Assigment .Apa seven . All instructions attached.

Ariel Lopez

5/31/23, 10:24 PM

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Discussion $: Ariel Lopez

Question 1

The increase in tuberculosis (TB) cases during this period has been attributed to several factors, including:

1. The HIV/AIDS epidemic: The human immunodeficiency virus (HIV), which causes acquired immune deficiency syndrome (AIDS), significantly increases the risk of active TB disease in people with latent TB infection. The HIV epidemic in the 1980s and early 1990s corresponded with an increase in TB cases during this period (CDC, 2016).

2. Increased immigration: During the 1980s and early 1990s, there was an increase in immigration from countries with high TB prevalence. Many immigrants carry latent TB infection, which can become active under certain conditions (CDC, 2016).

3. Drug-resistant TB: There was an increase in multidrug-resistant TB (MDR-TB) during this period, which is harder to diagnose and treat, leading to more prolonged periods of infectiousness and thus more secondary cases (World Health Organization, 2018).

Question 2

A.A. Based on the given data, the group with the greatest number of TB cases in 2007 was males in the age group 45-64 years, with 2747 reported cases.

B. Not necessarily. The raw number of cases in a certain demographic does not directly indicate the risk of developing the disease. Risk, as the question outlines, is typically determined by incidence rate, which is calculated using the formula provided. To determine whether males 45-64 years of age are at the greatest risk for developing TB, we would need to know the total number of people in that demographic during the time period (the population at risk) to calculate the incidence rate. The group with the highest incidence rate would then be considered at greatest risk for developing TB.

For example, if there were 100,000 males aged 45-64 and 2747 who developed TB, the incidence rate would be 2747/100,000 * 100,000 = 2747. However, if there were 1,000,000 males aged 25-44 and 2557 who developed TB, the incidence rate would be 2557/1,000,000 * 100,000 = 255.7. Despite having fewer cases, the older age group would be at a higher risk due to their higher incidence rate.

Question 3

To calculate the TB incidence rates (case rates per 100,000 population) for each year, we can use the formula:

 

Number of  new TB Population 100, 000  

2001: (15946 / 284,750,000) * 100,000 = 5.6

2002: (15056 / 289,538,462) * 100,000 = 5.2

2003: (14837 / 290,921,569) * 100,000 = 5.1

2004: (14501 / 295,938,776) * 100,000 = 4.9

2005: (14065 / 293,020,833) * 100,000 = 4.8

2006: (13754 / 299,000,000) * 100,000 = 4.6

2007: (13299 / 302,250,000) * 100,000 = 4.4

So the trend in TB incidence rates from 2000 to 2007 is a gradual decline. The rate drops from 5.8 cases per 100,000 population in 2000 to 4.4 cases per 100,000 population in 2007. Please note that these calculations are based on the provided estimated population values and reported TB cases for each year.

Question 4

Use the CDC data and Table 3 below to calculate the age-specific incidence rates of TB for 2007. EXAMPLE: 2007 <15 yr. old males = 245/10,652,174X 100,000= 2.3

Table 3. Case Rates: 2007

The number of TB cases in this age group in 2007 is 915, and the estimated population of males aged 15-24 is 21,785,714. To calculate the incidence rate per 100,000, you would do the following:

Incidence rate = (Number of cases / Population) * 100,000

= (915 / 21,785,714) * 100,000

= 4.2

Question 5

A. Based on the provided data in Table 3, the group with the highest incidence rate of TB in 2007 is males aged ≥65, with an incidence rate of 9.4 per 100,000.

B. There can be several reasons why the incidence rate of TB is highest in this age group. For one, older people generally have weaker immune systems compared to younger individuals, which makes them more susceptible to diseases such as TB. Additionally, they may have been exposed to TB earlier in their lives when the disease was more prevalent, and the disease can reactivate in older age. Lastly, there can be social and healthcare-related factors like longer duration of undiagnosed disease, difficulties in accessing healthcare, and comorbidities that make the disease more likely to manifest and be diagnosed in this age group.

Yes, my answer for question 5a is different from my answer for question 2a. This difference arises because the two questions are asking about two different measures:

· Question 2a is asking about the absolute number of TB cases, which was highest in the male 45-64 years age group (2747 cases).

· Question 5a is asking about the incidence rate, which takes population size into account. The incidence rate was highest in the male ≥65 years age group (9.4 cases per 100,000 population).

Question 6

TB incidence rates have generally declined over time in many countries, including the United States. This decline is primarily attributed to improved public health measures, such as the availability of effective antibiotics, increased access to healthcare, better living conditions, and enhanced public health programs targeting TB prevention, detection, and treatment.

In the mid-20th century, prior to the availability of effective antibiotics, TB was a major public health concern with high incidence rates. However, with the introduction of antibiotics like streptomycin in the 1940s and subsequent developments of other drugs, TB treatment became more effective, leading to a decline in TB cases and incidence rates.

