Tuberculosis and Healthcare Risk Factors

Research Question

In this proposed research, the main question that the study would seek to establish is, “what is the relationship between tuberculosis and potential risk factors in the healthcare system, and whether the new cases of tuberculosis are more prevalent in persons visiting third world countries as opposed to developed countries?”

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Problem Statement

The problem of tuberculosis in the healthcare sector has been increasing in terms of severity in Slavonia and globally. The condition could be largely attributed to a lack of a proper health care program. In comparison to the rapidly growing population, the development in the health care system was inadequate in 1905. Both men and women in Slavonia lived in poor living conditions, which exposed them to the risk of contracting tuberculosis infections. Since the disease is transmitted through the atmosphere, health experts find it challenging to combat the increasing infection. Although the health care providers stress the need for personal hygiene as a remedy for controlling its spread, little has been achieved in developing countries, where the majority live in poverty.

Descriptive Epidemiologic Analysis

This descriptive epidemiological assessment on tuberculosis had shown severe health problems, especially in Slavonia. In such underdeveloped nations, there was fewer medical personnel who could attend to urgent health requirements of the rapidly growing population (Borovecki & Gjenero, 2002, p.353). In comparison, England “had 1physician per 1,730 inhabitants, Germany with 2,820 inhabitants per physician, Slavonia had 1 physician per 6,948 inhabitants” (Borovecki & Gjenero, 2002, p.353). If these statistical data were something to go by, then it was important to seek an early discovery on tuberculosis. In addition, it would be a more pragmatic approach to appropriate preventive measures, which are aimed at stopping the spread of tuberculosis among the persons who had been exposed to the risk of contracting the disease. This could only be attained through the enhancement of the best healthcare system. Besides, more physicians would be required to help in preventing more occurrences of tuberculosis disorders among the population.

The achievements above could be attained through the support of the Slavonia government that was meant to set up special committees for addressing the issues of tuberculosis, which were affecting several parts of the world. This would call for the issuance of some special decrees on ways of controlling tuberculosis in the third world nations, especially Slavonia. Among the issues to be addressed were bad housing conditions, poverty, and poor hygienic conditions, which led to high mortality rates of this health disorder. It was ascertained that the worst affected persons were the working class who were living in deplorable conditions (Borovecki & Gjenero, 2002, p.353). The tuberculosis prevalence rate was on the rising trend, as evidenced from the following quotations:

Health care services in Dalmatia at the beginning of the 20th century, tuberculosis and malaria were reported as the deadliest diseases (1,547 deaths in 1903, 1,688 deaths in 1904, and 1,687 deaths in 1905” (Borovecki & Gjenero, 2002, p.353).

It can be revealed from this assessment of tuberculosis by sex that there is a significant difference between the rates of mortality and morbidity. In most cases, death rates of tuberculosis cases have been witnessed to be higher for both men and women. However, morbidity rates are higher among females. This comes as a result of early and frequent medical care that women often seek. This makes it possible to diagnose tuberculosis at its earlier stages before the disease spreads to other parts of the body. It is easier to treat the disease at its infant stages. In comparison to females, males are often reluctant to seek early medical care. This puts men in a riskier position to contract tuberculosis and stay with it in their bodies before it is diagnosed for treatment. Besides, this makes it difficult to administer preventive care among the males, who may be ignorant of the potential risk of tuberculosis transmission and infections. This phenomenon is more common in persons visiting third-world countries than in developed countries.

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Family size is another important variable that can be explored in this descriptive epidemiological analysis on tuberculosis. Individuals who come from large families are often deprived of some resources, such as access to the best quality healthcare facilities. Such cases are often witnessed in third-world countries, where there are large numbers of families. Indeed, such large families put a lot of pressure on the resources available to the members. This limits the families’ capability to finance the medical bills of their members, thus making them prone to more infections since tuberculosis is an infectious disease that is easily transmitted from one ‘tuberculous’ person to another. However, the situation is completely different in developed countries, where the family sizes are smaller than those of the developing countries. In such developed nations, families can easily afford medical bills for their members, but this is not possible in third-world countries. Following this argument, it is, therefore, possible that there can be new cases of tuberculosis, which are more prevalent in persons visiting third world countries as opposed to developed countries.

Literature Review

The following chapter contains a summary of the research regarding causes of tuberculosis in human beings that are appropriate for students studying Ph.D. in business and economics. There is extensive theoretical literature on tuberculosis in human beings ranging from position statements to scientific research data, which was deemed appropriate for the understanding of this study. The literature review covers several thematic areas concerning the causes of tuberculosis prevalence. The review of literature covers many thematic areas related to the causes of tuberculosis in human beings, focusing on species identification. Dissertations, journal articles, and books were consulted for this review

