Epidemiology
Epidemiology is the science of the causes, mechanisms, patterns of occurrence, and mass spread of certain diseases, as well as prevention and control methods. Epidemiology is justifiably the central science of public health and can be considered simultaneously as a unique approach to the examination of diseases using probability theory, statistics, and methods of conducting scientific experiments, a plan by which cause-and-effect relationships can be established by testing hypotheses about the reasons of diseases and ways to prevent them, as well as a tool that helps to make managerial decisions in the field of public health based on scientific data, uncovered cause-and-effect relationships and common sense. Moreover, it should be noted that the objects of study in epidemiology are infectious conditions since their spread has often assumed and continues to presume the character of pandemics, accompanied by millions of victims. In addition, epidemiology is one of the fields of medicine, and the new epidemiological data obtained are used to prevent diseases and promote a healthy lifestyle. Thus, epidemiology can be considered both a science and a healthcare practice. In particular, in modern epidemiology, the leading doctrine is the epidemic process, the elements of which are the source of the causative agent of infection, the mechanism of transmission, the susceptibility of the collective, and the patterns of the spread of diseases depending on social and other environmental factors. Moreover, this science uses a comprehensive method including epidemiological examination, microbiological, sanitary studies, comparative historical epidemics research, statistical analysis, and experimental approach. Consequently, the development of the science is mainly due to the success of microbiology, virology, parasitology, immunology, hygiene, as well as the clinic of infectious diseases. Accordingly, in epidemiological practice, the achievements of these disciplines are used in creating vaccines, disinfection, or laboratory diagnostics.
Outbreak
An epidemic outbreak is a category of the intensity of the epidemic process characterized by the simultaneous occurrence of infectious diseases in people in a specific territory (in a particular collective) associated with a common source of infection or ways of its transmission. This outbreak may occur in a particular area or society and affect several countries. In addition, this process can take several days and weeks or many years. Some outbreaks may be expected in a certain period, such as influenza. Sometimes, there are isolated cases that can rightfully be considered an outbreak and have severe consequences for citizens and public health. Moreover, investigation of an outbreak for an epidemiologist presents difficulties not only professionally but also due to the fact that a large number of people are involved, often causing a negative attitude towards healthcare institutions in society.
Incidence
Incidence is the prevalence of diseases among the population or in its groups. It is determined by identifying and registering the number of cases of illness when applying to a health facility (or during a dispensary examination) during the year. Incidence data serve as a basis for planning in healthcare. Based on these data, the volumes of medical care needed by the population, the bed fund, and the human healthcare resources are planned. Primary incidence is recorded when a patient is diagnosed in a given year for the first time in his life. The general morbidity rate takes into account not only new cases of diseases detected in a given year but also all cases of diseases that were established last year and served as the reason for the treatment (or the first visit) in a given year. The incidence rate is estimated by the number of diseases per 1000 or 100 thousand inhabitants living in a particular territory. The frequency of the spread of diseases is determined by the ratio of the number of patients to the average annual population. The contingent of patients is the totality of all persons suffering from this disease. This indicator is calculated as the number of patients registered in healthcare institutions (who applied both in the current and in previous years) at the end of the year to the population at the end of the year. Incidence data is collected from various sources. Of these, there are two main ones: the appeal of the population for medical care and medical examinations of the people. Additional sources are data obtained during the registration of hospitalization cases and causes of death (received during pathologic-anatomical and forensic autopsies) and data from comprehensive socio-hygienic studies. Considering all these data on morbidity, it is possible to judge the exhaustion or substantial morbidity. The exhausted incidence rate includes all diseases identified by circulation, as well as those identified additionally during medical examinations and analysis of the causes of death of the population.
Prevalence
Prevalence is the number of patients with the disease under study, present in a specific population at a given time. Like the morbidity rate, the morbidity rate is calculated per 100, 1000, 10,000, or 100,000 population. Since the number of existing patients among the population is much greater than the number of newly ill (at least with mental illnesses), the prevalence rate is most often calculated per 1,000, and the incidence rate is calculated per 100,000 population. When calculating the prevalence index, as already mentioned, one is talking about the number of patients among the population. In recent years, attempts have been made to clarify the concept of “sick”: after all, some people may have a mental disorder now, others in the past. Therefore, in modern literature, the prevalence at the time of examination (point prevalence) is distinguished, for example, as an indicator reflecting the number of people with the studied mental disorder at a given time; annual prevalence (year prevalence) is an indicator reflecting the number of people who had this disorder in any period of a year preceding the time of the survey; lifetime prevalence (life prevalence) is an indicator reflecting the number of people who had the disorder at some time in their lives.
