Tuberculosis

Tuberculosis

Tuberculosis

Abstract

The paper aims to analyze three articles on tuberculosis and present the most appropriate teaching plan for the community or patients regarding tuberculosis. The first article presents a review of the role migration plays in increasing the risk for a migrant to get tuberculosis and the need for implementation of End TB strategy to prevent and treat tuberculosis on a national level. The second article presents a case study highlighting the relationship between tuberculosis awareness and various socioeconomic characteristics of the population. The third article is an evaluation of the application of tuberculosis preventive treatment concerning prevention and treatment of TB. Finally, a teaching plan for patients or the community at risk of getting TB is created with the specific aim of drafting a plan that promotes effective learning.

Introduction

Tuberculosis is considered to be among the ten most killer diseases in the world. Tuberculosis (TB) is caused by Mycobacterium tuberculosis. The disease mainly attacks the lungs (World Health Organization, 2016). TB is spread from an infected person to another healthy person via the air. In 2016 alone, almost 10.5 million people were infected with tuberculosis (TB), leading to about 1.7 million deaths from the disease, including approximately 400,000 people who had HIV (World Health Organization, 2018). Facts show that over 95.0% of these deaths happen in the low and middle-income countries. Regarding children, approximately 1 million children fell ill in 2016 resulting in about 250,000 deaths (World Health Organization, 2018). Making matters worse is the fact that TB is the leading cause of deaths in people living with HIV.  In the United States, 82.0% of all reported instances of TB was in the racial and ethnic minorities; 29.0% Hispanic, 28.0% non-Hispanic African-Americans, 23.0% Asian, 1.0% American Indians while less than 1.0% Native Hawaiian while 18.0% of TB cases occurred in non-Hispanic whites (World Health Organization, 2018).

The World Health Organization has set eradicating TB as one of the health targets, and it has been recently adopted as one of the Sustainable Development Goals. The target of realizing 95% reduction in deaths and a 90% decline in TB incidence has been set for 2035 (World Health Organization, 2018). However, this might not be possible if the contributing factors for TB among the minorities are not adequately addressed, and their attitudes towards TB are not well understood. Similarly, proper educating and awareness programs that are tailored to address the needs of these communities ought to be well thought-out (World Health Organization, 2016).

Article One

Dhava, P., Dias, H., Creswell, J. & Weil, D. (2017). An overview of tuberculosis and migration. Int J Tuberc Lung Dis, 21(6): 610–623

The main purpose of the article was to provide readers with a global overview of migration trends, migration pathways and social determinants and impacts on TB. Efforts are also directed towards outlining a framework to prevent and reduce the TB burden among the migrants. The authors hold the view that the strategy of the World Health Organization if implemented can significantly contribute to ending TB. The strategy is in line with the sustainable development goals, agenda and the TB partnership global plan. The overview reiterates on the requirement for a migrant-inclusive countrywide TB strategy and the need for action to be taken across all the three End TB strategic pillars targeting at prevention and treatment of TB (Dhaya et al., 2017). From the overview, there are various ways in which determinants of health and tuberculosis interact at different phases of migration pathways leading to increased risk of migrants contracting TB infection, disease as well as the reported poor treatment results. For the End TB strategy to be implemented successfully within the five year period. It is vital that the migrant-inclusive national strategic plans (NSPS) are designed and implemented based on the adapted principles and interventions stipulated in the Global Plan.

Article Two

Suleiman, A., Sahal, N., Sodemann, M., Elsony, A., & Aro, A. R. (2014). Tuberculosis awareness in Gezira, Sudan: Knowledge, attitude and practice case-control survey. Eastern Mediterranean Health Journal20(2), 120-129

The article is a case study attempting to assess awareness of tuberculosis and the related sociodemographic traits in Gezira, Sudan. The study sample involved new smear-positive in TB patients who were registered in the state between January and June of 2010 and the age-matched control that sought services from the same healthcare facility for different reasons. The study was aimed at assessing TB awareness among TB controls and TB cases in Gezira region and the relationship existing between the level of awareness of the respondents and their sociodemographic characteristics (Suleiman et al., 2014). The study results reveal that the sex of the respondents was linked to awareness among the study control and that the type of residence, level of education, type of occupations as well as age had significant relations with TB awareness levels while no effect on awareness was found on the marital status of the respondents.

