Toronto Public Health and TB Program Prevention, Management and Treatment
Thi Thanh Tuyen (Rosa) Pham
NUR 102
Luella Orr
October 26, 2016
Toronto Public Health and TB Program Prevention, Management and Treatment
Tuberculosis (TB), which infects one-third of the world population, is a disease with one of the highest mortality rates in the world (Centers for Disease Control and Prevention, 2016a). It is reported that there is an approximately low TB occurrence in nations that have the highest income and middle income; however, there are specific communities such as homeless, poor people and lawbreakers in these countries that have the highest TB incidence (Gärden et al., 2013). Therefore, public health policies about preventing and treating tuberculosis in the marginalized and disfavoured groups have never failed to get social attention. The city of Toronto has been applying Nightingale’s theory of ensuring ventilation and warming, maintaining the cleanliness, and reinforcing the observing of the sick to develop a TB program in order to diminish the spreading and impacts of TB as well as to enhance the support for displaced, disciplinary communities.
Nightingale’s notion of a therapeutic environment plays a critical role in establishing the TB program for homeless, correctional populations of Toronto because it has reduced TB’s airborne transmission, a factor that makes TB a worldwide pandemic. In Canada, TB was possibly transmitted to Aboriginal people in
Thank you for reaching out to Dallas County Health and Human Services(DCHHS). In response to your inquiry, DCHHS is unaware of an increased incidence of Tuberculosis among Square Cottage residents. In the event as such, DCHHS would not disclose a specific location due to medical confidentiality and personal privacy reasons. Overall, DCHHS has shown that the number of annual TB cases have decreased by 37% from 1993 to 2015 in Dallas County. In regards to homelessness specifically, I can confirm the proportion of TB cases occurring in persons experiencing homelessness has increased since 2014. Please note, homeless individuals are disproportionately affected by Tuberculosis in Dallas County as well as the United States. In an effort
Homelessness is a growing problem in the U.S according to Rukmana, (2012) “there is more than 800,000 homeless individuals in the U.S”. People who are homeless have poorer health and higher mortality than the general population, because of these statistics my program will be targeting the homeless population in our Miami-Dade community who are suffering from tuberculous. Tuberculosis have been recognized as an important health problem among the homeless population, that is why I believe it is very important to teach the homeless population in our community how to prevent the spread of tuberculosis and how to take preventable measures not to contract the disease.
Tuberculosis (TB) is one of the top causes of death worldwide (WHO, 2016). In 2015, TB affected 10.4 million people and was the cause of death for 1.8 of them (WHO, 2016). TB is spread by air, what makes it contagious and dangerous. In order to prevent the spread of TB and support for individuals with TB as well as their families, the city of Toronto developed programs which are definitely based on Florence Nightingale’s theories regarding ventilation, clean air, observation of the sick and food.
In the City of Exeter Rhode Island, the Browns family has contracted Consumption, “Tuberculosis”. Suffering from the disease, one by one a family member
Tuberculosis (TB) is an infectious killer worldwide. However, over 95% of TB deaths occur in developing countries (WHO). TB is found to be a curable disease when appropriate medications and treatment are taken. Using the biomedical system is not sufficient to eradicate TB because medical interventions will fail if social determinates aren’t taken into considerations. The biomedical system is a key component in diminishing TB because it allows for diagnosis and control. Social determinants of health play a huge role in shaping one’s health. Three main social determinants that acts as a barrier in curing and preventing TB are income, food insecurity and access to health care.
Throughout the past six years, two outbreaks of tuberculosis occurred within the homeless population in the city of Toronto. With intensive care management and contact follow-up partnership with City of Toronto Shelter, Support and housing Administration Division, shelter staff, TB clinics, the provincial public health laboratory and community partners, the Toronto Public Health (TBH) was able to effectively manage these outbreaks (Toronto Public Health, 2016). TBH created a program to help homeless shelters, and drop-in operators apply the correct protocols to essentially reduce TB transmission risk by enforcing environmental control measures (Toronto Public Health, 2016). Similarly, implementing Florence Nightingale’s theories, found in the novel Notes on Nursing, developed an imperative understanding that the patients’ wellbeing is dependent on their surrounding environment. City of Toronto TB program for the under-housed, homeless and correctional population with tuberculosis, is based on Florence Nightingale’s theories of providing ventilation and warming, maintain cleanliness of rooms and walls, and ensuring observation of the sick.
