Tuberculosis: Health Behaviors, Surveillance System, and Risk Communication

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Currently, around the world, people have become aware of their health, issues, connected with it, and precautions they can take in order to avoid facing various diseases, such as tuberculosis (TB). According to OCPHS1, although TB is not so widespread in the US, there are many people from Africa, Mexico, Asia, and South America coming to the US who are more susceptible to TB (OCPHS1, 2014). Therefore, it is essential to develop appropriate and helping health behaviors among the US population, to establish properly working surveillance systems, and to identify crucial risk factors.

To start with, the willingness to take some precautions against TB has resulted in people developing certain health traits. Although there are health behaviors that genuinely help to fight off illnesses and stay in favorable conditions, there are also some health traits that solely seem to be useful, but instead may be even worsening the situation. For instance, researchers note that if all the patients with latent tuberculosis infection are provided with prophylaxis, it will only lead to an increased possibility of future anti-TB drug resistance (Ai, Ruan, Liu,and Zhang, 2016). Therefore, it may be even more dangerous to undergo prophylaxis than not to do it.

As for other health behaviors that contribute to the increased risk factors, they include, for example, smoking and underweight status (Ai et al., 2016). While smoking is scientifically proved to affect health severely, comprising higher TB risk, underweight status is claimed to be rather insignificant. However, trying to lose weight using unhealthy methods can result in overall weakened conditions, and, therefore, among other diseases risks, there will be an increased TB risk.

It is undeniable that tuberculosis and its risk factors must be monitored and studied. There is a system in the US aimed at controlling TB that is called the United States National Tuberculosis Surveillance System (NTSS). According to Bonney, Price, and Miramontes (2018), “it contains reported tuberculosis cases provided by all 50 US states” (p. 1). In addition, the US NTSS analyzes the data in four different electronic systems and conducts researches based on the collected information.

Researchers note that “despite major changes that took place in 2009, completeness has remained high for most data elements in TB surveillance” (Yelk Woodruff, Pratt, and Armstrong, 2015, para. 6). Besides, there is only one percent of reported cases containing missing or incorrect information. Moreover, new protocols and developing projects for the US NTSS are invented every year, which helps to optimize the system.

One more implement that can be utterly useful against TB is risk communication. Its primary function is to inform people about the risk and, consequently, to allow them to take action in order to protect their families and themselves. Risk communication generally implies the exchange of current information, opinions, and advice between professionals and people whose health or another well-being is threatened. In the case of TB, risk communication, especially between ordinary people, is essential, since some people may be ashamed of their disease and even prefer not to treat it rather than make it known (OCPHS1, 2014).

Although TB can be cured, it is equally significant to consult a specialist when some symptoms similar to those of TB occur. Moreover, it is possible to highlight that both latent TB infection and active TB disease are curable and preventable, and the medicines are available, in some states like Minnesota, they are even for free.

In the given case of Sara and her TB disease, risk communication was implemented by announcing to Sara’s boss and co-workers her diagnosis. It seems essential to warn them, although they took somewhat incorrect precautions. It was apparent that Sara would be able to go to work only when her disease was not contagious. Therefore, to distance themselves from Sara was not helpful for her co-workers if they wanted to avoid being infected.

They should have analyzed their recent state of health and, maybe, taken the TB test. Moreover, the fact that some of Sara’s co-workers started to display similar symptoms proves that they should have considered Sara’s disease as a motivation to check themselves. On the whole, there is no Sara’s fault that TB started to spread since she contributed to the dissemination of risk communication that, in its turn, was not correctly understood and reacted to. Moreover, it resulted in Sara being stressed and continuously coping with pressure, which could lead to a new active stage of her disease.

Crisis and emergency risk communication messages require careful planning and development. There are many factors that must be considered, such as psychological, behavioral, social, and communicative aspects. Emergency risk communication is not the same as a mere announcement or advertising. It is essential to understand the audience, its current state and conditions, and how to adapt the message that needs to be delivered (US Centers for Disease Control and Prevention, 2018).

Therefore, key components in developing such messages can be expressed as follows. The first one is conciseness (which helps to make a message coherent), then there should be repetition (which helps to remember it during anxiety). A message should also contain respect to people’s fear and a suggestion of options to show that they are understood and accepted. Besides, it may be a sound strategy to use positives instead of negatives in such messages if it does not impede communication.

To sum up, the current situation around TB in the US seems to be under control, since, according to researchers, the US NTSS works appropriately and is developed yearly. However, there is a lack of public awareness of the actions needed to be done as a reaction to emergency risk communication, as was shown by the analysis of Sara’s case. There was an unpleasant environment created around Sara as a result of weak risk communication, which led to her being distanced and stressed.

It, in its turn, could contribute to a new outbreak of Sara’s disease. In addition, beneficial health behaviors must be established among the US population, as currently, there are some health traits that lead to an increased TB risk. It is also significant to train social workers and medical staff to deliver emergency risk messages accurately since it can be crucial in terms of preventing the spreading of TB and other diseases.

On the whole, further studies on the TB issue, its risk factors, the US NTSS, and the delivery of risk messages are to be conducted. Also, the US NTSS needs new protocols and some minor improvements in order to remove occasional current inaccuracies. It would also be useful for TB prevention if social programs aimed at general population health strengthening, such as antismoking policies, were developed and promoted.

References

Ai, J. W., Ruan, Q. L., Liu, Q. H., & Zhang, W. H. (2016). Updates on the risk factors for latent tuberculosis reactivation and their managements. Emerging Microbes & Infections, 5(1), 1-8.

Bonney, W., Price, S. F., & Miramontes, R. (2018). Improving the Quality of Data Exchange Formats in the US National Tuberculosis Surveillance System. Online Journal of Public Health Informatics, 10(1). Web.

OCPHS1. (2014). What is tuberculosis? [Video file]. Web.

US Centers for Disease Control and Prevention. (2018). Crisis and emergency risk communication manual. Web.

Yelk Woodruff, R. S., Pratt, R. H., & Armstrong, L. R. (2015). The US National Tuberculosis Surveillance System: A descriptive assessment of the completeness and consistency of data reported from 2008 to 2012. JMIR Public Health and Surveillance, 1(2). Web.

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Tuberculosis: Health Behaviors, Surveillance System, and Risk Communication

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