Non-Communicable Diseases and Nursing Roles
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Questions and Answers

Which of the following are categories of non-communicable diseases (NCDs)? (Select all that apply)

  • Chronic respiratory diseases (correct)
  • Respiratory infections
  • Diabetes (correct)
  • Cardiovascular diseases (correct)

    • What role do nurses play in relation to NCDs?

    Nurses play a significant role in reducing the burden of NCDs through interventions at various levels.

    The four common modifiable risk factors for NCDs are nutrition, physical activity, _____, and _____?

    tobacco use, alcohol use

    Chronic diseases can be caused by infectious agents.

    <p>False</p> Signup and view all the answers

    What is one of the leading causes of death related to NCDs in the United States?

    <p>Heart disease</p> Signup and view all the answers

    Which factors can lead to the prevention of NCDs?

    <p>Reducing risk factors</p> Signup and view all the answers

    The prevalence of diabetes has increased due to changes in lifestyle, particularly _____ and _____?

    <p>exercise, diet</p> Signup and view all the answers

    What effect does screening have on NCDs?

    <p>Screening leads to early detection and treatment.</p> Signup and view all the answers

    Which of the following are risk factors for cancer? (Select all that apply)

    <p>Exposure to carcinogens</p> Signup and view all the answers

    What is the second leading cause of death globally?

    <p>Cancer</p> Signup and view all the answers

    What does substance use refer to?

    <p>The use of psychoactive substances that have a pharmacological effect on the brain and central nervous system.</p> Signup and view all the answers

    Which of the following are classes of substances? (Select all that apply)

    <p>Cannabis</p> Signup and view all the answers

    What are the measures of substance use?

    <p>Quantity, frequency, pattern, and duration.</p> Signup and view all the answers

    Barriers to prevention of substance use include a lack of economic resources.

    <p>True</p> Signup and view all the answers

    What is substance use related harm?

    <p>Use linked to health-related harm, including physical, mental, and socioeconomic harm.</p> Signup and view all the answers

    What are the classifications of substance use? (Select all that apply)

    <p>Moderate use</p> Signup and view all the answers

    What is the goal of harm reduction models?

    <p>To reduce the harm related to at-risk substance use and aim for safer use or abstinence.</p> Signup and view all the answers

    What is the prevalence of tobacco use like in the United States?

    <p>Declining</p> Signup and view all the answers

    What does Medication-Assisted Treatment (MAT) address?

    <p>Opioid use disorders and alcohol use disorders.</p> Signup and view all the answers

    There is an acceptable level of substance use during pregnancy.

    <p>False</p> Signup and view all the answers

    Which of the following is a consequence of drug use?

    <p>Rebound effect</p> Signup and view all the answers

    What is stigma in the context of substance use?

    <p>A mark of disgrace or reproach.</p> Signup and view all the answers

    Which of the following are main categories for non-communicable diseases (NCDs)? (Select all that apply)

    <p>Cardiovascular diseases</p> Signup and view all the answers

    Nurses do not play a significant role in reducing the burden of NCDs.

    <p>False</p> Signup and view all the answers

    What are the four common modifiable risk factors for NCDs?

    <p>Nutrition, Physical activity, Tobacco use, Alcohol use</p> Signup and view all the answers

    What percentage of leading causes of death in the United States are NCDs?

    <p>7 out of 10</p> Signup and view all the answers

    What is the second leading cause of death globally?

    <p>Cancer</p> Signup and view all the answers

    The majority of NCDs can be prevented by reducing __________ risk factors.

    <p>modifiable behavioral</p> Signup and view all the answers

    What is a risk factor for developing chronic lower respiratory diseases?

    <p>Tobacco use</p> Signup and view all the answers

    What are two contributing factors to the increase in type 2 diabetes globally?

    <p>Changes in lifestyle and improved treatment</p> Signup and view all the answers

    Which of the following factors are considered environmental risk factors for NCDs? (Select all that apply)

    <p>Air quality</p> Signup and view all the answers

    Match the following NCDs with their primary risk factors:

    <p>Cancer = Tobacco use Diabetes = Obesity Chronic respiratory diseases = Air pollution Heart disease = Poor nutrition</p> Signup and view all the answers

    What is the UNAIDS 95-95-95 target?

