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Community Nurse Role In Contemporary Health Care Systems Add in library

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Description of the communicable disease (causes, symptoms, mode of transmission, complications, treatment) and the demographic of interest (mortality, morbidity, incidence, and prevalence).?

Describe the determinants of health and explain how those factors contribute to the development of this disease.?

Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. (The textbook describes each element of the epidemiologic triangle).?

Explain the role of the community health nurse (case finding, reporting, data collecting, data analysis, and follow-up).?

Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organization(s) contributes to resolving or reducing the impact of disease.?



Tuberculosis (TB) is one of the dangerous communicable diseases that can be transferred from one individual to other and makes people sick. The communicable diseases are caused by pathogens, which enter into the human system and release toxins (Dyer, 2010). This causes damage to the normal human cells and obstruct their functional capacity. In severe conditions, these diseases may cause death. In case of tuberculosis, the infectious agents float in the air and transmitted into the human system through the respiratory tract. Therefore, the mode of transmission is termed as air-borne transmission. According to the CDC, almost 9,582cases were documented in the US, in 2013. 536deaths were reported in 2011 (, 2015). The causative agent of tuberculosis is Mycobacterium tuberculosis. It is a small nonmotile, aerobic bacillus. High lipid content of Mycobacterium explains unique medical characteristics. TB particularly affects the lungs, but can also attack other organs of the human system. If an affected individual sneezes or coughs, the disease transmits through air. The immune system builds up complicated reaction to Mycobacterium and sometimes become successful in preventing their spread. TNF and IFN-gamma are the two types of cytokines, secreted in response to the Mycobacterium.TNF enhances mycobactericidal and phagocytic activities of macrophages, whereas, IFN-gamma develops the production of hydrogen peroxide by macrophages. From various analysis it is founded that tuberculosis pleuritis affected individuals generally recover without any therapy and TNF and IFN-gamma concentrations are 5-30times higher in their blood concentrations (da Silva, Von Groll, Martin & Palomino, 2011). Symptoms include constant cough with sputum, chest pain. Individuals may cough up blood. In chronic condition extensive scarring of the lungs is also common. The upper lobes get frequently affected by TB than the lower lobes probably due to poor drainage of lymph in these areas or to better airflow (Provenzano, 2005). The suggested treatment of TB is administration of combine dosages of antibiotics that include isoniazid, rifampicin, ethambutol and pyrazinamide for initial two months and then isoniazid and rifampicin for last four months.   

Description of determinants of health and contributing factors to the development of TB 

The direct and indirect determinants of health are the population, economy, biological, social and behavioral risk issues, TB control intensity and health services. Determining health determinants are of utmost important as it reinforce or generate social satisfaction within the society. Social satisfaction causes an uneven distribution of the health determinants, comprising mental circumstances and living conditions along with biological and behavioral risk factors. The fundamental structural determinants include inequalities in global socioeconomic condition, elevated population mobility, population growth and rapid urbanization. These situations cause asymmetrical distributions of basic social determinants of tuberculosis, comprising malnutrition, food insecurity, environmental conditions, poor housing, geographic, financial conditions and cultural obstructions to attainment of healthcare (Okuonghae & Omosigho, 2010). Sequentially, the distribution of TB population reveals the distribution of the social determinants that influence four steps of the disease pathogenesis: infection exposure, disease progression, inappropriate or late analysis, and treatment, poor adherence to success and adherence. These determinants are the basic factors for Tuberculosis. For instance: overcrowding workplaces, communities, homes and poor ventilation increase the chance of healthy individuals being exposed to this infection. Malnutrition, hunger and poverty increase the vulnerability to disease, infection and acuteness of clinical consequence. Affected individual with constant cough face major economic and social barriers, which setback their accessibility with healthcare systems where proper diagnosis could be made (McNutt, 2010). This includes transportation difficulties to healthcare facilities, panic of stigmatization if these individuals seek TB diagnosis and inadequacy of societal support to search for care while they fall ill.


Discussion of the epidemiologic triangle

The epidemiologic triangle is said to be a scientific model that is developed for analyzing health problems. It helps to understand communicable diseases and their mode of communication. The basic three factors of this model include agent, host and environment. Agent means the pathogen that gives rise to the disease (Quinn & Samet, 2010). Host harbors the disease and environment allows the disease to transmit from one individual to another.  

The agent; what?

Bacteria- these organisms are made up of single cells. They have the mechanisms to self-replicate themselves. They are bigger than viruses, but very tiny to be detected with the naked eyes. These cells are filled with intracellular fluid and sometimes have strand-like structures for their easy movement.

