Tuberculosis: Background, Strategies, Policies, and Ethical Considerations

This document provides information about tuberculosis, including its background, strategies used to measure and control incidence, current public health policies, models and theories of health behavior change, the impact of legislation and policies on health and wellbeing, and ethical considerations. It also includes recommendations for healthcare professionals.

Tuberculosis

Table of Contents
Background of the public health issue identified in the group presentation....................................1
Strategies used to measure, monitor and control the incidence.......................................................1
Current public health policy approaches to reduce or control incidence.........................................2
Models and Theories of health behaviour change...........................................................................4
Impact of legislation and policies on the health and wellbeing of individuals in health or social
care settings......................................................................................................................................5
Ethical considerations......................................................................................................................5
Recommendations............................................................................................................................6
References........................................................................................................................................7

Background of the public health issue identified in the group presentation
Tuberculosis (TB) can be defined as a health condition which is caused by a bacterium for
developing infection and start damaging lungs. It includes the condition of contagious infection
which is responsible to mainly affect lungs that may spread in other parts of human body
including spine as well as brain. Basically, the health problem of tuberculosis is caused by a
bacterium named Mycobacterium tuberculosis among people. It consist the different types of
tuberculosis such as latent TB and active TB that occurs among citizens (Gilpin and et. al.,
2018). Initially, it involves latent TB in which germs are present in human body but immune
system keeps them from spreading and person has no symptoms as they are not contagious.
Secondly, it includes the active TB when germs multiply and make an individual sick and patient
with active TB are contagious in terms of spreading the same to others. It is observed that around
90 % of active cases in adult people come from a latent infection of tuberculosis. However, it has
been identified that tuberculosis has number of symptoms such as chest pain, coughing up blood,
feeling tired all the time, night sweats, chills, fever, loss of appetite, weight loss and a cough that
lasts more than 3 weeks.
In addition to this, a healthy immune system is required to fight with bacterium of TB but a
person cannot overcome easily with active TB if they have some of severe health problems. It
includes the complicated health issues like diabetes, severe kidney disease, head & neck cancers,
cancer treatment like chemotherapy, low body weight & poor nutrition, medications for organ
transplants, HIV or AIDS and certain drugs for treating rheumatoid arthritis, Crohn’s disease and
psoriasis. Meanwhile, it consist the use of appropriate diagnosing methods including skin test
and blood test in order to evaluate the presence of TB bacterium and severity of an individual. It
involves the criterion of carrying out the further diagnosis if the blood and skin test results
positive (Migliori and et. al., 2018). Moreover, it has been identified that chest X-ray or CT Scan
are required to be carried out to evaluate changes into lungs and acid-fast bacillus (AFB) tests for
TB bacterium in sputum which helps to make accurate decision of treatment for making patient
wellbeing.
Strategies used to measure, monitor and control the incidence.
Tuberculosis can be considered as a major health problem among public that requires proper
clinical procedures and strategies in order to measure, monitor and control the relevant
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incidences. It includes the way of carrying out skin test and blood tests in order to evaluate the
presence of TB bacterium which facilitates to provide desired medication in appropriate manner.
Basically, it is observed that tuberculosis is required to be diagnosed in order to provide desired
medication and care facilities for improving condition of an individual. It consist the criterion of
the monitoring the condition of particular patient by evaluating effects of medication and identify
need of making changes in treatment by analysing actual response of human body (Agins and et.
al., 2019). Meanwhile, it has been analysed that regular monitoring is required to be done with
the help of conducting the blood test and sputum test to make sure that given treatment is correct
for wellness of a person or not. It is required for healthcare professionals to formulate more
effective as well as efficient care on the basis of specific patient condition which facilitate to
deliver better quality of care for them. It will provide support to treat the health problem of
tuberculosis and make an individual disease free respectively.
On the other hand, it has been identified that several strategies are formulated for measuring,
monitoring and controlling the incidences of TB among public. It is required to increase
awareness between citizens about tuberculosis and its initial symptoms along with appealing
them to not taken them casually but immediately consult from a registered physician. It is
necessary to provide information about early warning signs so that people can quickly visit
hospital for gaining appropriate treatment Basically, the important strategy is to make citizens
aware of early warning symptoms such as a loss of appetite & weight, a general feeling of
fatigue & being unwell, swelling in the neck, a fever, night sweats, chest pain, a persistent cough
lasting at least 3 weeks and phlegm which may have blood in it when patient cough (Dara and et.
al., 2016). It involves the way of providing free of cost medications related to TB which helps to
treat tuberculosis of many poor people that helps to control the relevant more cases among
public.
Current public health policy approaches to reduce or control incidence.
