Tuberculosis as the Health Problem in New Jersey

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Abstract

Tuberculosis is not a new problem for public health systems, but in the realities of today is the United States, it still has the potential to pose a public health threat. Tuberculosis has the potential to affect the human body through its airborne transmission. Issues such as screening and control of tuberculosis cases, as well as the problem of selecting effective therapies for the disease, are essential in the development of strategic national and federal programs. This research paper will collect material describing tuberculosis and current statistics on America and New Jersey in particular. In addition, it will provide an overview of current policy programs to combat disease.

Keywords: public health problem, federal programs, New Jersey, control of tuberculosis cases

Introduction

In recent decades, there has been a negative upward trend in tuberculosis prevalence almost everywhere in the US. Tuberculosis, a particularly airborne infectious disease, poses a severe threat to the country’s public health system. It is known that among the states of America, New Jersey is one of those where there is an increased risk factor of tuberculosis infection. The purpose of this research paper is to identify the public health threat posed by tuberculosis in New Jersey and to discuss national programs to combat the disease.

The Problem of Tuberculosis

Tuberculosis is a common, socially dependent infectious disease that affects all human organs and tissues. Statistics show that tuberculosis is one of the leading causes of death in the world (Yu, Wang, Mei, Hu, & Ji, 2020). Each year, this pathology kills about 2 million people on the planet, with the number of cases increasing by 9 million (Yu et al., 2020). The rise in tuberculosis and deaths in recent years has rightly raised concerns among tuberculosis services. This underlines the critical importance of further research on the treatment and prevention of morbidity.

Reasons for Tuberculosis

The causative agent of tuberculosis is mycobacteria, which is common in the environment. The source of infection is a patient with an open disease form (Brown, 2016). The problem of tuberculosis is a priority for various health systems around the world, as negative pathomorphism is noted: the incidence is increasing, and the rate of acute and antibiotic-resistant forms is increasing (Yu et al., 2020). This is due to the socio-economic and environmental situation and a number of aggravating factors: age, chronic non-specific respiratory diseases, diabetes mellitus, and HIV infection (Kreisel, Passannante, & Lardizabal, 2019). Infection with tuberculosis mycobacteria does not always cause the development of the tuberculosis process. Adverse living conditions, inhalation of contaminated air, and a reduction in the body’s resistance play a leading role in the development of tuberculosis (Torres et al., 2019). All of the above aggravates the course of the disease, reduces the effectiveness of therapy, and significantly increases mortality.

New Jersey Statistics

The spread of tuberculosis is not only a problem in countries with weak health system performance. Although the modern U.S. is one of the least affected countries, government programs and national projects must be established to help people already diagnosed and to prevent the potential spread of the disease. Moreover, it is essential to note that there is some geographic inequity in the U.S. to the problem of tuberculosis: New Jersey’s regions, according to studies, have the highest rates of infection and pose serious risk factors for tourists and urban residents (Brown, 2016). Statistics describe five cases of tuberculosis infection per hundred thousand New Jersey residents, while the neighboring states of Delaware and Pennsylvania have no more than four (Brown, 2016). Elevated state cases of tuberculosis infection generate increased interest and trigger a discussion of national health practices that exist to analyze improvements.

Alternative Views

The development of medical technologies undoubtedly has a positive impact on the detection of new cases of tuberculosis and their subsequent treatment. However, for large states of America, in particular, New Jersey, it is not very easy to assess real control figures (Gulati et al., 2019). In this regard, several opinions are emerging in public. For example, Matthau (2018) is convinced that New York City has more infections than New Jersey. In his article, he writes about an unprecedented drop in new infections, pointing out that recently there has been an almost 72 percent drop (Matthau, 2018). However, official statistics based on CDC data do not agree with this information (“Tuberculosis incidence rate,” 2019). The data presented in this online report indicate that tuberculosis incidence among the New Jersey population declined between 2010 and 2019, but only by 31 percent (“Tuberculosis incidence rate,” 2019). Thus, there is some misinformation aimed at creating a more positive public sentiment about the problem of infection with Tuberculosis Bacillus.

