Tuberculosis is a bacterial infection, caused by mycobacteria tuberculosis. It is an airborne infection which infects the lung resulting in coughing, chest pains and chills. This is usually spread by inhaling droplets from an infected person who is coughing or sneezing. There are different types of TB one of them being Latent tuberculosis which has no symptoms and it’s not infectious. Another type is pulmonary tuberculosis also known as Active TB, which is very contagious as the infection spreads to other parts of the body due to the weakened immune system. There is also extrapulmonary TB which occurs outside the lungs.
The treatment for tuberculosis (TB) typically involves taking antibiotics over several months. TB is a serious condition that can be deadly when left untreated hence why it takes longer to treat compared to other types of bacterial infections. You are required to take antibiotics for over 6-9 months depending on the type of TB and the individual’s age and overall health. Research has shown that shorter-term treatment is more effective as people are more likely to complete the course. The benefit of having shorter-term treatment is that it will prevent the latent TB from progressing into Active TB.
Those who have latent TB will require one type of drug, however, those who have Active TB will require several drugs at a time since it can have a drug-resistant strain. Those who are 65 and under are recommended treatment. If you do not treat the active TB it can kill the individual. Examples of medication are; Isoniazid which must be taken daily or twice weekly for nine months. Other options available are taking Isoniazid as well as Rifapentine once weekly for 12 weeks or taking Rifampicin up to 4 months daily. The antibiotics used to treat TB have an impact on the liver and can cause damage; therefore, those who aged between 35-65 your TB team will discuss the benefits and disadvantages of the treatment available.
Pulmonary Tb is very infectious and about 2-3 weeks into treatment you have to be kept isolated because it’s very contagious so you must take precautions. For active pulmonary TB, you’re given a six-month course of antibiotics. This involves taking two antibiotics of isoniazid and rifampicin for six months. Other antibiotics are pyrazinamide and ethambutol which are taken in the in the first two months of the six-month treatment.
Extrapulmonary TB can be treated with the same antibiotics as pulmonary TB, however, if the TB is in the brain or around the heart, you can be given corticosteroid like prednisolone along with the antibiotics in order to reduce any swelling in the certain area. Overall to have successful treatment of TB the patient and doctor must be able to cooperate.
The problems with taking medication are that it has very bad side effects because of the impact it has on the liver which causes nausea, vomiting, and loss of appetite. It can also affect physical appearance causing the skin to go yellow and dark urine. This is why you are required to follow instructions from your doctor. Completing treatment is vital because if an individual was to stop taking TB drugs the bacterium that is alive in the body can become resistant and become more harmful making it difficult to treat. To help people will their treatment there is a program called directly observed therapy (DOT) where health care providers administer your medication so that individuals are kept up to date and remember to take their medication. It is better to prevent the TB than treating it which is why people are advised to cover their mouth when coughing or sneezing to prevent spreading. Treatment is recommended for those who live in countries where TB is common which is why the BCG vaccine is available to prevent the spread of TB. This is usually given to infants.
Methods of treatment
Antibiotics are given for treatment against an infection caused by bacteria or virus. How antibiotics work is by stopping the bacteria from reproducing or they just destroy it. Bacteria antibiotics like penicillin kill the bacteria by interfering with the formation of the bacterium cell wall. A bacteriostatic stops the bacteria from multiplying. They can be used to treat disease like bacterial meningitis. This disease can be life threatening which is why you are given antibiotics intravenously into the veins. There are antibiotics available which can be taken orally however they are less reliable because people can vomit or have poor absorption which makes it less effective. The type of bacteria causing meningitis will determine what type of antibiotic is used. How the antibiotic would work is by killing the harmful bacteria so that it cannot reproduce. It also reduces any risks or complications like brain damage for those who have bacterial meningitis. The disadvantages are that the bacteria can become antibiotic resistant making the antibiotic no longer effective or useful. This is because the bacteria has adapted over time and is not affected by the drug, this happens when you’re frequently exposed to the same antibiotics or that they are used inappropriately. This is why you are required to complete the course of antibiotics as the bacteria can still be alive and result in an antibiotic-resistant strain. This is why you should follow the doctor’s instructions.
