NRS 428 Epidemiology Paper Assignment

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

This guide will demonstrate how to complete the Grand Canyon University NRS 428 Epidemiology Paper Assignment 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 Assignment

Whether one passes or fails an academic assignment such as the Grand Canyon University NRS 428 Epidemiology Paper Assignment 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 Assignment

The introduction for the Grand Canyon University NRS 428 Epidemiology Paper Assignment 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 Assignment

After the introduction, move into the main part of the NRS 428 Epidemiology Paper Assignment 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 Assignment

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 Assignment

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 Assignment

Epidemiology is the scientific study of how frequently diseases occur in different groups of people and why. It is based on two fundamental assumptions. Firstly, it assumes the occurrence of the disease is not random because several factors concomitantly influence the likelihood of developing the disease (Stover et al., 2021). Further, it assumes the study of populations facilitates the recognition of the causes and preventive factors analogous with the disease. Communicable diseases refer to infectious diseases caused by different microorganisms such as bacteria, viruses, fungus, and parasites that can be spread directly or indirectly from one individual to another. Many infectious diseases can be transmitted via bites from insects, while others are caused by ingesting contaminated substances such as food or fluids. Although several infectious diseases pose serious health risks to communities, HIV can never be underestimated. The purpose of this paper is to discuss HIV and apply epidemiology and nursing research concepts to this communicable disease.

Description of HIV as Chosen Communicable Disease

HIV is a retrovirus that destroys cells of the human immune system (mainly CD4-positive T-cells and macrophages), which are the cellular immune system’s critical components, and kills or impairs their role. Infection with this virus results from the progressive depletion of the immune system, leading to immunodeficiency (UNAIDS, 2021). The Human Immunodeficiency Virus comprises two strands of RNA, 15 types of viral proteins, and a few proteins from the last host cell it infected, all surrounded by a lipid bilayer membrane. There are two categories of HIV, HIV-1 and HIV-2. HIV-1 can be found worldwide, but HIV-2 is almost exclusively limited to West Africa. HIV-1 is transmitted more easily than HIV-2(UNAIDS, 2021). The advanced level of HIV infection is acquired immunodeficiency syndrome (AIDS). AIDS is determined by developing certain malignancies, conditions, or other acute continuing clinical indications. HIV-1 infection progresses more rapidly to AIDS compared to HIV-2.

Causes of HIV

A virus causes HIV through sexual contact or blood. In addition, transmission can occur from mother to child during pregnancy, childbirth, or breastfeeding. When the virus enters the blood, it destroys the white cells that provide the body with the ability to fight infections and disease (UNAIDS, 2021).

Symptoms

The symptom of HIV varies and is determined by the phases of infection. Several people infected with HIV may manifest flu-like symptoms a few weeks after the entry of the virus. The likely symptoms at the acute stage may include fever, headache, skin rash, sore throat, and painful mouth sore. Similarly, swollen lymph glands, especially on the neck, muscle aches, joint pains, and diarrhea may manifest. In addition, the person could also manifest coughs, weight loss, and night sweats (UNAIDS, 2021). As the pathogen mutates in the blood and destroys the white cells at the symptomatic stage, the following symptoms may manifest Pneumonia, herpes zoster, thrush or oral yeast infection, fatigue, and fever. Furthermore, when the virus progresses to the stage of AIDS, the mentioned symptoms would manifest to be persistent and severe (UNAIDS, 2021).

Mode of Transmission

The predominant mode of HIV transmission is through unprotected sexual contact with an infected partner. In addition, exposure of broken skin or wound to infected blood or body fluids. Similarly, transfusion with HIV-infected blood is another avenue for transmission (Stover et al., 2021). Moreover, when an individual is injected with contaminated objects like needles and unsterilized syringes or razorblades, the virus is likely to be transmitted. Furthermore, transmission can also occur from mother to child during pregnancy, birth, or breastfeeding (UNAIDS, 2021).

Complications

People infected with HIV who do not get proper treatment for HIV/AIDS develop a wasting syndrome accompanied by diarrhea, fever, and chronic weakness. In addition, individuals are likely to develop neurological complications as the virus reduces mental functioning. The difficulty includes kidney disease, such as the inflammation of kidney filters that remove excess fluid and waste from the blood to the urine. Similarly, there is the liver complication (UNAIDS, 2021).The other common infectious complications related to or due to HIV comprise Pneumonia that causes severe illness. The difficulty of thrush or candidiasis causes inflammation on various body parts, i.e., the mouth, tongue, and esophagus. Similarly, the other problematic condition is Tuberculosis, especially in developing countries(Mahy et al., 2021).

Treatment

HIV has no cure but can be controlled through antiretroviral therapy. The treatment entails taking medicine that lessens the viral load in the blood. The medicine for HIV therapy is called antiretroviral (UNAIDS, 2021).The treatment involves a combination of everyday medications that prevent the virus from multiplying. The treatment aids protect the CD4 cells, keeping the immune system strong enough to combat infection and disease. The ART lowers the viral load and reduces the chance for transmissions from one person to another ((Mahy et al., 2021)

Demographic- Prevalence

The global prevalence of HIV, according to UNAIDS (2021), estimates that about thirty-eight million people living with HIV. Women accounted for fifty-three percent of the number, while men accounted for forty-seven percent. Furthermore, two million are children between zero to nineteen years of age. In addition, data indicate that women aged fifteen years up to twenty-four years globally acquire HIV. Furthermore, Sub-Saharan females account for sixty-three percent of the newly acquired HIV infection. Women accounted for fifty –three percent. Similarly, in 2020, 1.5 million people contracted HIV globally (UNAIDS, 2021).

According to the UNAIDS report, the most affected populace with HIV is from developing countries. For instance, in 2020, east and southern African countries had twenty-seven million people infected with HIV, accounting for fifty-five percent of global infection. Moreover, Asia and Pacific regions had six million people infected, accounting for fifteen percent of global infection. In addition, western and central Africa had five million infected, accounting for thirteen percent. Moreover, North America and Central Europe had two million, accounting for six percent of the global infection prevalence (UNAIDS, 2021).

Reporting of HIV

The primary object for reporting is for public health authorities to know where several diseases are found in a population. The information helps them take steps to mitigate the spread of infectious diseases and safeguard the community’s health. Further, it ensures linkage of care for any newly infected patients or continuation of care for earlier diagnosed patients(Stover et al., 2021). Moreover, timely monitoring presents trends in the epidemic and secures proper funding for local treatment and prevention services.HIV is a reportable condition that medical practitioners and pathology services must notify within five days of diagnosis to the HIV is reported only to the HIV/AIDS Surveillance Program at the Department of Public Health.

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

Social health factors are the conditions in which people are born, grow, live, work and age. The social determinant includes factors like socioeconomic status, education, neighborhood, physical environment, employment, social support networks, and access to health care(Stover et al., 2021) The social factors of health can influence a person’s likelihood of acquiring HIV through influences on improper behavior, limited access to preventive measures, and limited access to healthcare providers or testing sites.

Studies show that abuse drugs such as alcohol, cocaine, marijuana have exacerbated the risk of HIV infection. Similarly, the use of drugs leads to confinement. The individuals under detention are reported to be engaging in unprotected sex leading to a high rate of HIV infection. Further, the social-economic status has contributed to the prevalence of HIV. The economically poor are more likely to get into unwarranted behaviors, e.g., indulging in commercial sex, thus risking and enhancing the infection of the virus (Mahy et al., 2021). Economically vulnerable women experience the scarcity of health-related resources in poor, under-served communities or villages where access to health care and condoms are not readily available(Mahy et al., 2021). These compounding social health determinants extrapolate the prevalence and the risk of acquiring the virus.