The progress of tuberculosis infected more people over the years. The rate of Inuits being infected with tuberculosis still continues to be high and has gotten higher, the amount of Inuits infected by latent tuberculosis has increased, but the rate of latent turning to active tuberculosis has decreased because some Iqaluit's died from it.(1). Iqaluit has the most case and highest rate of tuberculosis in Canada(2). The reason why these cases are still high is because the health system is not so great in Iqaluit and functions very poorly. Because the nurses or doctors in Iqaluit who don’t diagnose patients quickly or a mislead on diagnosis. Also tuberculosis is high in Iqaluit is because the housing is often overcrowded which would enable the infections to spread by air. Lack of food is also a problem followed up with security and access to health care are part of the factors why tuberculosis is high in Iqaluit.(4)
Little was known about treatment and prevention of the disease at that time. It was not until 1953 that the United States began collecting data and reports on the 84,304 new cases of TB. This data could be used in research. TB was recognized as a preventable deadly disease, and a common goal to eradicate TB was adopted. Over the next 32 years, the new TB cases dropped 74%. By 1985, there were only 22,201 TB cases. History notes that law makers and public health officials became complacent and thought they had found the solution for eradicating TB. Resources for TB surveillance, prevention, and treatment options were reduced, while homeless numbers increased. This changed history as from 1985 to 1992 TB rates started to increase. Data collected from demographic regions and surveillance records show TB cases rose by 20% in those seven years to equal new 26,673 cases, and the estimated number of TB cases (old and new cases together) during that time was more than 64,000 cases. This was the last recorded peek in TB history. Since 1992, there has been a decrease of 67% in all TB cases. Studies reflect this decrease from 10.5 to 3.4 per 100,000 persons. Much credit for this continued decline is attributed to state and federal aid in addition to the state and local programs aimed at fighting TB and the helping the homeless population. Continued public education, proactive surveillance,
The tuberculosis in the United States increased by 20 percent between 1985 and 1992 due to the following reasons: “(1) Inadequate funding for TB control and other public health efforts, (2) the HIV epidemic, (3) increased immigration from countries where TB is common, (4) the spread of TB in certain settings (for example, correctional facilities and homeless shelters), and (5) the spread of multidrug-resistant TB (MDR TB)” (CDC). Meanwhile, as what is evident in Dr. Trudeau’s experiment, the factors for Tuberculosis to thrive are due to inadequate-lacks-in-nutritional-value food supply, and poor environmental conditions. In like manner, incarcerated populations resemble that situation. Thus, one of the many reasons that TB can be higher in prisons, is that most prisons are not kept that clean and sanitary. Even though they may sweep and mop thinking they are getting rid of TB, there is a form of Tuberculosis called latent TB which lie dormant for days or even many years that can actually reactivate (CDC), and spread the disease between prisoners. A second reason that TB is high in prisons is due to overcrowding. The prisoners are in such close proximity of each other on a daily basis, that there is no way of separating themselves from getting TB. A third reason, the prisoners could have easily gotten Tuberculosis from each other due to small areas. Since some forms of Tuberculosis is spread by airborne droplets (Mayo Clinic) it would make sense why prisoners get it so much easier. Other factors in
A resolution was introduced by the Minister of Health ”Through this Framework, the federal government will focus its efforts on reducing the burden of tuberculosis within those populations by: Optimizing and enhancing current efforts to prevent and control active tuberculosis disease, facilitating the identification and treatment of latent tuberculosis infection for those at high risk of developing active tuberculosis disease, and championing collaborative action to address the underlying risk factors for tuberculosis.” (The Honourable Rona Ambrose, P.C., M.P Minister of Health). In 2004, total tuberculosis-related expenditures in Canada were estimated at $74 million dollars, with the average cost of treating a case of active tuberculosis being approximately $47 thousand dollars. Treatment for latent TB infection, on the other hand, is estimated to be less than $1000 per
On the eve of November 8th, 2016, secretary of the Democratic Party Hillary Clinton or politician of the Republican Party Donald Trump will become president of the United States. With their dividing views, it splits the nation in half with their ideals and plans for the future. This election is what brings out the true form of freedom of speech in America-polarization between the Democrats and the Republicans. Not only does this election bring out the significance of how important it is to vote, but also what kind of leader people want to lead for the next four years. The vision of America 's future could possibly be at stake depending on who comes out as the winner in less than a week. Power will be given to either Clinton or Trump, and that is what will determine the outcome of the fates for everyone residing in the Unites States for the next four years.