    <p>An ambitious treatment target to help end the AIDS epidemic by 2030.</p> Signup and view all the answers

    What percentage of people living with HIV knew their HIV status in 2020?

    <p>84%</p> Signup and view all the answers

    What is one of the main approaches to controlling communicable diseases?

    <p>Changing the environment</p> Signup and view all the answers

    One of the main approaches to controlling communicable diseases is increasing population density.

    <p>False</p> Signup and view all the answers

    What is involved in 'increasing host resistance'?

    <p>Active or passive immunity, including the use of vaccines.</p> Signup and view all the answers

    Which of the following diseases are noted as the leading causes of death globally in 2020?

    <p>Diarrheal diseases</p> Signup and view all the answers

    What are the three key components needed in the transmission cycle?

    <p>Agent, Host, Environment</p> Signup and view all the answers

    Malaria is transmitted by the bite of an infected mosquito.

    <p>True</p> Signup and view all the answers

    Which of the following factors can prevent diarrheal diseases?

    <p>Sanitary systems</p> Signup and view all the answers

    What is the main mode of transmission for diarrheal diseases?

    <p>Fecal-oral route</p> Signup and view all the answers

    What is herd immunity?

    <p>Immunity of a population to a disease</p> Signup and view all the answers

    The attack rate is calculated by dividing the number of ill persons by the total population.

    <p>True</p> Signup and view all the answers

    Tuberculosis is caused by _____.

    <p>Mycobacterium tuberculosis</p> Signup and view all the answers

    What is the role of the World Health Organization (WHO) regarding tuberculosis?

    <p>To aim for a 90% reduction in TB deaths by 2030</p> Signup and view all the answers

    Which of the following pathogens is NOT one of the six general categories of agents?

    <p>Fungi</p> Signup and view all the answers

    Sexually transmitted infections can be transmitted through unprotected sexual contact.

    <p>True</p> Signup and view all the answers

    What are the three elements of epidemiology?

    <p>Person, Place, Time</p> Signup and view all the answers

    The epidemiological triangle consists of three components: Host, Agent, and _______.

    <p>Environment</p> Signup and view all the answers

    The ecological model is used only for designing health interventions.

    <p>False</p> Signup and view all the answers

    What is defined as the average number of years a person born in a given country would live?

    <p>Life expectancy</p> Signup and view all the answers

    Which of the following is a core part of public health science?

    <p>Epidemiology</p> Signup and view all the answers

    What is prevalence in epidemiology?

    <p>The number of existing cases divided by the total population</p> Signup and view all the answers

    Incidence is defined as what?

    <p>The number of new cases diagnosed in a given time period</p> Signup and view all the answers

    Ecological fallacy refers to the risk of drawing conclusions for individuals based on group findings.

    <p>True</p> Signup and view all the answers

    What is the role of passive surveillance?

    <p>Data collection based on voluntary or mandated reporting</p> Signup and view all the answers

    Study Notes

    Non-Communicable Diseases

    • Non-Communicable Diseases (NCDs) are not caused by infectious agents
    • Four main categories of NCDs are:
      • Cardiovascular diseases
      • Cancers
      • Chronic respiratory diseases
      • Diabetes

    Nursing Role

    • Nurses significantly reduce the burden of NCDs through interventions at all levels of care
    • The three levels of care include:
      • Primary
      • Secondary
      • Tertiary

    The World Health Organization (WHO) and NCDs

    • The majority of NCDs are preventable by reducing risk factors
    • Risk factors can be categorized as:
      • Modifiable behavioral risk factors
      • Genetic risk factors
      • Environmental risk factors
      • Sociodemographic risk factors

    Prevention

    • A comprehensive approach to preventing NCDs is required:
      • Individual level
      • Community level
      • Global level

    Chronic Care Model

    • The Chronic Care Model helps to improve the care of people with chronic conditions
    • The model incorporates the following principles:
      • Self-management support
      • Delivery system design
      • Decision support
      • Clinical information systems
      • Community resources
      • Health care organization

    Premature Death and NCDs

    • The majority of NCDs can lead to premature death
    • Premature death occurs earlier than the standard life expectancy
    • Premature death reflects the number of years of potential life lost

    NCDs in the United States

    • The four common risk factors for NCDs are modifiable:
      • Nutrition
      • Physical activity
      • Tobacco use
      • Alcohol use