The Epidemiologic Triangle

The Epidemiologic Triangle is a tool that researchers employ in addressing the three constituents that contribute to the spread of infections or disease. The triple components comprise an external agent, a susceptible host, and an environment that brings the agent and host together (Mahy et al., 2021).The triangulation of HIV (causative agent) refers to factors and attributes of the virus that concomitantly aids its infection and spread on the host. Firstly, the nature of the subtype of the HIV Virus determines the extent of infection and spread. Studies show that HIV-I is easily transmitted due to its biological and chemical characteristics. To underscore, HIV-1 RT is a heterodimer composed of p66 and p51 subunits, with p66 harboring two functional, active sites: an N-terminal RNA- and DNA-dependent DNA polymerase and a C-terminal RNase H that digests the RNA component of RNA–DNA hybrids (De Almeida et al., 2021). Due to its nature, HIV -1, therefore, binds more efficiently and faster than HIV 2 with the receptor molecule CD4 on the cell surface.; thus having a higher capability to infect and spread rapidly. Similarly, the other exacerbating factors include having a sexually transmitted infection (STI) such as syphilis, herpes, chlamydia, gonorrhea, and bacterial vaginosis that enhance chances for infection.

The host triangulation characterizes the host (human) factors as those that help enhance infection and spread the virus. The factors include having unprotected sex, having a frequent change of partners or having sexual activity for financial gain, peer pressure, drug and substance abuse (Hershow et al., 2019). These behaviors aid in enhancing HIV infection and spread. Similarly, urban health studies have found that poverty and unemployment, vacant buildings, and high crime rates are concomitant with an increased risk of HIV infection. The Social economic factors such as lack of access to care, discrimination, stigma, homophobia, and poverty enhance higher rates of HIV infection. Studies from cosmopolitan and urban areas indicate that poverty, unemployment, and high crime rates increase the risk of HIV infection and spread (Hershow et al., 2019). In addition, viral load increases in the infected occur for reasons such as not taking antiretroviral medication consistently due to lack of access to ART.

Special Consideration

There are special considerations or notifications for the community regarding the triangulation of HIV. Communities affected by HIV usually do risky behaviors, including sexual activities without protection and sharing paraphernalia that contribute to HIV infection. HIV education can aid learners in schools and the community develop and maintain safer behaviors and reduce stigma and discrimination towards people affected by and living with HIV (Hershow et al., 2019).

Role of the Community Health Nurse and Importance of Demographic Data

Nurses play vital roles in educating patients about HIV, providing support for treatment adherence, and assisting with navigation of care delivery. APRNs, further, are positioned to provide ART directly, consistent with their state practice authority.The community health nurse has professional technical skills and knowledge that the community populace may not have; thus, the nurse has the role in ensuring the quality of community-based care(Stover et al., 2021). They form a significant component in delivering quality HIV services, including counseling, adherence support, development of a referral framework, and dissemination of information. They also have the role of reporting and HIV data collection.

Demographics are essential since they offer an exhaustive comprehension of a population’s various features. The provided information is particularly vital to government organizations and institutions for making crucial policy decisions concerning the people(Stover et al., 2021). Similarly, demographics data is critical as it gives the health authorities andpopulace information they need to strategies and implements future investments and services; data from sources such as the CDC and the US Census aids in determining where assistance programs need to be directed (UNAIDS, 2021)

National Agency or Organization That Works to Addresses Communicable Disease

The USAID is one of the major federal agencies that implement the PEPFAR core mandate. The USAID’s Office of HIV/AIDS reinforces country-led efforts to combat the complex challenges of HIV in over fifty countries around the globe. The agency avails global leadership in developing projects and plans of actions that amplify impact. Similarly, it reinforces country-led programs and policies while at the same time administering USAID’s elaborate health and development skills and particularized HIV/AIDS technical capability(Stover et al., 2021). Further, the organization applies research, technology, and change to encourage cost-effective, sustainable, and judicious integrated HIV/AIDS interventions.

Global Implication of HIV

Notwithstanding the existence of treatment that can manage and mitigate the progression of HIV viral transmission, the virus remains a major leading cause of death and a health risk to millions globally. HIV is non-endemic; it is widespread globally. Different countries have put various strategies to mitigate the infection surge among their population. Techniques like the use of male and female condoms are encouraged by various governments. Further, voluntary medical male circumcision is agitated across the globe to minimize the chances of infection. (UNAIDS, 2021).Moreover, many countries use antiretroviral drugs to prevent mother-to-child transmission, pre-exposure prophylaxis, post-exposure prophylaxis, and treatment as prevention. Similarly, sex and reproductive health services are used to inform the population on the crucial knowledge that helps reduce infection of the virus (Stover et al., 2021).

Conclusion

HIV is a retrovirus that destroys cells of the human immune system, specifically the CD4-positive T-cells and macrophages. There are two types of HIV, namely HIV-1 and HIV-2. HIV-1 can be found worldwide. In addition, the infection is non-endemic but widely spread. Further, it is caused by a virus that enters the blood and impairs the white cells. Moreover, the primary mode of HIV transmission is through contact with infected blood body fluids. In addition, people infected with HIV who do not get proper medication for HIV/AIDS develop diarrhea, fever, and chronic weakness. In addition, they are likely to develop complications like neurological malfunction, kidney, and liver, among others. UNAIDS 2021 report reveals that about thirty-eight million people live with HIV, of whom women are the majority with infection. Similarly, regionally, the Sub-Saharan countries lead with an infection of about twenty-seven million, accounting for 53% of the world infection as of 2020. Moreover, the condition is modifiable to the health authorities to help mitigate the spread of infectious diseases and safeguard the community’s health.

References

De Almeida, S. M., Rotta, I., Tang, B., Vaida, F., Letendre, S., Ellis, R. J., & HNRC Group. (2021). IgG intrathecal synthesis in HIV-associated neurocognitive disorder (HAND) according to the HIV-1 subtypes and pattern of HIV RNA in CNS and plasma compartments. Journal of Neuroimmunology, 355, 577542. https://doi.org/10.1016/j.jneuroim.2021.577542

Hershow, R. B., Gonzalez, M., Costenbader, E., Zule, W., Golin, C., & Brinkley-Rubinstein, L. (2019). Medical providers and harm reduction view on pre-exposure prophylaxis for HIV prevention among people who inject drugs. AIDS Education and Prevention, 31(4), 363-379. https://doi.org/10.1521/aeap.2019.31.4.363

Mahy, M. I., Sabin, K. M., Feizzadeh, A., & Wanyeki, I. (2021). Progress towards 2020 global HIV impact and treatment targets. Journal of the International AIDS Society, 24, e25779. https://doi.org/10.1002/jia2.25779

Stover, J., Glaubius, R., Kassanjee, R., & Dugdale, C. M. (2021). Updates to the Spectrum/AIM model for the UNAIDS 2020 HIV estimates. Journal of the International AIDS Society, 24, e25778. https://doi.org/10.1002/jia2.25778

UNAIDS (2021) epidemiological estimates.https://aidsinfo.unaids.org

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Sample Answer 2 for NRS 428 Epidemiology Paper Assignment

According to the Federal government Healthy people 2020, The SDOH is defined as “the conditions in the environment in which people are born, learn, live, play, work, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks”. The Social Determined of health (SDOH), which affects the family health status, according to the assessment and interview, conducted on topic 2, identified the individual domain as an environmental factor affecting his Health.

The SDOH contributing to the family’s health status are conditions that make up our social, economic, and physical environments. The impact not only affects our physical health but also can have a major

influence on a person’s mental health and their misuse of alcohol and their family and quality of life.

The SDOH can be categorized into 5 domains

Neighborhood and built environment

Health and Health care

Social and community context

Education Access and Quality

Economic stability

Exposure to adverse SDOH factors can increase the level of stress experienced by individuals, which can raise the risk of experiencing mental health issues, and substance use problems, like alcohol abuse, these are some of the issues that are prevalent in this individual identified by our evaluation assessment. The reason these factors are prevalent is because of the environment the family is exposed to.

Based on the information gathered through the family health assessment we recommend the appropriate screenings for each family member begin at an early age, children are sometimes exposed to traumas like divorce, Neighborhood violence, alcohol or substance use by family, for example, and are disproportionately exposed to trauma likely to be vulnerable to substance use. However, exposure to adverse events during childhood is associated with an increased likelihood of developing mental health conditions and substance and alcohol abuse disorders in adulthood. Children living in poverty and racial and ethnic minorities are more likely to experience adverse childhood events, children with parents with mental health conditions also are more likely to develop mental health conditions, same with alcoholic parents, children are more likely to become alcoholics Lindsey M, (2020).

