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There is an enormous quantity of microorganisms like viruses, bacteria, unicellular organisms, fungus surrounding a human being throughout life. A human being is constantly at risk of getting some contagious disease that can cause severe intoxication of the organism. Various viruses, bacteria, and bacilli can provoke more than 200 communicable diseases, and tuberculosis is also in this group. This paper will focus on clinical aspects of tuberculosis, the determinants of health and their influence over the sickness development, its epidemiology, and community health care actions on this issue. Furthermore, the contributions of the different tuberculosis-oriented organizations will also be mentioned.

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Despite the breakthroughs in the modern medicine, it is yet not possible to overcome the disease. Tuberculosis still belongs to the most frequent diseases. It is caused by the infectious agent known as Mycobacterium tuberculosis that provokes contamination of the body due to the damaged immune system (National Institute of Allergy and Infectious Diseases, 2014). The infection primarily affects the lungs but can also affect other organs such as eyes, skin, bones, moveable joints, and urinary organs. At the initial stage, the clinical course can remind either a respiratory sickness or pneumonia, or can be even asymptomatic.

Tuberculosis

Tuberculosis can be primary and post-primary. The primary type is accompanied by the site formation that is the part of the lung damaged by Kochs bacillus. The secondary stage is a result of primary contamination or reactivation of already existent infection. Formation of new caverns and sites characterizes this stage of tuberculosis. They can conjugate and provoke extensive intoxication of the body. Tuberculosis infection can exist in latent or active forms. The latent form of TB does not affect the body because it is battled by the immune system. The active tuberculosis form manifests itself with continuing fatigue, weakness, somnolence, anorexia, night sweats and hyperthermia. The active TB form shows in persistent coughing that lasts three or more weeks, hemoptysis, pains in the chest, weight loss, and pain during breathing or coughing (Mayo Clinic, 2016). The bacteria are carried through the air, physical contact, food, and in the intra-uterine way. The majority of the tuberculosis cases derive from the air contamination, considering that an infected person spreads bacteria while coughing or sneezing. Inhalation of respiratory droplets that contain bacteria is the cause of infection spreading (Maurer & Smith, 2011). One can be infected via contact with contaminated individual or his/her personal things. Tuberculosis is blood-borne and sexually transmitted. Contamination via nutrition means the consumption of the products received from the infected animals. A contaminated mother can transmit the disease to a newborn.

Tuberculosis can be fatal without proper and in-time treatment. The uncured active form of tuberculosis can result in serious complications inside a body. Complications manifest themselves in spinal pain, joint destruction, TB-caused meningitis, and brain swelling. Liver and kidneys stop filtering impurities from ones bloodstream in the case they are infected with tuberculosis. The infection can penetrate the heart tissues and damage them. Other complications lead to adult respiratory distress syndrome, lung failure, and disease recurrence.

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Treatment of tuberculosis takes more time than of any other bacteria-caused sickness. To cure or suppress the infection, a contaminated individual needs an antituberculotics prescription. In case of latent tuberculosis, there is a single TB-drug prescription. Active tuberculosis requires multi-drug administration. The most common medication involves the antituberculotics as Isoniazid, Rifampin, Ethambutol, and Pyrazinamide. Drug-resistant tuberculosis requires the intake of antibiotics combination called fluoroquinolones and injectable medications, such as amikacin, kanamycin or capreomycin (Mayo Clinic Staff, 2016). Nowadays, the health care providers insist on using a directly observed therapy for increasing treatment efficiency. Isolation, rest, respiratory supportive care, sufficient nourishing for active-TB patients are the additional factors which ensure a positive result in treatment.

As indicated earlier, tuberculosis is one of the most widely spread lethal diseases. It is one of the main reasons of morbidity and mortality worldwide. Center of Disease Control and Prevention state that one third of the worlds population is infected with TB. In 2014 there are 9.6 million people all over the world infected with TB disease and 1.5 million TB-related deaths worldwide (CDC, 2015). Tuberculosis is a life-threatening disease for HIV-infected people or people whose immune system is severely damaged. As per the World Health Organization in 2013, there were approximately 480,000 people infected with multi-resistant form of tuberculosis insensitive to treatment.

