Tuberculosis 800 years ago before European contact.” Furthermore, immunocompromised

Tuberculosis is caused by
Mycobacterium tuberculosis that attacks the respiratory system. Mycobacterium
Tuberculosis is a small, aerobic, nonmotile bacillus and it is an acid-fast
bacillus bacteria. Mycobacteria have an outer membrane lipid bilayer. If a Gram
stain is implemented, Mycobacterium Tuberculosis either stains very fragile
“gram-positive,” or it does not maintain dye as an outcome of the
high lipid and mycolic acid content of its cell wall. The bacterium can spread
and cultivate only within the cells of a host organism, yet it can be cultured
in the laboratory. This bacterium can divide every 16 to 20 hours, which is
very slow rate collated to the other bacteria that usually divide in less than
an hour. Mycobacterium tuberculosis can grow into humans, primates, birds,
reptiles, and rodents but it is in common with humans. This deadly disease is
communicable; it means that an active TB person spread it to other and it
infects others rapidly fast.

         Approximately
one-third of the world population is infected with Mycobacterium Tuberculosis.
It is the second most usual source of death from infectious disease. But in
2012, there were 8.6 million new cases of active TB and roughly 1.3 million
TB-related deaths worldwide. There are also 310 000 incident cases that are
multidrug-resistant tuberculosis, caused by organisms resistant to at least
isoniazid and rifampin. Also, 84 countries were reported to be extensively
drug-resistant tuberculosis. But Asia, particularly in China and India, has the
highest number case of this disease. However, in Canada, Tuberculosis started
during the First Contact, where Europeans settler began some trading here in
Canada, Europeans were blamed for bringing a variety of disease with lethal
outcomes. There is evidence that Tuberculosis (TB) disease started about 800
years before European contact and that it is also found in Aboriginal people
remains. “Just such an examination led to the identification of acid-fast
bacilli of Mycobacterium tuberculosis, the microorganism associated with
tuberculosis, in the lungs of a young Peruvian boy whose death is estimated to
have occurred in the eight century, some 800 years ago before European
contact.” Furthermore, immunocompromised individuals are at greater risk
for an active TB. The general signs and symptoms of TB include loss appetite,
fever, chill, night sweats, weight loss, and fatigue. To diagnose Latent
tuberculosis, people who are at greater risk were asked to take Tuberculin Skin
Test. It is an intradermal injection of 0.1 mL of 5 tuberculin units of
purified protein derivative into the dorsal or voral surface of the forearm. This
test results can be interpreted after 48 to 72 hours after administration.
Interpretation of the results is based on the induration size. Induration that
between and 15mm is considered positive for specific groups. Also, IGRA
(Interferon-gamma release assay) can be alternative to the Tuberculin Skin
Test, and it is more specific than TST. It is required a single blood test.
This test measures the release of interferon-y in the blood after T cell
stimulation by Mtb antigens. There are two IGRAs that are available:
QuantiFERON-TB Gold and T-SPOT). Results of these two can be reported as
positive, negative, indeterminate or borderline and quantitatively. The results
can be available in 16 to 24 hours. To diagnose Active Tuberculosis is to get a
clinical sample of sputum, pus or a tissue biopsy and a chest x-ray. Also,
there is a new molecular diagnostic test called Xpert MTB/RIF assay that
detects Mycobacterium tuberculosis complex within 2 hours. This diagnostic test
is available in Europe. This type of disease can be easy to get by getting it
from an active TB person through coughing & sneezing that can transmit
respiratory fluids through air. Also, Lifestyle is one of the reasons that
impact Tuberculosis. Since Tuberculosis spread through air, there is a chance
risk of having the disease. According to Leung Chi-Chiu and Chang Kwok-Chiu’s
Journal article, smoking has been related to excess risks of TB infection. In
1918, the relation between smoking and TB had been investigated. “…
current smokers had a higher risk of pulmonary TB but not extra pulmonary
TB”. Also, a current smoker that is in the process of ending smoking could
have a chance to reduce the risk of having Tuberculosis by half. Furthermore,
there is limited information that is available to support the relation between
TB disease and secondhand smoke exposure and the use of biomass fuel.
Furthermore, Tuberculosis is linked to malnutrition; which is often a problem
to grown and growing country. Lack of nutrition or having a poor diet could put
an individual, at risk of Tuberculosis, whereby there are no enough nutrients
that could help to prevent the disease. There are further studies that show,
that there is a high rate of tuberculosis among malnourished people.  Due to the high rate of tuberculosis among
undernourished people, it is significant to know how malnutrition can intensify
the risk of disease. The host immune system with Mycobacterium tuberculosis
critically relies on synergy between monocyte-macrophages and T-lymphocytes and
their cytokines. There is experimental evidence that shows that malnutrition
can cause an immunodeficiency, which the host can increase the exposure to the
infection.