The health plan I choose for our individual plan of action will be a prevention model that initiatives focus on implementing coordinated strategies across different sectors in neighborhoods with social, economic, and environmental barriers because that leads to poor health outcomes and health disparities. Prevention improving the educational, economic, and health outcomes of the community through a broad range of family-based, social service, and health programs ODPHP, (2020

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According to (PMC, 2020). Family-centered health promotion is a promising strategy because the family unit is both, a resource, and a priority group needing preventive services across the life course, growing numbers of successful efforts, family health systems are underutilized in health promotion practice, lacking, and hampering the collection of robust evidence of family health. Family unity plays a significant role in maintaining health and preventing disease because members may support and nurture one another through life stages and over time. According to “The family’s capacity to nurture, care, protect, teach, and influence throughout the life course makes it an effective entry point in the promotion and maintenance of individual and collective health and a vital component for public health practice.” The strategies of communication will be used with channels that can allow health messages that change people’s lives with interpersonal, small group, or community groups, Health communication strategies aim to change people’s knowledge, attitudes, and/or behaviors, for example:

Increase risk perception

Reinforce positive behaviors

Influence social norms

Increase availability of support and needed services

Empower individuals to change or improve their health conditions. (RHIH,2022).

Conclusion:

“The family or household setting is the natural place where many health behaviors, good or bad, are developed, maintained, and changed. Preliminary research confirms that family-oriented health promotion and disease prevention are promising strategies because the family unit is both a resource and a priority group needing preventative and curative services across the life course. Furthermore, there are growing numbers of successful efforts, family health systems are underutilized in health promotion practice.” RHIH, (2022).

Development of HIV/AIDS

The social determinants are factors influencing the risk of transmission of HIV/AIDs disease. Social activities influence the spread of the disease significantly and that is why community behavioral modification campaigns are developed to promote healthy lifestyles among people. The rate of transmission of the disease varies from one social setting to another due to various reasons. The social determinants for HIV/AIDS include sexual violence, gender inequality, marital status, migratory behaviors in search of employment, geographic locations, and stigma related to HIV/AIDS and legal status (Laurencin et al., 2018). Also, promiscuity is linked to the high spread of the disease. Victims of sexual violence such as rape are also most likely to contract the disease and that is why they must be tested. The incidences of HIV/AIDs cases among the victims of rape and sexual violence are high and this could be because the perpetrators of the crimes are sometimes influenced by the desire to revenge. Exploring social factors is important in the fight against HIV/AIDS because it focuses on reducing risky behaviors and promoting responsibility among the populations.

Assessment Description

Communicable Disease Selection

Chickenpox
Tuberculosis
Influenza
Mononucleosis
Hepatitis B
HIV
Ebola
Measles
Polio
Influenza

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Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.

Epidemiology Paper Requirements

Describe the social determinants of health and explain how those factors contribute to the development of this disease.
Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.

A minimum of three peer-reviewed or professional references is required.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Resources if you need assistance.

Attachments

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Epidemiologic Triangle as it Relates to the HIV/AIDS

The epidemiological triangle focus on the relationship between the host, agent, and environment. The triangle also helps in guiding the prevention measures. In this case, reducing the interaction between the agent, the host, and the environment. In this case, the agent refers to HIV which is a pathogenic micro-organism. The virus targeted the human CD4 cells and this means eliminating the receptors for the viral attachment into the host could reduce the infection rate. The host in the triangle refers to human beings. Human beings harbor the virus in their system (Bandera et al., 2018). Human beings act as carriers for the virus and they can spread it through sexual intercourse and blood transfusion among other methods as discussed above. The transmission and spread of the virus entirely depend on human behavior. Finally, the environment refers to the environmental factors facilitating the spread of the virus. Some of the factors include social pressure, lack of adequate healthcare system to create interventions for the vulnerable groups, and the increasing poverty rates in some areas that lead to prostitution or increased sexual activities for income.

Education and awareness creation are important tools for fighting the spread of HIV/AIDs. Education and awareness create consciousness among the population to avoid social activities that could predispose them to the disease. On the other hand, it also helps in preventing unwanted behaviors such as stigmatization which reduces the willingness of the people to go for screening and thus increases the risk of transmission. Lack of screening is associated with high transmission and spread of the disease by people who may not know that they have the disease. Other preventive measures have always included abstinence from sex and adherence to antiretroviral drugs.

Role of the Community Health Nurse in the Management of HIV/AIDS: NRS 428 Epidemiology Paper Assignment

Community health nurses play critical roles when it comes to the management of HIV/AIDS. Their involvement in the intervention processes aids in stopping the spread of the virus and subsequent reduction in the number of cases across different regions. Community health nurses facilitate case findings, data collection processes in the research processes to identify the required interventions, and follow-ups to determine the effectiveness of the required interventions. Win the increasing cases of HIV/AIDS; there is always the need for research processes that can help in the development of the epidemiological triangle; these studies require the intervention of the community health nurses, epidemiologists as well as other healthcare professionals (Bandera et al., 2018). Community health nurses play critical roles when it comes to the management of different complications associated with HIV/AIDS. In their process of engagement with the infected persons or victims, they often tend to enhance case findings, case reporting, data collection, and analysis, NRS 428 Epidemiology Paper Assignment.

Demographic data are critical for the health of the community. They enhance the research processes aimed at establishing effective research processes. The demographic data can establish the trends or rates of HIV/AIDS infections. Demographic data are often used to develop epidemiological methods for disease surveillance to determine the critical hazards associated with the disease. Demographic data are also used in the studies to identify the risk factors that may represent the critical control points in the management of HIV/AIDS.

Agencies Involved in Addressing HIV/AIDS-NRS 428 Epidemiology Paper Assignment

The agencies involved in fighting HIV/AIDS establish measures and protocols to reduce the spread of the disease. One of the agencies involved in addressing HIV/AIDS is the USAID (U.S Agency for International Development). The agency was established in 1986 to support the PRPFAR programs in more than 100 nations (Bandera et al., 2018). The agency is involved in the management of HIV/AIDS programs by targeting vulnerable populations or those at high risk of being infected by HIV/AIDs.

The agency offers support to the HIV/AIDs programs to various nations. They set goals for the various nations to eradicate the disease and improve adherence to the people on medications. The agency focuses on strengthening the primary healthcare systems to prevent and enhance the management of HIV/AIDS (Bandera et al., 2018). Furthermore, through constant research, the agency establishes new measures of reaching more populations in terms of screening and curbing the spread of the disease. Various agencies work together to achieve a synergized outcomes on fighting HIV/AIDs and promoting positive behavioral patterns among the populations.

Global Implication of HIV/AIDS: NRS 428 Epidemiology Paper Assignment

The impact of HIV/AIDs is wide-reaching. There are currently many orphans in the world courtesy of the HIV/AIDS disease. Therefore, the analysis of the burden of the disease should focus on both the social and financial impacts. It is estimated that about 770,000 people died of HIV/AIDS disease in 2018. The statistics show that many people have died over time and the number of people left as orphans is high. The majority of the orphans tend to be dependent and this shows that HIV/AIDS creates a significant economic crisis.

According to (Bandera et al., 2018), 1.7 million new infections new cases of HIV/AIDs have been reported this year with many families being destabilized due to death. For example, in cases where a family loses their breadwinner to the virus, their living conditions change significantly. Therefore, high incidences of HIV/AIDS are linked to high poverty levels. Furthermore, government institutions have to spend a lot of money on HIV/AIDS drugs, screening, and health promotion. Besides, it takes a lot of resources to manage the complications arising from the infection.

The rise in healthcare costs is always addressed by developing measures aiming at reducing the spread of the disease among the populations. While many organizations donate funds to fight the disease, such measures may not be sustainable as many resources could be lost in the process. Therefore, reducing the spread of the infection is the main target in the minimization of the costs incurred in the health sector. Various foundations have been established include the Bill and Melinda Gates Foundation which supports many people living with HIV/AIDS in Africa (Bandera et al., 2018). HIV is endemic in some regions due to poor cultural and social practices. Statistics indicate that the disease is becoming endemic in sub-Saharan Africa, with an estimated prevalence rate of 12%; this is higher than the global prevalence rate of 5%.