Public health efforts also played a significant role in reducing TB incidence rates. These efforts include widespread screening programs, contact tracing, implementation of directly observed therapy (DOT) to ensure treatment adherence, and increased awareness campaigns

Question 7

To calculate the percent change, we can use the formula:

Percent change = (Rate2 - Rate1) / Rate1 * 100

Where Rate1 is the initial rate (1978) and Rate2 is the final rate (1979).

Substituting the values:

Rate1 = 1.3 per 100,000

Rate2 = 0.9 per 100,000

Using the formula:

Percent change = (0.9 - 1.3) / 1.3 * 100

Calculating the numerator:

0.9 - 1.3 = -0.4

Now, substituting this value into the formula:

Percent change = (-0.4) / 1.3 * 100

Calculating the division:

-0.4 / 1.3 = -0.3077

Finally, calculating the percent change:

-0.3077 * 100 = -30.77

Question 8:

Therefore, the TB death rate percent change between 1978 and 1979 is approximate -30.77%. This indicates a decrease in the TB death rate from 1978 to 1979.

Question 9:

Without the specific rates for 1978 and further information, it is challenging to determine the reasons for the large difference between the rates for those years. Possible factors that could contribute to differences in TB death rates include changes in healthcare access, improvements in TB treatment and diagnosis, changes in population demographics, variations in TB control measures, and changes in reporting practices or data quality.

Question 10:

To calculate the prevalence ratio of TB infection in the nursing home during the month of July, we need to determine the proportion of residents with positive tuberculin skin test results.

Given that out of 100 nursing home residents tested, 30 had positive results, we can calculate the prevalence ratio using the following formula:

Prevalence ratio = (Number of positive test results / Total number tested) * 100

Substituting the values:

Prevalence ratio = (30 / 100) * 100

Calculating the division:

30 / 100 = 0.3

Finally, calculate the prevalence ratio:

0.3 * 100 = 30

Therefore, the prevalence ratio of TB infection in this nursing home during the month of July is 30 per 100 residents. This means that approximately 30% of the residents tested had a positive tuberculin skin test result, indicating a TB infection.

Question 11:

Assessing families and communities requires different tools and approaches. When assessing families, healthcare professionals often use tools such as genograms and ecomaps to understand family structures, relationships, and dynamics. They may also conduct interviews or use standardized questionnaires to gather information on family health history, social determinants of health, and individual health behaviors within the family context.

When assessing communities, tools, and methods can include community surveys, interviews with key informants, community mapping, and analysis of secondary data sources like census data or health records. These approaches aim to understand the social, economic, and environmental factors influencing community health, as well as identify community strengths, needs, and resources.

Both family and community assessments aim to gather information about the health status, needs, and resources of the individuals and populations they encompass. However, the focus and scope differ, with family assessments centering on the specific dynamics within a family unit, while community assessments take a broader perspective on the overall health and well-being of a larger group.

Question 12:

Epidemiology is the scientific study of how diseases and health-related events occur in populations. It involves investigating patterns, causes, and effects of diseases to guide public health interventions and policies. Key concepts in epidemiology include:

1. Web of causation: The web of causation is a concept that recognizes that diseases often have complex causes involving multiple interconnected factors, including biological, environmental, behavioral, and social determinants. It highlights the importance of understanding the interplay of these factors to effectively prevent and control diseases.

2. Morbidity: Morbidity refers to the presence of disease or illness within a population. It is measured using various indicators, such as incidence rates (new cases), prevalence (total cases), and specific disease outcomes. Monitoring morbidity helps identify disease burden, trends, and risk factors, enabling the development of appropriate interventions and healthcare planning.

3. Mortality: Mortality refers to deaths that occur within a population. Epidemiologists study mortality rates to understand the impact of diseases and identify trends and patterns. Mortality rates can be calculated for specific diseases or overall mortality, and they provide important insights into the burden of diseases and their associated risk factors.

In summary, epidemiology is a scientific discipline that investigates disease patterns, causes, and effects in populations. It considers the web of causation, examines morbidity and mortality, and uses data to inform public health interventions and policies.

References

Kim, K., Choi, J. S., Choi, E., Nieman, C. L., Joo, J. H., Lin, F. R., Gitlin, L. N., & Han, H. R. (2016). Effects of Community-Based Health Worker Interventions to Improve Chronic Disease Management and Care Among Vulnerable Populations: A Systematic Review. American Journal of Public Health, 106(4), e3-e28. This study discusses the importance of understanding community characteristics in delivering effective health interventions.

Marmot, M., & Bell, R. (2018). Social determinants and non-communicable diseases: time for integrated action. BMJ (Online), 364, l251. This source discusses the role of social determinants in health outcomes, which is relevant to understanding the broader context in community health assessments.

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Edited by Ariel Lopez on Jun 1, 2023, 12:07:30 PM