NRS 428 Epidemiology Paper

Grand Canyon University NRS 428 Epidemiology Paper– Step-By-Step Guide

This guide will demonstrate how to complete the Grand Canyon University NRS 428 Epidemiology Paper  assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NRS 428 Epidemiology Paper     

Whether one passes or fails an academic assignment such as the Grand Canyon University NRS 428 Epidemiology Paper depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NRS 428 Epidemiology Paper     

The introduction for the Grand Canyon University NRS 428 Epidemiology Paper  is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NRS 428 Epidemiology Paper     

After the introduction, move into the main part of the NRS 428 Epidemiology Paper assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NRS 428 Epidemiology Paper     

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NRS 428 Epidemiology Paper     

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer For NRS 428 Epidemiology Paper

Epidemiology Paper: Measles 

Measles, also referred to as Rubeola, is an acute and highly contagious disease that mainly affects children. Measles is a major cause of child mortality in developing countries. However, measles can affect individuals of all ages. At least 90% of measles secondary infection rates occur in susceptible domestic contacts. This paper discusses measles, including causes, symptoms, transmission, complications, treatment, and demographics, and how social determinants contribute to the disease. The paper will also explore the role of the community health nurse and agencies in addressing measles and the global implication of the disease.  

Description of Measles 

Causes 

The Measles virus causes measles. It belongs to the genus Morbillivirus in the Paramyxoviridae family. The virus is single-stranded with a negative-sense and is usually enclosed in the RNA iris (WHO, 2019). The virus is highly infectious, and almost all infected persons develop clinical illness.  

Symptoms 

The symptoms of measles depend on the nutritional status of the patient. The onset of measles symptoms occurs 7-14 days after exposure to the virus (Odei, 2018). The first clinical manifestation is a high fever of above 104⁰ F that usually lasts for 4-7 days (WHO, 2019). The prodromal phase manifests with symptoms of fever, malaise, loss of appetite, cough, conjunctivitis, and coryza (Odei, 2018). The characteristic manifestation of enanthem occurs 2-4 days after the start of the prodromal phase and lasts for 3-5 days, marked by Koplik spots inside the cheeks. Exanthema occurs 1-2 days after the occurrence of Koplik spots and is associates with mild pruritus (WHO, 2019). Exanthema presents with a rash that first develops on the face and upper neck.  After 24 hours, the rash spreads to the chest, abdomen, and extremities. The rash has a systematic pattern and has a similar appearance in all body regions.  

Well-nourished and slightly underweight children generally have uncomplicated measles. It presents with fever, conjunctivitis, rhinitis, cough, koplik spots, stomatitis, and skin rash (Odei, 2018).  On the other hand, complicated measles occurs in malnourished and underweight children. It presents with nasal flaring, tachypnea, dyspnea, hoarse voice, barking cough, inspiratory stridor, skin rash, anorexia, vomiting, diarrhea, keratitis, photophobia, convulsions, and ear discharge.                                              

Mode of Transmission 

The Measles virus is transmitted by a sneeze- or cough-produced respiratory droplets through invisible droplets produced in the respiratory tract of an infected individual. Respiratory droplets remain active and contagious for almost two hours (WHO, 2019). The virus disseminates fast and infects the skin and the cells lining the mouth, throat, lungs, eyes, and gastrointestinal tract (Odei, 2018). The measles virus impairs the immune system for a long period after the onset of the disease, putting one at risk of infections. 

Complications 

Complications of measles occur more in individuals below five years or older than 30 years. Complications occur in various body systems, including the respiratory, neurological, gastrointestinal, eyes, and ear-nose-throat (Odei, 2018). Common complications of measles include pneumonia, croup, and encephalitis, and the major causes of measles-related death. Patients also develop gastroenteritis, convulsions, meningitis, conjunctivitis, and otitis media (Odei, 2018).  A patient can also develop Xerophthalmia, which is an ophthalmic condition characterized by dryness of the conjunctiva ad cornea. 

Treatment 

There are no Antiviral drugs available for the treatment of measles. Treatment of measles involves supportive care (WHO, 2019). Persons with uncomplicated measles are usually managed on an outpatient basis, whereas those with complicated measles are treated as inpatients. Supportive management involves maintaining hydration, and replacement of fluids lost through emesis and diarrhea (WHO, 2019). For children, the caregiver should be advised to provide the child with adequate fluids and light, nutritious diet. IV rehydration is given in patients with severe dehydration. Paracetamol is administered to relieve pain and fever. Children with complicated measles should be admitted and be provided with a balanced diet to improve their nutritional status. They should be weighed to assess the nutritional status, and the caregiver should be instructed to bring the child to the clinic daily for follow up. 

Vitamin A should be administered to speed up recovery of measles and prevent complications such as Xerophthalmia. The recommended Vitamin A doses for children diagnosed with measles include: Infants below six months should be administered with two doses of 50,000 IU per day; 6-11 months two doses of 100,000 IU per day, and above one year two doses of 200,000 IU per day (Odei, 2018). Besides, children with clinical signs of Vitamin A deficiency should be administered with the first two doses as per the age then a third dose based on the child’s age after 2-4 weeks.  

Demographic of Interest 

The population at the highest risk of contracting measles are children below three years who are either non-immunized or malnourished. The viral load that one gets from an infected person determines the severity of the disease. Consequently, children living in overcrowded houses and are in close contact with an infected person during the infective period obtain a high measles viral load (WHO, 2019). They are highly likely to develop severe measles leading to high mortality rates. Unvaccinated males and females have equal susceptibility rates to infection by the measles virus (WHO, 2019). However, high mortality rates secondary to acute measles has been observed among females. Measles affects people from all racial groups. 

Morbidity and mortality rates are high in individuals with malnutrition, immune deficiency disorders, vitamin A deficiency, and inadequate vaccination. Mortality rates are higher among children below five years. The highest mortality rates are among children between 4 to 12 months, and in immunocompromised children due to HIV infection or other conditions (WHO, 2019). Post-exposure prophylaxis with Measles virus vaccine or human immunoglobulin is recommended in unvaccinated persons.  