Conclusion

The Human Immunodeficiency Virus (HIV) affects many populations globally both directly and indirectly. The disease is mainly transmitted through sexual intercourse, though, people may also contract it through blood transfusion and sharing sharp objects with infected individuals. Early diagnosis is key in reducing the spread of the disease since people initiated on ARTs develop low viral load which has a lower infectivity rate. Furthermore, the efforts directed to fight the disease should be guided by epidemiological information; more efforts should be directed to the endemic regions. Creating awareness and educating the public on the burden of HIV/AIDS disease is important in its eradication.

References

Bandera, A., De Benedetto, I., Bozzi, G., & Gori, A. (2018). Altered gut microbiome composition in HIV infection: causes, effects, and potential intervention. Current opinion in HIV and AIDS, 13(1), 73-80.

Labrique, A. B., Vasudevan, L., Kochi, E., Fabricant, R., &Mehl, G. (2016). eHealth innovations as health system strengthening tools: 12 common applications and a visual framework. Global Health: Science and Practice, 1(2), 160-171.

Laurencin, C. T., Murdock, C. J., Laurencin, L., & Christensen, D. M. (2018). HIV/AIDS and the African-American community 2018: a decade call to action. Journal of racial and ethnic health disparities, 5(3), 449-458.

Sample Answer for NRS 428 Epidemiology Paper Assignment

Chicken Pox

Chicken Pox is among one of the viral diseases that are highly contagious and prevalent among children. The condition is also referred to as Varicella and its early symptoms include the development of papule and vesicles accompanied by fever. In the early years of the disease, scientists were unable to differentiate between chicken pox and small pox until in the 19^th century. By the end of the 16^th century, Italian scientist Giovani Fillipo describe the first case of chicken pox.Further research work was conducted and in 1767 William Heberden came up with the differentiation between chicken pox and small pox (Presti et al., 2019). After conducting more research, Von Bokay concluded in 1875 that chicken pox is highly contagious due to it causative agent. In his studies, Bokay also made an observation in 1909 that helped in the differentiation of the two diseases. In 1954, Thomas Weller first isolated the causative agent of chicken pox. The first attenuated vaccine of the disease was developed in 1972 by Michiaki Takahashi. The purpose of this paper is to discuss the epidemiology of chicken pox.

Description of the Disease

The disease is caused by a highly contagious virus, varicella zoster (VZV) that is air-borne. The virus can be spread from an infected person to other people through the droplets from coughing or sneezing that are inhaled by the uninfected person. The virus particles are transmitted when uninfected person comes into contact with the viral particles shed from the patients or through inhalation of contaminated air (Yu, Ashworth, Hughes, & Jones, 2018). There are other unlikely means like sharing items with an infected person and the items were in contact with the open blisters on the patient. Individuals who have never contracted the disease and have not been vaccinated are at a greater risk of contracting the disease. Virology experts consider the VZV to be spread within one to two days upon the blisters from the infected person burst open, however, the incubation period is about 14 to 16 days upon which the symptoms become visible (Presti et al., 2019). The initial stages of disease are characterized by cold-like symptoms of sore throat, fever, running nose and malaise.

The major onset of the major symptoms of disease is marked by the development of the red spots from the trunk and scalp region, and then they spread out to other parts of the body. Red spots also affect the mucus membrane and would be seen spread out in the mouth and also along the nasal cavity. The red spots develop into vesicles that have the shape of a teardrop and within a period of eight hours, they turn into crusty lesions (Gray & Cathie, 2019). Newly formed spots with continue with the development as the old ones dry off and disappear. Research findings reveals that it takes about five days for the development of the new lesions to cease but the crusts take up to twenty days to disappear from the body.

Furthermore, the disease is characterized by an irresistible urge of itching that causes the patient to scratch the vesicles hence increased risk of developing cellulitis. It is a skin condition caused by bacterial infection (Cassidy and McBrien, 2019). There are other symptoms such as inflammation of the brain tissue, death of the soft tissue of the skin, sepsis and a streptococcal infection associated with Reye Syndrome. These additional symptoms are only common to patients who have a weakened immune system. In most of the cases, the diagnosis of the disease is based on the observable symptoms such as fever and a rush. However, additional confirmatory test can be carried out by taking a specimen sample from the lesion and it is cultured for a period of five to ten days.

The treatment of chicken pox is focused on managing the symptoms associated with the disease. The symptoms to be managed include the fever and the itchy rushes on the skin. This treatment model, aims at helping the patient alleviate the discomfort of the symptoms as they might take longer than expected if not treated. It naturally takes about two to three weeks for the symptoms to disappear. The pruritus symptoms are managed by taking antihistamine drugs like Benadryl or Atarax (Shin et al., 2017). The blisters are managed by using a wet compress. NSAIDS such as ibuprofen or acetaminophen are used to relieve the fever.

Additionally, given that the causative agent of the disease is a virus, the disease can further be managed by use of antiviral agents such as acyclovir and Val acyclovir. These pharmacological agents, help in healing process as they reduce the incubation period. The use of these agents is recommended immediately after being infected, to increase their efficiency and effectiveness (Duncan, 2019). The treatment program should also include adequate use of electrolytes to ensure that the patient is well hydrated. Moreover, hygiene is also considered a priority in the management of the disease. One should keep short nails and take frequent baths to keep the whole body clean.

The vaccine for chicken pox, Varivax, was developed and approved by the FDA in 1995. The vaccine has been used for many years and it is believed to have a 90 percent. The vaccine efficiency is low in children of age less than a year (Reisinger et al., 2019). The patient develops mild symptoms of chicken pox after receiving the Vivax vaccine, hence proving the effectiveness of the vaccine against the VZV. It is also effective in preventing contracting shingles. The VZV is also associated with shingles, which results from the virus being in a prolonged dormant stage within the Central Nervous System (CNS) that is reactivated over a period of time. There is high prevalence of chicken pox in children of age between one and four years, even though it is also still high in teenagers of up to age of 15 years. The virulence of the virus has decreased over the years. With the use of Vivax vaccine there has been significant reduction in the mortalities and comorbidities associated with chicken pox. However, in some regions of the world the disease is still a pandemic affecting approximately 10500 people who are hospitalized due to chicken pox annually (Senders, Bundick, Li, Zecca, & Helmond, 2018). The CDC report nodes that about 95% of the US adult population suffer from the disease in their lifetime.

The Infectious Disease Society of America, requires patients to report any case of chicken pox infections. The guidelines according to CDC, recommends that the in the intervention measures, three key areas have to be considered. That is; history of vaccination, how severe the disease is and the age of the patient. Information about epidemiologic, demographic and patient’s data relating to the infectious diseases should be reported. CDC also recommends use of technology by messaging the people concerning the chicken pox infections, spread and the symptoms to check out.

Social Determinants of Health

The determinants of health are conditions within our environment where we carry out our daily activities and have an impact on the quality of life we live and it is also associated with other risk factors that can affect our lives (Luyten & Beutels, 2016). The prevalence of chicken pox is associated with various social determinants in the community such as the level of education, the accessibility to quality and affordable healthcare, cultural and religious beliefs, economic conditions and the general public safety. There are other factors such as personal behaviors and genetics which can be linked to the prevalence of the disease even though there is no sufficient explanation from research to support this idea. There is need to carry out more systematic research to identify the linkage between these factors and the occurrence of the disease. Additionally, there is need to do more studies to help in understanding the overlapping impact of economic and social structures in the mortality and morbidity associated with the infectious diseases.

The communities in low economic status have a higher risk of developing the infectious diseases due to lack of resources to seek medical intervention and the preventive measures. Another factor associated with such populations is low level of literacy, lack of information and language barriers which negatively impact on the ability of people having relevant and appropriate information on the disease. Such people will not have adequate information about the vaccines, how to access them and the right timing to have the vaccine. Additionally, in such communities, the spread of such infectious disease like chicken pox is fast and could affect a large population as they lack sufficient information on preventive measures (Keefe, Lane, Heyman, & Congress, 2018). Since the disease is highly contagious, it is imperative that the social structures within the community are actively used, where awareness is raised on preventive measures.

