Comprehensive Primary Health Care framework for Zandile who has tuberculosis

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Comprehensive Primary Health Care framework for Zandile who has tuberculosis



 South Africa has the highest encumbrance of tuberculosis (TB), this infection it is an airborne disease which is caused by Mycobacterium tuberculosis, the main source for transmission of the disease is through a contagious person infecting those who share air space with. The most active method for preventing the infection it is early detection on new cases and immediate start of patients onto effective treatment. Well there are several factors that influence the success of the treatment and the transition of the infection into the development of an active disease, those factors includes socioeconomic issues, the etiologic agent and clinical treatment. 


There are several components of a Comprehensive Primary Health Care programme that are important in addressing the health crisis which will be used for Zandile namely curative, prevention, rehabilitative and promotive.


Curative
Curative approach places emphasises the treatment of the biological and psychological causes and symptoms of disease through the use of medicine and other therapies. TB can usually be cured and more than twenty drugs have been developed for treating TB. But most of the drugs were developed many years ago. The treatment usually consists of a combination of TB drugs that must be taken for at least six months. But the treatment will only be successful if the drugs are taken exactly as required for the entire length of time. The drugs are used in different combinations in different circumstances. For example, the five “first line”: Isoniazid, Rifampin, Pyrazinamide, Ethambutol and Streptomycin drugs are given to people who have never had treatment before. Some of the drugs have very severe side effects such as skin rashes,pins and needles,in very few cases people may experience jaundice, which is the yellowing of skin or eyes  and are very difficult to take for such a long period of time . This is why there is an urgent need for new TB drugs to be developed. In addition many people are now resistant to one or more of the drugs. 



                                                                                             Prevention
TB prevention consists of several approaches first being to stop the transmission of TB from one adult to another. This is done through firstly, identifying people with active TB, and then curing them through the provision of drug treatment. With proper TB treatment someone with TB will very quickly not be infectious and so can no longer spread the disease to others.




The second approach of TB prevention is to prevent people with latent TB from developing active, and infectious, TB disease.  Anything which increases the number of people infected by each infectious person, such as ineffective treatment because of drug resistant TB, reduces the overall effect of the main TB prevention efforts. Also the pasteurization of milk helps to prevent humans from getting bovine TB. There is also the vaccine for TB, but it makes only a small contribution to TB prevention, it does little to interrupt the transmission of TB among adults.

Health care workers, who provide care for patients for TB, should adhere to infection control procedures to ensure that TB infection is not passed from one person to another. However, infection control guidance must not only be written but also implemented. People should receive education on  Hygiene etiquette which will teach them on how to cough as to avoid the spread of  the infection, also the education of early detection of TB. the other important factor to prevent the infection would be the visible posters that are informative this posters should be visible in all health providers services hospital and clinics. 


                                                                                          Rehabilitative

Little attention is given to the social, psychological and economic impact extended treatment can have on the lives of individuals. Due, to a large extent, to the high levels of stigma that continue to exist in many high-burden countries, people affected must face obstacles even before diagnosis. The side effects of TB medication (especially DR-TB) are sometimes extreme, and require extensive therapy some patients for example even lose their ability to hear, also it has been discovered that most patients with TB are prone to develop  polyneuropathy which is affecting the peripheral nerves, therefore the rehabilitation through the physiotherapy. Nutritional support is another key factor that is needed to rehabilitate the patients as most patients lose appetite due to medication and vomiting - nutritional rehab, which includes dietitian that will provide eating plan and supplements. 


Promotive
Health it as a fundamental human right, therefore for individuals to have control over their health and its factors enables them to improve their health hence it is crucial that they have access to information or education involving factors of their health.
   

Health promotion, when implemented in concert with other strategies including education, community development, policy, legislation and regulation, is more effective in preventing Communicable and Non-Communicable Diseases.  Health promotion is a key strategy in the prevention and treatment of TB, it can assist in strengthening individual knowledge and skills on preventing this infection as well as education on proper ventilation in housing will help the patients which prevent the spread of PTB. 



References 

Nesheim M C. Ascariasis and human nutrition. In Ascariasis and its prevention and control, D. W. T. Crompton, M. C. Nesbemi, and Z. S. Pawlowski (eds.). Taylor and Francis,London, U.K.1989, pp. 87–100.
Otranto D, Capelli G, Genchi C: Changing distribution patterns of canine vector borne diseases in Italy: leishmaniosis vs. dirofilariosis.Parasites & Vectors 2009; Suppl 1:S2.

The Global Fund  (2012) Zandile in South Africa: TB Treatment Makes a Difference. Available at: https://www.youtube.com/watch?v=tZZNpdO_ABc (Accessed: 21 March 2018)


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