Tuberculosis is an infectious disease that occurs in many parts of the globe. Anon (1992) ascertained that a current publication of the World Health Organization (WHO) reported that “about a third of the world population is harboring the pathogen” (Pfeiffer, 1994, p.9). The main cause of T.B in human beings is attributed to Mycobacterium tuberculosis. However, Mycobacterium Bovis was regarded as the major cause of tuberculosis during the 19th century. Mycobacterium Bovis effect became less severe after the nineteenth century, especially when a breakthrough was made in controlling its spread from cattle. The WHO further reported that “in humans there are about 20 million active cases of tuberculosis in the world, who probably infect 50 to 100 million people (mainly children) annually” (Pfeiffer, 1994, p.9). These were worrying statistics, which would call for more detailed reaches on some urgent medical attention and preventive measures to curb this rising tuberculosis pandemic that was rapidly taking a toll on human lives in several parts of the world. To support this claim, Stead and Dutt (1988) postulated that “about 3 million die due to the disease every year, at least 80% in developing countries” (Pfeiffer, 1994, p.9 ). As a result of these statistical findings, more routine species identification would be necessary. This argument has also been supported by Pritchard (1988), who emphasized that “as species identification is not carried out routinely, it is difficult to estimate the present contribution of Mycobacterium bovis to total tuberculosis morbidity and mortality in humans” (Bovisfer, 1994, p.9). Therefore, it is evidenced that routine checks on the identification of species are necessary, especially in ascertaining whether the new tuberculosis cases are more prevalent in those individuals visiting third world countries than those of the developed countries.

Even though Pritchard has emphasized the need to embrace the routine task of identifying species, there are some limitations on his study since he failed to provide procedures that can be employed in carrying out this. It could be of more importance if the writer engaged the readers of this literature on the procedure used for species identification. Therefore, more study would be required in this area. Moreover, it is important to realize that every research should be detailed in accounting for each element used to explore the research problem. Though researches are often subject to further studies, it is more than necessary to provide the readers with sufficient literature on the problem of study.

In his literary analysis, “Schlisser (1985) explored the epidemiology of bovine tuberculosis in humans” (Pfeiffer, 1994, p.12). This scholar “emphasizes the importance of aerogenous as good ads alimentary transmission from cattle to humans” (Pfeiffer, 1994, p.12). This recent finding on the transmission of tuberculosis is contrary to the traditionally viewed knowledge that tuberculosis infections in human beings came as a result of consuming milk from infected cattle. To substantiate his claim, Schliesser argues from the works of Schmiedel (1970), suggesting that “due to its high-fat content which increases absorption into the lymph system, milk represents an ideal medium for alimentary transmission” (Pfeiffer, 1994, p.12). He further reaffirmed this position that “the accepted fact that pasteurization kills pathogenic bacteria in milk if the correct procedures are followed” (Pfeiffer, 1994, p.12).

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It is important to emphasize that milk consumption is not the main cause of tuberculosis in human beings. According to Schliesser:

meat from tuberculosis animals may constitute a significant risk of infection if available for consumption” (Pfeiffer, 1994, p.12). These statements prove that not only milk consumption but also consuming meat from infected cattle transmit tuberculosis from such animals to human beings. Arguably, it is evidenced that this research focused more on the causes of tuberculosis transmission, but it failed to incorporate various types of tuberculosis strains. Moreover, it would be important to establish causal links between the modes of tuberculosis transmission and the research problem.

Proposed Research Methodology

Under this section of the report, the proposed methodology includes various components, which are explored in the following paragraphs.

Description of the proposed study design

A quantitative research design will be used to gather feedback, especially from international flight passengers regarding their tuberculosis experiences while visiting both third-world countries and developed countries. The selection of a quantitative approach for the present study was deemed suitable because the process could provide a representation of the lived experiences of participants (Abusabha & Woelfel, 2003). Abusabha and Woelfel contended that the perceptions of participants allow the researcher to gather, analyze, and report information that is free of bias. Abusabha and Woelfel noted that “quantitative researchers argue that, in the absence of close connection with the object of study, results will be distorted” (p. 566); thus, the present study incorporated phone surveys. The present study on tuberculosis was focused on an approach with which to understand a phenomenon perceived by participants, to test a hypothesis with a numerical construct.

Measurements of Tuberculosis

Analytical epidemiology focuses on assessing reasons behind high/low tuberculosis frequencies in a particular population. To this extent, the epidemiological measurement includes two to three variables. To measure the relationship strength of tuberculosis, odds ratios, as well as relative risks, are employed. The relative risk can be calculated as shown below:

Relative risk (RR) = incidence rate of tuberculosis among the exposed individuals divided by incidence rate of this disease among the unexposed persons

  • RR = (a/a+b)/(c/c+d)

Where:

  • a = the number of people with tuberculosis who are exposed
  • b = the number of people without tuberculosis who are exposed
  • c = the number of people with tuberculosis who are not exposed
  • d = the number of people without tuberculosis who are exposed

Moreover, this study on tuberculosis is essential since it is a health disorder that affects several parts of the world. As a result, it is possible to understand its causes and find preventive measures for this pandemic. In addition, several people often travel to different parts of the world, thus making them prone to contracting tuberculosis from other areas that they visit. Therefore, it is necessary to establish whether new cases of tuberculosis are more prevalent in persons visiting third-world countries than in other developed countries.

