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Sample essay topic, essay writing: Tuberculosis - Everything U Need To Know (htis Is An Entire Report On - 3580 words
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What is Tuberculosis, and how serious is this problem? TB, or Tuberculosis, is a chronic or acute contagious disease caused by a bacterial infection. TB is the leading cause of death from a single infectious disease, accounting for over a quarter of avoidable deaths among adults. It can affect several organs of the human body, including the brain, the kidneys and the bones, but it predominately manifests itself in the lungs where it is called 'Pulmonary Tuberculosis'. According to the WHO, TB infection is currently spreading at the rate of one person per second. It kills more young people and adults than any other infectious disease and is the world's biggest killer of women.
Researchers have calculated that 8-10 million people catch the disease every year, with three million dying from it. It causes more deaths worldwide than AIDS and Malaria combined. The WHO predicts that by 2020 nearly one billion people will be newly infected with TB, of them 70m will die. TB black spots include Eastern Europe with 250,000 cases a year, South East Asia; three million cases a year and sub-Saharan Africa with two million cases a year. Tuberculosis, a sometimes crippling and deadly disease, is on the rise and is revisiting both the developed and developing world
The global epidemic is growing and becoming more dangerous. The breakdown in health services, the spread of HIV/AIDS and the emergence of multi drug-resistant TB are contributing to the worsening impact of this disease. Overall, one-third of the world's population is currently infected with the TB bacillus.How TB Spreads:TB is a contagious disease. Like the common cold, it spreads through the air. A person acquires a tuberculosis infection by inhaling tiny droplets of moisture contaminated with the Mycobacterium Tuberculosis bacteria.
The source of these droplets is frequently from infectious individuals who expel thousands of water droplets into the air every time they cough, sneeze, talk or spit. A person needs only to inhale a small number of these to be infected. The most common places for becoming infected with TB are right in your own home, or your workplace. Often the source of the infection is unknown since the initial infection may have occurred several years ago. Left untreated, each person with active TB will infect on average between 10 and 15 people every year and these people are mostly likely to be family members, friends, coworkers, and those who share the same breathing space.
However, TB infections are not readily acquired under most circumstance and usually do not occur vial casual contact on the street or bus. Only about 5 - 10 percent of people who are infected with TB become sick or infectious at some time during their life.What are the Chances of Becoming Infected?The process of catching Tuberculosis involves two stages: first, a person has to become infected; second, the infection has to progress to disease. To become infected, a person has to come in close contact with another person having active Tuberculosis disease (in the lungs and throat only, since TB in other body parts are not infectious), with TB germs present in the sputum. However, the likelihood of this happening also depends on the time spent in close contact with the person with active disease. It has been proven that a person who is taking their TB pills cannot pass on Tuberculosis.
The process of infection progresses to disease in about 10% of those infected, and it can happen anytime during the remainder of their lives. Although the chance of progression to disease diminishes with the passage of time, TB can develop more easily if the immune system weakens. Babies, young children and the elderly often have weak immune systems. Others who are immune-compromised, and thus more susceptible include those with: . AIDS, .
Substance abuse, . Diabetes mellitus, . Silicosis, . Cancer of the head or neck, . Leukemia or Hodgkin's disease,. Severe kidney disease,. Low body weight, . Malnutrition, .
Alcoholism,. Those undergoing chemotherapy,. Transplant recipients taking anti-rejection medications. The disease is often perceived as most frequently affecting the elderly, and in industrialized countries a quarter of all cases occur in those over 65. But in the developing countries of Africa and South America, TB is most common among young adults.
Women of childbearing age between the ages of 15 and 44 are more likely than men of the same age to fall sick with the disease. Women in this age group are also at greater risk from HIV infection, which makes them more susceptible to TB too.What is TB Infection?In most people who breathe in the bacteria and become infected, the body is able to fight the bacteria stop growing. This is the first stage, called 'Early Infection', which often heals without being noticed or might be passed off as a 'cold or flu'. The second stage of TB, called 'Dormant TB' or 'Sleeping TB', occurs when germs remain in the body and may be wide spread, but seem to have no effect on the health of their host. The bacteria become inactive, but they remain alive and can become active later.
This is called TB Infection. People with TB infection have no symptoms, don't feel sick, can't spread TB to others, usually have a positive skin test reaction or can develop TB later in life if they do not receive preventive therapy.What Is Active TB?The third stage of TB may develop when the dormant infection 'wakes up' and causes sores in the lungs and other parts of the body. This third stage is referred to as 'Active TB', or TB Disease. A person can develop active TB either soon after being infected, or later when their immune system becomes weak for some reason. The Tubercle bacillus can spread from the localized infection to throughout the body such as throughout the lungs, airway passages, the pleural space, blood vessels and in the blood stream it can even spread to other organs like the lymph nodes.