Determinants of health is a complex of personal, social, economic and environment factors that affect the health status of a person (HealthyPeople.gov, 2016). A health condition depends on many factors such as a health care policy, social aspect, medical service, individual behavior, biological and genetic aspects. To prevent tuberculosis from spreading, the developed countries design and implement special health care government-financed programs and conduct the adequate policy. Negative social and economic factors contribute to spreading of tuberculosis. There are definite groups that are more exposed to get TB-infection. They are HIV infected people, drug or alcohol addicts, people with chronic diseases including respiratory ones, homeless or imprisoned individuals. To this group one may refer people with low income, living in bad housing facilities and having improper nourishing. Furthermore, health care workers that treat TB-patients and people in close contact with TB-infected persons are also in greater risk of being contaminated.

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Epidemiological triangle of any contagious disease involves a host, a causative agent, and environment. The host is the organism that is capable of accepting and developing the disease. The host in the case of tuberculosis is primarily a human being but can also be cattle. Humans remain the only reservoir for M. tuberculosis, but M. bovis ( has its reservoir in cattle) will also sometimes infect humans through un-pasteurized milk and cause extra pulmonary TB (Microbiology, 2005). The causing agent is a disease-provoking microbe or bacteria. For tuberculosis, the cause is Mycobacterium tuberculosisthatis aGram-positive, non-spore forming bacterium with a thick, lipid-rich cell wall (The University of Iowa, 2016). Its ability to preserve stamina while exposed to various physical and chemical agents or any other aggressive environment effect, its alcohol and acid tolerance pose a threat to many people. Humid expectorations containing Mycobacterium tuberculosis are also a source of contamination. Mycobacterium tuberculosis is a fast-mutating microorganism and can frequently be antibiotic-resistant. Under environment one understands external factors productive for disease development and spreading. Severe living conditions, poor nourishing, improper health care policy, close staying near infectious source or dealing with it are the environmental factors favorable for tuberculosis progress.

Community health nursing is effective in preventing further spreading of tuberculosis inside one country and all over the world. A health nursing system has to provide necessary medical care. Moreover, it performs educative function in teaching people how to cure tuberculosis properly. Any state has to support non-government organizations that aim at combatting this dangerous disease. Filter masks, vaccination of the health care nurses and emergency services personnel also reduce the chance of getting the bacilli and therefore spreading the infection. Community health nurses are supposed to monitor and analyze the tuberculosis cases to avoid the severe epidemic. Health nurses ability to provide comprehensive medical care as well as their fast adaptability to the existing conditions increase their value for the community. Additionally, the promotion of the directly observed therapy without community health nurses involvement that assumes observation of each doses ingestion of the prescribed drugs is impossible (Maurer & Smith, 2013). Thus, community health nurses significantly contribute to preventing tuberculosis expansion.

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There are many state and non-government organizations, agencies, and institutes that contribute to combating tuberculosis worldwide. They are the World Health Organization, International Union against Tuberculosis and Lung Disease (IUATLD), Centers for Disease control and Prevention among others. Such organization as the International Union against Tuberculosis and Lung Disease makes their substantial contributions by conducting researches in this area, giving required technical assistance, organizing the international scientific conferences, meetings where the medical researchers and health care providers can learn the latest discoveries, experience, and clinical results. The IUATLD primarily plays an educative and supportive role that can be efficient in finding new remedy for tuberculosis and in applying preventive measures to stop tuberculosis from spreading.

In conclusion, tuberculosis belongs to the most dangerous communicable disease in the world. Tuberculosis is caused by Mycobacterium tuberculosis. It is air and blood borne. The disease weakens the immune system drastically and requires a multi-drug treatment. It can cause severe complications or be fatal without comprehensive medical treatment and care. Improvement of living standards and basic sanitary norms, advanced diagnostic techniques, and adequate medically-supervised treatment are effective measures in reducing tuberculosis spreading. Effective treatment of potentially infected people such as HIV infected individuals, or people with any other chronic pathology, sufficient medical care of the imprisoned, and improvement of their living conditions can minimize the risk of acquiring tuberculosis. Community health nurses play a substantial role in combating the disease by providing necessary aid and care. Many organizations aimed t controlling and preventing tuberculosis keep on conducting researches by developing efficient remedies to avoid or diminish destructive effect of the discussed disease.