The Epidemiologic Triangle

Epidemiological triage of infectious diseases like chicken pox includes three key areas, the host, environment and the causative agent. This epidemiological triage is crucial in determining the history related to the condition. The information gathered is crucial in the prevention of the spread of the disease (Hanson & Weinstock, 2016). It helps in identification of the weaker areas in the intervention process hence address the threats accordingly. The efforts are dedicated towards reducing the spread of the disease as well as reducing the severity of the disease hence cut down on the mortality rate. The epidemiologic triage aims at creating a linkage between the causative agent, that is the varicella zoster virus and the human who are the main hosts of the virus. This triage also provides explanation on the transmission mechanism of the virus and the predisposing factors to the infection.

Additionally, the triage provides information on the time of the year when there is a high prevalence of the disease (Smith, 2019). The disease prevalence is observed to be highest at the start of the spring and winter seasons in the US. In the months of March to May, the US records high cases of chicken pox while the lowest cases are reported between the months of September and November (Conway et al., 2018). This information is crucial as it helps the population be aware of the most dangerous seasons and come up with modalities of protecting themselves from the infection.

Topic 2 DQ 1

What are social determinants of health? Explain how social determinants of health contribute to the development of disease. Describe the fundamental idea that the communicable disease chain model is designed to represent. Give an example of the steps a nurse can take to break the link within the communicable disease chain.

Resources within your text covering international/global health, and the websites in the topic materials, will assist you in answering this discussion question.

Social Determinants of health (SDOH) are conditions of living that stem from circumstances that they were born into. They include, housing, transportation, economic status, social environment, were we work, play, education, racial/ethnic and religious. These conditions set populations into groups which can be seen as an affect on our health (Falkner, 2018).

Social Determinants of health (SDOH) contribute to disease because of limitations in health care and access to it. Unfair barriers to practice healthy behaviors (CDC, 2021). Human made surroundings contribute to the community as a whole and individual behaviors that determine health. Acceptance to education and being compliant understanding their actions will affect improved health. Cost for care and treatment, nutrition, and the ability to access quality and quantity of needed food to meet nutritional needs are all part of the fallout from SDOH.

The chain of infection shows how the cycle continues; each part plays a major role in transmission. Within a community it can spread very quickly, and this community will suffer within the SDOH due to lack of healthcare accessibility. Nursing education on basic infection control practices in these communities can break the chain and decrease the number of those becoming ill. Handwashing is the most effective way to break the chain, covering a cough or sneeze, disposal of garbage and the use of disinfectants can be taught in schools (school nurse), community centers (nurse on site) and at all health care visits. Families can make this an activity that they can do together (CDC, 2022).

Center for Disease Control CDC (2021, September 15th). Achieving Health Equity by Addressing the Social Determinants of Health. Social Determinants of Health. National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). https://www.cdc.gov/chronicdisease/programs-impact/sdoh.htm

Center for Disease Control CDC (2022, February 23rd). Handwashing in Communities: Clean Hands Save Lives. https://www.cdc.gov/handwashing/index.html

Falkner, A. (2018). Health Promotion in Nursing Care. In Grand Canyon University (Eds.). Health & wellness across the continuum. https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/2

Sample Answer for NRS 428 Epidemiology Paper Assignment

Epidemiology Paper: Tuberculosis

Tuberculosis (TB) refers to a variety of clinical illnesses caused by Mycobacterium tuberculosis complex. Tuberculosis is a multisystemic disease that can affect every organ, with the most affected being the lungs where there is granuloma formation. TB is primarily classified into two pulmonary TB (PTB) and Extrapulmonary TB (EPTB). PTB is defined as a case of TB that involves the lung parenchyma, while EPTB affects other organs apart from the lungs such as the lymph nodes, pleura, skin, gastrointestinal tract, bones, joints, and meninges (Sharma & Mohan, 2019). This essay aims at describing the epidemiology of Tuberculosis and the role of the community health nurse and national agency in addressing TB.

Description of Tuberculosis

Causes

The primary infectious agent of TB is Mycobacterium tuberculosis, which is an acid-fast aerobic rod that has slow growth and is sensitive to heat and ultraviolet light.

Other species include Mycobacterium africanum and Mycobacterium Canetti, which are rare causes of tuberculosis in Africa

Symptoms

The typical clinical features of active pulmonary TB include cough, anorexia, weight loss, fever, night sweats, chest pain, hemoptysis, and fatigue. Symptoms of Tuberculosis meningitis include an intermittent or persistent headache that lasts for 2-3 weeks, subtle mental status changes that may result in coma over days to weeks, and low-grade fever. Skeletal TB presents with back stiffness or pain, paralysis of the lower extremities, and arthritis, which involves only one joint, mostly the hip or knee joint (Sharma & Mohan, 2019). Genitourinary TB manifests with flank pain, urinary frequency, dysuria, painful scrotal mass, or epididymitis in males and symptoms mimicking Pelvic inflammatory disease in females (Sharma & Mohan, 2019). Symptoms of gastrointestinal (GI) TB depend on the infected site and may include, non-healing ulcers in the mouth or anus, swallowing difficulties with esophageal infection, abdominal pain with duodenal or gastric infection, malabsorption with small intestine infection, and pain, diarrhea or pain during defecation with colon infection (Sharma & Mohan, 2019).

Mode of Transmission

Mycobacterium tuberculosis is transmitted from one person to another through airborne transmission. Infected persons release droplets containing Mycobacterium nuclei, which are usually particles 1-5 um in diameter when coughing, sneezing, or talking (Koch & Mizrahi, 2018). The large droplets settle while small droplets are suspended in the air and get inhaled by susceptible individuals. The bacteria are transmitted via the airways to the lungs and deposited the alveoli where they multiply. The bacilli are also transported via the bloodstream and the lymphatic system to other body organs such as the cerebral cortex, bones, and kidneys, and other parts of the lungs such as the upper lobes (Koch & Mizrahi, 2018).

Complications

Complications of TB are usually a result of the disease process or from antimicrobial therapy. The most common late complication of PTB is hemoptysis, which refers to bleeding from submucosal bronchial veins. Other PTB complications include Broncholithiasis, which results from spontaneous migration of lymph nodes into the bronchial tree and Fibrothorax. Bronchiectasis, Aspergilloma, chronic obstructive pulmonary disease, and carcinoma of the lung tissue and relapse are late complications that develop after completion of drug therapy. Extrapulmonary complications following antimicrobial therapy include hepatitis, peripheral neuropathy, and Retrobulbar optic neuropathy.

Treatment

Pharmacologic treatment of is divided into first-line and second-line agents.

The first-line treatment consists of a 4-drug regimen, namely, Isoniazid (H), Rifampin (R), Pyrazinamide (Z), and Ethambutol (E). Isoniazid is the cornerstone of treatment and should be included in all therapies unless in cases where there is a high degree of Isoniazid resistance. Rifampin is the second major Anti-TB agent (Sotgiu et al., 2015). The intensive phase lasts for two months, and the drugs used include Isoniazid, Rifampin, Pyrazinamide, and Ethambutol. The continuation phase lasts for four months, and the drugs used are Rifampicin and Isoniazid. Pyridoxine is administered daily with Isoniazid to prevent peripheral neuropathy, and Vitamin A is administered as a STAT dose when treatment is initiated (Sotgiu et al., 2015). Treatment for defaulters, relapsed, or failed TB cases entail Intensive therapy for one month with Streptomycin, Isoniazid, Rifampin, Pyrazinamide, and Ethambutol and Continuation phase with Rifampin, Isoniazid, and Ethambutol for five months (Sotgiu et al., 2015).

