Topic
Tuberculosis is one of the prevalent public health problems across the world. The disease is spread through the air from one individual to another (SeyedAlinaghi et al., 2020). As a result, it makes congregate contexts high-risk environments for TB. Tuberculosis is a significant challenge in different settings and especially in correctional facilities where individuals from different backgrounds and groups are kept in very close proximity for different periods. Therefore, it is crucial to identify and implement measures to control the spread of the disease. The chosen topic is controlling the spread of tuberculosis in all-male correctional facilities.
Setting
The architecture, as well as the living conditions of correctional institutions, contribute to a high risk for developing tuberculosis. Designing of correctional facilities such as prisons focuses on security as the priority. As a result, ventilation is not sufficient in these facilities. Findings from numerous studies indicate that in circumstances in which inmates/prisoners with active tuberculosis are housed in settings with poor ventilation, the likelihood of rapid spread of the disease is very high. Most prisons are characterized by overcrowding, and poor ventilation and these conditions facilitate the spread of tuberculosis. They, in most cases, lead to outbreaks of tuberculosis.
Delegate your assignment to our experts and they will do the rest.
Problem Description
Tuberculosis transmission, as well as its reactivation, are of significant concern in prisons because of increased population concentration with risk factors of TB transmission and poor ventilation ( Carbone et al., 2015) . The risk factors, combined with constant movement in and out of correctional facilities, increase the risk of the infection. Most of the incarcerated people are men, and this makes male correctional facilities have a higher risk of tuberculosis because of overcrowding compared to all women correctional facilities. Also, there is insufficient control or delaying in making a diagnosis as well as providing treatment which increases the risk of spread in these settings. The prevalence rates of tuberculosis in all-male correctional facilities is high compared to the rates of the entire United States population. It is approximately eight times more than that of people who are not in correctional facilities. In the United States, an estimated four to six per cent of all the TB cases come from incarcerated individuals during diagnosis (CDC, 2020). Tuberculosis cases from correctional facilities comprise 25 per cent of the country’s burden of the disease.
Besides the risk factors related to the environment in correctional facilities, additional factors include HIV infection as well as various pathology prevalent in prisons and jails such as malnutrition and abuse of substances ( Lambert et al., 2016 ). These additional factors promote the development of active tuberculosis and increased spread of the disease. Multidrug-resistant TB is also common in correctional institutions. An estimated 24 per cent of all the multidrug-resistant TB come from correctional facilities. The same factors that encourage the spread of tuberculosis in these facilities facilitate the spread of multidrug-resistant types of infection. As a result of limitations in access to tuberculosis medication, incarcerated people sometimes self-medicate themselves with medication brought by visitors such as family members or from the internal market ( Lambert et al., 2016 ). The medication is sometimes not regulated, and this promotes the development of multidrug-resistant tuberculosis.
Effect of the Problem
Failure to control tuberculosis in correctional facilities contributes to increased morbidity and mortality associated with the infection. In addition, the problem contributes to the transmission of the infection in the community through visitors who go to see prisoners, the prison staff, and the incarcerated individuals who are released back into the community. The prison staff may contract tuberculosis from prisoners and transmit it to their families and other people that they are in contact with (Grenzel et al., 2018). The same case applies to visitors and released prisoners. This contributes to increased incidence, prevalence, and mortality related to the infection in the general population.
Significance and Implications for Nursing
Nurses play a very important role in the control of tuberculosis and success in completion of treatment. In addition, being a major public health problem, nurses must understand the infection as well as the groups at a high risk of being infected. They participate in the detection of tuberculosis cases in different settings such as correctional facilities, administration and monitoring of treatment regimen, training health workers on tuberculosis control and management, and conducting referrals and follow up. Nurses can contribute to the policy as well as participate in the making of strategic decisions to improve the quality and number of human resources in the control and care of tuberculosis (Rach, 2018). Incarcerated individuals have a right to quality tuberculosis treatment and care in the same way as the general population,
Proposed Solution
Controlling the spread of tuberculosis depends on reducing transmission risk. An effective tuberculosis transmission control initiative should protect the prisoners as well as the general population. The proposed solution is early detection of the infection and timely treatment among inmates. Tuberculosis control is, in most cases, realized through detecting the infection early and effectively treating those diagnosed with the infection (CDC, 2020). Prisoners should be allowed unrestricted access to TB diagnosis and medication. Delayed detection should be reduced to minimize transmission and the urge to self-medicate, which is common among inmates. Through early detection, prisoners who are most likely to have the infection are identified and treated before integration into correctional facilities populations. Also, new inmates should not be mixed with the other inmates until appropriate screening for tuberculosis is done. Screening would also help identification of individuals suffering from LTBI because they are at a high risk of developing tuberculosis. Such inmates can benefit from therapy (Dara et al., 2015).
References
Carbone, A. D., Paião, D. S., Sgarbi, R. V., Lemos, E. F., Cazanti, R. F., Ota, M. M., Junior, A. L., Bampi, J. V., Elias, V. P., Simionatto, S., Motta-Castro, A. R., Pompílio, M. A., De Oliveira, S. M., Ko, A. I., Andrews, J. R., & Croda, J. (2015). Active and latent tuberculosis in Brazilian correctional facilities: A cross-sectional study. BMC Infectious Diseases , 15 (1). https://doi.org/10.1186/s12879-015-0764-8
CDC. (2020, April 14). Correctional facilities | TB in specific populations | TB | CDC . Centers for Disease Control and Prevention. https://www.cdc.gov/tb/topic/populations/correctional/default.htm
CDC. (2020, April 10). TB guidelines . Centers for Disease Control and Prevention. https://www.cdc.gov/tb/publications/guidelines/correctional.htm
Dara, M., Acosta, C. D., Melchers, N. V., Al-Darraji, H. A., Chorgoliani, D., Reyes, H., Centis, R., Sotgiu, G., D’Ambrosio, L., Chadha, S. S., & Migliori, G. B. (2015). Tuberculosis control in prisons: Current situation and research gaps. International Journal of Infectious Diseases , 32 , 111-117. https://doi.org/10.1016/j.ijid.2014.12.029
Grenzel, M. L., Grande, A. J., Paniago, A. M., Pompilio, M. A., Oliveira, S. M., & Trajman, A. (2018). Tuberculosis among correctional facility workers: A systematic review and meta-analysis. PLOS ONE , 13 (11), e0207400. https://doi.org/10.1371/journal.pone.0207400
Lambert, L. A., Armstrong, L. R., Lobato, M. N., Ho, C., France, A. M., & Haddad, M. B. (2016). Tuberculosis in jails and prisons: United States, 2002−2013. American Journal of Public Health , 106 (12), 2231-2237. https://doi.org/10.2105/ajph.2016.303423
Rach, V. (2018). How is the role of the tuberculosis nurse pivotal in the multidisciplinary team? The British Student Doctor , 2 (1), 25. https://doi.org/10.18573/bsdj.31
SeyedAlinaghi, S., Farhoudi, B., Ataeinia, B., Dadras, O., Hosseini, M., Jafari, S., Mazaheri-Tehrani, E., Alasvand, R., Shahbazi, M., & Mohraz, M. (2020). Comparison of tuberculosis indicators after implementation of the clinical protocol for tuberculosis and HIV management in Iranian prisons: A quasi-experimental study. Journal of Health Research , ahead-of-print (ahead-of-print). https://doi.org/10.1108/jhr-04-2019-0074