Case Reporting 

Immediate reporting of any suspected case of measles is required in the United States (US). Health providers are obliged to report measles cases to the state department of health. Since endemic measles transmission has been eliminated in the US, measles cases should be reported within 24 hours by the state health department to the Centers for Disease Control and Prevention (CDC) through telephone or e-mail. The state health department is also required to report confirmed cases of measles to the National Notifiable Diseases Surveillance System (NNDSS). The US CDC clinical case definition for reporting a susceptible measles case requires the presence of a generalized rash that has lasted for three days or longer; a temperature of 101⁰F or higher; and presence of cough, conjunctivitis, or coryza (CDC, 2019). When reporting to the CDC, measles cases should be classified as either Suspected, Probable, or Confirmed.   

How Social Determinants of Health Contribute to the Development of Measles 

Social determinants of health (SDOH) refer to complex conditions in which individuals are born, raised, work, play, worship, and age. SDOH include five major areas, education, health care and neighborhood, social and community context, economic stability, and the built environment. Individuals not immunized against measles virus have the highest susceptibility to infection. SDOH has the possibility of affecting measles immunization programs globally (Gastañaduy et al., 2019). Therefore, it is essential to explore the types of SDOH affecting immunization efforts in a country for the state to address them, thus preventing the spread of measles and lower mortality rates.  

SDOH, such as housing and community design, contribute to the spread of measles in individuals living in congested areas such as slums. People living in overpopulated areas are likely to be infected with measles since it is airborne, spread very fast, and can result in outbreaks (Rivadeneira, Bassanesi & Fuchs, 2018). Individuals from low-income countries have a high likelihood of contracting measles due to inadequate health care facilities and inconsistent vaccine supply (Rivadeneira, Bassanesi & Fuchs, 2018). Families that travel for long distances to a health facility and those that lack transportation services often fail to take their children for immunization.  

Furthermore, access to education opportunities contributes to the development of measles since persons with high education levels understand the importance of immunization. As a result, they adhere to immunization guidelines while individuals with low educational levels fail to take children for vaccination due to ignorance on the importance of vaccination (Rivadeneira, Bassanesi & Fuchs, 2018). SDOH, such as availability of resources to meet daily needs, for example, healthy food, determine the nutritional status of an individual (Rivadeneira, Bassanesi & Fuchs, 2018). Individuals with inadequate access to healthy food often end up malnourished, which makes them susceptible to measles. 

The Epidemiologic Triangle of Measles 

Humans are the only known natural hosts of the measles virus. The virus is this spread from person to person. Host factors that increase the risk of infection include infants with diminished passive antibody before they reach the age of measles immunization (Odei, 2018). An immunocompromised state caused by corticosteroid therapy, HIV/AIDS, alkylating agents, or leukemia despite the immunization status. Besides, host factors such as malnourishment, pregnancy, vitamin A deficiency, and underlying immunodeficiency put one at risk of severe measles and complications (WHO. 2019). Environmental factors that favor the spread of the measles virus include temperate weather during spring and late winter.  

Notifications should be done in schools for if a patient is a school-going child since measles is highly contagious. Besides, school-going children are at a high risk since they have not received the second dose of the measles-mumps-rubella (MMR) vaccine (Odei, 2018). It should also be done in the community in situations where no history of contact with a known case can be identified, and if the patient mostly contracted measles from community institutions such as churches. 

The Role of the Community Health Nurse and the Importance of Demographic Data  

A community health nurse (CHN) has the role of conducting case finding by collecting information on the transmission setting such as school or household, the likely source of infection, travel history, and the number of contacts without evidence of immunity (Gastañaduy et al., 2018). The nurse carries out vaccination and recommends quarantine of susceptible contacts without presumptive evidence of immunity.  Furthermore, the CHN has the role of establishing the likely source of infection for every confirmed case. The nurse asks the patient or caregiver about contact with other known cases. In cases where no history of contact with a known case can be identified, the nurse identifies opportunities for exposure to unknown cases (CDC, 2019). For instance, exposures may occur in schools, during travel, or through contact with recent travelers or foreign visitors. 

The CHN has the role of reporting any suspected, probable, or confirmed case of measles to the state department of health. The CHN provides demographic information, reporting sources including state and county, the clinical symptoms, and the outcome of the case, whether the patient survived or died (CDC, 2019). In addition, the CHN collects information on the number of susceptible individuals with no probable immunity. The nurse then analyzes the data to establish what information is available and what still needs to be collected, referred to as information tracking (Gastañaduy et al., 2018). Information tracking is conducted by creating a line that lists all cases to facilitate easy identification of known and unknown data and guarantee complete case investigation. Lastly, the CHN follow-up patients and their contacts to assess disease prognosis and evaluate the development of complications. 

Demographic data help public health officials identify where measles transmission is occurring or likely to occur. This includes households, daycare, schools, health facilities, churches, and institutions. Furthermore, demographic data helps identify individuals at the highest risk of infection or transmission, such as non-immunized children, immunocompromised persons, pregnant women, students, health care personnel, or infants below 12 months (Gastañaduy et al., 2018). The data is used to establish the scope of the investigation and the potential for spread.  It also guides in identifying appropriate interventions using public health judgment to guide investigation and control efforts.  

National Agency/ Organization that Addresses Measles 

The CDC is a health protection agency in the US that addresses measles by helping in reducing the occurrence of the disease and the impact it has on Americans. The CDC provided scientific and technical support to health organizations and countries to help lower measles and rubella deaths (CDC, 2019). Besides, the CDC partners with the Pan American Health Organization to develop a regional measles-elimination strategy in 1996. This significantly led to the elimination of measles and rubella in the Western Hemisphere by 2016. Furthermore, the CDC supports countries to lower the burden of measles by helping in planning at macro-and micro-levels as well as implementation, monitoring, and evaluation of measles and rubella vaccination campaigns in target areas. 

