Feb 23, 2024 NR 503 Week 3: Discussion- Current Event
NR 503 Week 3: Discussion- Current Event
NR 503 Week 3: Discussion- Current Event
This week we will explore current events related to epidemiology. You will present a scientific article to the class. Please focus on interpreting the research question, methodology, results, and conclusions from a sample of peer-reviewed scientific literature. Please be sure the article is related to epidemiology, summarizing its contents for the class, and providing a succinct written summary. Current events must have been published within the last six months. Written summaries should include:
State the objectives of the study
Summarize the study design and findings
Provide a reference of the article
Provide your opinion on how the “average” reader will respond to the article. Will the article influence decision making or thinking? Does the article leave out any important information?
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Zaire ebolavirus is a filovirus with five subspecies (Bundibugyo, Zaire, Restone, Tai Forest, and Sudan) with a case fatality ratio of 25-90% (Barry et al, 2018). It is transmitted through contact with the body fluids of infected patients (CDC, 2018). The way of stopping the transmission is by patient isolation and care, early diagnosis, infection control, rigorous tracking of contacts, and the use of targeted vaccination.
On May 3, 2018, the Ministry of Health of the Democratic Republic of the Congo was notified from the Health Division of Equateur Providence that 40 cases of fever (95%) with gastrointestinal symptoms, general fatigue (37 [90%] cases), loss of appetite (37 [90%]), and hemorrhagic signs (14 [33%] people) were occurred including 17 deaths due to possible Ebola virus (Barry et al, 2018). These data were collected by health professionals attending to cases and field investigators. On May 8, 2018, the Democratic Republic of the Congo reported 50 cases (13 probable, 37 confirmed) of Ebola virus disease in Equateur Province where is connected to the capital city (Barry et al, 2018). In order to confirm the cases, detection of Ebola virus RNA in body fluids or blood by reverse transcription PCR was required and used. Since the affected area is concentrated with high population, this outbreak is the highest and complex risk ever experienced by the Democratic Republic of the Congo. On May 20, 2018, 25 deaths from Ebola virus disease had been reported (Barry et al, 2018). In addition, they also reported that 1,458 contacts had been reported and addition 78 cases were confirmed, assuming heterogeneous transmissibility (Barry et al, 2018). The median age of people with probable or confirmed infection was 40 years and usually male (30 [60%]) (Barry et al, 2018).
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The design of the study is an epidemiological study with the case-controlled group since it studied people that have already contracted the disease. This study also reviewed published epidemiological evidence about clinical characteristics of Ebola virus disease and contrasted the results of past outbreaks. The aim of this study was to investigate and control the current Ebola virus disease outbreak in the Democratic Republic of the Congo. The results showed that the epidemiological characteristics and features of this outbreak in the Democratic Republic of the Congo, such as signs and symptoms of cases were consistent with previous outbreaks of Ebola virus disease in West Africa(Barry et al, 2018). It also reported that the most common exposures were caused by contact with infected people and participation in traditional burial rites for those who have died from this disease. The source of this outbreak is unknown; however, it’s possible that a new chain of transmission could occur after sexual contact with a male survivor (CDC, 2018). In addition, the case fatality ratio was higher than when this outbreak occurred in West Africa from 2014 to 2016 (Barry et al, 2018). Since West Africa has greater access to Ebola treatment, the case fatality ratio was decreased. The article concluded the study with the importance of safe and dignified burials, community engagement, early detection, and implementation of Ebola treatment along with vaccination for outbreak control (Barry et al, 2018).
As the reader, I believe that this article was informative and written thoroughly with analytical data and literature reviews. The average reader would find this information useful since it’s easy to understand and follow without a lot of medical terminologies. The article is also reliable and credible by showing the author’s information on the article. The writer also believes that the article didn’t leave out any important information. The article will influence when the Ministry of Health of the Democratic Republic of the Congo reinforces the implementation of Ebola treatment and vaccination at community clinics, local hospitals, and public health centers since the study results show high mortality and fatality rate of Ebola virus disease.
Barry, Ahmadou et al. (2018). Outbreak of Ebola virus disease in the Democratic Republic of the Congo, April–May 2018: An epidemiological study. The Lancet, 392 (2) 213-221, doi.org/10.1016/S0140-6736(18)31387-4
The Centers for Disease Control and Prevention (CDC). (2018). 2018 Democratic Republic of the Congo, Bikoro. Retrieved from https://www.cdc.gov/vhf/ebola/outbreaks/drc/2018-may.html
In my introduction of myself in week one, I mentioned that I enjoyed going outdoors, doing stuff like hiking and camping. It is usually my husband, myself, and our dogs. One thing I always worry about is tics and Lyme disease. I live in Indiana and the CDC has shown a rise in Lyme disease cases from 26 in 2006 to 127 confirmed cases in 2016 (Lyme disease data tables, 2017). When I saw the increase in numbers I decided to research on the current information regarding Lyme disease. I was able to find a research article that was published June 11, 2018.
