Legal and Ethical Aspects of Health Care
You need to look at the previous three case assignments and SLP assignments to help with this final SLP assignment.
- Explore and outline what policy or employee education program you will propose to address the problems you identified in prior modules.
- As the Assistant Manager of a Home Health Agency, explain why the proposed policy and/or the employee education program are appropriate for addressing the problems.
Length: 3-4 pages, excluding title page and references.
I need 4 pages, APA, 4-5 intext citations, and 4-5 references
Public Health, Epidemiology, and Health Statistics 2 Senior Capstone Cleavon Battie AUG2018FT- BHS 499 Module 1 Case Assignment Dr. Roy Constantine 14 Aug 2018 1. Epidemiology of Tuberculosis Epidemiology of Tuberculosis (TB) includes the following -- the study of causative organism Mycobacterium tuberculosis, route of transmission in humans, occurrence rate, treatments and the possible precautions to avoid this disease. According to the CDC (2016), Tuberculosis originates from a microbe called Mycobacterium tuberculosis which normally infects the lungs, although it has been known to affect other parts of the body such as the spine, the brain, and the kidneys. As mentioned by Matteelli, Roggi, and Carvalho (2014), tuberculosis is a communicable disease which gets transmitted via liquid droplets from affected people. The most common symptoms include: chest pain, weakness, fever, weight loss, excessive sweating and coughing with sputum or blood. It is believed that about 30% of the globe’s population has been afflicted with this disease. Although new cases are still occurring in most part of the world, the infection rate is declining steadily. As mentioned by Yuen, Kammerer, Marks, Navin, and France (2016), tuberculosis is a poverty-related disease, affecting largely the population living in the poor infrastructure with inadequate cleanliness and poor sanitation facilities. According to Ahmed, Velayati, and Mohammed (2016) a rising number of cases of multidrug-resistant (MDR), extensively drug-resistant (XDR), and totally drug-resistant (TDR) tuberculosis are some of the major challenges in most countries. As mentioned by the World Health Organization (2018), they have launched an initiative to end the TB globally by 2035. This strategy is based on 3 pillars: prevention, patient-centric care, research and innovation. 2. Three Factors Contributing to Global Resurgence of Tuberculosis Drug resistance to antibiotics The Mycobacterium tuberculosis that has become resistant to the drugs used for treatment is known as multi-drug resistant tuberculosis (MDR TB). One of the major reasons for the rising number of drug-resistant tuberculosis is the poor management of TB treatment through the incorrect usage of drugs, premature interruption of treatment, and the use of poor quality drugs. As suggested by Pareek, Greenaway, Noori, Munoz, and Zenner (2016), treatment of tuberculosis is a costly affair, which requires the patient to follow the drug-routine for a set number of months strictly, therefore, many patients do not complete the full course and gradually the bacterium develops immunity for the drug. It is important to spread awareness about the importance of completion of the drug-schedule by the infected patient. Poverty and poor infrastructure and Increase of HIV Tuberculosis is a communicable disease, which can be easily transmitted in countries with poor-infrastructure where there are poor sanitary and cleanliness conditions. As suggested by Byron (2016), it is likely to easily spread in over-populated nations where there are crowded settings and more people may come into the vicinity of infected patients, this is evident from the high number of tuberculosis cases from over-populated nations such as China and India. Also, in some cases, the increase in the spread of the human immunodeficiency virus (HIV) has impaired the immune system and has left the host defenceless to diseases such as tuberculosis and pneumonia. Traveling to the TB affected state or country Due to a large number of people traveling across the nation and state, tuberculosis can spread from the infected parts of the nation to other previously non-infected parts of the country. TB is not just restricted to poor countries; now there is a rising number of cases in countries like the USA. Many countries have put in place TB screening for travellers, as a precautionary step to impede the problem (Miramontes et al., 2015). 3. Comparing Global Statistics of Tuberculosis between the US and Texas State Tuberculosis affects approximately one-third of the earth’s inhabitants and ranks above HIV/AIDS in terms of deaths due to a single infectious agent. In 2016, globally there were about 1,674,000 related fatalities and an approximated 10.4 million current cases of TB. In 2016, the US reported a total of 9,272 new TB cases, which was slightly less than several incidences reported in 2015. From the 9,272 reported cases, 66.2% of the cases were among foreign-born people and only 31.6% occurred among people born in the US. This indicates that the major cause for the rise in TB cases originated from the Non-US Born citizens (CDC, 2016). Among all the states, four states, California, New York, Florida and Texas, which account for about one-third of the US citizens, contributed to more than half (50.9%) of the US cases in 2016. In 