with is it
has been ensured by this Healthcare organisation, that a summary report of progress of all across
England will be duly published by PHC in proper time period as to execute functions in best
effective manner (Mogashoa and et. al., 2019). With the help of all these measures government
of UK ensure reduction in TB incidence, reducing of Healthcare inequalities and offer best
effective services as to eliminate inequalities that are mainly associated with TB. Decrease in TB
transmission, improvement of services, providing Universal access to patient of high-quality
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diagnosis and further offer them improve treatment and care services is being duly undertaken by
government in order to tackle problem of TB in best effective manner.
Conclusion
It has been summarised from this report that epidemiology aid to determine the most
spreading disease that highly affect the health of people. Through this study, it has been
concluded that a number of interventions have been taken in terms of public health care services
and practices, with their progressive state, that helps in controlling and preventing the pathogens
of diseases. As in present case, main focus is given on Tuberculosis, therefore, it has been
determined that social, economic and physical environmental state are the main determinant
factors, which affect human health and causes the communicable diseases. Due to less income
source, people in backward or less developed societies are at higher risk of TB and other
communicable diseases. Therefore, for this process, health organisations both at national and
international level like WHO and NHS are worked in collaboration for prevention and control of
such diseases. For this purpose, by addressing these determinants they are engaging in running
programs that bring awareness among people about serious causes and factors that arise such
diseases and affect their health.
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