Running Head: TURBERCULOSIS

Tuberculosis

Student’s Name

Institution Affiliation
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Tuberculosis

In addition to treatment of Tuberculosis (TB), the main aim of TB control programs is to

reduce transmission. The progression of TB in exposed individual occurs in a two-stage process.

The infection is contained by the immune system and pathogens are barred in the caseous

granulomas or tubercles. Research has shown that 5 percent of the infection cases, progression to

tuberculosis will happen within the first two years. 10 percent with inactive infections will

reactivate in the first year; mostly the reactivating latent tubercle bacilli are acquired through

primary infection or reinfection (Narasimhan, Wood, MacIntyre, & Mathai, 2013). Moreover,

the probability of new disease is determined by susceptibility, infectiousness, the environment

and exposure to an individual. This paper will discuss the spread and control measures for

Tuberculosis.

Factors that determine the infectiousness of tuberculosis (TB), patients

M. tuberculosis is transmitted through the air rather than surface contact. Infectiousness is

determined by the number of bacilli expelled into the air relative to the intrinsic nature of the

contagiousness of the source regarding the number of M. tuberculosis nuclei in the droplets and

the duration of presence in the air:

 Presence of cavity in a TB patient- A lung cavity harbors more TB bacilli. Therefore, the

patient will expel larger amounts of bacteria compared to a patient without the cavity.

 Presence of a cough and precautionary behavior- A patient undergoing cough-inducing

treatment or already has contacted a cough with sputum releases germs into the air more

than a patient without a cough. More so, not covering the mouth and nose while coughing

will spread the disease more rapidly.

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 The site of sickness- Infection in the airways, larynx and pulmonary is more infectious

than infection in non-pulmonary regions. Bacilli cannot get exposed to the air from non-

respiratory extrapulmonary sites.

 Lack of treatment- Usually, patients undergoing adequate treatment for more than two

weeks have reduced bacteria and associated symptoms like excessive coughing which

reduce their infectiousness.

The primary goals of a TB infection control program

A TB Infection control programs tenets are inclined to assess the probability of risk for

transmission. The primary goals include; prompt detection, airborne precautions, and treatment

(Lönnroth & Raviglione, 2008).

 Detection- Cases of undiagnosed patient pose the greatest threat in containing new TB

infections. For this reason, healthcare workers should be trained to identify signs and

symptoms of the disease, give a diagnostic evaluation to the suspected patient, separate

and induce the patient into a treatment program. The main exhibited symptoms include; a

cough lasting more than three weeks, blood in the sputum, fever, chest pain, chills,

sweating at night and fatigue.

 Airborne precautions- After diagnosing and initiating treatment, the patient remains

infectious; therefore, he/she should be isolated from the healthy persons and put in an

Airborne Infection Isolation room (AII) for specialized treatment. Here the environmental

factors are controlled to reduce the spread of the infection agent.

 Treatment- Patients who have been diagnosed with an infection or proven to be highly

probable to the disease should initialize treatment. Nonetheless, treatment can be

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discontinued if the patient had improved symptoms and had recorded negative AFB

sputum smear results

The levels of an effective TB infection control program (Dye & Williams, 2010)

 Administrative controls- Administrative controls are measures to reduce the exposure of

infected patients. They involve activities such as; 1) sensitizing and training health

workers on the precautions and procedures o countering the deadly disease.2) Risk

assessment and classification to determine to areas with need and the frequency of

testing. 3) Coordinating efforts to stock necessary hospital facilities.

 Environmental controls- They entail reducing the spread through nuclei droplets by

primary and secondary means. Primary controls which are ventilating contaminated air

using doors, windows and mechanical tools like booths to keep the air flowing.

Secondary means are controlling air flow into other areas from the AII's and cleansing

the air using High-Efficiency Particle Air filtration (HEPA) and Ultraviolet Germicidal

Irradiation (UVGI)

 Respiratory protection controls- These are wearing protective gear while interacting with

infected persons. Health workers are trained on respiratory protection and the

implementation of the program. Additionally, the mass is sensitized on hygiene and

cough etiquette.

Purpose and the characteristics of a TB airborne infection isolation room

The AII rooms are single –patient rooms for persons suffering from TB intended to direct

the pathogens into a safe containment area. They are designed such that air supplied into the

room is balanced with outgoing air to create a -0.01” WC negative pressure difference relative to
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the adjacent environment to prevent contaminated air from flowing into the environment.

Exhaust air is filtered in the ventilation systems HEPA, or UVGI usually place in the rooftops

where atmospheric air dilutes it into a safer air (Villafruela, Castro, San José, & Saint-Martin,

2013).

Circumstances when respirators and surgical masks should be used

Surgical masks are worn by the patient only to prevent him/her from exhaling the bacteria

nuclei while the respiratory masks are worn by the health worker and uninfected people to filter

the TB nuclei when inhaling. Both protective gears are worn when interacting with people

infected with an airborne disease or in identified TB risk environments by their respective users.

In conclusion, TB is a deadly disease that steeps the human mortality rate. Prompt

diagnosis, isolation, and adequate treatment are necessary to contain the ailment. Additionally,

control programs should be initiated to sensitize and educate both the mass and health workers

on how to contain the disease.

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References

Dye, C., & Williams, B. G. (2010). The population dynamics and control of tuberculosis.

Science, 328(5980), 856-861.

Lönnroth, K., & Raviglione. (2008). Global epidemiology of tuberculosis: prospects for control.

Seminars in respiratory and critical care Medicine, 481-491.

Narasimhan, P., Wood, J., MacIntyre, C. R., & Mathai, D. (2013). Risk factors for tuberculosis.

Pulmonary medicine.

Villafruela, J. M., Castro, F., San José, J. F., & Saint-Martin, J. (2013). Comparison of air change

efficiency, contaminant removal effectiveness and infection risk as IAQ indices in

isolation rooms. Energy and Buildings, 5(7), 210-219.