Antiviral drugs are specially used to treat viral infections like the influenza flu. These drugs are available by the NHS and must not be bought over the internet. They disrupt the reproductive process by killing or inhibiting the growth of the virus. Examples of antiviral medication include Oseltamivir (Tamiflu) and Zanamivir (Relenza) which are used against the flu virus. These drugs are prescribed by doctors they may not cure the flu but help with the symptoms and can reduce the duration of the illness. Tamiflu comes as capsules which should be swallowed as a whole with water, however, it’s advised to take antivirals with food to reduce the feeling of sickness. On the other hand, Relenza is given as a dry powder to inhale. Theses antivirals can be taken at the along with paracetamol, aspirin or ibuprofen as there is a small chance that the antivirals will alter the effect of any other medications.
Antifungal medication also referred as antimitotic medication, is a medical fungicide or fungistatic used to treat and prevent diseases caused by infection with fungi such as athlete’s foot, ringworm, vaginal thrush and many others that affect your skin, nails and hair. Serious systemic infections such as Cryptococci meningitis, and more. You’re able to get antifungal medicine from the pharmacy but for some types, you require a prescription from your GP. The job of antifungal medicine is to prevent the growth and reproduction of fungal cell or to kill the fungal cells by affecting a substance in the cell walls, which will cause contents of the fungal cells to leak out and the cells to die. The types of antifungal medicines are tropical antifungal which comes as a cream/ointment or even spray which can be applied directly to your skin, hair or nails. Oral antifungals are capsule/tablets or liquid medicine that you swallow. Intravenous antifungals are given in injection form usually by hospitals. Intravaginal antifungal pessaries are soft tablets you can insert into the vagina. The side effects of the antifungal medicine are itching, abdominal pains, and feeling of sickness, diarrhea and rash. More serious allergic reactions can occur causing swelling on the face, neck and tongue leading to difficulties breathing. More serious side effects are liver damage which is very rare where you experience loss of appetite, vomiting, nausea, dark urine or pale feces.
Antimalarial medication is used to treat and prevent malaria. When you’re bitten by a mosquito that carries a plasmodium parasite it injects it into the bloodstream allowing it to multiply and invade the red blood cells and eventually reach the liver. The way antimalarial work is by killing this parasite, therefore, it is not able to form malaria. They work against the parasite enzymes within the infected erythrocytes. People are advised to take antimalarial medicine when travelling to other countries where malaria is common like Africa. These are usually prescribed by your GP depending on where you going, past records, age, family and whether you are pregnant. Antimalarial medication is often supplied in a tablet or capsule form, however, those who are really ill are provided with an alternative where they administer it via intravenous injection directly into the veins of the arm which is usually done by the hospital.
Oral rehydration therapy (ORT) is treatment using salt and sugar based solution to treat severe dehydration. This can be used against diseases like cholera where you have lots of diarrhea. Those who have severe diarrhea lose lots of body fluids like sodium and potassium. ORT helps with rehydration because the salts and glucose help with the absorption of salt and water into the intestine walls. Water it self-doesn’t rehydrate you because it doesn’t have electrolytes which is why this treatment method is effective as by the process of osmosis the salt and sugar allow you to get water into your bloodstream more quickly. ORT doesn’t stop the diarrhea but replaces the fluids lost and essential salt treating dehydration. It replenishes the blood with the key minerals. ORT packets are available from pharmacies, health centers and shops. If this is not available you can make the solution at home using 6 teaspoons of sugar and half a teaspoon of salt dissolved in 1 liter of clean water. The exact measurement must be used as too much sugar can worsen the diarrhea and too much salt is also dangerous. The benefits of this treatment is that it’s a cheap and easy way to rehydrate yourself and maintain good health which is why it’s used by people who do intensive amounts of exercise and those who are exposure to extreme weather conditions.
Immunoglobulin therapy, also known as normal human immunoglobulin, is the use of a antibodies to treat a number of health conditions and to help the body protect itself from different autoimmune infections and idiopathic diseases. This is used for those whose immune system isn’t able to make enough antibodies to fight against the diseases. This therapy however may not work for every disease as someone who has an immune system which makes sufficient amount of antibodies means that this therapy will not work. The risks with this treatment is that it includes injecting antibodies in to the veins which can lead to an allergic reaction, head ace, flu like symptoms or even kidney failure. The disadvantages are that this treatment is made from the blood of human donors which means that there’s a risk of transmitting virus. Not only this but it’s really expensive. The cost is usually dependent on the individual’s weight, body and dose. It only provides protection over a certain amount of time which means that you will require regular updates which can go up to a patient’s whole life time.
Access and acceptance of treatment
Many people have problems with accepting treatment due to cultural and religious beliefs. People may have a stigma towards treatment which is why they tend to stay away. Other reasons may be because of problems with accessing the treatment due to high costs or large distance. Lastly, there are some adverse effects of treatment which is why people don’t accept it.
