Although there have been topical studies to assess TB infection among young children (Shanaube et al. 2009), there are hardly any data evaluating TB infection in adolescents and older children in communities that have high TB and human immunodeficiency virus problems (Wood et al
First, there is a need to target reducing the high force of TB infection, particularly in high-density townships. It is paramount to understand that the benefits of enhanced case finding will depend on the existing epidemiology of TB transmission (Zhang, Jiang, and Wang, 2009)
If a health care worker has a chronic medical condition or is taking certain, specific medications, that worker is also at higher risk for acquiring the TB bacteria and should try to avoid environments where transmission could take place - but of course this is not always possible (Joint, 2000). Transmission Modes People transmit TB through coughing, sneezing, and spitting, or other saliva contact (Dormandy, 2000)
For the health care worker, that is a very serious and very real concern (Lawlor, 2007). Agent of Disease The disease is spread through coughing, sneezing, or through saliva - similar to the flu or a cold (Kidder, 2004)
Tuberculosis (TB) is a serious health concern for many people, mostly in developing countries, but some populations have a higher chance of catching the disease than others (Lawlor, 2007)
It can spread through the bloodstream and the lymph nodes to any other part of the human body. TB spreads through the air when affected individuals who have the infection in an active stage sneeze, coughs, or transmits any other respiratory fluid through the air to a non-infected person (Al Jahdali, Menzies & Al Otaibi, 2011)
Occasionally, the infected individuals may cough out blood-stained sputum and in rare occasions, TB infection may erode into the pulmonary artery, causing an immense bleeding, a condition termed Rasmussen's aneurysm. TB may develop into a chronic illness and result into a wide-ranging scarring within the upper lobes of the human lungs (Gerald, Wang & Elwood, 2008)
108). In fact, a study of the New York City jail system showed that TB infection and progression to active TB disease take place at higher rates in individuals with more frequent incarceration and longer total time spent in jail (Braithwaite et al
As with a number of other infectious diseases, though, there are a variety of causes or combinations of causes that can contribute to such higher incidence of TB among prison populations. For example, prisoners are especially susceptible to infection tuberculosis than other members of the community (Wilcox, Hammett, Widom & Epstein, 1996) and this higher rate of tuberculosis infection is consistent with the fact that prisoners typically come from lower socio-economic backgrounds and because TB is an airborne infection, overcrowded housing conditions associated with poverty facilitate its spread (Coyle, Campbell & Neufeld, 2003)
Unfortunately, if tuberculosis infection is not correctly assessed and treated among in-coming prisoners, and an infected prisoner develops active tuberculosis, the extraordinarily high-density prison environment is the perfect setting for the disease to spread (Coyle et al., 2003); however, previous studies have identified deficiencies in tracking inmate tuberculosis status that have made such assessments problematic (Dolovich, 2005)
68). This outbreak of TB was responsible for the deaths of 36 prisoners and one correctional officer, as well as the infection of a number of healthcare employees with a strain of multi-drug resistant tuberculosis (Dooley, Jarvis, Martone & Snider, 1992)
Conceptual Framework The conceptual framework to be followed in the proposed study follows the precepts of public health model wherein the goal is to effect substantive changes in health standards and practices by public health administrators. This conceptual framework is congruent with the growing body of evidence showing that major changes in health behavior can be achieved by the public health sector, and that these changes in behavior are credibly associated with public health communication, including both deliberate communication programs and normal media coverage of health issues (Hornik, 2002)
In addition to clinical skills, prison healthcare workers are required to draw upon custodial and people skills and seek to establish and maintain positive relationships with prisoners. Working as a team member or individually, healthcare workers will need to be aware of the pressure felt by patients and colleagues" (Howard, pp
Given the many different policy options and the difficulty of evaluation, however, it may take decades to build up a reasonably extensive evidence base. It is therefore better to be pragmatic and to be prepared to decide for the implementation of policies and interventions in the absence of full documentation of their effectiveness" (Mackenbach and Bakker, p
For example, prisoners are especially susceptible to infection tuberculosis than other members of the community (Wilcox, Hammett, Widom & Epstein, 1996) and this higher rate of tuberculosis infection is consistent with the fact that prisoners typically come from lower socio-economic backgrounds and because TB is an airborne infection, overcrowded housing conditions associated with poverty facilitate its spread (Coyle, Campbell & Neufeld, 2003). Whatever its source, medical experts recommend swift and accurate diagnoses for TB in these institutionalized populations because early diagnosis can literally mean the difference between life and death (Mueller, 1996)
100). Rationale of the Proposed Study As early as 1904, prison management officials have recognized the need for improved care and education of inmates to help stem the incidence of TB in their institutions and to prevent its subsequent spread to the community at large (Roe, 2007)
108). Not surprisingly, infection rates for tuberculosis among inmates in federal and state prisons are far greater than for the American population as a whole (Smith, 2006; Louis, 2002)
Alternate Hypothesis (#2): A tuberculosis (TB) prevention and TB treatment intervention on males whom have been diagnosed with latent TB infection (LTBI) or active TB disease (TB) and are newly released from New York City Correctional facilities will reduce the rates of infection. Background and Significance The United States incarcerates more of its citizens than any other country in the world today with some concomitant implications for healthcare providers responsible for this population (Stanko, Gillespie & Crews, 2004)
Indeed, American Lung Association (2004) considers tuberculosis as the an "ancient scourge," gaining prevalence in the 19th century and resurging once again in the 21st century, despite medical technologies developed to curb the said airborne disease. Tuberculosis is an airborne disease that is characterized chronic or acute bacterial infection that attacks the lungs, and can also affect other parts and vital organs of the body, such as the bones, skin, kidney, gastrointestinal tract, and the neck (affecting the lymph nodes) (Reichman, 2002:14)
must develop new research, work with other developing nations more closely, educate the public about TB, develop better skin tests, and test immigrants to the country, and create national training and educational programs. They also need to encourage the development of new products to treat and identify the disease, and encourage state and local health agencies to become more active in the identification and treatment of the disease (Swartz 39)