    Leading Causes of Death and Disability

    • Seven of the top 10 leading causes of death in the United States are NCDs
      • Heart disease
      • Cancer
      • COVID-19
      • Accidents
      • Stroke
      • Chronic lower respiratory diseases
      • Alzheimer’s disease
      • Diabetes
      • Influenza and pneumonia
      • Nephritis, nephrotic syndrome, and nephrosis

    Cancer

    • Cancer is the second leading cause of death in the United States
    • Cancer is the second leading cause of death globally
    • Screenings have decreased death numbers
    • Survival rate has increased

    Risk Factors for Cancer

    • A combination of factors are associated with an increased risk of cancer:
      • Behavioral factors
      • Genetic factors
      • Environmental factors

    Breast Cancer Example

    • All three levels of risk apply to breast cancer:
      • Family history
      • Diet
      • Exercise
      • Reproductive history
      • Alcohol use

    Chronic Lower Respiratory Diseases (CRD)

    • The most common types of CRD are:
      • Chronic Obstructive Pulmonary Disease (COPD)
      • Asthma
      • Occupational lung diseases
      • Pulmonary hypertension
    • Main risk factors for CRD:
      • Tobacco use
      • Air pollutants
      • Environmental chemical fumes and dust

    Prevalence of Diabetes

    • Two underlying factors have contributed to an increase in the incidence of type 2 diabetes:
      • Changes in lifestyle
      • Improved treatment

    Risk Factors for NCDs: Behavioral

    • Common behavioral risk factors include:
      • Nutrition
      • Exercise
      • Obesity
    • These risk factors are higher in the Southern United States

    Risk Factors for NCDs: Environment

    • Pollutants increase the risk of:
      • Asthma
      • Cardiovascular health problems
      • Cancer
    • Pollutants can be found in the following places:
      • Home
      • Work
      • Air
      • Water
      • Ground

    Prevention Strategies for NCDs

    • At the individual and family levels, primary prevention focuses on behavioral change
    • Population-level primary prevention programs help to change barriers to a healthy lifestyle

    Secondary and Tertiary Prevention

    • Screening leads to early detection and treatment
    • Treatment, including early intervention, aims to:
      • Reduce morbidity and disability
      • Prevent premature death

    Substance Use

    • Refers to the use of psychoactive substances that affect the brain and central nervous system (CNS).
    • Effects include altered mood, perception, and consciousness.

    Substance Use and Health

    • Common substance classifications: Stimulants, Depressants, Inhalants, Dissociative anesthetics, Narcotics, Hallucinogens, Cannabis.

    Measures of Use and Risk

    • Quantity: Amount consumed.
    • Frequency: How often consumed (daily, weekly, monthly).
    • Pattern: Consistent or episodic use (binging).
    • Duration: Length of use over a lifetime.

    Barriers to Substance Use Prevention

    • Lack of economic resources hinders policy development and enforcement.
    • Understanding the context of substance use, burden of disease, and evidence-based approaches are crucial.
    • Linked to physical, mental, and socioeconomic harm.
    • Includes a spectrum of use from low risk to diagnosable substance use disorders (SUDs).
    • Consists of acute and chronic harm.

    Measurement, Surveillance, and Risk

    • Substance use measurement is crucial for surveillance.
    • Classification of use: Abstinence, Low-risk/moderate use, Harm-related use.
    • Distinction between low-risk and risky use is less clear for some substances.
    • All tobacco or illegal substance use is considered at-risk.
    • Prescribed psychoactive substance use is harmful if not aligned with the prescription.
    • No acceptable level of substance use exists during pregnancy.

    Substance Use and Health Surveillance

    • National surveillance surveys on substance abuse are regularly conducted in the US.
    • Examples include the Behavioral Risk Factor Surveillance System (BRFSS), National Survey on Drug Use and Health (NSDUH), and National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

    Excessive Alcohol Use

    • Heavy drinking: Exceeding recommended weekly drinks (15+ for men, 8+ for women and those over 65).
    • Binge drinking: Exceeding recommended drinks per occasion (5+ for men, 4+ for women or those over 65).

    Understanding Risk Across the Life Span

    • Fetal alcohol spectrum disorders (FASD): Caused by alcohol exposure in utero.
    • Alcohol use and adverse effects occur on the adolescent brain.
    • Older adults have increased risk due to changes in alcohol metabolism.
    • Duration of use increases risk for alcohol-related adverse outcomes (e.g., liver disease).