Demographic of Interest

Globally, TB is the leading cause of mortality from a single infectious agent and the leading cause of mortality among people with HIV infection and accounts for about 40% of death in HIV-infected persons. As per the World Health Organization (WHO) 2019 TB report, approximately 10 million individuals got infected with TB in 2018. The burden of the disease varies significantly among countries from less than five to greater than 500 new cases annually, and the global average of new TB infected cases was 130. In 2018, approximately 1.2 million TB deaths were reported among HIV-negative persons and an estimated 251000 deaths among HIV positive persons (WHO, 2018). TB affects individuals of both sexes in all age groups, but the highest-burden is in males above the age of 15 years. In 2018, this population accounted for 57% of all TB cases, while women and children below 15 years accounted for 32% and 11%, respectively (WHO, 2018). Besides, 8.6% of all TB cases in 2018 were people infected with HIV.

A majority of TB cases in 2018 were in the geographic regions of South-East Asia with a prevalence of 44%, Africa with 24%, and Western Pacific with 18% (WHO, 2018). The lowest prevalence was in the Eastern Mediterranean with 8%, America with 3%, and Europe with 3%. Furthermore, eight countries accounted for two-thirds of the global total TB cases, and these were India, China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh, and South Africa (WHO, 2018).

In the United States (US), TB infection was more prevalent in Asians, with 30% followed by Hispanics with 29% and African Americans/ Non-Hispanic blacks with 23% (Schmit et al., 2017). The least affected ethnic groups were American Indians/ Native Alaskans and Native Hawaiians and Pacific Islanders with a prevalence of 1%. More than 60% of TB infections in the US occur in individuals aged 25-64 years; however, the risk is highest in individuals above 65 years (Schmit et al., 2017). TB is less prevalent in children between 5-15 years.

Reporting of TB Cases

TB is a notifiable disease, and countries have different TB reporting laws. The recommended timeframe to report suspected or confirmed cases of TB in the USA is within 24 hours (Thombley & Stier, (2016). The general requirement is that any individual having knowledge of the disease or has reason to believe that an individual has TB should report to facts to the local health department. Healthcare providers licensed under state licensure code, include the list of specific persons required to notify the TB program in the state department of new TB cases within 24 hours (Thombley & Stier, (2016). Upon receiving the notice, the TB Program should notify the local board of health in the community where the TB case resides within 24 hours.

Laboratories are required to report to the local or state health department of health the identification of or any laboratory findings indicating the presence of microscopical, immunological, cultural, serological, or other evidence of TB (Thombley & Stier, (2016).

The report should contain information about the individual, and this includes the individual’s name, address, and county, and if the individual is homeless. The telephone number, date of birth, sex, race, ethnic origin, occupation, and country of origin, including the month and year the person arrived in the US, should be indicated (Thombley & Stier, (2016). In addition, the site of infection, chest radiography date and results, lab results, tuberculin skin test history, HIV status, alcohol, and drug use history, initial drug regimen, whether the individual is a resident of a long-term or correctional facility, signature of the person reporting and date of report submission should be included.

Social Determinants of health

Healthy People 2020 define social determinants of health (SDOH) as the conditions in the environment in which individuals are born, live, work, play, and age (People, 2017). The conditions affect health, functioning, and quality of life outcomes and risk in various ways. Factors that improve the quality of life significantly influence population health outcomes, and they include safe and affordable housing, public safety, availability of nutritious food, access to education, accessibility to local health services, and an environment free of toxins (People, 2017). Examples of SDOH include social norms and attitudes, socioeconomic conditions, availability of resources to meet day-to-day needs, access to education, access to healthcare services, residential segregation, and social support.

The risk factors for TB transmission include persons without adequate health care, immigration from countries with a high prevalence of TB, institutionalization, living in substandard, and overcrowded housing. Consequently, people who live in crowded neighborhoods and substandard housing are at a high risk of being infected with TB. For instance, people living in slums where the environment has toxins, including TB aerosol droplets, have the highest risk of TB infection with TB (People, 2017). Besides, TB infected people with no access to healthcare are likely to transmit the disease to other individuals due to the lack of appropriate treatment (People, 2017). Furthermore, individuals with no access to education are at a high risk of TB infection since they are less informed of the prevalence and complications of TB as well as how to prevent and control TB, especially when living with TB infected people.

Transportation options also contribute to the transmission of TB when people use public transportation. Transmission takes place as people interact and move using public transport facilities such as buses and trains where individuals inhale contaminated aerosol droplets in the environment. Moreover, people living in overcrowded confined spaces such as prisons have an increased likelihood of TB transmission.

Epidemiological Triangle

Host

Humans are the only known reservoirs for Mycobacterium tuberculosis through various animals that are susceptible to infection. The likelihood of a person developing active TB depends on the intensity and duration of exposure to infected aerosol droplets. Individuals with intense exposure have the highest risk of infection and also for the development of TB (Koch & Mizrahi, 2018). Factors that make an individual susceptible to TB infection include alcoholism, malnutrition, immunocompromised status, history of substance abuse, and preexisting medical conditions.

Agent Factors

Mycobacterium tuberculosis is an aerobic, non–spore-forming, nonmotile bacillus with a high cell wall content of high-molecular-weight lipids. It has slow growth and has a generation time of 24-30 hours (Koch & Mizrahi, 2018).

Environmental Factors

Mycobacterium tuberculosis is resistant to desiccation, and this makes it remain viable as droplet nuclei when suspended in a room for about 30 minutes. However, the aerobic rode is sensitive to heat and ultraviolet light. An infected person can transmit the organism to numerous persons in an exposed group when there is no appropriate isolation (Koch & Mizrahi, 2018). The community should be notified when they are at risk of transmitting TB and be educated disease prevention strategies against TB infection when interacting with TB infected individuals.

Role of the Community Health Nurse

The role of a community health nurse not only entails management services involved in patient care and treatment but also consists of a range of public health activities that aid in the prevention and control of TB in the community, which is the eventual goal of case management in TB (Chikovani et al., 2019). The community health nurse has the role of conducting an assessment, which involves systematic data collection, monitoring, and giving information on the health status of the community. The nurse has the responsibility of collecting data on the number of TB cases in the community and conducting an analysis to determine the success of the efforts to manage and control the occurrence of new TB infections (Chikovani et al., 2019). Besides community health, nurses are mandated to report suspected or newly diagnosed cases of TB to the local health departments to aid in the follow-up of the patients. They are further required to follow-up TB-infected patients in their residence to monitor drug-adherence and provide health education to their families on how to prevent the transmission of the disease (Chikovani et al., 2019). Demographic data is necessary in the health of the community as it helps in monitoring the success of treatment and identifying the rate of transmission and relapse cases of TB. Besides, the data guides in the allocation of resources needed for TB programs and determining the health status of a community.

National Agency that Addresses Tuberculosis

The National Tuberculosis Controllers Association (NTCA) is a non-profit organization whose mission is to enhance the elimination of TB in the US and its territories. It achieves this through the collective, concerted action of local, state, and territorial governments who are authorized by their jurisdiction with the responsibility of conducting programs to prevent and control TB (Sosa et al., 2019). NTCA participates and supports other annual Regional Tuberculosis Controller Meetings. It works with the CDC Division of Tuberculosis Elimination (DTBE) in mutual consultations, projects, and joint committees and has a representation on the CDC Advisory Council to Eliminate Tuberculosis.

The objectives of NTCA include to develop and provide a common voice for TB controllers to advocate for TB elimination and control programs in the US. It counsels agencies, committees, organizations, and task force on issues affecting TB control and elimination (Sosa et al., 2019). NTCA also works with other organizations to advance the control and elimination of TB and supports them in efforts that are beneficial in the advancement of TB control and elimination (Sosa et al., 2019). Lastly, NTCA advocates for policies, laws, and positions to enhance TB control and elimination at local, state, and territorial levels.

Global Implication Of The Disease

In 2018, approximately 1.7 billion people were infected by TB bacteria, which is roughly 23% of the world’s population. Out of the 10 million people who got infected with TB in 2018, about 3 million cases were not identified by the health systems and did not receive the appropriate treatment allowing further transmission of the disease (WHO, 2018). Besides, approximately 1.1 children got infected with TB in 2018, and 205,000 children died due to TB. Misuse or mismanagement of anti-TB drugs causes TB resistance, such as the multidrug resistance (MDR) TB or extensively drug-resistant (XDR) TB (Weyer et al., 2017). MDR-TB has become a public health crisis and a threat to health with an estimated 484,000 new cases of resistance to Rifampicin. In 2018, which is the most effective first-line drug.