In context of tuberculosis, it has been analysed that there are several kinds of approaches are
used in order to reduce or control the incidences of TB between citizens. It includes the number
of strategies and principles formulated by healthcare organisations for solving the global threat
of tuberculosis. Basically, the WHO focus on several pillars of strategy to end the global TB
such as integrated patient centred care & prevention, bold policies & supportive systems and
intensified research & innovation. It includes the global adoption of ‘The end TB strategy’ which
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is more effective as well as efficient approach in order to control the occurrence of relevant
cases. Meanwhile, it is observed that umber of approaches are available which has much
potential to control the TB incidences for improving public health in which some of them are
explained further.
Expanding care, strengthening prevention and intensifying research: This is an effective
approach for increasing the capability of healthcare system to enhance the care facilities by
adopting advanced technologies and treatment procedures to improve patient condition
immediately. It includes the criterion of implement appropriate clinical strategies for preventing
the occurrence of tuberculosis between people (Prasanna and et. al., 2018). It is necessary to use
health promotion campaigns to increase knowledge level of citizens and provide free diagnosis
of TB which helps to them to identify their diseased condition to gain treatment in proper
manner. However, it is required to conduct investigations and researches of TB to develop more
advanced treatment for treating the similar condition effectively. It consist to consider integrated
approaches and innovative clinical procedures for improving efficiency of healthcare sector to
control the TB incidences between citizens.
Eliciting systematic support and engaging stakeholders: The systematic support includes to
organise health promotion programs in terms of encouraging people to take their regular and
continuing coughing seriously and go for diagnosis to make sure about their appropriate health
condition. It includes the criterion to focus on strategy of collaboration by make collaborative
programs with government and other advanced organisations in order to develop more effective
treatment process that impact positively to relieve the symptoms of patient with TB to make
them healthy as soon as possible. However, it includes the criterion of involving stakeholders
like government authorities, legal organisations, senior employees and doctors to develop
appropriate vaccine for controlling the incidences of tuberculosis among public. Moreover, the
utilisation of integrated approach to apply clinical strategies to control the increasing TB cases
between citizens for improving health status of public (Uplekar, 2016).
Elevating leadership and widening ownership: This can be defined as an effective approach of
improving leadership approaches and styles for delivering appropriate care and facilities in terms
of controlling incidences of TB. It includes several aspects which should be focussed for
reducing the cases of tuberculosis among public that are given here. Initially, it includes attain
universal access to early detection and proper treatment of all the patients suffering from TB.
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Secondly, it involves the factor of putting supportive health and social sector policies as well as
systems in place to enable effective delivery of TB care and prevention. Thirdly, it consist the
way of intensifying research to develop and apply fresh technologies, tools and approaches for
enabling eventual tuberculosis elimination respectively.
Models and Theories of health behaviour change.
There are number of models and theories which play an important role to make changes in
behaviour of people for adopting appropriate habits for maintaining healthy condition. It includes
the use of accurate behavioural change model by care professionals among people in order to
avoid the problem of tuberculosis (Jaramillo, Yadav and Herrera, 2019). Meanwhile, it involves
the several models in which some of them are given below.
The Health Belief Model: This can be defined as influencing the behaviour of patients for
developing healthy habits along with avoiding unhealthy habits. It includes the criterion of
encouraging people to avoid habits like alcohol intake and excess smoking for reducing their risk
of complications in order to become wellbeing very soon. Basically, it is required for care
professionals to consider its important components including perceived susceptibility, perceived
vulnerability, perceived benefits, perceived barriers, cue to action and self-efficacy. However,
this model should be used among public to control TB as it is beneficial to improve behaviour of
patients to remain aware and follow healthy routine to avoid problem of tuberculosis.
The Theory of Planned Behaviour: This model has the basic criterion to evaluate the intention
of an individual to get involved in the behaviour at a particular time as well as place. It includes
the potential of this model to predict the wide range of health behaviours and intentions such as
smoking, drinking, health services utilisation, breastfeeding, substance abuse etc. However, it
includes the focus on several important factors including attitudes, behavioural intention,
subjective norms, social norms, perceived power and perceived behavioural control to improve
behaviour of people for avoiding occurrence of tuberculosis among them (Solovic and et. al.,
2017).
Diffusion of Innovation theory: This theory of behaviour change is based on the adoption of
new and unique concept related to health. It includes the way of developing new adopter
categorise for adopting new behaviour of maintaining appropriate health that includes
innovators, early adopters, early majority, late majority and laggards. However, it consist to
focus on important factors including relative advantage, compatibility, complexity, triability and
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observability. These elements are responsible for influencing the behaviour of people in order to
adopt healthy habits and gain knowledge for avoiding tuberculosis which facilitate to reduce the
incidences of TB among public respectively.
Impact of legislation and policies on the health and wellbeing of individuals in
health or social care settings
In context of care services related to tuberculosis, it has been analysed that there are number of
policies which are required to be followed by care professionals for delivering appropriate care
facilities to make people disease free. It includes the policy of increasing awareness among
people regarding early symptoms of TB and encourages them to immediately consult to nearby
registered physicians. However, it includes the policy of carrying out appropriate diagnosis of
patients by conducting blood tests, skins test, sputum tests etc. to identify actual condition of an
individual to provide appropriate treatment facilities for their betterment (Shapiro and et. al.,
2018). It consist the criterion of following all the legislations, policies and guidelines which
impact positively on their health condition.