The objective of the study was to determine if early medical intervention would improve complications of infection compared to delayed medical treatment (Hirsch, et al., 2018). This study used a qualitative study that conducted interview with 26 participants and found that there was a lack in education from both population and healthcare providers (Hirsch, et al., 2018). Of the 26 interviewed, ten stated they sought care at the start of symptoms and 7 of the 26 stated they were missed diagnosed by the medical provided that provided their initial assessment (Hirsch, et al., 2018). The researchers did not ask specifics of how the delay in treatment effected the participants but many did voice that it affected their ability to work and manage household responsibilities (Hirsch, et al., 2018).
I think, for the average reader the information in this research article does not provide much help. The article’s objective was to determine if there is an improvement in medical outcome by seeking medical treatment earlier; however, they failed to mention the complications or even determine them. They article states there is a lack in education but, again, failed to offer any education. With the general information given in this article it may cause the average person to do a little more research on their own, or even prompted them to question their PCP about general symptoms.
Early symptoms of Lyme disease fever, chills, joint pain and swelling, and a rash, which can be said of many different infection and easy to misdiagnosis (Signs and symptoms of untreated lyme disease, 2016). I don’t think that this information given will influence any of my decision making in my clinical practice, as there is not a huge population in my area that are at risk. However, it does make me think about educating myself more and look at more ways of prevention.
References
Hirsch, A. G., Herman, R. J., Rebman, A., Moon, K. A., Aucott, J., Heaney, C., & Schwartz, B. S. (2018). Obstacles to diagnosis and treatment of lyme disease in the usa: a Qualitative study. BMJ Open, 8(6), 1-7.
https://bmjopen.bmj.com/content/8/6/e021367Links to an external site.
Lyme disease data tables. (2017, November 1). Retrieved from CDC: https://www.cdc.gov/lyme/stats/tables.html
Signs and symptoms of untreated lyme disease. (2016, October 26). Retrieved from CDC: https://www.cdc.gov/lyme/signs_symptoms/index.html
During this week’s lesson, I was able to learn more about epidemiological research. Specifically, I am now able to understand key components and designs within epidemiological research such as case control designs, cohort designs, association, causation, and relative risk. Understanding these key elements will be foundational for future advanced practice nurses (APNs) as they distinguish creditable research. The two most widely used research design methods are case control and cohort design studies. Both studies seek to test assumption to find the correlation between a risk factor and a disease. A case-control study design begins with the disease prominence and associates risk factors amongst diseased (cases) and not diseased (controls) groups. Through this an odds ratio is produced and associates the ratios of individuals with the intervention between two groups being studied. On the other hand, the cohort design begins studying at contact to the risk factors and relates the incidence of the variable (sickness) in those that have been exposed to it and those in the groups that have not (control) (Aamir, 2016).
Next, association aids in developing a connection between variables. Causation suggests that contact with a variable produces causation of another variable or the disease. Interpreting variables and determining whether or not one causes another is key to determining causation in research. Austin Bradford Hill’s ‘aspects of causation’ can help form a list of components to help in this determination of causation: time, space, and form. By answering these, it can help validate causation and eliminate other types of association (Evans, Lucas, & Kerry, 2016).
Lastly, given the trivia question this week, relative risk (RR) is a ratio that compares two populations. Population A divided by population B equals the RR. The numbers in the RR equation are representative of the percentages reported within each population. If A represents the intervention or experiment group and B is the control group, then if the RR is < 1 it means that the intervention or experiment is not as likely to happen in A as it is in B, the control. If the RR is > 1 then it means that the intervention would more likely occur in A the experimental group, than in B, the control. If both populations equal each other than A/B would give an RR of 1, implying that there is no difference between the two groups (Sheldrick, Chung, & Jacobson, 2017).
References:
Aamir, O. (2016). Selecting the appropriate study design: Case–control and cohort study designs. Journal of Health Specialties, 4(1), 37-41. doi:10.4103/1658-600X.173842
Evans, D. W., Lucas, N., & Kerry, R. (2016). Time, space and form: Necessary for causation in health, disease and intervention? Medicine, Health Care, And Philosophy, 19(2), 207-213. doi:10.1007/s11019-015-9662-5 Sheldrick, R. C., Chung, P. J., & Jacobson, R. M. (2017). Math Matters: How misinterpretation of odds ratios and risk ratios may influence conclusions. Academic Pediatrics, 17(1), 1-3. doi:10.1016/j.acap.2016.10.008
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