NRS 428 Epidemiology and Communicable Diseases

NRS 428 Epidemiology Paper Essay

NRS 428 Epidemiology and Communicable Diseases

Communicable diseases, including tuberculosis, HIV/AIDS, and influenza, have a considerable effect on the global population. Factors such as globalization significantly impact the spread and severity of communicable diseases. For example, the constant changes in the status of human interactions affect the spread of infectious diseases globally. Nurses and other healthcare providers have the essential role of minimizing the spread and impact of communicable diseases in their populations. They utilize primary, secondary, and tertiary health promotion methods to empower the affected and those at risk to transform their lifestyles and behaviors. They also select best practice interventions that optimize care outcomes, including safety, quality, and efficiency. Therefore, this research paper explores the epidemiology of HIV/AIDS.

Description of the Communicable Disease

HIV/AIDS is the chosen communicable disease. HIV/AIDS is a viral infection attributed to the human immunodeficiency virus. It attacks the immune system of the body. Lack of treatment leads to viral progression to acquired immunodeficiency syndrome (AIDS). People affected by HIV/AIDS experience various symptoms during its symptomatic phase. They include fever, chills, night sweats, rash, muscle aches, swollen lymph nodes, fatigue, sore throat, oral ulcers, and diarrhea that last for a week (Dumais, 2017). Patients also report rapid weight loss, pneumonia, skin blotches, and neurological disorders, including depression and memory loss.

The main transmission mode of HIV/AIDS is through contact with infected fluids, including semen, breast milk, blood, or vaginal secretions. Direct transmission also occurs during the utero life, where the mother transmits the virus to the fetus during pregnancy and delivery. Behaviors such as having multiple sexual partners, injectable drugs, unprotected sex, and a history of sexually transmitted diseases predispose to HIV/AIDS. HIV/AIDS is associated with several complications. They include tuberculosis, cytomegalovirus, toxoplasmosis, cryptococcal meningitis, candidiasis, and pneumocystis pneumonia. Patients are also increasingly predisposed to non-AIDS-related cancers, liver disease, frailty, renal disease, and diabetes (Capriotti, 2018; Dumais, 2017). HIV/AIDS does not have a cure. However, patients are treated with antiretroviral medications that suppress the viral load in the body. Symptomatic treatments for conditions such as oral candidiasis, meningitis, and pneumonia are also used to prevent further immune suppression.

The existing statistics show HIV/AIDS as a national and global health concern. Statistics show that 34800 new HIV/AIDS cases were reportedin 2019. It represented a decline of 8% in the incidence rate. The rate of infections was highest among people aged 45-54 years, followed by those aged 35-44 years. Overall, about 1.2 million people in the USA  have HIV/AIDS, with 13% not knowing their status. The minority groups, including bisexual, gay, and other men that have sex with men, lead in the populations affected by HIV/AIDS in the USA (HIV.GOV, 2021). HIV/AIDS is a reportable disease. Healthcare institutions report diagnosed cases of HIV/AIDS to the CDC’s National HIV Surveillance System and the respective departments of health in different states. The cases are reportedafter they are diagnosed.

Social Determinants of Health

Social determinants of health refer to modifiable factors that contribute to health inequalities. Factors evident in places where people are born, live, work, and thrive act as social determinants of their health. HIV/AIDS is associated with several determinants of health. One of them is ethnicity (Hogan et al., 2021). HIV/AIDS is high in ethnic minorities, including African Americans. Socioeconomic status or poverty is also another social determinant of health. Accordingly, the rate of HIV/AIDS is high among individuals from socio-economically deprived families. Factors such as engagement in risky sexual activities predispose them to sexually transmitted infections, including HIV/AIDS.