    Person-Centered Approach

    • Shift from "addict" to "person with an SUD".
    • "Harm-related substance use" emphasizes harm over diagnosis.

    SUD Occurs Across a Continuum

    • Classified by severity, physiological dependence, and treatment course.
    • Physiological dependence: Evidence of tolerance or withdrawal.
    • Tolerance: Needing more of a substance to achieve the same effect.
    • Withdrawal: Drug-specific physical or mental symptoms when use is stopped.

    Substance Use and Health Prevention Model

    • Health and Medicine Division prevention model clearly separates prevention and treatment.
    • Three levels of prevention:
      • Universal level: Identifying at-risk populations.
      • Selective level: Specific, higher-risk subgroups.
      • Indicated level: Subgroups at the highest risk.

    Harm Reduction Model

    • Aims to reduce harm associated with at-risk substance use.
    • Focuses on safer use or abstinence.
    • Aims to reduce harm at community and population levels.

    Prevalence of Tobacco Use

    • Prevalence varies by country.
    • Declining in the U.S., increasing globally, especially in low-income countries.
    • Majority (almost 80%) of smokers live in middle- or low-income countries.

    Screening and Treatment for Tobacco Use

    • Screening: Assessment of quantity, frequency, type, history, and duration of use.
    • Smoking cessation: Brief provider help, counseling, behavioral therapies, mobile phone-assisted treatment, and medications.

    Medication-Assisted Treatment (MAT)

    • Effective for opioid use disorders and alcohol use disorders (AUDs).
    • Part of a comprehensive treatment plan, including behavioral treatment.

    Consequences of Drug Use

    • Vary based on the drug's pharmacokinetics.
    • Rebound effects occur once the drug leaves the system (e.g., cocaine use understimulates the CNS, causing depression and decreased energy).
    • Increased risk of comorbid mental disorders, sexually transmitted infections, and other health issues.

    Drug Use and Vulnerable Populations Across the Life Span

    • Adverse effects vary based on the drug and individual characteristics:
      • Maternal and infant risks.
      • Effects on adolescent brain development.
      • Increased use in older adults.

    Screening and Treatment for Drug Use

    • Screening:
      • Drug Abuse Screening Test (DAST-10).
      • National Institute on Drug Abuse (NIDA) ASSIST tool.
    • Substance Abuse and Mental Health Services (SAMHSA) recommends SBIRT (Substance Abuse and Mental Health Services) to address drug use, mirroring its use for at-risk alcohol use.

    Substance Use and Communicable Diseases

    • Occurs across multiple levels.
    • Increases transmission risk.
    • Poorer health outcomes.
    • Lower engagement in care for those with substance use.

    Substance Use and Stigma

    • Stigma is a mark of disgrace or reproach.
    • Moral views on substance use vary based on factors like culture, social practices, substance, and user gender.
    • Can be a barrier to treatment.

    Non-Communicable Diseases (NCDs)

    • Focus: Diseases not caused by infectious agents, often chronic and prevalent.
    • Four Main Categories: Cardiovascular diseases, Cancers, Chronic respiratory diseases, Diabetes

    The Nursing Role in NCDs

    • Key Role: Nurses play a vital role in reducing the burden of NCDs through interventions at various levels:
      • Primary: Prevention
      • Secondary: Early detection and treatment
      • Tertiary: Managing existing conditions to prevent complications

    The World Health Organization (WHO) and NCDs

    • Emphasis on Prevention: NCDs can be prevented by reducing risk factors.
    • Types of Risk Factors: Modifiable behavioral, genetic, environmental, and sociodemographic factors.

    Prevention of NCDs

    • Comprehensive Approach: Requires efforts at individual, community, and global levels.

    Chronic Care Model

    • Goal: Improve chronic disease management through a collaborative approach.
    • Key Elements: Self-management support, care coordination, information systems, and organizational support.

    Premature Death and NCDs

    • Cause: NCDs frequently lead to premature death, defined as death occurring earlier than the standard life expectancy.
    • Significance: Reflects years of potential life lost.