Description of the study population

The sample would be drawn from the population being studied that will be selected to be representative of the entire population. Therefore, the numerical data that will be gathered from quantitative surveys would be a true reflection of the population. The sample group would consist of flight passengers who travel to other parts of the world. On the other hand, flight passengers who travel locally will also be used as control cases in the experiment.

Description of sample size and sampling method

Sampling is the process by which the researcher chooses a representative sample from an entire population. The number of flight passengers runs up to millions worldwide, thus it would be impractical to examine all. Therefore, to conduct internet surveys with the majority, the researcher would choose participants through the extraction of a sample that was representative of the entire population. In this regard, an alpha error of 5% (0.05) or 95% level of confidence would be more appropriate for the chosen sample size.

Description of data sources or data collection methods

Data can be obtained from secondary sources such as books and journals on the research problem. The data will be collected using the two identified methods, which are purposive sampling and survey. These methods of data collection would be preferred because they are cheap to execute and can reach a large number of participants. For example, internet and mail surveys will be explored because they reach as many respondents as possible due to a large number of internet users of the internet around the globe. Since the respondents will fill the forms without intimidation or being forced, the responses will be significant as they will reflect the person’s inner feelings about the particular questions (Gardener, 2011). Similarly, purposive sampling would be very useful since only the people considered to be endowed with appropriate information and ideas about the matter being investigated.

Description of independent and dependent variables

This can be presented in the following table.

Variable Variable type
Family size Discrete
Social class Ordinal
Occupation (independent) categorical
Sex dichotomous

Description of analytic methods

This analysis has been shown in the table below.

Analytical method Variable
Family size Regression analysis
Social class Chi-square
Occupation ANOVA test (multivariate)
Income T-test statistic
Sex Regression analysis (bivariate)

Statistical analysis of the above variable can be represented in the following table. This can be done using T-Statistic, which has been fully explored in the excel workings (attached). This has been done to determine the association between the levels of income and the occurrence of new tuberculosis cases in both developed and third world countries. The numerical data has been gathered from the survey samples.

Potential Limitations of Studies

The scope of the research was within the establishment of the new cases of tuberculosis and its causes. In addition, the research ascertains whether the new tuberculosis cases are more prevalent in persons visiting third world countries as opposed to developed countries. This study was limited to participants in flight traveling and did not include those individuals who travel by other means of transport.

A major limitation was that most participants were deeply engrossed in in-flight activities, leaving little room for participation in such research. For this reason, mail surveys could only be done after prior appointments and follow-ups. These limitations did not degrade the quality of research because the procedures and requirements of the research were well defined. The extra information gained about participants’ experiences in tuberculosis cases as a result of traveling to different economically empowered parts of the world created a wealth of knowledge essential to the entire research.

Another limitation in the data recording and analysis was the fact that most of the responses that participants gave were coded in general terms that, at times, obscured the finer points of the response. For example, the contraction of tuberculosis as a result of traveling to third-world countries was as varied as the number of respondents. However, only four codes were used, limiting the recognition of creative and unique responses. Additionally, a single participant could offer more than one response to a particular question, but the cases could only accommodate a single attribute per case. Moreover, the use and incorporation of multiple responses to the casebook were limited, and the trends for a single attribute could not be expressed as percentages.

In this context, it is also important to explore an explanation about the researcher’s own experiences with the proposed study design of this case. This considered the context and circumstances that have influenced the researcher’s involvement in analyzing this study problem on tuberculosis. This kind of self-reflection serves as a personal statement to discuss the researcher’s role during the study (Davies, 2007), allowing him/her to look back and focus on the importance of the research problem to the chosen field of study. Moreover, the purposive sampling method, which had been employed in this research failed to provide a representative result. Therefore, it was difficult to produce more refined research. Besides, more quantitative data analysis would be necessary for this research problem. Finally, there are potential confounding factors in the proposed study such as observation bias and non-responsive respondents. Some respondents dropped out of the exercise before the research project was completed due to limited time and interest to pursue other activities.

References

Abusabha, R., & Woelfel, M. (2003). “Qualitative vs. quantitative methods: Two opposites that make a perfect match”. Journal of the American Dietetic Association, 103(5), 566-569.

Borovecki, A. & Gjenero, I. (2002). Epidemiological Analysis of Tuberculosis in the Kingdom of Croatia and Slavonia during 1901-1910. Web.

Davies, M. (2007). Doing a Successful Research Project: Using Qualitative or Quantitative Methods. New York, NY: Palgrave Macmillan.

Gardener, M. (2011). Data Collection, Exploration, Analysis, and Presentation. London: Pelagic Publishing. 2011.

Pfeiffer, D. (1994). The Role of a Wildlife Reservoir in the Epidemiology of Bovine Tuberculosis. Web.

Tuberculosis and Healthcare Risk Factors
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