The CDC carries out operational research to generate scientific knowledge that guides the agency in developing recommendations that guide measles- and rubella-control strategies at local, national, and international levels. The agency provides technical assistance in conducting measles outbreak investigations, surveillance, and evaluation of routine vaccination programs. Moreover, it helps create and improve case-based measles surveillance systems that enable countries to identify, monitor, and promptly respond to measles infections (CDC, 2019). The CDC serves as the international reference laboratory for measles and offers resources to national reference laboratories. Lastly, the CDC assists global public health laboratories in collecting and transporting clinical samples for measles testing using real-time polymerase chain reaction. 

Global Implication of Measles and How It Is Addressed in Other Countries  

Measles affects approximately 30 million children annually in developing countries and causes about a million deaths. It has been associated with 15000 to 60,000 cases of blindness every year globally. Although a safe and cost-effective vaccine is available, there were more than 140,000 measles deaths globally in 2018, primarily among children under the age of five (WHO, 2019). Countries are addressing the issue of measles by introducing free immunization programs for children. Immunization has been the key public health strategy to lower measles death and eliminate measles. Countries have a routine immunization program that consists of two MMR vaccination doses (Gastañaduy et al., 2018). Countries with high case and death rates conduct mass immunization campaigns in addition to the routine measles-rubella vaccination.   

Measles is not endemic in the US, and most cases result from international travel (Gastañaduy et al., 2019). However, measles is endemic in many parts of the Americas, Asia, Europe, the Middle East, and Africa (Gastañaduy et al., 2019). Countries with recent measles outbreaks include Thailand, Israel, Ukraine, Vietnam, Japan, the Philippines, DRC, Liberia, Madagascar, and Somalia. 

Conclusion 

Measles is a highly contagious disease caused by the Measles virus that spreads from person to person via respiratory droplets. It mostly affects children below five years but can also affect persons of all ages. Individuals highly susceptible to melees include those that are non-immunized, immunocompromised, pregnant, and malnourished. The typical symptoms of measles include fever, koplik spots, conjunctivitis, cough, and coryza. The characteristic rash of measles can be distinguished from other conditions in that it begins from the face and upper necks and then spreads to the trunk, abdomen, and extremities after 24 hours. Measles is associated with severe complications such as convulsions, severe dehydration, pneumonia, croup, and encephalitis.  SDOH, such as lack of access to health services, low-income countries, poor housing and neighborhood, and inadequate access to healthy foods, contribute to the development of measles.  A CHN has the role of conducting case findings and identifying contact individuals susceptible to developing measles as well as reporting suspected and confirmed cases of Measles to the state department of health. Measles has contributed to high blindness and mortality rates globally, and most countries are addressing this issue through immunization programs. 

References 

Centers for Disease Control and Prevention. (2019). Surveillance manual | Measles | Vaccine-preventable diseases | CDC. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/pubs/surv-manual/chpt07-measles.html 

Centers for Disease Control and Prevention. (2019). Measles. Centers for Disease Control and Prevention. https://www.cdc.gov/globalhealth/newsroom/topics/measles/index.html 

Gastañaduy, P. A., Banerjee, E., DeBolt, C., Bravo-Alcántara, P., Samad, S. A., Pastor, D., Rota, P. A., Patel, M., Crowcroft, N. S., & Durrheim, D. N. (2018). Public health responses during measles outbreaks in elimination settings: Strategies and challenges. Human vaccines & immunotherapeutic, 14(9), 2222–2238. https://doi.org/10.1080/21645515.2018.1474310 

Gastañaduy, P. A., Funk, S., Lopman, B. A., Rota, P. A., Gambhir, M., Grenfell, B., & Paul, P. (2019). Factors associated with measles transmission in the united states during the postelimination era. JAMA pediatrics, 174(1), 56–62. Advance online publication. https://doi.org/10.1001/jamapediatrics.2019.4357 

Odei, M. (2018). Measles is in the news yet again. Journal of family medicine and primary care, 7(6), 1166–1168. https://doi.org/10.4103/jfmpc.jfmpc_234_18 

Rivadeneira, M. F., Bassanesi, S. L., & Fuchs, S. C. (2018). Role of health determinants in a measles outbreak in Ecuador: a case-control study with aggregated data. BMC public health, 18(1), 269. https://doi.org/10.1186/s12889-018-5163-9 

World Health Organization. (2019). Measles. WHO | World Health Organization. https://www.who.int/news-room/fact-sheets/detail/measles 

Sample Answer 2 NRS 428 Epidemiology Paper

 There is a significant impact that communicable diseases, such as tuberculosis, HIV/AIDS, and influenza, have on the population of the entire world. The rate of transmission and the severity of communicable diseases are both significantly influenced by factors such as globalization. For instance, the status of human interactions is always shifting, which can have an impact on the way infectious diseases are disseminated across the world. The primary responsibility of reducing the incidence and severity of communicable diseases in their respective populations falls on the shoulders of nurses and other healthcare professionals. They utilize primary, secondary, and tertiary health promotion methods in order to empower those who are affected and those who are at risk to make changes to their lifestyles and behaviors. In addition to this, they choose interventions that are examples of best practices and improve care outcomes in terms of factors such as safety, quality, and efficiency. As a result, the epidemiology of HIV/AIDS is the topic that will be investigated in this paper. 