    NCDs in the United States

    • Leading Risk Factors: Four modifiable risk factors account for most NCDs:
      • Nutrition
      • Physical activity
      • Tobacco use
      • Alcohol use

    Leading Causes of Death and Disability

    • Prevalence: Seven of the top 10 leading causes of death in the US are NCDs.
    • Causes:
      • Heart disease
      • Cancer
      • COVID-19
      • Accidents
      • Stroke
      • Chronic lower respiratory diseases
      • Alzheimer’s disease
      • Diabetes
      • Influenza and pneumonia
      • Nephritis, nephrotic syndrome, and nephrosis

    Cancer

    • Significance: Second leading cause of death in both the US and globally, but screening and survival rates have increased.

    Risk Factors for Cancer

    • Combined Factors: Behavioral, genetic, and environmental factors contribute to cancer risk.
    • Examples:
      • Behavioral: Indoor tanning, secondhand smoke, alcohol use, tobacco use
      • Genetic: Family history
      • Environmental: Exposure to carcinogens in the workplace

    Breast Cancer Example

    • Multiple Levels of Risk: Family history, diet, exercise, reproductive history, and alcohol use all contribute to breast cancer risk.

    Chronic Lower Respiratory Diseases (CRD)

    • Forms of CRD: COPD, Asthma, Occupational lung diseases, Pulmonary hypertension
    • Main Risk Factors: Tobacco use, air pollutants, environmental chemical fumes and dust

    Prevalence of Diabetes

    • Increase in Diabetes: Lifestyle changes (exercise and diet) and improved treatment have contributed to a rise in diabetes cases.
    • Growing Prevalence: A combination of increased incidence and decreased mortality has further pushed up diabetes prevalence.

    Risk Factors for NCDs: Behavioral

    • Key Factors: Nutrition, exercise, and obesity, with higher rates in the southern US.
    • Cultural Influence: Cultural factors can create barriers to lifestyle changes.

    Risk Factors for NCDs: Environment

    • Environmental Impacts: Pollutants increase risk of asthma, cardiovascular health problems, and cancer.
    • Pollutant Sources: Home, work, air, water, and ground.

    Prevention Strategies for NCDs

    • Individual and Family Prevention: Emphasize behavioral change, particularly healthy eating and exercise.
    • Population-Level Prevention: Target barriers to a healthy lifestyle through programs.

    Secondary and Tertiary Prevention

    • Secondary Prevention: Screening for early detection and treatment.
    • Tertiary Prevention: Treatment to reduce morbidity and disability related to the disease and prevent premature death.

    Communicable Disease Across Time

    • Communicable diseases (CDs) were the leading cause of death in 1900.
    • Measles and mumps were common in school children between 1950 and 1960.
    • Emerging communicable diseases began to appear at the end of the 20th century.
    • Communicable diseases remain a major cause of morbidity and mortality in the 21st century, with new diseases emerging.

    Global Causes of Death (2020)

    • Communicable diseases are among the top 10 causes of death.
    • COVID-19, lower respiratory infections, diarrheal diseases, and tuberculosis are included.

    Communicable Disease and Surveillance

    • Public health is responsible for the surveillance of communicable diseases from a local to a global level.
    • An epidemic is a significant increase in disease.
    • An endemic is the usual number of cases of a disease within a population.
    • A pandemic refers to epidemics occurring worldwide.

    Communicable Diseases and Nursing Practice

    • Nurses care for patients with communicable diseases.
    • Prevention measures include personal protective equipment (PPE), proper cleaning of equipment, and preventing transmission to coworkers, oneself, and other patients.
    • Nurses must understand communicable diseases on an individual and population level.

    Populations and Communicable Diseases

    • Caring for a patient requires considering the implications for the population.
    • This includes understanding the infectious agent, who is at risk, the mode of transmission, prevention, and treatment.

    Communicable Diseases and the Burden of Disease

    • Advances in technology and transportation have increased the spread of emerging and re-emerging infectious diseases such as Zika, Ebola, Tuberculosis, and SARS-CoV-2.

    Infectious Respiratory Diseases

    • Many different infectious diseases (bacterial and viral) can affect the respiratory system, including chicken pox, diphtheria, rubella, and influenza.
    • Vaccinations have led to a decline in these diseases.

    Parasitic Diseases: Malaria

    • Malaria is a global health problem spread by infected mosquitoes.
    • It is found in subtropical areas and affects more than half of the world's population.
    • Around 172 million cases were reported worldwide in 2020.

