Tuberculosis Essay

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Introduction
This report is an overview of the epidemiology of Tuberculosis rates in the United Kingdom between 2004 and 2013. The report is done with the aim to review the trend of Tuberculosis spread in the UK and its impact on morbidity and mortality records, which remains significant to the UK public health system, with huge socioeconomic concerns.
Tuberculosis or TB is an infectious disease affecting mainly the lungs, though it generally affects a number of organs in body (Ivany and Boulton, 2014; NHS, 2014). It is caused by a bacterium called Mycobacterium tuberculosis (Stanton and Wijgerden, 2010; WHO, 2015a). In 2013, about 9 million people were reported to be affected by Tuberculosis, with fatality of over 1.5million people (WHO, 2015b). Globally, mortality rate for Tuberculosis is observed to be on the decline by almost 45% in the last decade, with case infection rate also dropping by 1.5% (Talip et al., 2013; WHO, 2015b), meeting the target of the Millennium Development Goals (MDGs) 2015. However, this trend is observed to be inverse in most under-developed and developing countries (Kazemnejad et al.,2014), where poor public health system possess a great challenge to the management of the infection. Importantly, TB presents a “co-epidemic” with Human Immunodeficiency Virus (HIV) remains an issue of public health concern, with about 13% of the current global disease burden for TB linked with people infected with HIV (Oliver, Graig and Zumla, 2015; WHO, 2015b, page unavailable). TB presents with persistent and severe cough, weight loss, fever or high temperature, loss of appetite, fatigue painful sensations in the chest region. The mode of transmission is via person-to-person exchange of the bacteria which is usually present in the lungs and throat of symptomatic patients and transmitted by coughing, spitting, sneezing and other ways. However, some people are known to be carriers of “latent TB”, where though they have the bacteria in them, it does not spread around the body and the carriers are asymptomatic. It is estimated that about 2.5 billion people have latent TB in them (NHS, 2014; Crofts et al., 2008). Diagnosis is usually through blood test and chest x-rays. Though TB presents with high fatality, it however is curable and can be treated using antibiotics, though treatment period is usually elongated (NHS, 2014; Wolfson et al., 2015). A major concern for TB treatment is the formation of resistance by the bacterium to certain treatment drugs (Cohen et al., 2014). This remains a growing concern to the global health community. Many have attributed the TB infection to a number of social determinants like socioeconomic status, age, sex, ethnicity or race, behavioural tendencies and access to health services (Gerrish, Naisby and Ismail, 2013)). Prevention is majorly by vaccination using “…Bacillus Calmette-Guerin (BCG) vaccine…” which is universally accepted in the UK as vaccine for M. tuberculosis, after review of the “…Health and Social Care Act…” (Crisp, 2013, p.496; Anderson et al., 2014). Method and Data Source A search of relevant data sources was conducted on Tuberculosis cases notified in the UK between 2004 and 2013. Two key sources which revealed uniform and consistent data reporting for the infection include Public Health England (2014) and WHO (2015c). Data was subsequently sourced from PHE (2014) for further analysis and review. Public Health England uses an “Enhanced Tuberculosis Surveillance” (ETS) PHE (2014, no page), which captures real-time incidence of TB cases in the UK, through the notifiable disease reporting system. Knowing that the ETS is fed through a number of national and local surveillance structures and systems in England, Northern Ireland, Wales and in Scotland through an “Enhanced Surveillance of Mycobacterial Infection (ESMI)” (Health Protection Scotland, 2014, no page) the information recorded are defined
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Limitations
A major limitation is cost due to amount of both human and financial investment involved in the constant vigilance of the surveillance teams; in ports, hospitals, clinics, border regions, local communities and other relevant surveillance points.
Furthermore, a search of the data source revealed that case distribution based on gender was not made available. While this may be a limitation based on researcher’s personal search skill, every dataset from the source was thoroughly searched for this information. Ability to make data readily accessible to the public for further research and analysis is importance in determining the trustworthiness of a data source.

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