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Employment status is also another social determinant of health in HIV/AIDS. Employment status influences an individual’s socioeconomic status, access, and care affordability. The rate of HIV/AIDS tends to be higher among unemployed individuals than employed due to their increased predisposition to risky behaviors, including drug abuse and prostitution. The level of education is also a critical social determinant of health in HIV/AIDS. High rates of HIV/AIDS have been reported in populations with a low level of education (Friedman et al., 2018). Level of education influences constructs such as level of awareness, employment, and socioeconomic status of the population. Access to care also acts as a source of inequality in individuals affected by HIV/AIDS. Populations with limited access to healthcare due to lack of medical insurance coverage and unaffordability of care are likely to report high cases of HIV/AIDS. Factors such as delays in early diagnosis and initiation of treatment contribute to poor outcomes in HIV/AIDS management. Low access to healthcare services also affects the knowledge of the population about the prevention of the spread of HIV/AIDS (Santos et al., 2018). Therefore, it is important that interventions that address the social determinants of health in HIV/AIDS be implemented to promote the population’s health.

Epidemiological Triangle

An epidemiological triangle is a tool used to develop a deeper understanding of the mechanism of an infectious disease in the population. It provides insights into the relationships between agent, host, and environment in infectious disease. The agent refers to the microorganism causing the disease. Concerning HIV/AIDS, the agent causing the infection is a virus. The commonest type of virus causing HIV/AIDS is HIV-1 (Gopalappa et al., 2017). HIV-2 is less common with low virulence and similar symptoms to HIV-1. Factors related to HIV influence its ability to cause infection to the host. They include virulence or pathogenicity and dose. Virulence is the ability of a disease-causing microorganism to cause disease. HIV has a high level of virulence, as it can invade and multiply itself in the host. The dose refers to the amount or concentration of a disease-causing microorganism (Gopalappa et al., 2017). Often, HIV exists in high doses with an enhanced ability to invade and multiply in the host. HIV spreads through hosts’ direct contact with infected fluids, including semen, vaginal secretions, and blood.

Host in the epidemiological triangle refers to the carrier of the disease. It refers to the individuals affected by HIV/AIDS. Several host factors influence their ability to be affected by HIV and the development of AIDs. One of them is immune status. The risk for HIV infection is high in individuals with lowered immunity. The rate of viral invasion, multiplication, and further suppression is high. The other host-related factor is individual behaviors. Behaviors such as engaging in unprotected sex, having multiple sexual partners, and using injected drugs with sharing needles increase the risk of host exposure to the agent (Mahdavi et al., 2021). Pregnancy is also another host-related factor for HIV/AIDS. Pregnant mothers infected with HIV/AIDS have an increased risk of infecting their unborn babies through mother-to-child transmission or during delivery and breastfeeding. Individuals suffering from existing medical conditions are also increasingly predisposed to HIV/AIDS. Co-existing comorbidities low immune status of the patients, hence, their vulnerability to the agent. Patients on existing treatments for malignancies also have a high risk of HIV infection due to their suppressed immunity (Joas et al., 2018). Patients receiving blood transfusions or involved in road accidents are also at risk due to contact with contaminated fluids.

Environment refers to the external factors that affect the epidemiologic outbreak. Environmental factors affect the spread of the disease,not attributed to the host and agent. The environmental factors in HIV/AIDS include communities with a high rate of sexually transmitted diseases and a low level of reporting (Dumais, 2017). Such conditions contribute to the flourishing of HIV/AIDS. Socioeconomic factors such as poverty also contribute to the spread of HIV/AIDS by limiting access to the needed treatment. Social discrimination or isolation of individuals affected by HIV/AIDS also discourages the populations from utilizing screening and treatment services (Dumais, 2017). Consequently, they contribute to the increased spread of the disease in the population.

Role of the Community Health Nurse

Community health nurses have several roles in the epidemiological management and prevention of HIV/AIDS. One of the roles is case finding. Case finding entails the identification of cases affected by HIV/AIDS and the populations at risk. The community health nurse screens the population to identify the cases. She also determines the vulnerable populations, including sex workers, transgender persons, substance and drug abusers, and individuals with multiple sex partners and engaging in unprotected sex (Mottiar& Lodge, 2018). The nurse educates the vulnerable population about the preventive measures against HIV/AIDs and the importance of screening and early treatment for the identified cases.