The usual site of the disease is the lungs, but other organs may be involved. Generally, the active disease is manifested by destruction or 'consumption' of the tissues and the development of granulomas (granular tumors) in the infected tissues. The symptoms of the disease vary according to which body organ is infected. The common symptoms however, usually include. Sweating,.
Fatigue, . General discomfort, . Uneasiness, or ill feeling (malaise), . Weight loss,. Cough, . Fever,. Shortness of breath.Types Of Tuberculosis:TB can be categorized into two different types, according to where it has manifested itself.
These two types are described as: Pulmonary Tuberculosis and Non-Pulmonary Tuberculosis.Pulmonary Tuberculosis accounts for most cases of infection by Mycobacterium Tuberculosis as well as for about 85 % of all Tuberculosis deaths. Primary infection of the lung generally occurs in the lower division of the bottom lobe, the middle lobe, and the anterior segment of the upper lobe. These sites obtain the greatest volume of airflow and, therefore, bacilli are deposited there in the greatest numbers. However, TB tends to localize most often at the apex of the upper lobe of lungs. This localization pattern is attributable to two reasons: first, the concentration of oxygen at the apex is greater than other portions of the lung; and second, venous and lymphatic fluid pressures are lower at the apex.When the bacillus population becomes large enough, they cause symptoms like anorexia, diminished respiratory capacity, fatigue, weight loss, chilly sensations, afternoon remittent fever and night sweats. Associated chest pain is also sometimes felt which is usually due to inflammation of the parietal pleura.
In addition to the symptoms of Pulmonary Tuberculosis stated above, another symptom deserves special mention because it is recognizable as the 'cinematic symptom' of TB. A Tuberculosis lesion that perforates a venous wall can cause Haemophtysis, which is the expectoration of bloody sputum through coughing. The hemophtysic cough is also highly characteristic of Pulmonary Tuberculosis.Non-Pulmonary Tuberculosis in a general sense, describes a TB infection that has disseminated, or spread, to various sites in the body from the lungs. The Tubercle bacilli usually disseminate through out the body during the early stages of infection. From here (usually the blood stream) they can infect various sites.
Although no organ or site in the body is immune to the TB bacillus, certain areas are of special concern due to their vulnerability and vital functions. Non-Pulmonary TB is very common among patients with an HIV infection in conjunction with Pulmonary TB. 60-80% of these patients develop non-Pulmonary TB in contrast to 17% of non-HIV patients who develop non-Pulmonary TB. Extra-pulmonary TB is considered an AIDS defining disease by the Center for Disease Control (CDC).Tuberculosis of the Spine (Tuberculous Spondylitis): This is characterized by softening and collapse of the vertebrae, often resulting in a hunchback deformity. The condition is named after an English surgeon, Sir Percivall Pott, who described it in a monograph published in 1779. The infection begins in the body of the vertebra (the most common site of bone Tuberculosis) and spreads slowly to contiguous structures. Abscesses may form, migrate, and cause pain in sites quite distant from the spine.
Occasionally, the spinal nerves are affected, and a rigid paralysis may result. Affected persons complain of pain on movement and tend to assume a protective, stiff position. Spinal TB symptoms may include: loss of appetite, night sweats, malaise, (a vague feeling of physical discomfort) and evening rise in temperature. Other effects such as stiff painful movement of the spine and localized deformity and spasm of muscles are more common to more progressive stages of the infection. The course of the disease is slow, lasting months or years.Bone and Joint TB: After infection of the spine, Tuberculosis can spread via the blood to other areas.
Other common sites for extra Pulmonary TB infections in the bones and joints include knees (15%), hip (15%) and other weight bearing joints. It is spread via the blood by small Tubercle bacilli, which cause small lesions (damage) in the bone marrow. Symptoms of bone and joint are pain, localized swelling, fever and weight loss. In progressive stages of the disease, Tuberculosis may cause Paraplegia (paralysis of the lower part of the body) in severe and extreme cases if untreated.Central Nervous System Tuberculosis (Meningeal): The meninges are membranes that envelop the brain. Meningeal or CNS TB deals with the basal meninges, or those located near the brain stem, which is the most common site. Meningeal TB occurs in three stages depending on time of infection. Symptoms are classified into three stages.
