Essay on Causes of MDR-TB Docs
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Added on 2020-02-24
Essay on Causes of MDR-TB Docs
Added on 2020-02-24
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Running head: NURSING ASSIGNMENT Nursing assignment Name of the StudentName of the UniversityAuthor note
1NURSING ASSIGNMENT Tuberculosis (TB) is one of the major causes of morbidity and mortality affectinghumankind worldwide. It is caused by bacterium, Mycobacterium tuberculosis that spreadsthrough air from one person to another. It affects lungs and in extreme cases, affects other bodyparts and cause symptom like chest pain, chronic cough, fatigue, weakness, fever or weight loss.TB deaths are widespread contributing to 7% of most common deaths and first infectious diseasebecoming a major public health issue. There are also problems of late diagnosis and interruptedtreatment being the cornerstone for TB widespread affecting millions of people. Control andprevention of TB are the priority areas to curb this major health issue. This essay aims toexamine the causes of MDR-TB and genetic resistance and mismanagement of TB as the keycontributing factors to high morbidity and mortality rates worldwide, and then asses the twoeffects, side effects of drug-resistant TB treatment, high Tb transmission rates, emergence andmajor public health issue. TB is one of the major causes of death worldwide and greatly contributing to burden ofdisease due to mismanagement of TB medications and bacterial resistance to drugs. In 2015, 1.8million people died from TB majorly in low and middle-income countries (95%). In addition,10.4 people In addition, 10.4 million people fell ill with TB and estimated 480,000 casesdeveloped MDR-TB. This shows that TB incidence has accelerated to four to 5% annually andlikely to increase by 2020 (Zumla, George, Sharma, 2015). This evidence shows that TB Is goingto be epidemic taking a heavy toll of life by 2030. It is important to study the causes of MDR-TBresistance to mitigate this major public health issue. There is an ineffective use of formulation ofdrugs, poor quality medicines, single drug usage, or bad storage conditions causing drugresistance. An also premature treatment interruption is causing this drug resistance andtransmission to the population. It is difficult to treat MDR TB resistance as the treatment options
2NURSING ASSIGNMENT are expensive and limited and the recommended medicines are not always available. People faceadverse drug reactions that is difficult to be treated and as a result, MDR TB is developed. it hasbeen reported that apart from multidrug resistant TB there is additional anti TB drug resistancethat respond to few medicines in around 117 countries worldwide. Rifampicin and Isoniazid are considered powerful first line drugs for treating TB andMDR TB is treatable only with second line drugs, however, they are expensive, limited andhighly toxic and genetic mutations. The main mechanism of this drug resistance is due to geneticmutation at the bacteria loses the ability to transfer genes through plasmids between organismsby horizontal transfer. There are other mechanisms of drug resistance where M. tuberculosis(TB) cell wall consisting of complex liquid molecules act as barriers and stop drugs fromentering the cell. There are also inactivating and drug modifying enzymes TB genome that codefor protein and has the ability to inactive drug molecules (Augustine & Jain, 2014). Theseenzymes are acetylate, adenylate or phosphorylate drug compounds. There are also drug effluxsystems in TB cell consisting of molecular systems that pump drug molecules actively out of thecell. There are also instances of spontaneous mutations that can occur in TB genome altering theproteins of the target cells by the drugs which make the drug of the bacteria resistant. The mutation takes place in the genes of the bacteria, changes conformation and as aresult, unable to prevent the infection spread due to bacterial resistance. Mutation takes place inrpoB gene that code for bacterial RNA polymerase beta subunit (Prammananan, 2017). In TB,which are non-resistant rifampins binds to the RNA polymerase beta subunit and there isdisruption of elongation step in transcription. When mutation takes place in the rpoB genethereis change in the Amino acid sequence and eventually beta subunit conformation changes.Therefore, rifampin is no longer able to prevent or bind transcription and bacteria become
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