Tuberculosis (TB) is an infectious disease affecting the lungs and it poses a severe threat to human health. Following the World Health Organization (WHO) (2021), TB is the 13th most common cause of death worldwide. According to the latest estimates from 2020, about 10 million people, and 1.1 million of them – children, were infected worldwide, and 1.5 million died that year (WHO, 2021). The Centers for Disease Control and Prevention (CDC) (2021) states that the number of reported cases in the United States in 2020 was 7,174. Although TB is curable and preventable, it is still a global health problem and a heavy burden for worldwide healthcare systems.
Professionals need to understand the features of TB, its ways of spreading, symptoms, risk factors, and other aspects. The disease is transmitted by airborne droplets released during coughing or sneezing, containing the bacteria Mycobacterium tuberculosis (WHO, 2021). Since, in some cases, the immune system can fight TB, experts distinguish two forms – latent and active. In the first case, bacteria are present in the body but do not cause symptoms, and the carrier is not contagious; in the second, there are illness signs and a chance of infection in the surroundings (Mayo Clinic, 2021). TB symptoms include prolonged cough (sometimes with blood), chills, high fever, chest pain, lack of appetite, weight loss, and fatigue (Mayo Clinic, 2021). Moreover, the disease can affect other organs – the brain, kidneys, and spine. People who notice symptoms need professional help from a doctor.
The risk of infection is relevant for people of any age, but one can distinguish several risk factors. A significant factor is a suppressed immune system, for example, due to HIV or other conditions. HIV has led to the spread of TB in countries with more advanced health care, although the disease is more common in developing countries (Mayo Clinic, 2021). Other contributing factors are staying in regions where TB is widespread, contact with infected people, and tobacco use.
TB diagnosis begins with a patient’s physical examination, including a lymph node check and auscultation. Diagnostic tests may include skin tests, blood tests, imaging, including a CT scan or X-ray, and sputum analysis (Mayo Clinic, 2021). The skin test is the most common and involves administering tuberculin under the skin to monitor the reaction. This test has a high probability of error, and therefore other additional tests are conducted to confirm the diagnosis. TB prevention focuses on vaccinating children in countries where the disease is common, treating the latent form before the transition to active, and limiting the actions of patients with the active form. Children are vaccinated with bacilli Calmette-Guerin (BCG), and treatment involves taking the necessary drugs (Mayo Clinic, 2021). Restrictions for patients with active TB include wearing a mask, reducing contact with people, and staying at home.
The disease requires long-term and robust treatment and caution, as TB with antibiotic resistance can develop. Therefore, it is critical to manage medicines competently and provide patients and their families with the necessary educational information and support. Nurses have a crucial influence in performing these tasks, and they also can evaluate the patient, give a nursing diagnosis, prepare a care plan, and provide guidance. Advanced practice nursing can also include the development of innovative interventions and initiatives, for example, offering alternative methods for TB management (Goss et al., 2019). Nurses are often more involved in communication with patients and better understand their needs.
The choice of medications and duration of their application depends on the form of TB and the patient’s health. Latent TB requires taking one or two drugs and active – several medications within 6-9 months. The most common drugs are Ethambutol (Myambutol), Isoniazid, Pyrazinamide, and Rifampin (Rifadin, Rimactane) (Mayo Clinic, 2021). Resistant TB requires a combination of other drugs – antibiotics, fluoroquinolones and injections of amikacin or capreomycin for a period of 20 to 30 months (Mayo Clinic, 2021). During treatment, patients should be aware of the potential side effects of drugs.
Follow-up care is determined by the form of TB and the effort required to treat it. Care includes assessing treatment outcomes, making adjustments in drug management if necessary, and identifying treatment side effects for their subsequent elimination. These measures require regular clinical visits, bacteriological monitoring, and additional tests depending on the form of TB (Varaine & Rich, 2022). Schoeman and Sifumba (2021) also recommend support for TB survivors, particularly psychological counseling and efforts to get rid of the stigma and help socialize. Follow-up care is crucial for patients’ full recovery and adaptation.
Thus, TB is a complex infectious disease, and it presents a severe burden to global healthcare. It can affect people with suppressed immunity and those who stay in regions where the disease is widespread. It is worth contacting doctors for treatment if a person has such symptoms as prolonged coughing, chest pain, weight loss, and fever. Specialists act depending on the form of TB – latent, active, or resistant to drugs. Treatment usually involves the use of a combination of several medicines. After treatment, patients also need follow-up care, including clinical visits, testing, and psychological care.
Centers for Disease Control and Prevention. (2021). TB incidence in the United States, 1953-2020. Web.
Goss, L., Balcom, D., Mutsch, K., Carrico, R., & Bosson, R. (2019). Treating latent tuberculosis infection in newly arriving refugees: An advanced practice nurse initiative at the University of Louisville Global Health Center. Journal of Refugee & Global Health, 2(1), 1-3. Web.
Mayo Clinic. (2021). Tuberculosis. Web.
Schoeman, I., & Sifumba, Z. (2021). Tuberculosis care does not end at treatment completion-a perspective from tuberculosis survivors. The Lancet. Infectious Diseases, 21(7), 896-897. Web.
Varaine, F. & Rich, M.L. (2022). Tuberculosis. A practical guide for clinicians, nurses, laboratory technicians and medical auxiliaries. Médecins Sans Frontières. Web.
World Health Organization. (2021). Tuberculosis. Web.