The first stage can include: nonspecific symptoms, headache, fever, irritability, and sleepiness. The second stage is characterized by sudden appearance of: lethargy, convulsions, nuchal rigidity, (stiffness of the nape of the neck) vomiting, meningeal irritation, and increased intracranial pressure. The final stage brings: irregular pulse, altered mental state, cranial nerve lesions (damage), respiratory hemiplegia, (half-paralysis) paraplegia or paralysis of the waste down, coma and eventually death.Pericardial Tuberculosis: This is TB that occurs in the heart. Pericardial Tuberculosis is a fairly recent problem because of its uncommon presence in the pre-AIDs era. It usually occurs as a late effect of Pulmonary Tuberculosis. Pericardial Tuberculosis can also occur from the spreading of Plural Tuberculosis to pericardial. Symptoms of Pericardial Tuberculosis can vary depending on the case.
Some of the less severe complications include coughing, vague discomfort, and difficult or labored respiration. Acute pain is occasionally suffered in some cases, and in the most severe situations a frictional rub of the heart and escape of fluids into other cavities can occur.Gastrointestinal Tuberculosis (Peritoneal TB): The peritoneum is a membrane lining the cavity of the abdomen. Peritoneal TB occurs when tubercle bacilli, coughed up from a primary infection in the lungs, are swallowed. The tubercles can form lesions on the peritoneum, which can spread to other organs, or the organs can spread the infection to the peritoneum. Infection of the gastrointestinal tract can include common symptoms such as fever, weight loss, anorexia, abdominal swelling, vague pain in the stomach, and bowel habit abnormalities. Other recognizable problems include obstruction, perforation or ulceration, and fistula (channeling.)What Causes Tuberculosis?TB is caused by a fungus-like bacterium that belongs to a special group of microorganisms called mycobacterium.
The species of bacteria that most commonly infect humans is called Mycobacterium Tuberculosis complex (called 'MTB' for short.) Robert Koch first discovered this in 1882. Tuberculosis in humans is usually caused by the human variety of the mycobacterium, M. Tuberculosis, and in fewer cases by the bovine variety, M. bovis. Besides cattle, which are infected by the bovine type of bacillus, other domestic animals susceptible to tuberculosis include swine and fowl, the latter being infected by the avian type. Strains of Mycobacteria africanum have also been found in Africa.Mycobacteria: Mycobacteria are long, rod-shaped cells that develop into long chains that look a bit like a string of sausage links when viewed under a microscope. Many bacteria cells are long and slender like this and are known as 'bacilli'.
This is why the tubercle-forming TB bacteria are often called 'Tubercle bacilli'. Genetically speaking, Mycobacterium Tuberculosis is unusual in several aspects, making it a difficult organism to study. One of these peculiarities is the high content of cytosine and guanine in its DNA. This high level of CG may be a survival strategy employed by the bacteria: heat-stability of DNA increases with the number of C-G bonds. The walls of Mycobacteria are also very special. They are made of 60% 'mycolic acid', a special lipid substance that is only found in Mycobacteria.
This mycolic acid makes the cells hydrophobic --an effect that is much like pouring water over a surface that is covered with margarine. The success of M. Tuberculosis as a pathogen would not be possible without the role played by it's cell wall. The cell wall is responsible for protecting the cell and regulating the interaction between the bacillus and it's environment (the human body). This is why, even today MTB is difficult to stain for identification, and lab workers have to use a special technique to distinguish these bacteria. Mycobacteria are aerobic, which means they like to grow in an environment with oxygen, and a bit of carbon dioxide as well.
Mycobacteria do not like Ultraviolet (UV) rays from the sun. MTB is susceptible to inactivation from UV light and this is the reason why TB patients were once prescribed suntan for treatment of their disease. Like many Mycobacteria, MTB is also heat-sensitive. Milk producers have been required by law to heat all milk to a certain temperature for a specific length of time to kill all Mycobacteria present in developed countries. It is because of this pasteurization that bovine tuberculosis is not common anymore, except in third world countries.Detection and Diagnosis:Enlarged lymph nodes, enlarged liver, and enlarged spleen are revealed with physical exam, but these are not confirmatory tests for TB.
The initial diagnostic/screening test to find out if a person has TB infection is the TB skin test. The test consists of scratching the skin with a protein substance derived from cultures of tubercle bacilli. Although there is more than one TB skin test, the preferred method of testing is to use the Mantoux test. For this, a small amount of testing material is placed just below the top layers of skin, usually on the arm. Two to three days later a health care worker checks the arm to see if a bump has developed and measures the size of the bump.
If the bump is of a certain size (varying with group) the test is positive. A positive skin reaction indicates the presence of tuberculosis, whether active or inactive. To ascertain whether there is any active disease, diagnosis is made by the detection of tubercle bacilli in the sputum.The standard chest X-ray also provides a method of mass screening of people for evidence of early pulmonary tuberculosis. Although an X-ray will reveal the presence of a lung lesion, confirmation of its nature requires further testing. A physician or a trained health professional will also review your history and may order further tests, if necessary. If you are diagnosed as having active TB, you will be required to take medications as prescribed by the physician.