The Role of Nursing within Epidemiology
It is no secret that nursing within the framework of epidemiology plays an essential, crucial, and significant role in ensuring the health and well-being of a particular population. Notably, the practice of autonomous and joint care of people in the spectrum of specific science is associated mainly with such concepts as prevention, promotion, curing, and rehabilitation (Nursing Path, 2020). In this case, nursing and epidemiology, as key and integral parts of the healthcare systems, form, develop and implement ideas regarding providing competent and correct patient care and proper infection control. Based on these principles and concepts, a nurse’s immediate duties and obligations are vividly expressed in guardianship, protection, patronage, consultation, advising, teaching, and expertise in the field of case detection. These specialists actively and continuously care for people in various conditions and circumstances and help them cope with stress and mental tension. In addition, they train and conduct awareness-raising programs, deeply study the health problems of a specific population, develop targeted interferences, and much more. In general, nurses are the primary communication points between patients and several health care providers. Therefore, without these medical professionals, it is impossible to thoroughly and comprehensively study specific types of illnesses. Hence, relying on a broader scope and range of actions, nursing and epidemiology improve, enhance, and raise national awareness regarding health issues and protection from harmful and dangerous phenomena. In brief, without the intervention of nursing practice in epidemiological studies and experiments, it would be challenging and unlikely to achieve good results and high achievements in realizing nations’ health, happiness, and prosperity. Due to these directions, humanity has managed to cope with many serious diseases and prevent their spread.
Diseases within the Community (Harlem, NY): Gonorrhea, Chlamydia, HIV
Primarily, the analysis of relevant, appropriate and reliable information has demonstrated incredibly disappointing indicators regarding the ratio of the number of healthy people and citizens infected with a sexually transmitted infection. Thus, for example, in 2020, Harlem became one of the areas with a high incidence of gonorrhea and P&S syphilis (NYC Health Department, 2020). Accordingly, Chlamydia is not pronounced and widespread in this territory in such a way. Based on other statistics, it can be additionally noted that Harlem is among the regions with high rates of HIV infection diagnosis (NYC Health Department, 2019). As a rule, women and men aged 15 to 24 become the most vulnerable to these infections (NYC Health Department, 2020). Notably, the figures regarding the number of cases continue to grow steadily. Over time, this situation may become a serious problem threatening the whole country, not just the region.
Diseases within the State (NY): Gonorrhea, Chlamydia, HIV
In general, the dynamics of the growth and prevalence of sexually transmitted diseases are especially evident not only in the territory of Harlem but also throughout the State of New York. Therefore, according to the specialists, infections such as syphilis, gonorrhea, and Chlamydia still “feel themselves” in the State. Although HIV has not been included in the list as one of the most common infections in the territory, the Department of Health calls on New Yorkers to resume routine testing for HIV and STIs in general (Gallahue & Lanza, n.d.). For example, from 2019 to 2020, the proportion of syphilis cases increased by at least 9%, and gonorrhea affected more than 5% of all women living in New York (Gallahue & Lanza, n.d.). Nonetheless, it remains reassuring at least the fact that the proportion of those infected with Chlamydia is gradually decreasing, which means that this infection will soon become less significant against the background of other illnesses. Accordingly, citizens may have serious health consequences if one does not make clear, accurate, and prompt interventions. Lockdowns and restrictions on the movement of New Yorkers during the COVID-19 outbreak have reduced the number of sexually transmitted conditions infected (Braunstein et al., 2021). If such and other measures are implemented, the government will have a better chance of defeating these diseases and preventing their spread to other cities and countries.
Diseases within the Nation (USA): Gonorrhea, Chlamydia, HIV
However, such a disappointing picture is noted throughout the United States. Despite the advanced medicine, the wide availability of contraception, and various tests, Americans are exposed to dangers such as gonorrhea, syphilis, Chlamydia, and HIV almost daily (Elflein, 2021). For example, the incidence of gonorrhea has reached highs in recent years, and young men under 30 are more likely to get syphilis in this area (Elflein, 2021). In the United States, the incidence of sexually transmitted diseases has increased dramatically, especially during the pandemic. More than half of the reported STDs are between the ages of 16 and 24, and racial minorities, including blacks, Latinos, and Native Americans, are disproportionately affected. Factors blamed for the surge include a decrease in the frequency of personal health services, fewer screenings, the diversion of health workers from STD-related work to respond to the COVID pandemic, and a shortage of STD tests and laboratory tests supplies, and interruptions in health insurance due to unemployment. However, social and economic factors, such as poverty and insurance status, additionally led to the worst consequences of STDs in 2022.
Associating 3 of the Most Current Infectious Diseases with Healthy People 2030 Objectives
Before drawing a parallel between particular infectious diseases and the specific program, it is necessary to identify the objectives of Healthy People 2030. Hence, Healthy People 2030 highlights such fundamental goals as ensuring health and well-being without preventable diseases, injuries, disability, and premature death. Moreover, the program focuses on eliminating health inequalities, creating an environment for opening the potential of health and well-being for all citizens and involving key parties in decisive actions aimed at improving the health of nations. Accordingly, based on this information, the program plans to achieve the health and well-being of citizens by 2030 by minimizing and eliminating diseases and infections of physical, mental, and social health, including those that are sexually transmitted. This shared responsibility extends to the entire country, states, and communities. Thus, Healthy People 2030 aims to form a prosperous and just society, and whether it is gonorrhea, Chlamydia, HIV, or another disease, it must be eliminated in every possible way.