Description of the Communicable Disease  

HIV/AIDS is the main infection/illness that will make the major part of this discussion. The viral infection known as HIV/AIDS is caused by the human immunodeficiency virus. It makes the immunological system of the body its main target. In the absence of therapy, it is possible for the virus that causes acquired immunodeficiency syndrome to progress (AIDS). Those who have HIV or AIDS encounter a wide range of symptoms throughout the stage of the illness known as the symptomatic phase. There are a range of symptoms associated with HIV/AIDS, and they can differ depending on the stage of infection. Early symptoms may include fever, rash, fatigue, enlarged lymph nodes, and sore throat (Dumais, 2017). As the infection progresses, people may develop more severe symptoms such as fevers that don’t respond to medication, significant weight loss, recurring infections, and problems with the nervous system. AIDS is the most advanced stage of HIV infection, and can lead to debilitating illnesses and death. Patients often include fast weight loss, pneumonia, skin rashes, and neurological conditions including depression and memory loss. 

HIV is most commonly spread through sexual contact and the exchange of physiological fluids containing the virus, such as semen, vaginal fluid, or blood. It can also be spread through contact with infected mucous membranes, such as the inside of the mouth or rectum. HIV can be spread from mother to child during pregnancy, labor and delivery, or breastfeeding. It can also be spread through needle sharing among intravenous drug users. And finally, it can be acquired through a blood transfusion or organ transplant if the donor is infected with HIV. While bringing the pregnancy to term and again after the baby is born, the mother may directly transmit the virus to the growing fetus. A history of STDs, injecting drugs, a large number of sexual partners, and participating in sexual activity without using protection are all risk factors for HIV and AIDS. There are many issues that are related to HIV/AIDS. This group of illnesses includes pneumocystis pneumonia, cryptococcal meningitis, CMV, toxoplasmosis, candidiasis, and tuberculosis. Along with frailty, liver disease, renal disease, diabetes, and malignancies unrelated to AIDS, patients are also more likely to have these conditions (Capriotti, 2018; Dumais, 2017). Currently, there is no HIV/AIDS therapy or cure. On the other hand, antiretroviral drugs are used to treat patients and they lower the level of virus that is present in the body. Treatments for symptoms of illnesses including oral candidiasis, meningitis, and pneumonia are also used to stop further immune suppression. 

The data that are now available show that HIV/AIDS is a problem for both national and international health. Statistics show that in 2019, there were 34 800 newly discovered cases of HIV/AIDS. It was an 8% drop from the incidence rate of the prior year. The age group with the greatest infection rate was 45 to 54 years old, followed by 35 to 44 year olds as the second highest age group. In the US, there are 1.2 million persons living with HIV/AIDS, of whom 13% are uninformed of their infection status. The demographics most affected by HIV/AIDS in the United States include those from underrepresented groups, such as homosexual men, bisexual men, and other males who have sex with other men (HIV.GOV, 2021). A sickness like HIV/AIDS must be disclosed. Healthcare institutions report cases of HIV/AIDS that have been clinically identified to the National HIV Surveillance System, which is maintained by the CDC, as well as to the health departments of the individual states. The instances are reported once the patients have been diagnosed. 

Social Determinants of Health 

The term “social determinants of health” refers to the factors that can be changed but still contribute to health disparities. Social determinants of health are things that are present in the environments in which people are born, where they live, where they work, and where they thrive. The HIV/AIDS epidemic is linked to a number of factors that determine health. Ethnicity is one of these factors (Hogan et al., 2021). The number of people living with HIV/AIDS is significantly higher in certain ethnic groups, including African Americans. A person’s socioeconomic status, as well as their level of poverty, is yet another social factor that influences their health. As a consequence of this, the prevalence of HIV and AIDS is high among people who come from families with low socioeconomic status. They are more likely to contract sexually transmitted infections, such as HIV/AIDS, due to certain risky behaviors, such as engaging in risky sexual activities. 

Employment position is an additional social component that influences health in the case of HIV and AIDS. The work position of a person affects both their socioeconomic situation and their ability to get inexpensive health care. People who are unemployed are more prone than those who are working to participate in dangerous activities like drug use and prostitution, which increases their risk of contracting HIV. The HIV infection rate is often greater among the jobless as a result of this. The degree of education a person has is another crucial social factor of health when discussing HIV/AIDS. There have been reports of increased HIV/AIDS infection rates in communities where the average level of education is low (Friedman et al., 2018). The population’s degree of education has an impact on a variety of factors, including the population’s awareness, employment, and socioeconomic position. Another issue that adds to inequality among those with HIV/AIDS is access to care. Due to a lack of health insurance and inability to pay for treatment, it is expected that a large number of HIV/AIDS diagnoses will be recorded among communities with restricted access to healthcare. Delays in early diagnosis and treatment start are among the variables that contribute to poor outcomes in HIV/AIDS care. The population’s degree of awareness on how to limit the spread of HIV/AIDS has been proven to be impacted by low access to healthcare services (Santos et al., 2018). Because of this, it is crucial to implement interventions that focus on the socioeconomic variables leading to the spread of HIV/AIDS in order to enhance population health. 

Epidemiological Triangle 

An epidemiological triangle is a technique that helps researchers better understand how infectious diseases spread among people. It clarifies the intricate connections between infectious disease pathogens, their hosts, and the settings they live in. The agent is the name for the microbe that is the cause of the illness. In the context of HIV/AIDS, a virus is the infectious agent that causes the illness. The most prevalent kind of the virus that may lead to HIV/AIDS is called HIV-1 (Gopalappa et al., 2017). HIV-2 is a rare virus with modest virulence with signs and symptoms similar to HIV-1. A variety of HIV-related variables have an impact on the virus’s capacity to infect a host. They include virulence, often referred to as pathogenicity, and dosage. A disease-causing microorganism’s pathogenicity refers to its ability to really cause illness. The HIV virus has a high degree of virulence since it may infect and spread throughout the host. A dosage is a measurement of a pathogen’s amount or concentration (a microbe that causes sickness) (Gopalappa et al., 2017). The majority of the time, HIV is present in high concentrations, which increases its ability to infect and spread throughout the host. HIV is spread from one person to another by direct contact between hosts and infectious fluids, such as blood, vaginal secretions, or sperm. 