Compared to pulmonary TB, diagnosis of non-pulmonary TB is usually problematic due to the inaccessibility of the sites of infection and the relatively small number of bacilli present in many infection sites. Other tests such as bronchoscopy and biopsies of affected organs or tissues are used to determine whether a person has TB.How to Treat Tuberculosis:The goal of treatment is to cure the infection with antitubercular drugs. Daily oral doses of rifampin, isoniazid, pyrazinamide and thambutol (or Streptomycin) are given for a period of 3 months. This is followed by a continuation phase consisting of rifampicin, isoniazid and ethambutol for next 9 months; thus completing one-year treatment. For atypical Tuberculosis infections, or drug-resistant strains, other drugs may be indicated to treat the infection. Normal activity can be continued after the infectious period.
Rest, a healthy environment (clean dry air), stress reduction and a good diet high in vitamin C, factors normally considered conducive to good health, improve the speed and response to treatment. It is very important, however, that the patient continue to take the medicine correctly for the full length of treatment. If the medicine is taken incorrectly or stopped the patient may become sick again and will be able to infect others with TB. As a result many public health authorities recommend Directly Observed Therapy (DOT), in which a health care worker insures that the patient takes his/her medicine. If the medicine is taken incorrectly and the patient becomes sick with TB a second time, the TB may be harder to treat because it has become drug resistant.
Hospitalization is only in seriously ill patients, but once the disease has been brought under control the patient may return to normal activity; complete treatment usually takes one year.Expectations (Prognosis):Symptoms may improve in 2 to 3 weeks, with improvement seen in the chest X-ray lagging behind clinical improvement.Complications:All medications used to treat TB have some toxicity. Rifampin and isoniazid may both cause a noninfectious hepatitis. Rifampin may also cause an orange or brown coloration of tears and urine. Other complications include drug resistance to particular TB strains and a relapse of the disease in some patients. PreventionsRoutine skin testing for tuberculosis is done during routine well-baby exams.
Infants are normally screened at 1 year and children at 5 years. Individuals exposed to tuberculosis should be skin tested immediately and the skin test repeated in 3 to 6 months if the initial skin test is negative. The importance of the skin test is that it shows if you have been exposed to Tuberculosis; it helps determine if you are at risk for developing the disease and treatment can be provided before you become sick. Detection of early cases and prompt treatment are paramount in controlling the spread of tuberculosis.(BCG): The BCG Vaccine was derived from a strain of M. bovis in France by Calmette and Gu'erin. BCG does not prevent initial infection, but does prevent the spread of the infection.
The vaccine, which consists of a live bacterium, was first administered in 1921 and now exists in several forms. The BCG vaccines vary substantially in effectiveness, ranging from 0-80%. The vaccine is still heavily relied upon in many countries to protect infants from the life threatening disease.But in countries where the general population is at low risk of acquiring TB, the BCG vaccines are not widely used. Instead a positive skin test and drug therapy of isoniazid and rifampin are relied upon. After vaccination the widely used TB skin test will cause a false positive.
The benefit of the skin test is considered more valuable then widespread vaccination of a population not at risk. Studies have shown, however, that although this vaccine protects some people, many are either not protected at all, or are immune for only a short time. BCG vaccination is not a guarantee against becoming infected with TB, and a positive TB test is probably not due to prior vaccination with BCG. BCG is not administered to patients who have compromised or suppressed immune systems; HIV, lymphoma, leukemia, radiation treatment, transplant recipients, etc. For this group vaccination increases the risk of developing TB and consequently death. This means that the BCG vaccine is sometimes not available to those who need it the most.As mentioned before, Bovine TB has been effectively countered by the popularization of pasteurization of milk.
It is only in third-world countries that Bovine TB is still detected. In such places, cattle should be routinely screened for the infection, and infected cows should be slaughtered and incinerated.History of Tuberculosis:There is evidence that man has suffered from Tuberculosis for more than 5,000 years. Tuberculosis bones and the remnants of old Tuberculosis adhesions in the chest have even been found in Egyptian mummies dating back to 1500B.C. The disease was well recorded by Hippocrates, (460-370 BC) the father of medicine, who described Pulmonary Tuberculosis as occurring in day-to-day clinical experience. Over the years, a number of different names have been given to this disease, such as Consumption, miasma, scrofula, phthisis, Pott's disease, Lupus vulgaris and cutaneous infection. Many prominent physicians and doctors were concerned with the symptoms and possible cures of T.B, as we can see in the History of Tuberculosis Timeline.
However, before any significant advances were made in identifying the causes and how to properly treat TB, mankind had come ...
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