The community health nurse also reports identified cases to the respective authorities. Reporting is important to determine HIV/ the prevalence, incidence, and severity of HIV/AIDS in specific populations. The data aids in distributing resources for HIV/AIDS to the population. The nurse also collects data related to HIV/AIDS in the population (Knettel et al., 2021). The data provide insights into the severity, spread, and patterns of the disease in the population. The nurse analyzes the collected data to provide an accurate picture of the population’s disease pattern, spread, and burden. The nurse also disseminates the analyzed data to the population, healthcare providers, and public health officials to stimulate action. Dissemination approaches, including community presentations, journal publications, conference presentations, and new policies based on the outcomes, are effective. The community health nurse also undertakes follow-up of cases. Follow-up aims to ensure adherence to treatment by the infected and determine other needs that may affect the treatment outcomes (Knettel et al., 2021). Therefore, community health nurses play crucial roles in the epidemiological management of HIV/AIDS.

National Agency

UNAIDS is a national agency that addresses HIV/AIDS in the USA and other global states. UNAIDS is a global effort initiated to drive efforts to end HIV/AIDS by 2030 as part of the global Sustainable Development Goals. The agency prides itself in inspiring regional, global, national, and local leadership in addressing HIV/AIDS (UNAIDS,2021). The agency acts as a global problem solver by incorporating the populations affected by HIV/AIDS in decision-making. It also delivers and monitors the response initiatives against HIV/AIDS. The agency collaborates with countries and communities to develop appropriate interventions to ending HIV/AIDS and advocate the adoption of measures to address policy and legal barriers to HIV/AIDS response. UNAIDS benefit patients affected by HIV/AIDS in several ways. First, it advocates for access to treatment and preventive services by the affected populations and those at risk (UNAIDS,2021). An example is seen from expanding the access to antiretroviral drugs for HIV/AIDs patients. UNAIDS also advocates the rights of HIV patients. It ensures the prioritization of their needs in policy planning and implementation. It also supports programs to enhance the quality of life of HIV patients, including education, gender-based, and social protection of their rights.

Global Implication

HIV/AIDS has adverse global implications. Statistics show that HIV/AIDS affects about 38 million people globally. It acts as a source of disease burden since most of the affected globally do not access preventive and treatment services. HIV/AIDS affects the quality of life of the affected patients and their significant others. Patients require frequent hospitalizations for opportunistic infections, which can take a toll on them and their significant others (Navon, 2018). The need for frequent hospital visits and hospitalizations also result in declining productivity among the patients and their families.

HIV/AIDS also has huge financial implications for the global states. For example, the USA spent more than $34.8 billion in 2019 treating and combating HIV/AIDS (KFF, 2021). According to Dieleman et al. (2018), there was an increase in the annualized rate of healthcare spending per capita due to HIV/AIDS from 1995 to 2015. The largest growth was reported in upper-middle-income countries and low-middle-income countries. The increase led to $9.1 trillion spent on healthcare globally in treating and combating HIV/AIDS.

HIV/AIDS also contributes to a high percentage of mortalities globally. For example, the UNAIDS report that 47.8 million have died due to HIV/AIDS-related illnesses since its start as a global epidemic. In addition, 680000 people died due to HIV-related illnesses in 2020(UNAIDS, n.d.-a). UNICEF (2021) reports that about 330 children globally died due to HIV/AIDS-related illnesses daily in 2020. Factors such as inadequate access to HIV treatment and prevention contributed to most children’s mortalities.

Countries have adopted several interventions to address HIV/AIDS. One of the interventions adopted in most countries is increasing access to treatment by ensuring free antiretroviral drugs. Access to treatment prolongs the life of the affected and improves their overall quality of life (Chenneville et al., 2020; Mandsager et al., 2018). Screening services for HIV/AIDS are also free. The population can access free HIV testing and health educational services. The population also receives support in nutritional aid to address nutrition-related deficiencies.


