Tuberculosis Epidemiology Paper

Tuberculosis Epidemiology Paper

Tuberculosis Epidemiology Paper 150 150 Peter

Tuberculosis Epidemiology Paper

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.

Communicable Disease Selection

Hepatitis B
Epidemiology Paper Requirements

Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
Describe the social determinants of health and explain how those factors contribute to the development of this disease.
Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.
A minimum of three peer-reviewed or professional references is required.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Resources if you need assistance.

Sample Paper


Tuberculosis remains to be one of the most dangerous infectious diseases across the world. By 2020 the WHO estimated that up to 1.5 million people succumbed to TB (WHO, 2021). This made TB be the 13th leading cause of death and the second leading infectious disease that caused death after Covid19. This paper evaluates TB and the demographics of interest related to the disease. This paper also considers various determinants of health and how they contribute to the development of TB, the epidemiologic triangle of TB, and the role that the community health nurse can play in the prevention of TB.

Communicable Disease and Demographic Of Interest 

Tuberculosis is a contagious infection that attacks the human lungs and can also spread to other parts of the body like the spine and brain. Tuberculosis is caused by the mycobacterium tuberculosis bacteria (Churchyard et al., 2017). There are two types of tuberculosis which include latent TB and active TB. Latent tuberculosis is when the tuberculosis bacteria will be inside an individual’s body, but the immune system of an individual will be able to keep such bacteria from spreading. Individuals who have latent tuberculosis are not contagious and do not have any symptoms. Individuals struggling with latent tuberculosis risk the activation of the bacteria, for example, in instances where their immune system is weakened by conditions such as HIV. Another type of tuberculosis is active TB which is readily observable through bacteria that make an individual sick. Individuals with active TB can spread the bacteria to others. Approximately 90% of tuberculosis in adults comes from latent TB infection (Churchyard et al., 2017).

Latent tuberculosis doesn’t have any symptoms and can only be detected through a blood or skin test. On the other hand, signs of active tuberculosis include chest pain, a cough that lasts more than three weeks, coughing up blood, night sweats, feeling tired all the time, fever, chills, weight loss, and loss of appetite (Langer et al., 2019). Tuberculosis is therefore only transmitted through the air like the flu or cold virus. One can consequently get TB if they come into contact with people who have it. Tuberculosis risk factors include having a co-worker, family member, or friend who has active TB, living or traveling in an area where tuberculosis is common like Africa, Russia, Asia, Eastern Europe, the Caribbean, or Latin America, and if one is a member of a group where TB is likely to spread such as people in prison or jail homeless people with HIV and people who inject drugs in their veins (Langer et al., 2019). Smokers and healthcare professionals who live and work in nursing homes will also be at a high risk of TB. Individuals with a healthy immune system might be able to fight off a tuberculosis infection. However, those with diabetes, HIV, or low body weight are among the vulnerable populations that might be easily infected with tuberculosis. Tuberculosis is therefore transmitted when an infected person sings, laughs, talks, and sneezes which might release tiny droplets containing  Mycobacterium tuberculosis that can infect other people (Langer et al., 2019). However, research has indicated that tuberculosis will not be easy to catch, and one has to spend a long time around people with the bacteria in their lungs, such as family members, friends, and co-workers. Tuberculosis is also not transmissible through shaking hands with an infected person or sharing drinks and food because tuberculosis bacteria do not thrive on surfaces (Fogel, 2017).

Tuberculosis infection can result in different complications such as lung damage, joint damage, liver or kidney problems, infection or damage of the spinal cord bones, lymph nodes, and brain, and inflammation of tissues around an individual heart (Fogel, 2017).

Tuberculosis treatment depends on an infection that a patient is suffering from patients suffering from. Latent tuberculosis patients will receive medication from killing bacteria so as to prevent the infection from becoming active. Medication for patients with latent tuberculosis includes rifapentine, isoniazid, and rifampin. These medications can be administered on their own or combined. Patients with latent tuberculosis have to take drugs after nine months and report any signs of active tuberculosis to their doctors right away. On the other hand, a combination of medication is used to treat active tuberculosis, which mostly includes isoniazid rifampin pyrazinamide and ethambutol (Langer et al., 2019). Individuals with active tuberculosis need to take their medication for at least 6 to 12 months. On the other hand, individuals with drug-resistant tuberculosis might receive one or more different types of medication and might be required to take their medication for a long period of up to 30 months which can result in some side effects (Langer et al., 2019).

In 2020, 7174 tuberculosis cases were reported in the US, which represented a prevalence rate of 2.2 cases per 100,000 persons (Mirzazadeh et al., 2021). According to the CDC, nearly 13 million estimated individuals live with latent TB infection in the US. However, data from 2020 highlight a significant decline in the number of reported tuberculosis cases in the US. This has mainly been attributed to the onset of the Covid 19 pandemic, which might have affected the underdiagnosis of tuberculosis or caused a true reduction in the incidence (Mirzazadeh et al., 2021).