In the epidemiological triangle, the term “host” refers to the person who is carrying the disease. It is a reference to the people whose lives have been altered by HIV/AIDS. Their susceptibility to HIV infection and the subsequent progression of AIDS is influenced by a number of host factors. The state of one’s immune system is one of them. People with weakened immune systems have an increased likelihood of becoming infected with HIV. There is a high likelihood of viral invasion, further multiplication, and subsequent suppression. The individual behaviors of the hosts are another factor related to the hosts. The risk of the host being exposed to the agent is increased by behaviors such as having sexual contact without protection, having a large number of sexual partners, and injecting drugs while sharing needles, among other things (Mahdavi et al., 2021). Another host-related risk factor for HIV and AIDS is the possibility of becoming pregnant. Infected pregnant women have an increased risk of passing the virus on to their unborn children either through mother-to-child transmission, which can occur during delivery and breastfeeding, or through mother-to-baby transmission. People who already have a medical condition are at a greater risk of contracting HIV/AIDS than those who do not have a medical condition. Comorbidities that are already present in patients lower their immune status, which in turn increases their susceptibility to the agent. Patients receiving standard treatments for cancer are at an increased risk of contracting HIV due to the suppression of their immune systems caused by these treatments (Joas et al., 2018). Patients who are receiving blood transfusions and those who have been involved in car accidents are also at risk because of their contact with contaminated fluids. 

The word “environment” describes the different external factors that affect the epidemiologic epidemic. Environmental elements, in addition to the host and the infectious agent, contribute to the spread of the illness. The environmental variables that contribute to the transmission of HIV/AIDS include places with a high frequency of sexually transmitted infections and poor levels of reporting (Dumais, 2017). Situations like this promote the spread of the HIV/AIDS pandemic. Socioeconomic variables, such as poverty, also contribute to the spread of HIV/AIDS since they make it harder to get the essential therapy. Another thing that deters people from enrolling in testing and treatment programs is when people with HIV/AIDS experience stigma or social isolation (Dumais, 2017). They are to blame for the increased pace of the disease’s population-wide spread as a direct consequence of this. 

Role of the Community Health Nurse 

Community health nurses have a number of roles in the epidemiological treatment and prevention of HIV/AIDS. One of the responsibilities involved is case discovery. The search for cases entails looking for those who have had HIV/AIDS as well as those who are at risk. The community health nurse conducts population screens in order to find the patients. She also outlines the susceptible groups, which might include those who are transgender, misuse alcohol or drugs, have several sex partners, or participate in unprotected sexual activity, such as those who work in the sex industry (Mottiar& Lodge, 2018). The nurse educates the vulnerable population on HIV/AIDS prevention strategies as well as the need of being screened and starting treatment for cases as soon as they are found. 

A case that has been detected must also be reported to the proper authorities by the community health nurse. To correctly estimate the prevalence, incidence, and severity of HIV/AIDS in a specific community, data must be gathered and reported. The information is useful in figuring out how to best provide the people with resources linked to HIV/AIDS. The nurse is also in charge of gathering information on HIV/AIDS in the general community (Knettel et al., 2021). The information provided by the data provided insights on the severity, prevalence, and trends of the illness in the community. In order to provide a true picture of the illness pattern, distribution, and burden throughout the community, the nurse will do an analysis on the data that was gathered. The nurse will also share the studied data with the general public, healthcare professionals, and public health authorities in an effort to motivate individuals to take action. Presenting results to communities, publishing findings in journals, presenting findings at conferences, and creating new policies based on study findings are all examples of effective dissemination tactics. Additionally, the community health nurse is in charge of case follow-up. Follow-up is conducted to make sure infected individuals continue to take their medications as directed and to look for any additional needs that could affect the outcome of treatment (Knettel et al., 2021). As a consequence, community health nurses must play a crucial role in the epidemiological treatment of HIV/AIDS. 

National Agency 

A national organization called UNAIDS fights HIV/AIDS both in the US and in other countries across the globe. UNAIDS is a worldwide program that was started to spearhead efforts to eliminate HIV/AIDS by the year 2030 within the framework of the global Sustainable Development Goals. The organization takes special pride in its capacity to encourage leadership in the battle against HIV/AIDS at all levels—regional, global, national, and local (UNAIDS,2021). The organization acts as a global issue solution by integrating communities affected by HIV/AIDS in the decision-making process. Additionally, it carries out and keeps track of response activities in the war against HIV/AIDS. The group collaborates with other countries and communities to develop strategies that are successful in ending HIV/AIDS. It also campaigns for the adoption of policies to eliminate the political and legal barriers that prevent effective HIV/AIDS response.  

UNAIDS can help patients with HIV and AIDS in a variety of ways. First, it encourages individuals who are afflicted by the illness and those who are at risk of developing it to have access to treatment and preventative services (UNAIDS,2021). Increasing patient access to antiretroviral drugs for the treatment of HIV/AIDS would be an excellent illustration of this. In the battle against HIV, UNAIDS also defends the rights of the patients. It ensures that their needs will be given top consideration in the formulation and application of policy. Additionally, it supports initiatives aimed at enhancing the quality of life for HIV patients, including as social and gender-based rights protections and educational initiatives.  

Global Implication 

Globally, the expansion of HIV/AIDS has a detrimental impact. According to estimates, there are over 38 million persons living with HIV/AIDS worldwide. It contributes to the spread of illness since the vast majority of persons affected globally lack access to treatment or preventative programs. A reduction in quality of life is experienced by HIV/AIDS patients and those who are important to them. Patients with opportunistic infections must stay in the hospital for extended periods of time, which may be difficult for both the patient and their loved one (Navon, 2018). As a direct consequence of having to visit the hospital often and being admitted, the productivity of the patients and their families is negatively impacted. 

