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Tuberculosis


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...Read More


~Posted on Feb 2018

Tuberculosis

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

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., 2017).

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).

Epidemiology

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 Tuberculosis

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).

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