Despite the significant differences in the figures presented, the authors agree that most cases of the disease are common to migrants and people from outside the American nation. For example, Asians and Hispanics living in New Jersey are more likely to be infected with tuberculosis (Gulati et al., 2019). According to Elnahal (2018), by 2017, more than 84 percent of tuberculosis cases in New Jersey are registered with foreign nationals. In general, the sources studied show a positive trend in cases of declining incidence among residents.

Medico-Political Programs

Reducing the social and economic burden of tuberculosis is possible with the adoption of a single national program aimed at improving the system of prevention and medical care. Such programs should be based on practical and scientifically based technologies for tuberculosis control and adequate modern measures for medical and social rehabilitation after treatment. The modern U.S. health care system includes several government programs designed to monitor and control the spread of the disease (“Complete health indicator report,” 2018). It is estimated that by 2012 about 46 percent of the population did not have a health insurance policy that could cover the cost of screening and treatment (Balaban et al., 2015). For this reason, in recent decades, the national tuberculosis policy has focused on promoting the maximum inclusion of the American population in the health insurance program.

Monitoring Programs

Furthermore, tuberculosis surveillance programs are not only at the federal level but also the state level. New Jersey has a health policy that postulates the actions of physicians and medical personnel in cases of new cases of tuberculosis (Department of Health and Senior Services, n.d.). The policy states that if a patient is diagnosed with a case of tuberculosis, the health care provider must notify the Department of Health within 24 hours. Each patient is provided with a nurse who oversees the treatment and care process (Elnahal, 2018). In addition, such a patient must be regularly monitored every three months or if the patient’s tests show changes (Department of Health and Senior Services, n.d.). Through such a program, state authorities seek to control and prevent transmission of tuberculosis infection between populations promptly.

Another mandatory public health program in New Jersey is the annual check-up of schoolchildren and educational personnel for Koch’s bacillus. This includes a Mantoux test and chest X-ray for pathological changes in lung structure (New Jersey Department of Health, 2016). The policy is not to treat patients, but instead to help the state administration monitor morbidity.

Treatment Programs

State health programs at the municipal and district levels not only play a regular monitoring role but also contribute to improving current treatments. Research and development carried out by the Global Tuberculosis Institute at Rutgers play a significant role in the development of medical technology (Romano, n.d.). The National Institutes of Health provide grants to universities and research centers on an ongoing basis to improve existing equipment (RGHI, 2019). This encourages the further development of existing projects, which will contribute to the development of more effective methods of analysis and control of tuberculosis.

Federal health programs are echoed in similar programs at the New Jersey level. For example, to improve U.S. health outcomes, the Healthy People 2020 program has set a goal to reduce the proportion of people with different diseases by advancing treatment and screening (“Healthy People 2020,” 2019). The New Jersey State Administration expects to achieve a 93 percent completion rate for tuberculosis patients within 2020 (“Complete Health indicator report,” 2018). All available medical and research resources are aimed at achieving this number.

Conclusion

Tuberculosis is a severe problem that is still a threat to American lives, despite the current negative trend of new infections. Although treatable at an early stage, it does cause significant social harm. The state of New Jersey demonstrates the greatest threat to new infections of healthy people, which may be associated with the abundance of migrants and residents of different ethnicities. Benchmarks for the number of diseases vary from source to source and generally show public attitudes toward tuberculosis. While some believe that the infection is not dangerous for residents of the state, others are afraid because there is only a slight decrease in the number of infections.

To address tuberculosis, national and state governments are developing several strategies aimed at both monitoring the prevalence and improving current treatments. Such programs include regular review of schoolchildren and education center staff and immediate referral to the Ministry of Health if a new patient is found. Grants programs are also being developed, providing financial support to research institutes to develop new methods of tuberculosis control and therapy.