Tuberculosis is a reportable infectious disease with any suspected or confirmed cases of tuberculosis needing to be reported to the State Department of Health within 24 hours after the identification of the cases. Both the extrapulmonary and pulmonary forms of tuberculosis are reportable across the U.S. Both individuals and healthcare practitioners can report suspected or confirmed cases of tuberculosis by calling the TB prevention and control program through their numbers, contacting via email, or faxing them (Schluger, 2019).

Determinants of Health and How They Contribute To the Development of Tuberculosis

The main structural determinants of the epidemiology of tuberculosis include high levels of population mobility, social-economic inequalities, population growth, and rapid urbanization (Langer et al., 2019). These structural determinants of tuberculosis contribute to the unequal distribution of the main social determinants of tuberculosis which include malnutrition and food insecurity, environmental conditions, poor housing, geographic, financial, and cultural barriers to healthcare access, among others (Langer et al., 2019). The distribution of the prevalence of tuberculosis across different populations therefore significantly reflects the distribution of various social determinants of the disease, which also significantly influences the main stages of tuberculosis pathogenesis which include exposure to the infection, disease progression, inappropriate or late diagnosis, and treatment and poor adherence to treatment or lack of success during treatment (Churchyard et al., 2017).

The social determinants of tuberculosis are among the key risk factors for the disease. For instance, overcrowding and poor ventilation in homes, workplaces, and communities contribute significantly to an increased likelihood of an infected individual being at an increased risk of TB infection. On the other hand, hunger, malnutrition, and poverty may increase the susceptibility of an individual tuberculosis infection due to having a low body weight and poor immunity (Fogel, 2017). Malnutrition, hunger, and poverty can also increase the severity of the clinical outcome. On the other hand, individuals that may show tuberculosis symptoms such as having a persistent cough might experience forms of economic and social barriers that can delay their contact to healthcare systems which can eventually delay an appropriate diagnosis. Individuals showing persistent tuberculosis symptoms such as persistent coughing might also not access facilities such as transportation and might also fear being stigmatized as a result of having a tuberculosis diagnosis (Churchyard et al., 2017).

Epidemiologic Triangle

The epidemiologic triangle, which is also referred to as the epidemiologic triad, is a tool that is used by scientists to identify and address the three major components that contribute to the spread of diseases, which include agent factors, host factors, and environmental factors (Langer et al., 2019). Environmental factors bring the susceptible host in the external agent together, resulting in the onset of a particular disease. The agent factors normally include pathogens such as bacteria, viruses, parasites, and other microbes. According to the CDC, the concept of agent includes both physical and chemical causes of injury or disease (Langer et al., 2019). For TB, the bacteria known as mycobacterium tuberculosis is the agent factor.

On the other hand, the host is an organism that might harbor a given pathogen after exposure. In some instances, the host might or might not show the signs and symptoms of a given illness and might even be unaware of having a given disease. For instance, in the case of tuberculosis, individuals with latent tuberculosis will not show any signs and symptoms of the disease and therefore might not be aware that they are suffering from such a serious disease. A set of risk factors affect the host of diseases, including gender, age, genetic composition, and hygiene practices which can influence the susceptibility of given hosts to an infectious agent. For many diseases, elderly people, children, and individuals with compromised immune systems will be susceptible to becoming hosts to a given pathogen. On the other hand, hunger, malnutrition, and poverty may increase the susceptibility of an individual tuberculosis infection due to having a low body weight and poor immunity (Langer et al., 2019).

The environment is the last component of the epidemiologic triad; the environment refers to the extrinsic factors that can influence susceptibility and exposure to a given pathogen that causes diseases. Environmental factors might therefore involve physical aspects like climate, social-economic factors like lack of sanitation, crowding, and poor ventilation, and biologic aspects like animal transmitting agents (Schluger, 2019). Overcrowding and poor ventilation in homes, workplaces, and communities contribute significantly to an increased likelihood of an infected individual being at an increased risk of TB infection.

Related to tuberculosis, special considerations are therefore made among low-income communities who are highly susceptible to spreading TB as a result of overcrowding, poor ventilation, and lack of access to health care services which can lead to early detection of tuberculosis. Consistent surveillance for TB is therefore required in low-income communities (Schluger, 2019).