Other countries have developed policies to help in the early detection, diagnosis, and treatment of TB. Various countries have decentralized the initiation of treatment at the primary care level, which is initiated by nurses and primary health care workers. In addition, guidelines have been developed that guide the early detection and initiation of treatment as well as hospitalization of TB infected patients. They have also developed frameworks that allow early access to new drugs and have processes set in place for registration of drug-resistance TB drugs (Weyer et al., 2017). Besides, they have adopted quality assurance standards and mechanisms that are in line with the WHO recommendations.

TB is not endemic in any state in the US but has a high prevalence in some states. In 2018, 70.2% of reported TB cases in the US were from non-US-born individuals (Schmit et al., 2017). A majority of TB cases were from four states, namely California, with 23.2%, Texas 12.5%, New York 8.3%, and Florida with 6.5%.

Conclusion

TB is a worldwide public health concern and the second leading cause of death due to a single infectious agent. TB is classified into pulmonary and extrapulmonary TB and can affect every organ. It is caused by Mycobacterium tuberculosis, which an aerobic rode, and its transmission is high in overcrowded settings. TB begins when a susceptible individual inhales mycobacteria and becomes infected when the bacteria are transported via the airways to the alveoli and multiply. Anti-TB drugs include Isoniazid, Rifampicin, pyrazinamide, and ethambutol and have an intensive phase lasting two months and a continuation phase that lasts four months. However, drug resistance develops when there is poor management or misuse of Anti-TB drugs, and when patients default from the drug regimen.

References

Chikovani, I., Diaconu, K., Duric, P., Sulaberidze, L., Uchaneishvili, M., Mohammed, N. I., Zoidze, A, & Witter, S. (2019). Addressing challenges in tuberculosis adherence via performance-based payments for integrated case management: protocol for a cluster randomized controlled trial in Georgia. Trials, 20(1), 536.

Glaziou, P., Floyd, K., & Raviglione, M. C. (2018). Global epidemiology of tuberculosis. In Seminars in respiratory and critical care medicine (Vol. 39, No. 03, pp. 271-285). Thieme Medical Publishers.

Koch, A., & Mizrahi, V. (2018). Mycobacterium tuberculosis. Trends in microbiology, 26(6), 555-556.

People, H. (2017). Social determinants of health| Healthy People 2020. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health

Schmit, K. M., Wansaula, Z., Pratt, R., Price, S. F., & Langer, A. J. (2017). Tuberculosis—the United States, 2016. MMWR. Morbidity and mortality weekly report, 66(11), 289.

Sharma, S. K., & Mohan, A. (2019). Extrapulmonary tuberculosis 4. Mycobacterium tuberculosis: Molecular infection biology, pathogenesis, diagnostics, and new interventions, 37.

Sosa, L. E., Njie, G. J., Lobato, M. N., Morris, S. B., Buchta, W., Casey, M. L., Goswami, N.D., Gruden, M., Hurst, B.J., Khan, A.R., & Kuhar, D. T. (2019). Tuberculosis screening, testing, and treatment of US health care personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019. Morbidity and Mortality Weekly Report, 68(19), 439.

Sotgiu, G., Centis, R., D’ambrosio, L., & Migliori, G. B. (2015). Tuberculosis treatment and drug regimens. Cold Spring Harbor perspectives in medicine, 5(5), a017822.

Thombley, M. L., & Stier, D. D. (2016). Menu of suggested provisions for state tuberculosis prevention control laws. Centers for Disease Control and Prevention, National Tuberculosis Controllers Association, Association of State and Territorial Health Officials and National Association of County Health Officials Workshop; Feb 4–5, 2010; Atlanta, GA, USA: CDC; [Accessed on Mar 10, 2017].

Weyer, K., Dennis Falzon, D., Jaramillo, E., Zignol, M., Mirzayev, F., & Raviglione, M. (2017). Drug-resistant tuberculosis: what is the situation, what are the needs to roll it back. AMR control, 20, 60-67.

World Health Organization. (‎2018)‎. Global tuberculosis report 2018. World Health Organization. https://apps.who.int/iris/handle/10665/274453. License: CC BY-NC-SA 3.0 IGO

Rubric Criteria

Total125 points

Criterion	1. Unsatisfactory	2. Less Than Satisfactory	3. Satisfactory	4. Good	5. Excellent
National Agency or Organization That Works to Addresses Communicable Disease National Agency or Organization That Works to Addresses Communicable Disease	0 points Agency and description of contribution are omitted.	10 points An agency or organization is identified, but discussion is vague or inaccurate in relation to the communicable disease chosen.	11 points An agency or organization is identified, but discussion regarding efforts to address communicable disease is lacking.	11.5 points An agency or organization is identified, but discussion regarding efforts to address communicable disease is brief.	12.5 points An agency or organization is identified. A clear and accurate description of efforts to address communicable disease is offered.
Determinants of Health and Explanation of How Determinants Contribute to Disease Development Determinants of Health and Explanation of How Determinants Contribute to Disease Development	0 points Description of the determinants of health and their role in disease development is omitted or presented with many inaccuracies.	10 points Paper partially describes the determinants of health in relation to disease development.	11 points Paper identifies the determinants of health in relation to the communicable disease selected but does not include an explanation of their role in the development of disease.	11.5 points Paper describes each determinant of health with a comprehensive discussion of their contribution to disease development and progression.	12.5 points Paper comprehensively discusses the determinants of health in relation to the communicable disease, explains their contribution to disease development, and provides evidence to support main points.
Development, Structure, and Conclusion Advances position or purpose throughout writing; conclusion aligns to and evolves from development.	0 points No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered.	5 points Writing lacks logical progression of the thesis, position, or purpose. Some organization is attempted, but ideas are disconnected. Conclusion is unclear and not supported by the overall development of the purpose.	5.5 points Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the development of the purpose.	5.75 points The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other. Conclusion aligns to the development of the purpose.	6.25 points The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and logical conclusion aligns to the development of the purpose.
Evidence Selects and integrates evidence to support and advance position/purpose; considers other perspectives.	0 points Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the perspective of the writer.	5 points Evidence is limited or irrelevant. The interpretation of other perspectives is superficial or incorrect.	5.5 points Evidence is used but is insufficient or of limited relevance. Simplistic explanation or integration of other perspectives is present.	5.75 points Relevant evidence that includes other perspectives is used.	6.25 points Specific and appropriate evidence is included. Relevant perspectives of others are clearly considered.
Thesis, Position, or Purpose Communicates reason for writing and demonstrates awareness of audience.	0 points The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident.	5 points The thesis, position, or purpose is unfocused or confused. There is very little awareness of the intended audience.	5.5 points The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear. There is limited awareness of the appropriate audience.	5.75 points The thesis, position, or purpose is adequately presented. An awareness of the appropriate audience is demonstrated.	6.25 points The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience.
Mechanics of Writing Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc.	0 points Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout.	2 points Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent.	2.2 points Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted.	2.3 points Few mechanical errors are present. Suitable language choice and sentence structure are used.	2.5 points No mechanical errors are present. Appropriate language choice and sentence structure are used throughout.
Role of the Community Health Nurse and Importance of Demographic Data Role of the Community Health Nurse and Importance of Demographic Data	0 points Discussion of the role of the community health nurse is omitted or unclear. An explanation of why demographic data are necessary to community health is omitted or unclear.	20 points Discussion of the role of the community health nurse is vague, with no integration of case finding, reporting, data collecting, data analysis, or follow-up skills. An incomplete explanation of why demographic data are necessary to community health is provided.	22 points Discussion of the role of the community health nurses is limited, with a brief overview of skills associated with community assessment and planning. An explanation of why demographic data are necessary to community health is summarized.	23 points Discussion of the role of community health nurse is clear, with a comprehensive description of skills associated with community assessment and planning. An explanation of why demographic data are necessary to community health is presented.	25 points Discussion of the role of the community health nurse is clear, comprehensive, and inclusive of the community nurse’s responsibilities to primary, secondary, and tertiary prevention through tasks such as case finding, reporting, data collection and analysis, and follow-up. A clear explanation of the importance of demographic data to community health is presented.
Global Implication Global Implication	0 points Global implication of the disease is omitted or unclear.	10 points A discussion of the global implication of the disease is vague, with no integration of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is not provided.	11 points A discussion of the global implication of the disease is limited, with some integration of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.	11.5 points A discussion of the global implication of the disease is clear, with a comprehensive description of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.	12.5 points A discussion of the global implication of the disease is clear, comprehensive, and inclusive with a comprehensive description of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.
Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors	0 points Description of the epidemiologic triangle is omitted or presented with many inaccuracies.	20 points The communicable disease is described with some inaccuracies within the epidemiologic triangle. A visual description of the factors and interaction is not present.	22 points The communicable disease is described accurately and clearly within the context of the epidemiologic triangle.	23 points The communicable disease is described accurately within the context of the epidemiologic triangle. A brief description of factors and interaction is presented.	25 points The communicable disease is described thoroughly, accurately, and clearly within an epidemiological triangle. A visual description of the triangle and how the components of the model interact is included.
Comprehensive Description of a Communicable Disease and the Demographic of Interest Comprehensive Description of a Communicable Disease and the Demographic of Interest	0 points Demographic of interest and clinical description are omitted or presented with many inaccuracies.	10 points Limited and/or vague summary of demographic of interest and communicable disease is provided. Overview does not offer a clear representation of information necessary for epidemiological study.	11 points Overview of the demographic of interest and clinical description of the communicable disease is presented with some inaccuracies of the clinical descriptors.	11.5 points Clinical description of the communicable disease and demographic of interest is provided. Summary is brief but accurate.	12.5 points Overview describing the demographic of interest and clinical description of the communicable disease is presented with a thorough, accurate, and clear overview of all of the clinical descriptors.
Format/Documentation Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline.	0 points Appropriate format is not used. No documentation of sources is provided.	3 points Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident.	3.3 points Appropriate format and documentation are used, although there are some obvious errors.	3.45 points Appropriate format and documentation are used with only minor errors.	3.75 points No errors in formatting or documentation are present.