HIV/AIDS is an epidemic with a high disease burden globally. Epidemiological analysis shows the presence of the host, agent, and environmental factors that influence its spread globally. The community health nurse plays several roles in addressing HIV/AIDS. The roles include case finding, data collection, analysis, dissemination, and follow-up of patients. HIV/AIDS has several complications, which increase the need for timely treatment of identified cases. Vulnerable populations should be prioritized in policy decision-making to minimize the spread and impact of the disease in them. Agencies such as UNAIDS play vital roles in addressing HIV/AIDS. Countries should collaborate in implementing interventions that reduce the incidence and prevalence rate of HIV/AIDS to promote the health of the public.


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Influenza is a highly contagious respiratory disease caused by influenza viruses. It is commonly referred to as flu. It is a cause of pandemics and epidemics, although it is not so contagious as the common cold. There are many influenza viruses, each causing its disease; some are very similar but different. The symptoms include fever, cough, sore throat, and coryza. Influenza can cause mild to severe illness in people of all ages. The condition, which is particularly quick and vigorous, has been observed to catch people during the fall and winter frequently. Reports indicate that millions of cases are reported worldwide during an epidemic season each year. Therefore, there is a need to prevent the disease. Vaccination is the most appropriate strategy to handle this health challenge. It helps to prevent the spread of the disease during its reach. Hence, according to the local healthcare department’s recommendation, people should seek vaccination yearly. This paper aims to describe influenza in terms of specific demographics, how various determinants of health contribute to its development, and the epidemiology triangle. Similarly, it will focus on the community health nurse’s role, the importance of demographic data, the national organization that works to address the disease, and the global implication.

Comprehensive Description of a Communicable Disease and the Demographic of Interest

Influenza is caused by influenza viruses infecting the upper respiratory tract. The viruses are classified as influenza A and B (Darricarrère et al., 2021). Each type causes distinct disease patterns, but both are capable of causing severe illness and death in young children, older adults, and people with other underlying health conditions who lack immunity to the virus (Kim & Chang, 2018). Influenza A viruses are further divided into subtypes based on the genetic makeup of their hemagglutinin (HA) and neuraminidase (NA) protein subunits (Kim & Chang, 2018). Hemagglutinins comprises H1 and H3 on the surface of the virus. These proteins help the virus bind to sialic acid molecules on host cells, thus allowing the virus to attach to them and enter through the cell membrane. Once inside a cell, the virus replicates and infects another cell by attaching itself to sialic acids on this new host cell. The H1 protein is responsible for causing symptoms such as fever, chills, coughing, sneezing, and sore throat (Kim & Chang, 2018).

The H3 protein does not have these symptoms; however, it helps spread infection from one person to another through coughing or sneezing. Influenza B viruses are further divided into subtypes based on the genetic makeup of their PB1 and PA protein subunits (Kim & Chang, 2018). Influenza is a highly contagious disease that spreads quickly from person to person, household to household, school to school, and workplace to workplace. In general, influenza is spread through direct contact with respiratory secretions such as coughing, sneezing, or droplets expelled from a sick person (Boktor et al., 2021). It can also be transmitted from objects and surfaces contaminated with infected respiratory secretions, such as doorknobs and phones.

Also, it occurs through touching things like toys and books that have come into contact with infected surfaces. Most people recover from influenza within a week. However, some people develop complications such as pneumonia or even death if they contract influenza while they have underlying health problems such as asthma or diabetes. Preventing flu is more accessible than treating it once it spreads (Kim & Chang, 2018). Vaccination can prevent infection with many types of flu virus; nevertheless, not all flu vaccines work equally well for everyone (Mameli et al., 2019). Also, vaccination should be done early in the season when the highest risk exists for developing severe illness from flu virus infection.

Influenza is a reportable disease for the U.S. Public Health Service (PHS). It is when one can be tested for influenza and reported to the local or state health department or hospital as appropriate (Morabia, 2020). A person who has had an influenza-like illness and presents to the health care provider with a fever, cough, or other respiratory symptoms should report within 24 hours after the onset of symptoms. If the patient cannot contact a health care provider or hospital within 24 hours, it is necessary to call a local or state health department or hospital at once and ask them to accept the report (Morabia, 2020). Also, the patients should contact their public information office to confirm if they would accept reports from a specific area code phone number.