In addition to this, it has been identified that several legislation are required to be used such as
Equality Act 2010, Health & Social Care Act 2012, Care Act 2012, and Data Protection Act
2018 and so on. These regulations encourage medical practitioners to behave equally with
patients and deliver care services to them in proper manner. However, it is required to enhance
the factor of confidentiality in terms of avoiding social issue for patients and every individual
will get proper medical attention as well as facilities to maintain tuberculosis respectively.
In context of improving public health regarding tuberculosis, it has been evaluated that
legislation and policies impact positively on decision making of treatment facilities for an
individual. It includes the criterion of avoiding drug errors and clinical mistakes while dealing
with TB patients in order to make them feeling wellbeing. However, it is necessary for
physicians and nursing staff to follow all the legislations which make them motivated to perform
with responsibility regarding either negative or positive patient outcomes accordingly. It will
provide support to reduce the factor of inequality among professionals while providing relevant
information, solving queries of people or deliver care services to avoid the incidences related to
tuberculosis.
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Ethical considerations
Ethical considerations play an important role in healthcare sector to behave with people in proper
manner. It includes the criterion of following the all the ethical factors as it is beneficial to
deliver appropriate care and information regarding welfare of people. However, it involves
number of ethical factors such as informed consent, beneficence, honesty, confidentiality,
trustworthiness, justice and many more. It is required for care professionals to consider ethics
while conducting health promotion campaigns for improving awareness among people to adopt
healthy habits to avoid TB and remain wellbeing.
In addition to this, ethical principles are beneficial in medical field as it facilitates to avoid wrong
aspects by implementing appropriate clinical practices and behaviour with patient in proper
manner. It includes the way of managing honesty towards people and deliver better quality of
facilities that is favourable for treating the condition of tuberculosis in more effective as well as
efficient manner (Sotgiu and et. al., 2016). However, it is observed that ethics is beneficial to
satisfy actual care needs of client and enhance accuracy of decision making of treatment which
helps to avoid risk of complications for people.
Recommendations
Considering the above data, it has been recommended that care professionals are required to
follow legal regulations and policies because they are helpful to direct the efforts of practitioners
in correct direction. It will provide support to reduce the chance of occurring clinical mistakes
and drug errors which is favourable to avoid complicated condition related to TB among
patients. However, it is suggested that proper guidelines and approaches given by WHO must be
followed in healthcare sector in respect of delivering appropriate care services for their
wellbeing. It will facilitates to treat the health condition effectively which helps to make an
individual disease free as soon as possible.
On the other hand, it has been recommended that appropriate behavioural change model or
theory is required to be used among people which help to influence their behaviour potentially. It
is very important to encourage citizens in respect of using the accurate model for changing
negative habits of people such as alcohol abuse, smoking, drug abuse etc. which impact
positively on treatment procedures in order to gain improved patient outcomes accordingly.
Meanwhile, the patient with healthy habits has limited risk of acquiring the problem of TB along
with managing better health condition.
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References
Books and journals
Gilpin, C. and et. al., 2018. The World Health Organization standards for tuberculosis care and
management.
Migliori, G.B. and et. al., 2018. ERS/ECDC Statement: European Union standards for
tuberculosis care, 2017 update. European Respiratory Journal, 51(5), p.1702678.
Agins, B.D. and et. al., 2019. Improving the cascade of global tuberculosis care: moving from
the “what” to the “how” of quality improvement. The Lancet Infectious Diseases, 19(12),
pp.e437-e443.
Dara, M. and et. al., 2016. Tuberculosis care among refugees arriving in Europe: a ERS/WHO
Europe Region survey of current practices. European Respiratory Journal, 48(3), pp.808-817.
Prasanna, T. and et. al., 2018. Catastrophic costs of tuberculosis care: a mixed methods study
from Puducherry, India. Global health action, 11(1), p.1477493.
Uplekar, M., 2016. Public-private mix for tuberculosis care and prevention. What progress?
What prospects?. The International Journal of Tuberculosis and Lung Disease, 20(11), pp.1424-
1429.
Jaramillo, J., Yadav, R. and Herrera, R., 2019. Why every word counts: towards patient-and
people-centered tuberculosis care. The International Journal of Tuberculosis and Lung
Disease, 23(5), pp.547-551.
Solovic, I. and et. al., 2017. Standard operating procedures for tuberculosis care.
Shapiro, A.E. and et. al., 2018. Completion of the tuberculosis care cascade in a community‐
based HIV linkage‐to‐care study in South Africa and Uganda. Journal of the International AIDS
Society, 21(1), p.e25065.
Sotgiu, G. and et. al., 2016. Fighting tuberculosis in the EU/EEA: towards the new European
Union standards on tuberculosis care.
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