Epidemiology Case

Epidemiology

NUR/408

December 24, 2012

Shannon Way

Epidemiology

HIV has evolved since the first cases were documented in 1981. Medical progress, technology, research, surveillance, and the advancement of antiretroviral therapy has taken HIV from being a fatal disease to a chronic disease. Epidemiology has played a major role in that achievement. One vulnerable population that is experiencing an increase in infection is in adolescent gay African American males. Epidemiological prevention tools provide scientific methods and interventions that increase the understanding of the relationship between agent, host, and environment in the infectious processes.

Definition and Description of Epidemiology

"Epidemiology is considered the fundamental science of public health, it is the distribution of health related states or events in specific popoulations, including the study of determinants that influences such states, and the application of this knowledge to control health problems" (Stanhope & Lancaster, 2012, p. 255). Epidemiologists investigate, observe, monitor, and classify elements and patterns that determine the presence or absence of disease in populations. Epidemiology incorporates "the examination and occurrences of chronic disease, mental health, and health related events such as accidents and injuries, and violence; occupational and environmental exposures and their effects and positive health states" (Stanhope & Lancaster, 2012, p. 255).

Steps and Methods of Epidemiology

Epidemiological methods are complex and consist of many steps. When an epidemiologic investigation is being conducted, clear steps must be followed to verify the existence of an outbreak. The initial step in the process is focused on collecting the facts. Compiling, analyzing, and interpreting vital statistics, disease records, census data, and health surveys are valuable sources of information (Ferng, n.d.). Organizing collected data and identifying cases will follow next in a natural progression, this will expand into a working theory. Analyzing and interpreting data will lead to a postulation. As validation occurs, interventions can be determined with cautious monitoring. As the process continues, interventions are recommended and are implemented based on scientific data. Effectiveness of interventions is evaluated as the source, place, and time of illness relevant to the data compiled are treated, and the disease is controlled. According to the CDC, once cases are verified and a diagnosis is made clinically and in the laboratory, disseminating the information to health care providers and the community, controlling the disease and prevention for further infections can begin, completing the steps in an epidemiologic investigation (CDC, n.d.).

Epidemiologic Triangle

Knowing what mechanism derives disease and the relationships that exist to make the disease thrive is epidemiology. According to Stanhope & Lancaster, 2012, there are three fundamental building blocks that modal what is referred to as the epidemiologic triangle; the agent, host, and environment. Interaction of these three elements successfully results in disease transmission (Stanhope & Lancaster, 2012).

The agent is representative of the "what" in epidemiology. The agent (microbe, virus, or organism) is the cause of the disease. This is further characterized as infectious process, chemical agent, or physical cause (Stanhope & Lancaster, 2012). HIV is the virus that represents the "what or agent" in the triangle, the transmittable agent that replicates in the host to create illness.

The Host in the triangle denotes the "who" in the triangle; humans, animals, and vectors that are exposed to disease act as a portal for the disease to enter. The host can be exposed to the disease or they can harbor the disease (Bam.gov, n.d.). HIV infection is transmitted via body fluids, breast milk, blood, or semen. The host may not know that he or she is infected at the time the virus enters the body, but may experience flu like symptoms lasting for a short time; this is known as primary infection. Antibodies from the virus may begin to develop six weeks to three months post infection, but illness may go undetected and recognized for several years before symptoms develop (Stanhope & Lancaster, 2012).

The Environment is the "where" of the triangle. This is distinguished by the atmosphere and conditions favorable for the transmission and growth of the agent (Bam.gov, n.d.). Environmental factors interact to stimulate disease augmenting their contribution to the triad; examples of environmental factors are "socioeconomic issues (SES), stress, behaviors, culture, and climate" (Stanhope & Lancaster, 2012). For HIV infection to occur, the environment for transmission has to be blood to blood contact through sexual transmission, sharing dirty needles to inject drugs, blood transfusions, organ donation or prenatally.

Descriptive and Analytical Epidemiology

Studying the distribution of disease to a specific population requires a methodical approach. Surveillance detects health threats and outbreaks in the community; it generates questions. Gathering and reviewing data that is collected from vital records, medical records, and health surveys will be a strong starting point .This information is informative, as it indicates specific behavior patterns of at risk populations and will answer the questions "what, who, where, when, and how many" (Stanhope & Lancaster, 2012, p. 256). This is known as descriptive epidemiology.

This aspect of epidemiology describes the pattern of conditions that occurs in the natural setting of the specific population. Information from descriptive fact finding may propose potential hypothesis testing, and statistical breakdown of the population at risk, exposed, and infected. This involves counting the population, the time, and proportion of the population that is at risk, the morbidity and mortality, and the prevalence of the existing disease in the population (Stanhope & Lancaster, 2012). This is the type of epidemiology used in the investigation of HIV positive adolescents. Characteristics of the person (race, ethnicity, sex, age, etc.) as it describes, identifies patterns of behavior, how the symptoms present, and a timeline of when infection is likely is descriptive.

Analytic epidemiology searches to identify associations between the