    Diarrheal Disease

    • Diarrheal disease is a major global health concern, with 1.7 billion cases annually.
    • It is the second leading cause of death for children under five years old.

    Diarrheal Disease Causes and Transmission

    • Diarrheal diseases are caused by bacteria, viruses, and protozoa.
    • Transmission occurs through waterborne routes, such as cholera, or foodborne/person-to-person routes, including Escherichia coli.

    Emerging Communicable Diseases

    • Emerging communicable diseases place a burden on economic, social, and healthcare systems.
    • Pandemics require a coordinated and timely response.

    Eradicated and Reemerging Communicable Diseases

    • Smallpox has been eradicated, and polio and dracunculiasis (Guinea Worm) are close to eradication.
    • Other diseases, including malaria, tuberculosis, and bacterial pneumonias, are re-emerging in drug-resistant forms.

    Tuberculosis

    • Tuberculosis (TB) is caused by Mycobacterium tuberculosis.
    • In 1889, TB was recognized as preventable rather than inherited.
    • The World Health Organization (WHO) End Strategy and the United Nations' Sustainable Development Goals aim to reduce TB deaths by 90% and TB incidence by 80% by 2030.

    Communicable Disease Transmission

    • The transmission cycle of a communicable disease involves three key components: the agent (pathogen), the host, and the environment.

    The Cycle of Transmission

    • The epidemiological triangle provides tools for researchers to understand the cycle of transmission.

    Agent Characteristics

    • The agent, or pathogen, is the infectious organism that causes the disease.
    • There are six general categories of pathogens: bacteria, rickettsia, viruses, mycoses, protozoa, and helminths.

    Specific Agent Characteristics

    • Infectivity refers to the capacity of the agent to enter and multiply in the host.
    • Pathogenicity is the capacity of the agent to cause disease in the human host.
    • Virulence is the degree of pathogenicity quantitatively.
    • Toxigenicity is the ability to release toxins that contribute to disease within the human host.
    • Antigenicity is the ability to produce antibodies in the human host.

    Environmental Characteristics

    • The environment refers to external conditions that affect the transmission of the infectious agent, including reservoirs like humans, animals, water, food, air, or soil.

    Human Reservoir

    • Humans can be a reservoir for a pathogen, either when acutely ill or as carriers.
    • Carriers can be incubating (infected but not yet showing signs), convalescent (infected but no longer showing acute signs), or chronic (infected with no signs for a long period).

    Mode of Transmission

    • The mode of transmission is the way the agent leaves its reservoir and enters a host.
    • This can be through various pathways, including water, food, air, vectors (like mosquitos), fomites (inanimate objects), unprotected sexual contact, or penetrating trauma.

    Host Characteristics

    • The host is the human at risk for disease due to exposure to the agent.
    • Susceptibility refers to the likelihood of becoming infected with the agent, influenced by immunity and resistance.

    Host Characteristics: Immunity

    • The immune system protects the body from pathogens, comprising innate and adaptive systems.
    • Innate immunity provides immediate defense through immune cells and chemicals.
    • Adaptive immunity targets specific pathogens through antibody production.
    • Humoral immunity involves B cells producing antibodies.
    • Cellular immunity involves T cells destroying pathogens.

    Host Characteristics: Immunity (continued)

    • Immunity can be passive (transferred from another individual) or active (acquired through exposure).
    • Artificial passive immunity involves transferring antibodies.
    • Active immunity is acquired through exposure to the agent.

    Host Characteristics: Defense Mechanisms

    • The body employs various defense mechanisms to avoid, resist, or tolerate infectious pathogens.
    • Avoidance involves preventing exposure through barriers, like the skin.
    • Resistance resists disease without antibodies, including inherited or acquired forms.
    • Tolerance enhances tissue resistance to pathogen-induced damage.

    Host Characteristics: Colonization

    • Colonization refers to being infected with an agent but showing no signs of disease.
    • Colonized individuals can still spread the disease.
    • Examples include Methicillin-resistant Staphylococcus aureus (MRSA).

    Breaking the Chain of Infection

    • Understanding the cycle of transmission for a specific pathogen provides valuable information for breaking the chain of infection.
    • Interventions can target any point in the transmission cycle.