Determinants of Health and Explanation of How Determinants Contribute to Disease Development

The social conditions in which one is born lives, and ages significantly impact the spread of influenza. These social determinants are responsible for how the disease affects the body and the people’s health experiences (Seligman etal., 2021). These factors include access to health care services, public safety, and the availability of resources that satisfy everyday needs, such as safe housing and food (Social Determinants of Health, 2018). Besides, they include the availability of resources and the patient’s capacity to access medical care, and many other circumstances might improve one’s health, including but not limited to employment, education, and social support.

Like many other diseases, social factors in health influence the frequency of influenza-related mortality and the harm that impacts economic growth. Researchers have discovered a connection between the improvement of social elements and the prevention of influenza outbreaks. For instance, if the economy were to improve, more people would have access to vaccinations, which would help reduce disease prevalence (Fell et al., 2017). Additionally, it would be beneficial in providing researchers with more adequate resources to undertake studies to comprehend the nature of the disease and stop its spread. Therefore, strengthening the economy is essential to easing the burden of this illness on the population. Lack of educational possibilities may also affect how the disease is handled because it is more likely to cause adverse conditions if people are unaware of how to take it (Fell et al., 2017). Given that the infected persons might not be aware of the associated symptoms and the use of preventive actions, it could be fatal because it would spread exceptionally quickly.

Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors

According to Fell et al. (2017), the four components of the epidemiological triangle are time, host, environment, and agent. The numerous influenza virus strains related to the illness are linked to the illness’s epidemiological triangle and attack the upper respiratory system. Fell et al. (2017) reveal that influenza viruses use animals as carriers and have a quick mutation rate. This aspect demands that new vaccines be continuously produced each year. The most susceptible individuals to this illness are those with immunological deficiencies (Tanner et al., 2021). Because there are not enough environmental health determinists, health professionals are also at risk of contracting the disease. The sickness’ causal agent, moisture from infected individuals, is responsible for its transmission. According to Fell et al. (2017), influenza has an incubation and a symptomatic period between 5 and 7 days. After this period, there is the likelihood that the disease will stop being infectious to the host. However, the host may experience the symptoms for up to 14 days.

Role of the Community Health Nurse and Importance of Demographic Data

Community health nurses should contribute to researching influenza. They are responsible for collecting and reporting influenza statistics to CDC, just like many other communicable illnesses (Grohskopf et al., 2018). This information is essential for the CDC to accurately assess the sickness and develop workable tactics to stop its spread. Community health nurses also help the general public’s awareness of the illness. They can develop public relations strategies, campaigns, and studios to increase awareness. Through a greater understanding of the illness and its risks, these initiatives may seek to reduce the spread of the disease (Grohskopf et al., 2018). In addition, community health nurses can be at the forefront of promoting and advertising the program in society during immunization campaigns to ensure it reaches the public.

Similarly, nurses are responsible for providing patients with medical care to encourage healthy lives and stop the spread of disease. In addition to providing medical care to the ill, they can provide educational programs with advice on how to stop the spread of the illness by choosing healthy lives (Grohskopf et al., 2018). Community health nurses can assist the health departments in setting up screening procedures and immunization cases of influenza outbreaks. Also, they can offer the general public personal protective equipment to keep them from catching the disease.

National Agency or Organization That Works to Addresses Communicable Disease

Over the years, World Health Organization (WHO) has been at the forefront of addressing the effects of influenza. According to Ly et al. (2017), WHO was established on 22nd July 1946 as a United Nations office focusing on solving global influenza and other medical issues. It has successfully reduced the flu through practical measures, a significant contributing component. The group focuses on changing some of the mechanisms that regulate all pandemics caused by the disease. Because of its dedication to improving public health and wellbeing, the organization has conducted extensive research on preventing sporadic influenza outbreaks and spreading the virus from animal to human. One instance was the 2009 H1N1 influenza A test conducted in Mexico.