Article Three

Çakar, B., Demir, N., Karnak, D., & Özkara, Ş. (2014). Tuberculosis preventive treatment in a single medical center and evaluation of the results. Experimental and therapeutic medicine, 8(6), 1874-1878.

The authors examined the use of the tuberculosis preventive treatment (TB-PT). The study involved evaluation of indications, and demographic data results for all the tuberculosis cases in Ankara tuberculosis control dispensary number seven who received tuberculosis preventive treatment between 2008 and 2011. The study established, that there was a reduction of the percentage of TB for those who received TB-PT during the study period while there was an increase in the percentage of cases with immunosuppression especially among patients using TNF-α inhibitors (Cakar et al., 2014). Finally, the study recommends that TB patients under TB-PT should be followed-up and monitored carefully to ensure that side effects resulting from the development of active TB and treatment is controlled.

Teaching Plan

a.    The three subjects of interest that patients or community would be taught about tuberculosis include the following:

I. Migrations increase the risk of contracting tuberculosis.

II. Factors impacting on TB awareness.

III. The effectiveness of Tuberculosis preventive treatment.

b.    Before commencing teaching the level of patients’ understanding of the selected topics can be assessed by asking them well-crafted questions. This can be done through a survey or informal interview with the targeted population. This is critical in enabling the educator to gain knowledge of what they already know about the subjects, the areas to cover, willingness to learn, and the expectations of the learners

c.    One problem with literacy issues during teaching among patients relates to low literacy levels that reduce the level of communication during the teaching. The problem of low literacy levels among patients can be minimized by considering various means of promoting effective communication such as using native language, verbal and nonverbal communication as well as using images and charts.

d.    Psychological factors affect learning among patients and include depression, anxiety, pain, and fatigue. For example, pain reduces learning ability by diverting attention from learning and reduces concentration levels.

e.    Learning can be assessed by giving patients a questionnaire with well-drafted questions targeting at gauging their understanding of the subject upon completion of teaching. The questionnaire must derive information of learners’ new understanding of the subject and knowledge gained.

Conclusion

Analysis of the three articles reveals that tuberculosis is one of the leading killer diseases in the world and various factors increase the vulnerability of the population to getting the disease as evident by the role that migration increases risks of migrants to get infected. Socioeconomic factors of the population determine their level of awareness about the disease, thus the need for designing and implementation of End TB strategy to ensure prevention and effective treatment of the disease. Finally, teaching the population about TB requires a teaching plan that takes into consideration of the needs of the patients including the expected learning outcomes. Ideally, all these will go an extra mile in ensuring that the target set by WHO of reducing death by 95.0% and incidences of TB by 90.0% will be met.

References

Çakar, B., Demir, N., Karnak, D., & Özkara, Ş. (2014). Tuberculosis preventive treatment in a single medical center and evaluation of the results. Experimental and therapeutic medicine8(6), 1874-1878.

Dhava, P., Dias, H., Creswell, J. & Weil, D. (2017). An overview of tuberculosis and migration. Int J Tuberc Lung Dis, 21(6): 610–623

Suleiman, M. M. A., Sahal, N., Sodemann, M., Elsony, A., & Aro, A. R. (2014). Tuberculosis awareness in Gezira, Sudan: knowledge, attitude and practice case-control survey. Eastern Mediterranean Health Journal20(2), 120.

World Health Organization, (2016). Global tuberculosis report 2016.

World Health Organization, (2018). Tuberculosis fact sheet. Retrieved on 13th Feb. 2018 from http://www.who.int/mediacentre/factsheets/fs104/en/


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