Tuberculosis (TB) is linked to morbidity, mortality, and devastating economic impact on healthcare systems, so medical professionals should be able to take urgent action to combat the disease. The issue of potential TB spread in the community presents a threat to public health and requires the nurse to follow a set of specific steps. Firstly, Debbie should report the occurrence of TB cases in Hispanic migrants to the Centers for Disease Control and Prevention (CDC) to stop a possible outbreak early on. Secondly, the BSN nurse might conduct a survey of the risk group patients and assess the feedback to identify the factors affecting to the frequency of TB and protect the community. Finally, based on the data from the questionnaires, Debbie can use the epidemiologic triangle to explore the relationships between hosts, infectious agents, and environmental factors (Stanhope & Lancaster, 2020). People are the primary hosts of the disease, and its causal agent is mycobacterium tuberculosis that can be discovered via tuberculin skin (the Mantoux) test or blood test (Herchline, 2020). Possible environmental factors in this scenario include poor nutrition, air pollution, substance abuse, unsatisfactory working/living conditions, and fatigue.
Based on the factors identified above, economic and social issues in Mexican migrant workers stem from poverty and associated malnutrition, overcrowding, and unhealthy behavior. Drug-resistant infections occur when bacteria develop resistance to antibiotics, so TB strategies should not only rely on antibiotic treatment but limit unnecessary prescriptions and promote preventive interventions (McKenna, 2015). Primary interventions aim to assess the risk and prevent the disease through education and promotion of healthy behaviors. Patient assessment and surveys can help the nurse to identify certain behaviors and factors leading to the outbreak (Stanhope & Lancaster, 2020). Secondary interventions that Debbie might use are radiograph screenings and blood testing to detect the cases of active TB and develop a timely response. Kim (2014) found that the only way to stop TB is to treat every affected individual regardless of how complicated or cost-effective the process is. Directly observed therapy (DOT) is the main tertiary intervention ensuring proper documentation of TB patients and medication to avoid drug-resistance in the community (Zuniga et al., 2014). Another tertiary intervention is psychosocial support for infected patients, as family involvement in the treatment results in improved patient compliance with medication and acceptance of the condition.
Similar primary interventions may be applied to our community, as TB prevention is the key to achieve a healthy population. Secondary and tertiary measures may not be relevant due to the limited number of local TB cases and the efficiency of existing prevention programs and support groups. In my community, TB is relatively rare, and the state’s case rate is below the national average. In 2019, there were 198 cases of TB in Pennsylvania or 1.5 cases per 100,000 people versus a 2.7 case rate in the U.S. (Pennsylvania Department of Health, 2021). In contrast to Debbie’s case involving patient assessment and surveys, public health in our community should focus on patient education and regular mandatory x-ray or lab testing and preventive medication for healthcare workers exposed to TB. Additionally, patients with suspected TB and individuals they contacted should be surveilled and instructed on the need to report any symptoms to stop the spread of the infection. There are several TB protection and control programs that work successfully to eradicate TB in our community. However, monitoring of immigration/migration from TB high-risk countries/U.S. states might also be considered to protect Pennsylvania residents from infection and possible bioterrorism attacks.
References
Herchline, T. E. (2020). Which infectious agent causes tuberculosis (TB) (consumption)? Medscape.
Kim, J. Y. (2014). Will the poor always be with us? [Video]. YouTube.
McKenna, M. (2015). What do we do when antibiotics don’t work anymore? [Video]. TED.
Pennsylvania Department of Health. (2021). Tuberculosis Statistics. DOH. Web.
Stanhope, M., & Lancaster, J. (2020). Public health nursing: Population-centered health care in the community (10th ed.). Elsevier.
Zuniga, J. A., Munos, S. E., Johnson, M. Z., & Garcia, A. (2014). Tuberculosis treatment for Mexican Americans living on the U.S.-Mexico border. Journal of Nursing Scholarship, 46(4), 253–262.