To the Mayor of Elizabeth, Chris Bollwage. About Tuberculosis Prevention

Dear Chris Bollwage, events taking place in the world demonstrate the importance of very rapid response of the health system to outbreaks of various diseases. Even though nowadays citizens are actively informed about the problem of the coronavirus infection COVID-19, the city administration should not forget about another pandemic that has been exterminating the population for more than a hundred years – tuberculosis. At first glance, it may seem that official statistics provide comforting news: in ten years, the incidence in New Jersey has fallen by almost 31%. However, it is worth looking at the situation from a different angle – there are still patients in Elizabeth who need treatment or are not even aware of their diagnosis. In addition, in the current situation, tuberculosis can be a lethal addition to the COVID-19, which affects the respiratory system. The analysis of the existing solutions offered by New Jersey’s Health Care System leads to the conclusion that several additional measures must be taken to ensure the safety of the population. In that regard, Mr. Bollwage, please note the proposed steps.

Diagnostic systems need to be improved, which includes mandatory tests (Mantoux test and fluorography) for all age categories once a year.
It is essential to monitor the implementation of the previously established measure whereby every patient is provided with a nurse. In practice, there may be a shortage of nurses due to understaffing.
A recovered patient is obliged to be diagnosed three months after the therapy. It is essential to control this and impose sanctions in case of bad faith of the patients.

Together with the proposed actions, I express my hope that starting from today, the overall tuberculosis incidence will only decrease. We must do everything possible to achieve the goal set by the World Health Organization, according to which the tuberculosis pandemic should be stopped already in 2030. Mr. Bollwage, I kindly ask you to pay special attention to this issue to ensure the safety of Elizabeth’s population.

References

Balaban, V., Marks, S. M., Etkind, S. C., Katz, D. J., Higashi, J., Flood, J.,… Chorba, T. (2015). Tuberculosis elimination efforts in the United States in the era of insurance expansion and the Affordable Care Act. Public Health Reports, 130(4), 349-354.

Brown, T. L. (2016). The impact of social determinants on tuberculosis incidence trends in New Jersey. Web.

Complete health indicator report of tuberculosis patients who complete curative therapy. (2018). Web.

Department of Health and Senior Services (n.d.). New Jersey administrative code. Web.

Elnahal, S. (2018). New Jersey Department of Health recognizes March 24 as World TB Day. Web.

Healthy people 2020. (2019). Web.

Gulati, N., Ram Pentakota, S., Feja, K. N., Ghoshal, B., Bhavaraju, R., Jindani, A.,… Kalyoussef, S. (2019). 1376. Physician practice patterns for screening and treatment of latent tuberculosis infection in the South Asian population in central New Jersey. Open Forum Infectious Diseases, 6(2), 499-500.

Kreisel, C. F., Passannante, M. R., & Lardizabal, A. A. (2019). The negative clinical impact of diabetes on tuberculosis: A cross-sectional study in new jersey. Journal of the Endocrine Society, 3(1), 62-68.

Matthau, D. (2018). Why is tuberculosis on the rise in NYC but not New Jersey? Web.

New Jersey Department of Health (2016). Tuberculosis program. Web.

RGHI (2019). Improving TB treatment – and survival – in the world’s poorest places. Web.

Romano, F. (n.d.). Tuberculosis Control Program. Web.

Torres, M., Carranza, C., Sarkar, S., Gonzalez, Y., Vargas, A. O., Black, K.,… Páramo-Figueroa, V. H. (2019). Urban airborne particle exposure impairs human lung and blood Mycobacterium tuberculosis immunity. Thorax, 74(7), 675-683.

Tuberculosis incidence rate, New Jersey, by year: Beginning 2010. (2019). Web.

Yu, W. Y., Wang, Y. X., Mei, J. Z., Hu, F. X., & Ji, L. C. (2020). Overview of tuberculosis. In W. Yu, P. Lu, & W. Tan (Eds.), Tuberculosis control in migrating population (pp. 1-10). Singapore: Springer.

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