Tuberculosis is a very dangerous
disease. It is d...
Tuberculosis is a very dangerous
disease. It is disease considered as old as humanity and is the main cause of
death in the world as a result of one agent of infection. TB was declared in the year by the world
health organization as a health emergency due to its potency and high rates of infection. It is also considered a disease that mostly
affects the poor. It is for this reason that more than ninety percent of deaths
as a result of TB took place in developing countries. The year 1997 saw great implications
associated with TB around the world. It was a year when the disease caused 1.86
billion infections which accounts for almost a third of the world’s population.
It is a disease that affects people with low immunity and therefore, is a
condition that greatly affects people with HIV. The destruction of the immunity
as a result of HIV makes people more susceptible to TB. TB as a disease for
centuries but knowledge of the organism that causes the disease is only recent.
A man discovered it by the name of Robert Koch, and this took place in the year
1882. Treatment for the disease was also problematic until mid 20ht century.
The development of a cure got rid of a lot of infections and was a success to
humanity. The developments of drugs such as containing, para-aminosalicylic
acid, rifampicin, isoniazid, streptomycin, ethambutol, and pyrazinamide led to
the great victories in the fight against TB. These treatments showed the world
that there was a high likelihood of the containment of the disease and soon it
could be eradicated from the world. It was a great victory for a while especially
in the field of medicine because of the ability to control such a potent
diseases. However, this was short-lived because of the development of the HIV
infection. HIV became a pandemic in the 1980s and caused, even more, problems
because of deficiency in immunity. HIV was an infection that affected many
people in the world this caused the resurgence of TB as a threat to the world.
Tb could now easily affect people with HIV because of low immunity. This
shortcoming led to the development of new strains of TB such as the M.
Tuberculosis which is resistant to some medicine such as rifampicin and
isoniazid. This strain is also referred
to as multi-drug resistant TB and is very dangerous because of the failure of
treatment and thus causes a high risk of death. This paper, therefore, explores
Tuberculosis as a disease that affects the population about the development new
strains that are resistant to drugs.
One issue to take into attention is the
fact that isoniazid is considered as one of the more powerful drugs against
mycobacteria. It has one important characteristic which is that it ensures that
sputum conversion occurs very early meaning that it helps decrease the
transmission of TB. Another factor is that Rifampicin has both sterilizing and
microbactricidial properties that help in the prevention of relapses. These are
thus two very important substances in the fight against Tuberculosis.
Resistance to these two substances caused great challenges which thus
necessitated the use of second-line drugs with limited efficiency and thus not
suitable for a short-term treatment plan (J., 2015).
Drug resistance has become a very
common term in the world of today. It is associated with micro-organisms such
as viruses, bacteria, parasites, and fungus, no longer have responses to the
drugs developed with the intention of eradicating them. These micro-organisms
were previously susceptible to these drugs but now seem to have little effects
on them. The drugs thus become inefficient as forms of treatment. Drug
resistance is a situation with great consequences. Some of these consequences
include having drugs that are harder to control. These cause the
micro-organisms to last long periods of time in the body thus having more
adverse effects. They cause social and economic problems associated with too
much time spent in hospitals trying to control the diseases caused by the
micro-organism (Hawn, Shah, & Kalman, 2015).
Drug resistance also increases the
rates of transmission since the micro-organisms stay longer in the body. It
also increases the rate as well as the risk of death in the population. Drug
resistance has become a common term and has led to major concerns because of
the development of a post-antibiotic era where common infections that were once
controlled by antibiotics become potent again and be able to kill. The
antibiotic resistance which is a term related to drug resistance is more
specifically associated with bacteria such as M. Tuberculosis resisting
antibiotics (Fonseca, Knight, & McHugh, 2015).
There are many cases of antibiotic resistance,
and they can be categorized as either societal or biological. Biological causes
of such resistance include mutation of the diseases. Genetic mutation can
occur, and this causes changes in the structure and functionality of the DNA of
the diseases. Mutation can lead to the
development of genes which aid the micro-organism in fighting off the effects
of the antibiotics. Mutations can also result in the development of completely
new strains which feel no effects from antibiotics that once killed them.
Another biological cause is gene transfer which is associated with the movement
of genes that cause resistance from one microorganism to another. The
interactions associated with microbes in the environment sometimes causes
transfer of genetic materials among them (Nguyen, 2016).
When a microbe, acquires new genetic
materials, it receives an altering factor that changes its structure and
functionality. Sometimes it acquires genes that cause resistance to the effects
of antibiotics. Sometimes these microbes have genes for resistance but in a
more recessive form. However, the selective pressure associated with fights
against these microorganism causes changes in them. Survival of these recessive
genes can lead to their development more dominantly and can, therefore, lead to
the development of strains that are antibiotic resistance (Blondiaux et al.,
There are also societal factors that
cause resistance, and they include inappropriate use of antibiotics allows the
disease to learn and develop mechanisms to fight off the effects of the
antibiotics. Inappropriate use of antibiotics is one of the major causes of
resistance. When patients fail to take medicine the way they are supposed to,
it results in unsatisfactory outcomes that can be dangerous to their health.
Another cause of resistance is a diagnosis of the disease that is inadequate.
Errors that occur as a result of poor diagnosis results to poor drug
prescription and this leads to the resistance of the disease to the drugs. The
above are factors that contribute to drug resistance. TB is, therefore, a
disease that is growing as antibiotic-resistant making it immune to normal
antibiotic treatment (Nguyen, 2016).