Due to HIV/AIDS, the world’s nations are also suffering severe financial consequences. For instance, the US spent more than $34.8 billion on HIV/AIDS prevention and treatment initiatives in 2019. (KFF, 2021). Dieleman et al. (2018) report that from 1995 to 2015, the annualized rate of healthcare expenditure per person related to HIV/AIDS grew. From 1995 to 2015, there was a rise in this. Both upper-middle income countries and low-middle income countries saw the greatest rates of growth. As a result of the rise, $9.1 trillion was spent on healthcare globally to combat and cure HIV/AIDS. 

Another cause of death that contributes significantly to global mortality is HIV/AIDS. For instance, a study released by UNAIDS estimates that since the start of the epidemic, 47.8 million individuals have died as a consequence of HIV/AIDS-related infections. Additionally, 680000 people died in 2020 as a result of HIV-related diseases. n.d. (UNAIDS). UNICEF (2021) estimates that 330 children would die from diseases associated with HIV/AIDS per day in the globe in 2020. A number of causes contributed to the majority of child fatalities, with inadequate access to HIV treatment and prevention being the most important. Several nations have put different initiatives into place to fight HIV/AIDS. One of the methods that has been put into practice in the majority of nations is expanding access to treatment by making antiretroviral medications free to use. Having access to therapy increases the overall quality of life and longevity of those who are afflicted (Chenneville et al., 2020; Mandsager et al., 2018). Furthermore, there are no fees involved with being tested for HIV/AIDS. Both free HIV testing and health education programs are available to the general population. In order to alleviate dietary inadequacies, the population also gets help in the form of nutritional aid. 

Conclusion 

The HIV/AIDS pandemic has a considerable impact on worldwide disease burden. The presence of the host, the infectious agent, and environmental elements that contribute to its worldwide spread are revealed via analysis employing epidemiological methodologies. In the battle against HIV/AIDS, the community health nurse is in charge of a number of tasks. You will be in charge of locating cases, gathering information, running analysis, sharing it, and keeping in touch with patients in this position. Numerous problems that are linked to HIV/AIDS add to the increased urgency with which confirmed individuals must be treated. To reduce the possibility of the illness spreading among such communities and its harmful impacts, vulnerable people should be given priority when making choices concerning public policy. Organizations like UNAIDS play crucial supportive roles in the battle against HIV/AIDS. National governments and international organizations should collaborate to implement policies that will reduce the incidence and prevalence of the illness in order to enhance public health and stop the spread of HIV/AIDS. 

References 

Capriotti, T. (2018).HIV/AIDS: An Update for Home Healthcare Clinicians.Home Healthcare Now, 36(6), 348–355. https://doi.org/10.1097/NHH.0000000000000706 

Chenneville, T., Gabbidon, K., Hanson, P., & Holyfield, C. (2020).The Impact of COVID-19 on HIV Treatment and Research: A Call to Action.International Journal of Environmental Research and Public Health, 17(12), 4548. https://doi.org/10.3390/ijerph17124548 

Dieleman, J. L., Haakenstad, A., Micah, A., Moses, M., Abbafati, C., Acharya, P., Adhikari, T. B., Adou, A. K., Kiadaliri, A. A., Alam, K., Alizadeh-Navaei, R., Alkerwi, A., Ammar, W., Antonio, C. A. T., Aremu, O., Asgedom, S. W., Atey, T. M., Avila-Burgos, L., Awasthi, A., … Murray, C. J. L. (2018). Spending on health and HIV/AIDS: Domestic health spending and development assistance in 188 countries, 1995–2015.The Lancet, 391(10132), 1799–1829. https://doi.org/10.1016/S0140-6736(18)30698-6 

Dumais, N. (2017). HIV/AIDS: Contemporary Challenges.BoD – Books on Demand. 

Friedman, E. E., Dean, H. D., &Duffus, W. A. (2018). Incorporation of Social Determinants of Health in the Peer-Reviewed Literature: A Systematic Review of Articles Authored by the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Public Health Reports, 133(4), 392–412. https://doi.org/10.1177/0033354918774788 

Gopalappa, C., Farnham, P. G., Chen, Y.-H., &Sansom, S. L. (2017).Progression and Transmission of HIV/AIDS (PATH 2.0): A New, Agent-Based Model to Estimate HIV Transmissions in the United States.Medical Decision Making, 37(2), 224–233. https://doi.org/10.1177/0272989X16668509 

HIV.GOV. (2021, June 2). U.S. Statistics. HIV.Gov. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics 

Hogan, J. W., Galai, N., & Davis, W. W. (2021).Modeling the Impact of Social Determinants of Health on HIV.AIDS and Behavior, 25(2), 215–224. https://doi.org/10.1007/s10461-021-03399-2 

Joas, S., Parrish, E. H., Gnanadurai, C. W., Lump, E., Stürzel, C. M., Parrish, N. F., Learn, G. H., Sauermann, U., Neumann, B., Rensing, K. M., Fuchs, D., Billingsley, J. M., Bosinger, S. E., Silvestri, G., Apetrei, C., Huot, N., Garcia-Tellez, T., Müller-Trutwin, M., Hotter, D., … Kirchhoff, F. (2018). Species-specific host factors rather than virus-intrinsic virulence determine primate lentiviral pathogenicity. Nature Communications, 9(1), 1371. https://doi.org/10.1038/s41467-018-03762-3 

KFF. (2021). U.S. Federal Funding for HIV/AIDS: Trends Over Time. 6. 