    Outbreak Investigation Steps

    • A systematic epidemiological investigation helps to determine if there is a sudden increase in the incidence of a CD.
    • This includes defining a case, determining the outbreak's severity (case fatality rate, CFR), mapping the epidemic curve, generating hypotheses, conducting case finding, determining common sources of exposure, identifying the source of transmission, and taking action.

    Life Cycle of the Agent

    • The life cycle of an agent provides insights into its spread and transmission.

    Case Fatality Rate and the Epidemic Curve

    • The CFR determines the outbreak's severity, representing the number of fatal cases divided by the total number of cases.
    • The epidemic curve, plotted on a graph, shows the number of cases on the Y-axis and time elapsed (from exposure to symptoms) on the X-axis.

    Epidemic Curve

    • The epidemic curve helps differentiate between point source (single exposure), intermittent source (exposure comes and goes), and continuous source (ongoing exposure).

    Managing an Outbreak

    • Managing an epidemic requires action on multiple levels, including identifying the source, isolating the source, and determining how to break the cycle of transmission.
    • The incubation period is the time between exposure and the onset of symptoms.
    • Herd immunity refers to the protection of a population by a large enough portion being immune through vaccination or past infection.
    • The threshold of immunity is the percentage of the population that must be immune to achieve herd immunity.

    Managing an Outbreak (continued)

    • Managing outbreaks requires prompt action, such as alerting the public to ongoing risks and providing treatment.

    Infectious Agents and Attack Rates

    • The incubation period for a pathogen refers to the time between exposure and the first signs of disease.
    • The infectious period is the time during which an infected person can transmit the infection.

    Herd Immunity

    • Herd immunity protects those who are not immune (through vaccination or prior infection) by preventing widespread transmission.

    Attack Rate and Secondary Attack Rate

    • The attack rate is the number of ill persons divided by the total population (ill and well).
    • This can be calculated based on specific risk factors.
    • The secondary attack rate is the number of new cases among contacts divided by the total number of contacts.

    Sexually Transmitted Infections (STIs)

    • STIs are transmitted through sexual contact and bodily fluid exchange.
    • They are preventable and caused by more than 25 infectious agents.
    • STIs can lead to serious illnesses and disabilities, impacting reproductive health, fetal and perinatal health, and cancer.

    Notifiable STIs in the United States

    • Chlamydia, gonorrhea, and syphilis are notifiable STIs with federally funded control programs.
    • Chlamydia and gonorrhea can lead to pelvic inflammatory disease (PID) and can be transmitted to infants during delivery.
    • Syphilis has four stages: primary, secondary, tertiary, and latent, and can be transmitted to infants during pregnancy or delivery.

    STI Risk Factors

    • Unprotected sexual contact is the main risk factor for STIs.
    • Other risk factors include gender, ethnicity, sexual orientation, socioeconomic factors, underreporting, and access to care.

    HIV and AIDS

    • HIV emerged as a new STI in 1981, initially with a high case fatality rate.
    • Effective treatment has reduced the risk of death from HIV infection.
    • At the end of 2019, 1.12 million people aged 13 and older were living with HIV in the United States.

    HIV and AIDS (continued)

    • HIV can remain undetected for up to 15 years after exposure.
    • 13% of people living with HIV in the US are unaware of their status.
    • The highest rate of new cases occurs among 25- to 29-year-olds.
    • The highest incidence is found in men who have sex with men, Black, and Hispanic/Latinx communities.
    • HIV infection is increasing among older adults.

    UNAIDS 95-95-95

    • This ambitious treatment target aims to end the AIDS epidemic by 2030.
    • In 2020, 84% of people living with HIV knew their status, 73% were on sustained antiretroviral therapy, and 66% in treatment were virally suppressed.

    Controlling Communicable Diseases

    • There are three main approaches to controlling communicable diseases:
      • Changing the environment: altering or eliminating the reservoir, controlling vectors, improving hygiene practices, and using aseptic techniques.
      • Deactivating the agent: using physical and chemical agents.
      • Increasing host resistance: through active or passive immunity, including vaccines to train the immune system.

    Epidemiology

    • Epidemiology focuses on three elements: person, place, and time.
    • Nurses play a vital role in data collection through assessments and timely reporting.