The introduction of a Pandemic Influenza Control (PIP) structure in the same year led to significant advancements in treating the condition. The system was intended to increase availability and significantly respond to the influenza epidemic. WHO works with its administrative bodies to create organizations for delivering impact populace training programs. The organization released the Global Influenza Strategy 2019–2030 on 11th March 2009 to protect the entire world’s population from influenza (Ly et al., 2017). According to Ly et al. (2017), the organization suggested using flu antibodies throughout the Northern Hemisphere’s 2019–2020 flu season. In addition, it has the Global Influenza Program, which aims to provide strategic direction, activity coordination, and technical support based on the threat from all types of influenza.

Global Implication

Influenza is a leading cause of global mortality and morbidity rates today. According to Ly et al. (2017), besides death, the disease has significant effects that cause major burdens towards the limited resources in the world. Therefore, the global implications of influenza are far-ranging and impact many industries. The economic costs of the pandemic have been staggering, with estimates placing them at $11.2 billion in the United States alone (Putri et al., 2018). These costs can be attributed to lost productivity, increased medical care expenses, travel disruptions, and even death. Similarly, in the last few decades, influenza viruses have evolved to overcome many antiviral drugs used to treat them. It has led to an exploding number of cases, with about 5-10% of adults and 20-30% of children worldwide becoming ill (Ly et al., 2017). These statistics contribute to between 3 and 5 million cases of influenza and nearly 1 million fatal cases worldwide (Ly et al., 2017). The World Health Organization (WHO) estimates that more than 200 different types of influenza A virus are circulating globally at any time. Vaccines or antiviral drugs do not recognize the majority of these types. Each year, the WHO publishes recommendations for countries on preparing for and responding to pandemic influenza outbreaks. These recommendations include using vaccines and antiviral drugs as their countries’ healthcare systems require. On the other hand, the influenza B virus is an endemic species to specific regions and does not spread globally. According to Ly et al. (2017), influenza B cases are reported in India and China.

Other diseases in several African nations exhibit symptoms similar to those of influenza. Due to the disease’s limited surveillance, they become confused (Ly et al., 2017). High poverty levels and weak health systems are present in various African nations, especially in the Sub-Saharan region. Similarly, the countries face significant obstacles brought on by illnesses like HIV and malaria, which change the focus of financial issues (Ly et al., 2017). The world must work together to address these issues and raise the region’s health standards. For instance, the CDC has significantly contributed to reducing malaria in Kenya through various programs.


Influenza is a contagious disease that spreads through contact with respiratory secretions, doorknobs, phones, and toys that have come into contact with infected surfaces. Vaccination can prevent infection with many flu viruses, but not all vaccines work equally well. A person with influenza-like symptoms should contact a health care provider or hospital within 24 hours. They can also get their public information office to confirm if they would accept reports from a specific area code phone number. The social conditions in which one is born lives, and ages significantly impact the spread of influenza. These social determinants include access to health care services, public safety, and the availability of resources that satisfy everyday needs, such as safe housing and food. The four components of the epidemiological triangle are time, host, environment, and agent.

Influenza viruses use animals as carriers and have a quick mutation rate, and the most susceptible individuals are those with immunological deficiencies. Community health nurses are responsible for collecting and reporting influenza statistics to the CDC, helping to develop public relations strategies to increase awareness of the illness, and providing medical care to patients to encourage healthy lives and stop the spread of disease. The World Health Organization is a United Nations agency that works to address infectious diseases. It has successfully reduced the flu through practical measures and created organizations to deliver impact training programs.

Influenza is a leading cause of global mortality and morbidity rates today. It has significant effects that cause major burdens towards the limited resources in the world and has cost the United States $11.2 billion. The WHO estimates that more than 200 different types of influenza A virus are circulating globally at any time. It recommends that countries use vaccines and antiviral drugs as their healthcare systems require. African nations face significant obstacles due to illnesses like HIV and malaria, which change the focus of financial issues. The world must work together to address these issues.


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