without fear of deportation, he exhorted, "You can come out of the shadows. But they can’t, while the U.S. is experiencing the expansion of health care access with the Affordable Care Act (ACA). This plan excluded about eleven million people who are in the country illegally. Nations with a lower social economic status are being greatly affected by the TB agent and do not have the resources available to people in the United States. According to World Health Organization (WHO): TB is the second greatest killer due to a single infectious agent in other nations, in 2012, 15% of the reported cases of TB resulted in death. TB is the third-leading cause of death for women ages 15-44 in low- and middle-income nations and the hardest hit by this disease are patients with compromised immune systems and elderly patients.
“Despite all the ghastliness in the world, human beings are made for goodness, the ones that held in high regard are not militarily powerful nor economically prosperous. They have a commitment to try and make the world a better place” (Desmond Tutu,15)- Archbishop Desmond Tutu. Strong words of hope and faith in humanity come from a man who is regarded in the same heights as Ghandi. Archbishop Desmond Tutu is a survivor of the deadly disease known as, Tuberculosis. According to the CDC, “One third of the world’s population is infected with TB” . A staggering number, but the amount of deaths from TB is even more astonishing, “1.8 million deaths in 2015” (Center for Disease Control). Most people get confused with what exactly tuberculosis even is, whether people say it’s like the flu or bronchitis, but it’s something truly life threatening. Tuberculosis is not exclusive to only one race, ethnicity, or gender, tuberculosis is able to kill anyone regardless of age. Therefore, it is important to raise awareness and educate all the people in the world of the Tuberculosis.
India, the second most populous country with over 1.31 billion people, has the highest burden of tuberculosis (TB) in the world, accounting for 20% of the global incidence of TB, and an even higher share of global incidence of multi–drug resistant (MDR) TB. With an estimated 2 million new cases of TB and 5, 00,000 TB-related deaths in India annually, those who got diagnosed with different forms of DR-TB were 35,385 cases but only 20,753 people started on multidrug-resistant TB (MDR-TB) treatment in 2013. The National Tuberculosis Program was launched in 1962, but suffered heavily continuing TB led mortality. Acknowledging this reality, a Revised National Tuberculosis Control Programme (RNTCP) was launched by the Government of India in 1997, however even today it does not comply with World Health Organization (WHO) recommendations.
As mentioned in the previous section, high TB notification rates in Hong Kong every year reveals the severity, reported statistics from CHP (CHP, 2016). Though there are decreasing TB notification cases, TB still puts pressure on Hong Kong’s citizens. In 1939, around 4,500 TB deaths report before the invasion by Japan, which made TB become a notifiable disease (DH, 2006). During the World War II, the unstable social conditions, poor nutrition, and serious overcrowding in Hong Kong increased the number of cases who died from TB (DH, 2006). As a result, with the influx of refugee from Mainland China, TB became the top killer in Hong Kong (DH, 2006). In 1940-1950, the Hong Kong Government and the Hong Kong Anti-Tuberculosis Association created plans for TB control services, after the development in anti-TB drugs and provided services for TB patients (DH, 2006). TB notification rate and death rate of Hong Kong reached its peak in 1951-1952 when prevention and treatment of TB was not yet commonly use (CHP, 2016). Afterwards, the usage of streptomycin and the BCG injection to newborn babies and schoolchildren decreased the amount of notification rate and death rate (DH, 2006). However, some TB patients had difficulties to complete the anti-TB treatment. Therefore, Directly Observed Treatment (DOT) was considered. The death rate of TB dropped dynamically to less than 1,500 cases after the usage of the DOT in 1970 (WHO, 2016). After 21st century, the new cases of TB dropped to less