    The Science of Epidemiology

    • The field shifted from sanitary phase to infectious disease phase, connecting specific organisms to diseases and linking exposures to occurrences.
    • Risk factor phase identified exposures linked to injury or disease, helping to identify and reduce risk factors.

    Genetic Risk Factors (Genomics)

    • Genomics explores the heritability of factors affecting illness and disease development.
    • Challenges include individual decision-making based on genetic testing and the multifactorial nature of most diseases, involving multiple genes and risk factors.

    Epidemiological Frameworks

    • Three frameworks guide epidemiology: epidemiological triangle, web of causation, and ecological model.

    Epidemiology Triangle

    • The triangle has three components: host, agent, and environment.
    • Applicable to all diseases, communicable and non-communicable.

    Epidemiology

    • Agent: biological, chemical, nutritive, physical, or psychological.
    • Host: Susceptible human or animal.
    • Environment: External factors influencing host vulnerability.

    Epidemiological Constructs

    • Concepts used to understand diseases and risk factors.

    Seven Questions for an Epidemiology Investigation

    • Who, what, when, where, why, how, and how long?
    • Analyzes illness at the population level to facilitate health improvements through intervention.

    Causality

    • Stimulus or action leading to an effect or outcome.
    • Determines the relationship between risk factor and health effect, investigating a statistical association.
    • Causal relationship can be direct or indirect.

    Web of Causation Framework

    • A complex model representing multiple factors influencing the development of disease.

    Ecological Model

    • Used for health promotion intervention design, understanding health behaviors, and analyzing groups.
    • Promotes understanding and population health and wellness.

    Life Expectancy

    • A measure of population health reflecting average lifespan if mortality rates remain constant.

    Biostatistics

    • Analysis of data related to human organisms.
    • Used in public health and other related sciences.
    • Examines variation among biological organisms.
    • A core component of public health science.

    Rates

    • Rates represent the proportion of disease or health events (e.g., mortality) within a population.
    • Used by epidemiologists to describe disease risk in a specific population during a defined period.

    Types of Rates

    • Mortality rate (death rate).
    • Morbidity rate (number or proportion of individuals with disabilities, illnesses, or diseases).
    • Attack rates.
    • Secondary attack rates.

    Prevalence

    • The number of existing cases divided by total population, multiplied by a multiplier.
    • Period prevalence considers the average population during a specified time.

    Incidence

    • Number of new cases diagnosed in a given time divided by total at-risk population, multiplied by a multiplier.

    Prevalence Pot

    • A visual representation of the relationship between incidence, prevalence, and duration of disease.

    Ecological Fallacy

    • An error in assuming individual conclusions based on group findings.

    Outbreak Investigations

    • Conducted for communicable and non-communicable diseases and toxic exposures.
    • Involve investigation, data analysis, interpretation, health promotion, and evaluation.

    Epidemiology Tools

    • Descriptive epidemiology analyzes existing population and health data.
    • Analytical epidemiology uses health data to determine associations between risk and occurrences.
    • Three types: case control study, cohort study, and clinical trial.

    Outbreak Investigations

    • Communicable disease outbreaks: Examine agent infectivity (number infected and route of infection) and analyze point sources and secondary spread.
    • Non-communicable disease outbreaks.

    Outbreak Investigations

    • Exposure to toxins: Analyze risk factors affecting public health.
    • Risk factors can be behavioral, environmental, or genetic.

    Surveillance

    • Ongoing, systematic collection, analysis, and interpretation of health data.
    • Essential for planning, implementing, and evaluating public health practices.

    Passive Surveillance

    • Data collected from individuals or institutions reporting health information voluntarily or through mandates.
    • Responsibility for data collection and reporting falls on healthcare providers or public health professionals.

    Active Surveillance

    • Involves public health professionals actively identifying disease or health condition cases.

    Results of Surveillance

    • Surveillance data helps researchers evaluate the impact of diseases on population health.

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    Related Documents

    Chapter 10 Non-Communicable Diseases PDF
    Chapter 9 Communicable Diseases PDF
    Chapter 12 Substance Use PDF
    Epidemiology and Nursing Practice Lecture Slides PDF

    Description

    This quiz covers key aspects of Non-Communicable Diseases (NCDs), including their categories, prevention strategies, and the significant role of nurses in managing these conditions. Additionally, it discusses the importance of the World Health Organization in reducing the burden of NCDs globally.

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