Knettel, B. A., Fernandez, K. M., Wanda, L., Amiri, I., Cassiello-Robbins, C., Watt, M. H., Mmbaga, B. T., &Relf, M. V. (2021). The Role of Community Health Workers in HIV Care Engagement: A Qualitative Study of Stakeholder Perspectives in Tanzania.Journal of the Association of Nurses in AIDS Care, 32(6), 682–692. https://doi.org/10.1097/JNC.0000000000000267 

Mahdavi, F., Shams, M., Sadrebazzaz, A., Shamsi, L., Omidian, M., Asghari, A., Hassanipour, S., &Salemi, A. M. (2021). Global prevalence and associated risk factors of diarrheagenic Giardia duodenalis in HIV/AIDS patients: A systematic review and meta-analysis.Microbial Pathogenesis, 160, 105202. https://doi.org/10.1016/j.micpath.2021.105202 

Mandsager, P., Marier, A., Cohen, S., Fanning, M., Hauck, H., & Cheever, L. W. (2018).Reducing HIV-Related Health Disparities in the Health Resources and Services Administration’s Ryan White HIV/AIDS Program.American Journal of Public Health, 108(S4), S246–S250. https://doi.org/10.2105/AJPH.2018.304689 

Mottiar, S., & Lodge, T. (2018). The role of community health workers in supporting South Africa’s HIV/ AIDS treatment programme.African Journal of AIDS Research, 17(1), 54–61. https://doi.org/10.2989/16085906.2017.1402793 

Navon, L. (2018). Hospitalization Trends and Comorbidities Among People With HIV/AIDS Compared With the Overall Hospitalized Population, Illinois, 2008-2014. Public Health Reports, 133(4), 442–451. https://doi.org/10.1177/0033354918777254 

Santos, V. da F., Pedrosa, S. C., Aquino, P. de S., Lima, I. C. V. de, Cunha, G. H. da, &Galvão, M. T. G. (2018). Social support of people with HIV/AIDS: The Social Determinants of Health Model.RevistaBrasileira de Enfermagem, 71, 625–630. https://doi.org/10.1590/0034-7167-2017-0346 

UNAIDS.(2021). Global HIV & AIDS statistics—Fact sheet. Retrieved December 17, 2021, from https://www.unaids.org/en/resources/fact-sheet 

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Sample Answer 3 For NRS 428 Epidemiology Paper

Communicable diseases are a global public health concern with huge disease burden to the population. Nurses and other healthcare providers rely mainly on epidemiological data to determine the severity of a disease and prioritize interventions. Epidemiological data also provides insights into the effectiveness of the public health interventions used to address a disease in the population. Therefore, this essay is an epidemiological and nursing analysis of HIV.

Description of the Chosen Disease

            HIV is the chosen communicable disease. HIV is a viral disease that attacks the immune system. HIV causes AIDs if left untreated. HIV primarily spreads through contact with body fluids such as blood, vaginal secretion and semen. Currently, HIV does not have a cure. However, patients mainly rely on antiretroviral treatment to suppress the viral load. Most patients affected by HIV show symptoms that start as flu-like symptoms within 2-4 weeks of infection. Some patients may not develop any symptoms. The most common symptoms of HIV include sore throat, fever, night sweats, lymphadenopathy, skin rash, muscle aches, fatigue, chills, weight loss, and mouth ulcers among others(Sullivan et al., 2021). The demographic of interest is African Americans. African Americans have the highest rate of people with HIV and new diagnoses as compared to other ethnicities and races. The Centers for Disease Control and Prevention (CDC) report that African Americans account for more than 40% of new HIV infections in the USA. Despite the rate of new HIV infections declining by 8% between 2015 and 2019, it remained stable among the African Americans(CDC, 2022).

Why it is a Reportable Disease

            HIV is a reportable disease. First, HIV is an epidemic. It affects a large proportion of the population with potential of a faster spread in the population if non-responsive interventions are not adopted. HIV is also a reportable disease because it provides accurate data for use in monitoring its trend. The data guides in determining public health initiatives and effectiveness of those adopted to curb its spread in the population(Jeffries &Henny, 2019). The data informs about severity of HIV among the population.

Social Determinants of Health

            Social determinants of health influence HIV rates in the population. They include social and economic marginalization, systemic inequalities, discrimination, and residential segregation. Social and economic marginalization increases the rate of poverty among the population. The affected experience challenges in accessing the care they need. They also fall prey to sex trafficking and substance abuse. Racism and discrimination are the leading factors contributing to the disproportionate rates of HIV among African Americans. Racism and discrimination affect access to educational and employment opportunities and the utilization of healthcare services. Sociodemographic factors such as lack of education lowers awareness about the preventive measures and risks associated with HIV(Jeffries &Henny, 2019; Menza et al., 2021). Therefore, addressing social determinants of health is a crucial step in reducing and preventing HIV in the population.

Epidemiological Triangle

            The epidemiological triangle is a model used to study health problems. The triangle provides a better understanding of the relationship between factors that contribute to disease spread. The triangle has three vertices that represent the agent, host, and environment. The agent refers to the microorganism that causes the disease. The host is the harbor of the disease. The environment is the external conditions that enable disease transmission. The agent in HIV is HIV virus. The host is an individual infected by the HIV virus(Chammartin et al., 2020; Sullivan et al., 2021). The environment include engaging in unprotected sex, exposure to infected fluids such as breast milk or saliva, sharing sharp objects with an infected person, and direct transmission from the mother to the fetus in utero.

Special Considerations

            Hospitals are mandated to report HIV cases to the CDC for analysis and tracking of trends. The CDC shares the data with its health partners, health departments, federal agencies, nonprofit organizations and academic institutions to inform public health initiatives. Specific populations are highly at a risk of contracting HIV. They include men who have sex with other men, bisexuals, gay, transgender women, youth aged between 13 and 24 years, drug users and abusers, and those involved in sex trade(Chow et al., 2019; Sullivan et al., 2021).

Importance of Demographic Data to Community Health

            Demographic data is important to community health. Community health nurses and other stakeholders in health use the data to track trends in health problems in a community. The data can be analyzed to determine if the cases are increasing or decreasing, hence, the adoption of appropriate interventions. Demographic data also provides insights into the effect of social determinants of health on the population. Demographic data such as employment status and level of education provide an accurate picture of the community’s ability to afford the care that they need. Demographic data also guides the allocation of resources to address the health needs of a community. The data informs the prioritization of the scarce resources to meet the needs of the most vulnerable in the community. Demographic data also helps determine the community’s risk of health problems(Khalatbari-Soltani et al., 2020). For instance, data on age, ethnicity, and medical history can enable public health professionals and healthcare providers to predict the susceptibility of the population to specific health problems and the required interventions for health promotion.

