Headline(s) Rehab and tuberculosis
Standfirst Robert Millett meets a respiratory and neuro physio who are working together to help rehab TB patients in London.
Byline
Contact/Other info Possible box at end of either 50 or 120 words
Subbed by
Many people think of tuberculosis (TB) as a ‘Dickensian’ era disease. But current figures from the World Health Organization (WHO) show that, alongside HIV, TB is the most deadly infectious disease in the world.
Most new cases occur in China, India, Indonesia, Nigeria and Pakistan.
But the UK has the highest TB rates in Western Europe, according to figures from Public Health England, with 12 cases per 100,000 people.
And the numbers in London are even higher. In November 2015 the London
…show more content…
The unit receives TB referrals from across southeast England and local district general hospitals. The trust’s physiotherapy TB provision consists of a band 5 physio who works half a day a week on the unit, and receives input from both the respiratory team and the trust’s neuro-outreach physiotherapy team.
‘We don’t have a blanket referral for all patients that are admitted with TB, but we are lucky to work with fantastic nurses and doctors who are able to identify when the patients need our input,’ says Ms Ricketts.
There is no typical pathway of care for patients who are referred to the unit with TB, she says, as each case is different and physiotherapy treatment – when needed – varies depending on the presentation and site of TB in a patient’s body.
Most cases of TB can be successfully treated with a six-month course of antibiotics, says Mrs Ricketts. But drug-resistant strains of the disease can involve lengthier and more complex treatment with antibiotics and injectable drugs, and often require inpatient care.
Physiotherapy may be needed if a TB patient has a high secretion load, respiratory compromise or functional or neurological impairment. And pulmonary TB patients may need inpatient physiotherapy if they experience a long hospital stay.
‘TB can affect different parts of the body – it can be in your bladder or in your spine, or anywhere – but with pulmonary TB one of the biggest problems is that patients often become very deconditioned,’ says Ms
With the close proximity infection range TB is known for completes the remainder of the epidemiologic triangle. Overcrowded environments are the coal to the fire of this transmittable disease with outbreaks capable of occurring, infection hundreds. Common symptoms of this active form of tuberculosis include: weight loss, coughing, fatigue, fever, night sweats, chills, and loss of appetite (MayoClinic, 2014). The Mayo Clinic also states that it is believed that 2 billion (one third) of the world population is living with Latent TB (2014). This emphasizes the need for public health and community involvement in order to completely abolish this disease from our planet.
Many people take breathing for granted, some never give it a second thought until a problem presents itself. Respiratory diseases affect millions of Americans as well as people from all over the world. Anyone can suffer from these disorders to include men, women, and children, with conditions ranging from mild, moderate, to chronic in nature. This paper will focus on one of the many respiratory disease called mycobacterium tuberculosis; more commonly referred to as TB.
Tuberculosis is a disease of an infectious nature caused by a bacterium known as mycobacterium tuberculosis. The disease spreads through the air. People with the disease can spread it to susceptible people through coughing, sneezing, talking or spitting. It mainly affects the lungs and other parts such as the lymph nodes and kidneys can also be affected. The symptoms for TB are fatigue, coughing, night sweats, weight loss and fever. One third of the population of the world is affected with mycobacterium tuberculosis. The rate of infection is estimated to be one person per second. About 14 million people in the world are infected with active tuberculosis. Drug resistant TB has been recorded to be a serious public health hazard in many countries. Resistant strains have developed making it difficult to treat the disease. TB has caused millions of death mainly in people living with HIV/AIDS ADDIN EN.CITE Ginsberg19981447(Ginsberg, 1998)1447144717Ginsberg, Ann M.The Tuberculosis Epidemic: Scientific Challenges and OpportunitiesPublic Health Reports (1974-)Public Health Reports (1974-)128-13611321998Association of Schools of Public Health00333549http://www.jstor.org/stable/4598234( HYPERLINK l "_ENREF_3" o "Ginsberg, 1998 #1447" Ginsberg, 1998). The World Health Organization came up with the DOTS (Directly Observed, Therapy, Short course) strategy. The approach involves diagnosing cases and treating patients with drugs for about 6-8
Tuberculosis is caused by the bacteria “Mycobacterium Tuberculosis” and is mainly causes infection of the lungs (WHO, 2016). Its mode of transmission is airborne, so it can be passed on by inhalation of airborne droplets which carrying the bacteria, when an infected patient coughs, sneezes, or spits the TB germs into the air (WHO, 1026). Among the symptoms of active TB are: cough with sputum and blood, chest pains, weakness, fever and night sweats (WHO, 2016). Most at risk to get the TB infection are people with weakened immune system such as people who are suffering from chronic diseases such as diabetes mellitus, severe kidney disease, silicosis and especially HIV infection (CDC, 2016). Children and Tobacco users are also at greater risk to fall ill with TB.
Due to the transmission that TB is spread, through the air from one person to another coughing, sneezing, and speaking. It is vital that those who have TB disease are treated, complete the medicine regimen, and take the medications exactly as prescribed. If one was to discontinue the medications without completion, they can become ill again and if they do not take the drugs correctly, the TB bacteria that are still alive may become resistant to those medications. TB must be treated by taking antibiotics, the exact drugs and length of treatment depend on your age, overall health, possible drug resistance, the form of TB, latent or active, and the location
Tuberculosis (TB) is caused by a bacteria called Mycobacterium Tuberculosis, which normally affects the lungs, but it can also affect any part of the body, including the bones and the nervous system. The disease is spread easily through prolonged exposure to someone who has the illness, from their coughs and sneezes. For a healthy individual the body’s immune system kills the bacteria and prevents it from spreading in the body, which is known as ‘latent TB’. However, if the immune system fails to fight the bacteria, it can easily spread in the body. Symptoms will develop within a few weeks or months depending on the individual. This is known as an ‘active TB’. The symptoms are, constant coughing that brings up phlegm that may also contain blood, which lasts more than three weeks, combined with weight loss, tiredness and fatigue, loss of appetite and also fever. Without treatment, TB can cause major health problems and if its left untreated can even cause death (NHS 2016).