Evidence-based Practices Aimed at Reducing Infectious Diseases
To date, there is a wide range of various reliable, objective, trustworthy, and scientifically sound practices in decreasing and eradicating infectious diseases. Thus, for example, the World Health Organization recommends that medical experts should adhere to specific tactics and strategies within the framework of training and mentoring, programs with specially trained experts, supervision, monitoring and auditing, the implementation of multimodal approaches, providing feedback, executing a particular environment and ensuring the availability of specific resources, as well as requirements for workload, staffing, and bed occupancy (Barrera-Cancedda et al., 2019). These are some of the most well-known and widespread practices approved by the specialized agency that plays a significant role in directing and coordinating international work in the health field within the UN systems. In particular, one should pay special attention to the following essential precautions. In this situation, the experts suggest referring to the standard, contact, droplet, and airborne precautions (Habboush et al., 2022). Therefore, one must monitor hand hygiene and cleanliness of the room in which a person is located and, in some cases, use personal protective equipment. Accordingly, patients with known or suspected infections should take precautions when moving and contacting other people. Moreover, if an individual has a disease transmitted by airborne droplets, then in such circumstances, they are required to follow the previously indicated advice in the same way. Finally, “special” patients should be under constant supervision in a particular isolation unit. In general, as practice shows, hand and environmental hygiene, screening and cohorting patients, surveillance, antibiotic stewardship, following guidelines, and patient safety are some of the safest and most reliable practices for reducing infectious diseases in nursing practice. Without any doubt, as an instance, one can cite various methods, techniques, tactics, and strategies to mitigate the situation. However, the above examples are sufficient for a general and complete understanding of the ways and measures of safety from the specific trouble.
Health Promotion Techniques
People should use the following health promotion techniques to combat various infectious, contagious, and communicable diseases. Primarily, one must pay attention to health communication, health education, as well as policies, systems, and environmental change (PSEs) in the spectrum of reorientation of medical services, the creation of a supportive environment, the development of personal skills of a nurse, strengthening the actions of society, and building a healthy public policy (5 health promotion action areas, 2022). Indeed, based on these concepts and ideas, the vast majority of citizens will be able to improve and enhance health literacy for prevention and early treatment (5 health promotion action areas, 2022). Moreover, through modern technologies and innovative solutions, PSEs play an active role in ensuring safety in certain public places. In addition, one should not forget about other equally essential strategies. As previously reported, it is necessary to promote a healthy lifestyle within the framework of particular policies, measures, interventions, actions, and plans to combat specific “harms,” coupled with mechanisms to support health promotion and disease prevention (Health promotion and disease prevention, n.d.). For example, a nurse can offer a patient to strengthen the immune system at home to avoid infection. To do this, they need to follow simple rules: eat more fruits and vegetables, move and exercise more, get enough sleep and rest, control stress, and drink more water. Furthermore, the scope of health promotion functions may include vaccination, dietary supplements, oral hygiene training, providing information about medical health risks, and much more (Health promotion and disease prevention, n.d.). Moreover, risk awareness, advertising of illness prevention, and promotion of a “right living” can also be added to this list.
References
5 health promotion action areas every nurse should know. (2022). University of Maine at Fort Kent.
Braunstein, S. L., Slutsker, J. S., Lazar, R., Shah, D., Hennessy, R. R., Chen, S. X.,… & Schillinger, J. A. (2021). Epidemiology of reported HIV and other sexually transmitted infections during the COVID-19 pandemic, New York City. The Journal of Infectious Diseases, 224(5), 798-803.
Barrera-Cancedda, A. E., Riman, K. A., Shinnick, J. E., & Buttenheim, A. M. (2019). Implementation strategies for infection prevention and control promotion for nurses in Sub-Saharan Africa: A systematic review.Implementation Science, 14(1), 1-41.
Elflein, J. (2021). Sexually transmitted diseases in the U.S. – statistics & Facts. Statista.
Gallahue, P., & Lanza, M. (n.d.). Health Department reports an increase in sexually transmitted infections in New York City from 2019 to 2020. City of New York.
Habboush, Y., Yarrarapu, S.N.S., & Guzman, N. (2022). Infection control. StatPearls Publishing.
Healthy people 2030 framework. (n.d.). Healthy People 2030.
Nursing Path. (2020).Role of a nurse in epidemiology. Nursing Path.
NYC Health Department. (2020). Sexually transmitted infections: Surveillance report, 2020.
NYC Health Department. (2019). HIV surveillance: Annual report, 2018.