Role of the Community Health Nurse

            The community health nurse plays several roles in primary, secondary, and tertiary prevention. One of the roles is screening suspected cases. Screening enables the identification of the populations affected by a problem. The nurse also reports data. The nurse obtains population specific data such as those on the demographic profile for use in analyzing the health needs of the community members. The nurse also analyzes data to provide detailed understanding of the community health and needs. The analysis may be shared with other stakeholders to guide decision-making. The community health nurse can integrate the Christian worldview when working with populations affected by HIV. An example is advocating the adoption of interventions that minimize the risk of unintended harm to the patients(Edelman &Kudzma, 2021). The nurse ensures the adopted care interventions for HIV management are evidence-based to prevent and reduce the potential of harm while optimizing outcomes.

National Agency or Organization

            The USAID is one of the organizations that addresses HIV burden in global states. The organization provides humanitarian efforts with the aim of saving lives, strengthening democracy in governance, and reducing poverty. The organization focuses mainly on improving the lives of the vulnerable populations in the developing countries. USAID helps patients and families affected by HIV. First, the organization providers the technical expertise and leadership needed in supporting HIV-related programs. It also designs and maintains HIV/AIDs service delivery platforms and programs in collaboration with local partners in member states. USAID also leads in the provision of HIV/AIDs prevention, treatment, and management guidelines for HIV(usaid.gov, 2023). Therefore, the organization exists to ensure the use of best practices in HIV management and enhance access to HIV care.

Global Implications of the Disease

            HIV has considerable global impacts. According to the World Health Organization (WHO), HIV is a serious public health concern that has claimed at least 40.4 million people. Some countries globally report increasing trends in infection, which threaten population health. Estimates show that 39 million people were living with HIV globally in 2022. Two-thirds of this population resides in the African region. HIV-related causes contributed to 630000 deaths in 2022 with 1.3 million people acquiring HIV in the same year. HIV also has immense economic impacts on global states(WHO, 2023). Governments incur significant costs in providing the treatments that patients with HIV require. For example, it is estimated that the US government spends more than $28 billion annually in responding to HIV. The expenditure is in forms such as Medicare, Social Security benefits, and Medicare. Countries also incur economic losses due to loss of productivity, premature mortalities, and absenteeism among patients and their significant others. Therefore, HIV has significant impacts on global economies. HIV is epidemic to developing countries as compared to the developed nations. For example, Africa accounts for two-thirds of the HIV rates. It also leads in the rate of new HIV infections.

Conclusion

            HIV is a viral infection that leads to AIDs if left untreated. HIV does not have a cure. HIV is a reportable disease. Social determinants of health contribute to the development of HIV. The epidemiological triangle can be used to understand the concepts related to HIV. Demographic data is important to community health. Community health nurse plays crucial roles in primary, secondary, and tertiary prevention. The USAID addresses HIV and reduces its disease burden. HIV has considerable global implications.

References

CDC. (2022, August 25). HIV and Black/African American People in the U.S. | Fact Sheets | Newsroom | NCHHSTP | CDC. https://www.cdc.gov/nchhstp/newsroom/fact-sheets/hiv/black-african-american-factsheet.html

Chammartin, F., Ostinelli, C. H. D., Anastos, K., Jaquet, A., Brazier, E., Brown, S., Dabis, F., Davies, M.-A., Duda, S. N., Malateste, K., Nash, D., Wools-Kaloustian, K., Groote, P. M. von, & Egger, M. (2020). International epidemiology databases to evaluate AIDS (IeDEA) in sub-Saharan Africa, 2012–2019.BMJ Open, 10(5), e035246. https://doi.org/10.1136/bmjopen-2019-035246

Chow, E. P. F., Grulich, A. E., & Fairley, C. K. (2019).Epidemiology and prevention of sexually transmitted infections in men who have sex with men at risk of HIV.The Lancet HIV, 6(6), e396–e405. https://doi.org/10.1016/S2352-3018(19)30043-8

Edelman, C., &Kudzma, E. C. (2021).Health Promotion Throughout the Life Span—E-Book. Elsevier Health Sciences.

Jeffries, W. L., &Henny, K. D. (2019). From Epidemiology to Action: The Case for Addressing Social Determinants of Health to End HIV in the Southern United States. AIDS and Behavior, 23(3), 340–346. https://doi.org/10.1007/s10461-019-02687-2

Khalatbari-Soltani, S., Cumming, R. C., Delpierre, C., & Kelly-Irving, M. (2020).Importance of collecting data on socioeconomic determinants from the early stage of the COVID-19 outbreak onwards.J Epidemiol Community Health, 74(8), 620–623. https://doi.org/10.1136/jech-2020-214297

Menza, T. W., Hixson, L. K., Lipira, L., &Drach, L. (2021). Social Determinants of Health and Care Outcomes Among People With HIV in the United States. Open Forum Infectious Diseases, 8(7), ofab330. https://doi.org/10.1093/ofid/ofab330

Sullivan, P. S., Johnson, A. S., Pembleton, E. S., Stephenson, R., Justice, A. C., Althoff, K. N., Bradley, H., Castel, A. D., Oster, A. M., Rosenberg, E. S., Mayer, K. H., &Beyrer, C. (2021). Epidemiology of HIV in the USA: Epidemic burden, inequities, contexts, and responses. The Lancet, 397(10279), 1095–1106. https://doi.org/10.1016/S0140-6736(21)00395-0

usaid.gov. (2023, June 15).HIV Prevention, Care & Treatment | Basic Page.U.S. Agency for International Development. https://www.usaid.gov/global-health/health-areas/hiv-and-aids/technical-areas/prevention-care-treatment

WHO.(2023). HIV and AIDS. https://www.who.int/news-room/fact-sheets/detail/hiv-aids