Role of Community Health Nurse and Importance of Demographic Data 

The community health nurse plays a significant role in increasing the resilience of a community towards communicable diseases such as tuberculosis. This includes collecting, analyzing, and reporting incidences of communicable diseases such as tuberculosis and related epidemiological data. The community health nurse is therefore actively involved in surveying the occurrence of communicable diseases such as tuberculosis among individuals and following medical guidelines, protocols, and procedures to communicate their findings and develop reports for other medical professional partners, including recommendations that can help to control the onset of a communicable disease in a given community (Mirzazadeh et al., 2021). The community health nurse also ensures compliance with certain program standards related to the prevention and response to communicable diseases such as tuberculosis and adheres to all legal requirements.

The community health nurse is also actively involved in providing case management services to individuals suffering from certain communicable diseases such as tuberculosis. A community health nurse assists tuberculosis patients to adhere to certain treatment regimens and dietary guidelines provided by physicians and other healthcare practitioners. A community health nurse is also actively involved in recommending different prevention and control measures for communicable diseases such as tuberculosis and educating communities on how to prevent the rapid spread of communicable diseases (Mirzazadeh et al., 2021). Finally, a community health nurse acts as the primary resource for consultation and providing critical health information to families, individuals, schools, and community agencies related to certain communicable diseases. On the other hand, a community health nurse is involved in enforcing communicable disease codes which relate to specific health authority guidelines and in consultation with health officers in their region.

Demographic data is essential and necessary for the health of a community because demographic data provide information that can be utilized to plan for future investments in the healthcare services of a community. Demographic data is also essential in helping to determine who should be targeted with specific public health interventions or assistance programs because of their susceptibility to certain conditions or diseases. Demographic data can also help to identify the social determinants of certain illnesses and diseases such as communicable diseases (Fogel, 2017). For instance, low-income individuals are most affected by tuberculosis compared to high-income communities mainly because of the contribution of demographic factors to their social environment.

National Agency Addressing Communicable Disease

The national tuberculosis control association is one of the main national agencies that address TB across the US. The mission of the NTCA is to protect public health by advancing efforts to eliminate TB in the US through concerted actions in territorial, local, and state programs (NTCA, 2020). The NTCA contributes to reducing the impact of tuberculosis across the US through the development and provision of services to TB control TB in the US. To advocate and enhance TB control and elimination activities, NTCA is also involved in counseling community organizations, agencies, and task forces on various actions and issues related to tuberculosis control and elimination at territorial local, and state levels. Finally, the NTCA is involved in advocating for laws, policies, and positions that advance tuberculosis control and elimination at territorial local, and state levels (NTCA, 2020).

Global Implication

Tuberculosis continues to be a challenging disease globally, with at least 1.5 million people succumbing to the disease in 2020. Tuberculosis was the 13th leading cause of death in 2020 and the second leading infectious disease that killed more people after Covid 19 (WHO, 2021). Across the world, an estimated 66 million lives have been saved through the treatment and diagnosis of tuberculosis in the past two decades (WHO, 2021). Different countries, including low and middle-income countries, account for nearly 98% of all reported TB cases. Such countries lack enough funds to adopt TB diagnosis prevention and treatment programs. Tuberculosis remains endemic in some areas of the world, such as Russia, Africa, Asia, Eastern Europe, the Caribbean, and Latin America. An individual is most likely to contract TB from these areas.


In summary, environmental factors such as the social-economic level of an individual will contribute significantly to susceptibility and the onset of tuberculosis. Low-income groups that live and work in crowded environments with poor ventilation will therefore be at a higher increased risk of being infected with TB compared to higher-income individuals. Low-income individuals might also struggle to access early diagnosis and treatment services for TB compared to higher-income individuals.



Churchyard, G., Kim, P., Shah, N. S., Rustomjee, R., Gandhi, N., Mathema, B., Dowdy, D., Kasmar, A., & Cardenas, V. (2017). What We Know About Tuberculosis Transmission: An Overview. The Journal of Infectious Diseases216(suppl_6), S629–S635.

Fogel, N. (2017). Tuberculosis: A disease without boundaries. Tuberculosis95(5), 527–531.

Langer, A. J., Navin, T. R., Winston, C. A., & LoBue, P. (2019). Epidemiology of Tuberculosis in the United States. Clinics in Chest Medicine40(4), 693–702.

Mirzazadeh, A., Kahn, J. G., Haddad, M. B., Hill, A. N., Marks, S. M., Readhead, A., Barry, P. M., Flood, J., Mermin, J. H., & Shete, P. B. (2021). State-level prevalence estimates of latent tuberculosis infection in the United States by medical risk factors, demographic characteristics, and nativity. PLOS ONE16(4), e0249012.

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Schluger, N. W. (2019). Tuberculosis Elimination, Research, and Respect for Persons. American Journal of Respiratory and Critical Care Medicine199(5), 560–563.

WHO. (2021, October 14). Tuberculosis (TB). Who. Int. Retrieved January 7, 2022, from