The host; who?

Human- humans are exposed to this disease and harbor Mycobacterium tuberculosis. Humans get sick due to the attack by the agents. The agents take accommodation from the host. Thus, show illness associated symptoms. Different hosts have different symptoms to the same agent. Suppose, an individual affected with tuberculosis may produce blood mixed cough and sputum and other may not.

The environment; where?

The environment is said to be the preferable conditions and surroundings external to the host, which allow the illness to be transferred. Some agents exist best in human blood, some in water. In case of tuberculosis, the preferable environment for disease transmission is air. Sometimes, environment factors also include seasons; for example: in the United States, the peak season for flu is between the months of November to March.

The role of the community health nurse

The community health nurses should be careful enough about the high-risk individuals, who are health care providers, HIV affected individuals, homeless individuals, prisoners and underprivileged minorities. The community health nurses should have a sound knowledge about current treatments and be capable of recognizing indications of drug-resistance in clients (Brookes, Davidson, Daly & Halcomb, 2007). Additionally community nurses should participate actively and educate general people and practitioners about careful application of antibacterial drugs to diminish the occurrence of drug-resistance. In case of frequent disease occurrence the community health nurses should involve themselves in case finding, documenting, data collection, analysis and follow-up. They should interview infected individuals, which will help them to identify the people who are at risk. They should visit homes to monitor individuals, who are under treatment and guarantee treatment adherence. They may take part in epidemiological assessments of disease outbreaks of identified illnesses. Controlling TB is not only the sole accountability of the healthcare workers. It is also the responsibility of individuals to eliminate the spread of this dangerous disease. Richter and Peu (2004) supported this view and stated that care providers can assist increase community awareness regarding their right to obtain TB care (Richter & Peu, 2004). The community health nurses should make individual aware about DOTS therapy and evaluate environmental situations to understand if the demands of the communities are being met.

One national agency that addresses the communicable disease chosen contributions to reducing the impact of TB

The National Tuberculosis Controllers Association was established in the year 1995 and brought together the heads of TB control programs form all the states and countries, also from many cities and countries’ health departments, which organize TB control programs by them (, 2015). Its vision is to free the world from tuberculosis and mission is to protect the health of the public by developing the eradication of TB in the US through related action of local, state and territorial agendas. It aims to provide and develop collective voice for the tuberculosis controllers to promote; advance TB control and abolition activities in the US. It aims to counsel agencies, task forces, committees and organizations on problems and related actions impacting on TB control and abolition at territorial, local and state levels. It also aims to support organizations and agencies for the advancement of TB control program and for elimination of this disease at local and state levels. It also aims to advocate for policies, positions, laws and advancement of TB control and elimination at territorial, local and state levels.   



Brookes, K., Davidson, P., Daly, J., & Halcomb, E. (2007). Role theory: A framework to investigate the community nurse role in contemporary health care systems. Contemporary Nurse, 25(1-2), 146-155. doi:10.5172/conu.2007.25.1-2.146,. (2015). CDC - Reported Tuberculosis in the United States, 2013 - TB. Retrieved 8 July 2015, from

da Silva, P., Von Groll, A., Martin, A., & Palomino, J. (2011). Efflux as a mechanism for drug resistance in Mycobacterium tuberculosis. FEMS Immunology & Medical Microbiology, 63(1), 1-9. doi:10.1111/j.1574-695x.2011.00831.x

Dyer, C. (2010). Tuberculosis. Santa Barbara, Calif.: Greenwood.

McNutt, J. (2010). Is Social Work Advocacy Worth the Cost? Issues and Barriers to an Economic Analysis of Social Work Political Practice. Research On Social Work Practice, 21(4), 397-403. doi:10.1177/1049731510386624

Okuonghae, D., & Omosigho, S. (2010). Determinants of TB Case Detection in Nigeria: A Survey.Global Journal Of Health Science, 2(2). doi:10.5539/gjhs.v2n2p123

Provenzano, G. (2005). TB screening and anti-TNF  treatment. Thorax, 60(7), 613-613. doi:10.1136/thx.2005.042457

Quinn, T., & Samet, J. (2010). Epidemiologic Approaches to Global Health. Epidemiologic Reviews,32(1), 1-4. doi:10.1093/epirev/mxq007

Richter, M., & Peu, D. (2004). The educational and supportive needs of informal caregivers working at Refentse Clinic, Hammanskraal. Curationis, 27(1). doi:10.4102/curationis.v27i1.951,. (2015). NTCA | National Tuberculosis Controllers Association. Retrieved 8 July 2015, from


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