In Community X (population 20,000), an epidemiologist conducted a prevalence survey in January of 2012 and reported an HIV prevalence of 2.2%. Over the next 12 months, the department of health reported an additional 50

In Community X (population 20,000), an epidemiologist conducted a prevalence survey in January of 2012 and reported an HIV prevalence of 2.2%

Morbidity is a term used to describe the unhealthy state of an individual (e.g., individual with diabetes) or within a population (e.g., the incidence of seasonal flu). Whereas mortality is the rate of death in population. Both terms are applied in epidemiology at the individual level and across a population. In public health, surveillance plays an essential role. Surveillance is carried out for many reasons, such as monitoring changes in disease frequency or monitoring changes in the levels of risk factors. Much of the information that is obtained about mortality and morbidity comes from surveillance.

For this assignment, examine prevalence and incidence to measure morbidity for a disease. Read the scenario below and complete the assignment as instructed.

Scenario

In Community X (population 20,000), an epidemiologist conducted a prevalence survey in January of 2012 and reported an HIV prevalence of 2.2%. Over the next 12 months, the department of health reported an additional 50 new HIV cases between February 2012 and January 2013. The total population stayed constant at 20,000.

Assignment Instructions

1. How many people had HIV in January 2012? Present or describe the formula you used to arrive at your answer.
2. Calculate the incidence rate assuming no HIV-related deaths over the 12-month period. Present or describe the formula you used to arrive at your answer. Be sure to clearly indicate the numerator and denominator used in your calculation and include an appropriate label for the rate.
3. In a summary of 200-250 words, interpret the results and discuss the relationship between incidence and prevalence. Discuss whether or not the epidemiologist should be concerned about these new HIV infections, assuming a previous incidence rate of 0.5 per 1,000 person-years prior to this updated risk assessment.

You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and public health content.

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This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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Expert Answer and Explanation

Measuring Morbidity: Prevalence and Incidence

The prevalence of disease and the incident rates are epidemiological concepts that help determine the number of cases of the disease in a population, and the rates of change of the disease within a specified duration of time (Dai et al., 2021). The latter is expressed as the incidences per a selected number of persons-years. Focusing on a hypothetical community, X, it is important to determine the prevalence of HIV cases including how these cases changed within a span of 12 months.

The Population of HIV Positive Persons in January 2012

Prevalence = The number of HIV incidences/ Population size x 100%

This implies that the number of incidences = (Prevalence in percentage x Population Size)/100

Given that the prevalence = 2.2%, and the population size = 20,000,

Then the population of HIV positive persons = (2.2x 20,000)/100

= 440

Out of the 20,000 persons that live in Community X,

Therefore, 440 were HIV positive in January 2012.

The Incidence Rates

Incidence rates = (The new infections / Population at risk within a given time) x 1,000

The population X =20,000, and 440 people are HIV positive,

Therefore, the population at risk = 20,000-440

= 19,560

Incidence rate in this case = (50/19,560) x 1,000

= 2.56 per 1000 individuals-years.

Interpretation of the Results

In January 2012, 440 persons of the 20,000 individuals living in community X were HIV positive, representing 2.2% of the population. The incidences increased by 50 cases within a period of 12 months, and because the incidence rates takes into account at risk population, the 440 value is subtracted from the total population, which remained constant. The calculation of the incidence rate revealed 2.56 cases per 1,000 person-years. Previously, the community recorded 0.5 cases per 1,000 person-years, and comparing this to the current rate, it is evident that the community’s current incidence rate is significantly higher. The rate of increase of the incidences is alarming considering that it is five times the previously recorded rates.

The information drawn from determining the incidence rate can be useful in informing epidemiological interventions focused on minimizing rates of infections or preventing new infections. The increase in rates is an indication of the infective interventions. It signifies the change in sexual behavior in the community, which results to the surge in cases. It also indicates poor adherence to treatment, exposing more people to the risk of infection. The other potential explanation is the laxity in the implementation of the public health education or anti-HIV campaign, resulting to lack of seriousness in terms of how individuals protect themselves against the infection (Lesko, Fox, & Edwards, 2022).

The findings can be useful in informing the development of interventions tailored towards slowing down the rate of growth of incidences. Part of these interventions may involve targeted public health education that considers individuals’ needs such as cultural needs (Johnson et al., 2024). It is equally important to emphasize the use of PrEP among discordant couples or people who suspect they have positive partners (Buitrago-Garcia, Salanti, & Low, 2022).

Conclusion

In conclusion, the incidence rates and the prevalence provide information that can be useful in establishing the effectiveness of the existing interventions, and informing the need to adopt new interventions. The two tools are useful in establishing how rates of HIV change with time in a community.

References

Buitrago-Garcia, D., Salanti, G., & Low, N. (2022). Studies of Prevalence: How a Basic Epidemiology Concept has Gained Recognition in The COVID-19 Pandemic. BMJ Open, 12(10), e061497. https://doi.org/10.1136/bmjopen-2022-061497.

Dai, H., Zhang, Q., Much, A. A., Maor, E., Segev, A., Beinart, R., Adawi, S., Lu, Y., Bragazzi, N. L., & Wu, J. (2021). Global, regional, and national prevalence, incidence, mortality, and risk factors for atrial fibrillation, 1990-2017: results from the Global Burden of Disease Study 2017. European heart journal. Quality of care & clinical outcomes, 7(6), 574–582. https://doi.org/10.1093/ehjqcco/qcaa061.

Johnson, L. F., Kassanjee, R., Folb, N., Bennett, S., Boulle, A., Levitt, N. S., Curran, R., Bobrow, K., Roomaney, R. A., Bachmann, M. O., & Fairall, L. R. (2024). A Model-Based Approach to Estimating the Prevalence of Disease Combinations In South Africa. BMJ Global Health, 9(2), e013376. https://doi.org/10.1136/bmjgh-2023-013376.

Lesko, C. R., Fox, M. P., & Edwards, J. K. (2022). A Framework for Descriptive Epidemiology. American journal of epidemiology, 191(12), 2063–2070. https://doi.org/10.1093/aje/kwac115.

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