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         To
prevent it, there is a drug that can help Tuberculosis where you can inject it.
BCG is signifying of bacille Calmette-Guérin vaccine that introduced by Dr.
Albert Calmette and Dr. Camille Guérin in 1924. The argument is the BCG vaccine
is more likely effective against TB meningitis and miliary TB than pulmonary
TB.  Fitzgerald stated, “A recent
meta-analysis suggested that BCG confers a protective effect of nearly 90%
against TB meningitis and miliary TB. The protective effect against pulmonary
Tb is less dramatic, probably in the range of 50%.” Usually, they give
infants of half adult doze of the vaccine, however “… approximately 2% to
3% infants have a local reaction”. 
By using BCG vaccine in infants with unrecognized HIV infection can lead
to BCG-itis. Therefore, it is recommended to get HIV test to all pregnant women
to see the results if there is a possibility that the baby could get an HIV
before having a vaccine that could lead to BCG-itis. Although, there is
controversy about BCG vaccine, the Medicine Services Branch of Health Canada
decided that will likely to continue and use the BCG. In fact, in 1930 to 1980,
BCG is found it to be highly protective by 60 to 80 percent. Also, vitamins and
minerals have a part in treating tuberculosis. Having enough vitamins and
minerals in our diet can improved immune response to tuberculosis. There is a trial
that Vitamins C and E were they found out that there are effective in enhancing
the immune response. Also, according to Lung India journal, it stated ”
the supplementation with Vitamin A and Zinc improved the effectiveness of
anti-tuberculosis drugs in the first two months”.

         Due
to the way of how the tuberculosis spread, it is easy to get this disease by
getting it from an active TB person through coughing & sneezing that can
transmit respiratory fluids through air. However, the tuberculosis is
treatable, and there are a variety of drugs and treatments that can help to
treat disease. To help those infected patients and lessen the number of people
who have TB, they opened some sanatorium to provide rest, nutritious food,
fresh air, education, and rehabilitation. In 1902 the first free sanatorium
that opened for the treatment of TB and believed that it is the first free
sanatorium in the world was the Muskoka Free Hospital for Consumption. Besides,
there are anti-tuberculosis drugs that were introduced in 1900s such as
Para-aminosalicylic salts and isoniazid, which can lessen resistance and when
combining it with streptomycin, it results in to close 100% effective, which
these drugs were available without charge to the patients. Most patients that
were infected by TB can be cured with precise adherence to their recommended
drug regimens.

         To
manage this disease, medical staff should perform physical measures that
include isolating the patients with possible TB disease in a private room with
negative pressure, have medical staff wear a high effectiveness disposable mask
that enough to filter the bacillus and continue isolation until the sputum
smears appear to be negative for three consecutive determinations. There are
also 4 drug regimens that patient could use as initial empiric pharmacologic
therapy such as Isoniazid, Rifampin, Pyrazinamide and either ethambutol or
streptomycin. For pregnant women, there is a special consideration for drug
therapy that includes streptomycin should not be used, preventive treatment is
recommended during pregnancy, breastfeeding can be continued during preventive
treatment, Pregnant women are at greater risk for isoniazid-induced
hepatotoxicity and also in the US, pyrazinamide is reserved for women with suspected
MDR-TB (multidrug-resistant TB). For children with TB, they can be treated with
isoniazid and rifampin for six months together with pyrazinamide for the first
two months, if the culture from the source case is fully manageable and for
postnatal, treatment duration may be increased to 9 to 12 months. Also,
Ethambol is often avoided in young children. For HIV-infected patients, dose
adjustments may be required, patients receiving protease inhibitors should
avoid rifampin and rifabutin may be substituted. For Latent TB, alternative
regimen used which is isoniazid plus rifapentine as directly observed therapy
once-weekly for 12 weeks but it is not recommended for children that under 2
years, pregnant women or women who plan to become pregnant or patients with TB
infection presumed to result from exposure to a person with TB that is
resistant to 1 of the 2 drugs. With these, all treatments and rest helps the TB
patients and relieves them from pain.