This study involved reviewed a program to determine the effectiveness of a program to control drug sensitive TB by improving the treatment adherence of patients. The study compared the results of a patient program involving education and counseling of the patient and family members followed by Text messages and phone calls to remind them to take medications and monitor treatment and side effects. This is compared to the WHO recommended treatment of requiring the patient to make daily visits to TB outpatient centers for drug administration.
a patient with a new case of TB can be treated at home. Others will enter the
I – Empower nurses with new evidence based practices and redirect their nursing practice skills towards early diagnosis of TB disease. Educate the society to be aware of TB disease and encourage them to seek medical help when experiencing any signs of TB. And provide resources to patients on Anti-TB Drugs to help them adherence with their medication.
Tuberculosis (TB) is a chronic bacterial infection that affects millions of people globally. It is a contagious disease that is spread through the air, and it usually affects the lungs. It is transmitted from person to person through droplets from the respiratory tract of those who are already infected with the disease. Some who are infected with the bacteria that causes TB often exhibit no symptoms, because their immune systems stop the bacteria from growing and multiplying. Those with compromised immune systems are more susceptible to developing the full blown disease which can cause symptoms that include coughing, spitting blood, chest pains, weakness, weight loss, and fever. Tuberculosis can be treated with a six to nine month course of a combination of antibiotics. If left untreated, TB will spread and can be fatal.
The most common symptoms are a lung infection, beside the lungs TB can cause other organs in the body to be infected. TB first essential exposer of the bacteria is often called primary TB. The body’s defence immune system is capable of stopping the bacteria from spreading therefore fights the infection. The way it does this is forming a scar tissue around the bacteria separating it from the rest of the body. The truth is anyone can have TB right now. Many individuals can have no symptoms. On the other hand, if someone’s immune system is weak or is unable to conceal the TB bacteria scar tissue and if erupt this can cause the active disease which is refer secondary TB. Beside the lungs the most frequent body part that are infected are kidneys, bones, the lining of the brain and spinal
There are many complications that individuals can experience once infected by TB. Complications of Pulmonary Tuberculosis are as followed: hemoptysis (the coughing up of blood), pleurisy, pleural effusion, empyema, pneumothorax, endobronchitis, bronchiectasis, laryngitis, cor pulmonale, ca bronchus, and enteritis. As dangerous and severe TB can be, there are plenty of ways to treat and combat the curable illness. TB is treated with the use of drugs susceptible for six months course of four antimicrobial drugs. The supervision and support to the patient by a healthcare provider or a trained volunteer are critical for the road to recovery for the sick individual. Without such support, treatment adherence can be different, and the disease can spread.
When a non-infected person inhales the droplets containing TB, the bacteria makes its way into their lungs and alveoli then begins to multiply. This is the onset of active TB. Once the bacteria has settled in the lungs, the patient’s local immune system responds by attacking the invading bacteria with macrophages which line the airways of the lung. In most people, their immune system is able suppress further growth of the bacteria, and they are said to have latent TB infection. Those with latent TB show no symptoms and cannot spread the disease. However, if an individual’s immune system is compromised or weak, the bacteria can progress further from its initial infection or be reactivated from a latent state. If the macrophages become overwhelmed by the infection, they begin to form together along with other diseased tissues into a well-defined mass (lesion) known as a granuloma or tuberculoma. Once the granuloma is of sufficient size or has calcified enough to be visualized by a diagnostic chest x-ray image, it is known as a ghon focus. The TB infection can also spread to the adjacent
If the patient is suffering from latent TB it means the patient ha mycobacterium Tuberculosis bacterium in his body, but they are inactivated. To treat TB infection it is most important that the patient consults their doctor. Most common medicine used for this type of TB is isoniazid (INH. In most of the cases this medicine would take about 6 months (if taken regularly) to kill all the inactivated bacterium.
Primary TB infection, the first stage, begins when a person inhales an airborne bacteria. This is mostly common when a person is in close contact with an infected person with active TB who is coughing or sneezing. For most, the inhaled bacteria is killed immediately by the immune system. However, others aren’t so fortunate because the TB bacteria are engulfed by macrophages, which are a type of white cell, and enter dormant state. The dormant state can last several years or even a lifetime. However that’s not always the case, in certain populations including infants, the elderly, those with recent acquired TB infection and those with weakened immune system the symptoms of tuberculosis can show within weeks of the primary infection. The second stage is the Latent TB infection Although the bacteria is dormant and the person won’t have any symptoms, a tuberculin skin test or blood test for TB will show a positive result. It will show that the person has been exposed to TB and has latent infection. If discovered, treatment is recommended in certain individuals at high risk to try and prevent further spread. The third and final stage is Active Tuberculosis in which the bacteria is multiplying in the body and causing symptoms and physical changes. These symptoms develop slowly due to the fact that the TB pathogen multiplies very slowly. The most common symptoms of active