There are stigmas associated with some diseases which therefore influences an individual’s choice in accepting certain treatment, For instance, TB is associated with being a curse on the family and that its witchcraft. They believe that Tb is spread in many generations for this reason but doctors know that this happens because it’s an airborne disease which is as a result of being in close proximity to family members. People with TB can be victimized and become isolated which is why women tend to get divorced as they are seen as unworthy of marriage. The impact this stigma has is that people fear discrimination and delay seeking any help. The disadvantages are that it then allows the disease to progress overtime worsen and infect others. People also become hesitant to stick to the treatment regime by fearing that they may get caught to have TB. A treatment regime is a methodical plan designed to maintain and improve the health of a patient whereas if this is not completed and treatment is taken irregularly you can be at risk of developing a drug-resistant strain.
Treatments are not always accessible to everyone for particular reasons like religious/cultural beliefs. For example, Jehovah’s Witnesses believe that worshipping God means that you have to live a certain way. They base their ethics and morals on the bible which is why they feel that you must live religiously, morally, and physically clean. For this reason, they do not accept blood transfusion as they consider it as unpure and that it’s a sin if you willingly accept it. Having certain beliefs makes it difficult for doctors to treat the individual or to carry out certain procedures. Doctors have no choice but to respect the patient’s decision as it’s a legal requirement that they take into account individuals choices. If they were to go against the individual’s decision even if it’s for their health and wellbeing it can be seen as an unlawful act. Although Jehovah’s Witnesses cannot accept blood, they are open to other medical procedures. Alternative treatment methods are also available like Cell-free blood products, which contain haemoglobin instead of red blood cells. Some Jehovah’s Witness accept autologous transfusion which is the individuals own blood which has been stored for later use in a medical procedure. Jehovah’s Witness hospital committees have various doctors who view treatments without the use of blood transfusion in order to address issues like this.
Another reason why people don’t accept medical treatment is that they believe that seeking medical care is unnecessary for the reason that the illness would improve over time on or that the body will heal itself. For example, Chinese people have this cultural belief that you must stay away from medical treatment and instead opt for herbal intervention. They tend to follow traditional Chinese medicine (TMC) and other practices which aim to nourish the body rather than treat the disease itself as that will allow the body to heal. They influence individuals to improve their lifestyle by carrying out exercise or dietary therapy. Overall they aim to heal the body naturally which is why they only use herbal medicine. They only accept certain procedures like acupuncture and massages to help people recover from illnesses.
The accessibility to certain treatments can be widely affected by the cost. Not everyone can afford to pay for treatments that are at high costs due to minimum wage. Many people around the world are living on the basics and cannot afford to pay for various medicines. Another reason why people do not take treatment is the long waiting times. It takes many weeks for referral and by the time you actually get the appointment the problem is even worse and difficult to treat which is why people don’t want to waste their time. The hassle of making timely appointments is another reason why people don’t get treatment. Distance is also a factor as some people live far away from their GP or hospital and are not able to go for a constant check-up or for regular treatment due to travel fare costs. Some people aren’t physically mobile because of illnesses like elderly; because of this they are not able to access treatment at places like hospital due to long distances. Methods of delivery can also impact an individual decision to take treatment. For example, Intravenous injections are directly administered into the veins from the wrist or forearm. They require the doctor or a trained professional around in order to administer. This makes it difficult to access when the doctor is not available as patents cannot get their regular treatment.
The problems with medication are that there are adverse effects. For example, Intramuscular injections are delivered into the muscles, at the deltoid, gluteus or thigh. The adverse effects it has is that it causes discomfort and lots of pains in the area where it was injected. Side effects include swelling redness, numbness. There can also be allergies which are dependent on the drug used and vulnerability of the individual. This is why doctors have to collect objective and subjective data from patients to evidence any possible effects and adverse reactions. Most of the time patients feel they are allergic to certain foods or medication which is why doctors do not prescribe a certain medication. The problem is that they may feel they have an allergy against something when that’s not the case and can miss out on vital treatments.
Treatment is not suitable due to contraindications like sensitivity or allergy to the medication, pregnancy, lactation, hepatic disease or renal disease. A relative contraindication is where the individual has to take caution when taking certain drugs or procedures. On the other hand, absolute contradictions mean that the treatment is life threating and must be avoided. This is why nurses are required to look at the patient’s condition before determining what medicine to supply. To identify that medication is contraindicated for an individual, the doctor must communicate with them to clarify whether or not it suitable. Only then a patient can accept certain treatment.