2017, Texas with a total population of 27,469,114 people, reported 1,127 TB cases, with 470 cases among people born in the United States and 657 people born abroad; contributing to a calculation of 4.5 per 100,000 population, which is greater than the nationwide average of 3 per 100,000 population. Geography Population (million) Total new TB Incidences Incidence per 100,000 people World 7500 10.4 million 721 USA 325.7 9,093 2.8 Texas 28.3 1,127 4.5 Table 1: Statistics on Tuberculosis (Source: Centers for Disease Control and Prevention, 2016) Globally, there are about 4.1% of cases with multi-drug resistant TB (MDR), while the same rate applies to the US, with only 1% of the reported cases to be primarily drug-resistant. The incidence rate in the US is significantly lower than the global average, however within the US, the incidence rate is significantly higher than the national average, this is largely due to a relatively high number of people resides in the state from foreign-born states (Centers for Disease Control and Prevention, 2016). 4. Continuing Challenges of Controlling Tuberculosis in the US From the statistics available for all the US states, it is evident that a relatively large number of TB incidences are being reported patients from foreign-born states such as China, India, and Vietnam among others. If the objective of the universal expulsion of the disease is to be accomplished; then resource-rich countries like the US, should voluntarily provide necessary supplies to other countries, in their fight against Tuberculosis. Another challenge for controlling Tuberculosis that the US should work harder to prevent the transmission of drug-resistant tuberculosis; as the cure for a drug-resistant disease is very difficult to find and highly expensive to treat (Salinas, 2016). There is a need for a surveillance and screening system to prevent migration of the disease from a foreign land. As a preventive measure, early detection of the disease is vital for curative treatment, therefore, regular diagnosis of vulnerable-sections of the population is highly recommended. There are a rising number of cases of ‘latent TB’, which occurs in people with close-contact with tuberculosis-infected patients. Latent TB can be controlled through targeted testing and administration of treatment course. Countries like the USA which have a high health budget, must invest more in the research and development fields to deal with a drug-resistant tuberculosis problem, otherwise many populations will remain infected and continue to spread the infection to others. In the globalized world, it is difficult to close the nation’s borders to people from other nations, therefore, global efforts are required to deal with the problem of tuberculosis. References Ahmed, M. M., Velayati, A. A., & Mohammed, S. H. (2016). Epidemiology of multidrug-resistant, extensively drug-resistant, and totally drug-resistant tuberculosis in Middle East countries. International Journal of Mycobacteriology, 5(3), 249-256. Retrieved 11 Aug 18 from https://doi.org/10.1016/j.ijmyco.2016.08.008 Byron, P. (2016). History of tuberculosis in the United States to be explored in unprecedented depth. Virginia Tech News. Retrieved 12 Aug 18 from https://vtnews.vt.edu/articles/2016/07/clahs-tuberculosisforum.html Centers for Disease Control and Prevention. (2016). Tuberculosis: Basic TB Facts. Retrieved 11 Aug 18 from https://www.cdc.gov/tb/topic/basics/default.htm Centers for Disease Control and Prevention. (2016). Reported Tuberculosis in the United States. 2016 Surveillance Full Report. Retrieved 13 Aug 18 from https://www.cdc.gov/tb/statistics/reports/2016/pdfs/2016_Surveillance_FullReport.pdf Centers for Disease Control and Prevention, (2016). Tuberculosis (TB). Division of Tuberculosis Elimination Strategic Plan 2016-2020. Retrieved 13 Aug 18 from https://www.cdc.gov/tb/about/strategicplan.htm Matteelli, A., Roggi, A., & Carvalho, A. C. (2014). Extensively drug-resistant tuberculosis: Epidemiology and management. Clinical Epidemiology, 6, 111-118. Retrieved 11 Aug 18 from https://doi.org/10.2147/CLEP.S35839 Miramontes, R., Hill, A. N., Yelk Woodruff, R. S., Lambert, L. A., Navin, T. R., Castro, K. G., & LoBue, P. A. (2015). Tuberculosis Infection in the United States: Prevalence Estimates from the National Health and Nutrition Examination Survey, 2011-2012. PLoS One, 10(11). Retrieved 12 Aug from https://doi.org/10.1371/journal.pone.0140881 Pareek, M., Greenaway, C., Noori, T., Munoz, J., & Zenner, D. (2016). The impact of migration on tuberculosis epidemiology and control in high-income countries: A review. BMC Medicine, 14(1), 48. Retrieved 12 Aug 18 from https://doi.org/10.1186/s12916-016-0595-5 Salinas, J. L., Mindra, G., Haddad, M. B., Pratt, R., Price, S.F., & Langer, A.J. (2016). Levelling of Tuberculosis Incidence—United States, 2013–2015. Morbidity and Mortality Weekly Report (MMWR), 65 (11), 273-278. Centers for Disease Control and Prevention. Retrieved 13 Aug from https://doi.org/10.15585/mmwr.mm6511a2 World Health Organization. (2018). The End TB Strategy. Retrieved 12 Aug 18 from http://www.who.int/tb/strategy/end-tb/en/ Yuen, C. M., Kammerer, J. S., Marks, K., Navin, T. R., & France, A. M. (2016). Recent transmission of tuberculosis— United States, 2011-2014. PLoS One, 11(4). Retrieved 11 Aug 18 from https://doi.org/10.1371/journal.pone.0153728 Public Health, Epidemiology, and Health Statistics