Drug resistance is a potential problem
in the world. It has been a factor prevalent in developing counties for a
while. However, in the 1990s, antibiotic resistance tuberculosis entered the
United States and caused a lot of attention to the risk factors and the
potential problem the disease can have in the world. Word Heal Organization
reports on tuberculosis based on a survey made between the years 1994 and 1997
show that there is resistance to four first-line antibiotics in more than
thirty countries in the world. This is a report that indicates that
tuberculosis has become a global problem and thus requires efforts from all
nations since all of them are susceptible to an epidemic (Nguyen, 2016).
The resistance to antibiotics ranges
from one drug to all of the drugs with the strain resistant to all of the drugs
being considered more dangerous. There exist areas of the world that are
considered hotspots for antibiotic-resistant tuberculosis. These areas are
hotspots because they of high prevalence to the extent that control programs
could fail. They include Russia, Ivory Coast, Argentina, Estonia, Dominican
Republic, and Latvia. These regions are spread in almost all continents, and
this shows that resistance is not influenced by global geography. However,
temporal changes associated with climatic and vegetative conditions have
influences on the prevalence of the disease. The same survey was carried out
between the year 1996 to 1999and show an increased prevalence of the disease,
and this shows that resistance is a factor that is rising. Resistance is a
clear indication of the existence of inadequate and inefficient mechanisms of
control. As the rise of drug resistance TB continues, more and more cases of TB
represent the diseases in a manner that cannot be controlled and is thus
causing great social, and economic strains for different nations (Hawn, Shah,
& Kalman, 2015).
HIV/AIDS A Global Epidemic
The onset of HIV/AIDS in the 1980s
caused great changes in the fight against tuberculosis.it was a time when the
drug was easily controllable because of the existence of a wide range of
treatments. Cases of the diseases were gone down, and it reached a point where
the diseases could be eradicated. However, HIV/AIDS caused great changes
associated with its development as a global epidemic. It is a disease that
affected many all around the world. HIV/AIDS knows no boundaries, and within a
short time, it had affected millions in all parts of the world. HIV/AIDS is a
disease that causes a deficiency in immunity. This is a factor that causes a
lot of vulnerability and susceptibility to other diseases (Nguyen, 2016).
In fact, it is not HIV/AIDS that kills
individuals, but the other infections that come as a result of the reduced
immunity. HIV/Aids, therefore, caused great implications in the fight against tuberculosis.
Before the onset of HIV/AIDs cases of tuberculosis had gone down but factors
changed, and cases began to rise. The combination of treatment between TB and
HIV/AIDS led to confusions diagnosis and retreatment of the disease.
Inappropriate use of drugs led to the development of resistance to the disease
and thus became a major problem that is still growing. Cases of antibiotics
resistant TB are higher than cases for normal TB, and this is a clear
indication of mutation that has led to the development of a new strain which is
more potent and thus claims more lives (Blondiaux et al., 2017).
Minimizing Antibiotic Resistance
One of the main ways of reducing
antibiotic resistance for tuberculosis is through the effective management of
medicine, through diagnosis and treatment. Tuberculosis remains on the leading
problems in health care, and this is because of the development of
Mycobacterium tuberculosis which is resistance to several important
treatments. The hope associated with
eradication of such a disease is slowly diminishing, and this has become
problematic since more people die each year. The reduced hope is because the
decline in discovery associated with antibiotics capable of fighting such
potent strains and also that there is a trend in evolution by pathogens against
antibiotics (Hawn, Shah, & Kalman, 2015).
However, effective and efficient
strategies are required to ensure that measures are mitigated to control the
rise of antibiotic-resistant tuberculosis and other pathogens. One of the most
important strategies is the effective use of current antibiotics. This is based
on the fact that antibiotic use has always been associated with the development
of new antibiotics. This is to say that resistance is always a factor that is
expected within the world of medicine because of the anticipation of the
development of more effective antibiotics (Blondiaux et al., 2017).
However, the development of new
antibiotics has dramatically gone down especially within the last thirty years,
the reduction in innovation in the development of better antibiotics is a
factor that has led to the rise in rates of resistance in the world. The only
mechanism left is the proper management of the drugs that currently exist.
There is a great need for a change in mentality associated with our perception
of antibiotics, and this includes the high anticipation for new drugs. Proper
prescribing and other effective management of drugs are expected to change the
trend by ensuring that people take the right dosage and that the right medicine
is used for the right condition (Hawn, Shah, & Kalman, 2015).
Prevention of Antibiotic Resistant
Antibiotic-resistant tuberculosis has
different pathways of access to the body, and they include; the acquired and
the primary drug resistance. Acquired drug resistance is a factor in poor
treatment that is incomplete and inadequate. Primary drug resistance involves a
person being infected by an antibiotic-resistant strain. There exist various
measures of intervention that ensure that antibiotic-resistant TB is prevented
and they include early detection and use of high-quality treatment. Early
detection is important because it identifies the diseases early enough before
it has adverse effects. The treatment
also needs to be of high quality to ensure that the disease is promptly
mitigated (Blondiaux et al., 2017).
This factor applies to both the
drug-susceptible TVB as well as the drug-resistant TB for the drug-susceptible
TB early detection, and quality treatment ensures that there is a limited
chance of mutation into a resistant strain. This is, therefore, a mechanism
that applies total control over the disease and reduces its transmission. As
for the antibiotic resistant TB proper diagnosis, treatment and management are
paramount. Early detection, as well as the use of quality treatment, are
considered as the most effective ways of controlling antibiotic-resistant
tuberculosis (Nguyen, 2016).
Another prevention measure is
associated with the control of the infection, and this is associated with
employing methods of minimizing the risk such as developing policies of hygiene
and healthy living. Congregate settings where many people live together need to
be well managed to ensure that there is little risk of infection and
transmission of the disease. Another measure includes the strengthening of
regulation and of health system structures to ensure that they have a high
capacity for management and control of the disease (Blondiaux et al., 2017).