Criterion

1. Unsatisfactory

2. Less Than Satisfactory

3. Satisfactory

4. Good

5. Excellent

National Agency or Organization That Works to Addresses Communicable Disease

0 points

Agency and description of contribution are omitted.

10 points

An agency or organization is identified, but discussion is vague or inaccurate in relation to the communicable disease chosen.

11 points

An agency or organization is identified, but discussion regarding efforts to address communicable disease is lacking.

11.5 points

An agency or organization is identified, but discussion regarding efforts to address communicable disease is brief.

12.5 points

An agency or organization is identified. A clear and accurate description of efforts to address communicable disease is offered.

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

0 points

Description of the determinants of health and their role in disease development is omitted or presented with many inaccuracies.

10 points

Paper partially describes the determinants of health in relation to disease development.

11 points

Paper identifies the determinants of health in relation to the communicable disease selected but does not include an explanation of their role in the development of disease.

11.5 points

Paper describes each determinant of health with a comprehensive discussion of their contribution to disease development and progression.

12.5 points

Paper comprehensively discusses the determinants of health in relation to the communicable disease, explains their contribution to disease development, and provides evidence to support main points.

Development, Structure, and Conclusion

Advances position or purpose throughout writing; conclusion aligns to and evolves from development.

0 points

No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered.

5 points

Writing lacks logical progression of the thesis, position, or purpose. Some organization is attempted, but ideas are disconnected. Conclusion is unclear and not supported by the overall development of the purpose.

5.5 points

Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the development of the purpose.

5.75 points

The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other. Conclusion aligns to the development of the purpose.

6.25 points

The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and logical conclusion aligns to the development of the purpose.

Evidence

Selects and integrates evidence to support and advance position/purpose; considers other perspectives.

0 points

Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the perspective of the writer.

5 points

Evidence is limited or irrelevant. The interpretation of other perspectives is superficial or incorrect.

5.5 points

Evidence is used but is insufficient or of limited relevance. Simplistic explanation or integration of other perspectives is present.

5.75 points

Relevant evidence that includes other perspectives is used.

6.25 points

Specific and appropriate evidence is included. Relevant perspectives of others are clearly considered.

Thesis, Position, or Purpose

Communicates reason for writing and demonstrates awareness of audience.

0 points

The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident.

5 points

The thesis, position, or purpose is unfocused or confused. There is very little awareness of the intended audience.

5.5 points

The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear. There is limited awareness of the appropriate audience.

5.75 points

The thesis, position, or purpose is adequately presented. An awareness of the appropriate audience is demonstrated.

6.25 points

The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience.

Mechanics of Writing

Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc.

0 points

Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout.

2 points

Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent.

2.2 points

Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted.

2.3 points

Few mechanical errors are present. Suitable language choice and sentence structure are used.

2.5 points

No mechanical errors are present. Appropriate language choice and sentence structure are used throughout.

Role of the Community Health Nurse and Importance of Demographic Data

0 points

Discussion of the role of the community health nurse is omitted or unclear. An explanation of why demographic data are necessary to community health is omitted or unclear.

20 points

Discussion of the role of the community health nurse is vague, with no integration of case finding, reporting, data collecting, data analysis, or follow-up skills. An incomplete explanation of why demographic data are necessary to community health is provided.

22 points

Discussion of the role of the community health nurses is limited, with a brief overview of skills associated with community assessment and planning. An explanation of why demographic data are necessary to community health is summarized.

23 points

Discussion of the role of community health nurse is clear, with a comprehensive description of skills associated with community assessment and planning. An explanation of why demographic data are necessary to community health is presented.

25 points

Discussion of the role of the community health nurse is clear, comprehensive, and inclusive of the community nurse’s responsibilities to primary, secondary, and tertiary prevention through tasks such as case finding, reporting, data collection and analysis, and follow-up. A clear explanation of the importance of demographic data to community health is presented.

Global Implication

0 points

Global implication of the disease is omitted or unclear.

10 points

A discussion of the global implication of the disease is vague, with no integration of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is not provided.

11 points

A discussion of the global implication of the disease is limited, with some integration of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.

11.5 points

A discussion of the global implication of the disease is clear, with a comprehensive description of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.

12.5 points

A discussion of the global implication of the disease is clear, comprehensive, and inclusive with a comprehensive description of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.

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

0 points

Description of the epidemiologic triangle is omitted or presented with many inaccuracies.

20 points

The communicable disease is described with some inaccuracies within the epidemiologic triangle. A visual description of the factors and interaction is not present.

22 points

The communicable disease is described accurately and clearly within the context of the epidemiologic triangle.

23 points

The communicable disease is described accurately within the context of the epidemiologic triangle. A brief description of factors and interaction is presented.

25 points

The communicable disease is described thoroughly, accurately, and clearly within an epidemiological triangle. A visual description of the triangle and how the components of the model interact is included.

Comprehensive Description of a Communicable Disease and the Demographic of Interest

0 points

Demographic of interest and clinical description are omitted or presented with many inaccuracies.

10 points

Limited and/or vague summary of demographic of interest and communicable disease is provided. Overview does not offer a clear representation of information necessary for epidemiological study.

11 points

Overview of the demographic of interest and clinical description of the communicable disease is presented with some inaccuracies of the clinical descriptors.

11.5 points

Clinical description of the communicable disease and demographic of interest is provided. Summary is brief but accurate.

12.5 points

Overview describing the demographic of interest and clinical description of the communicable disease is presented with a thorough, accurate, and clear overview of all of the clinical descriptors.

Format/Documentation

Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline.

0 points

Appropriate format is not used. No documentation of sources is provided.

3 points

Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident.

3.3 points

Appropriate format and documentation are used, although there are some obvious errors.

3.45 points

Appropriate format and documentation are used with only minor errors.

3.75 points

No errors in formatting or documentation are present.