Applying Epidemiologic Analysis

Running head: APPLYING EPIDEMIOLOGIC ANALYSIS

Applying Epidemiologic Analysis to a Long-Term Care Problem

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APPLYING EPIDEMIOLOGIC ANALYSIS 2

Applying Epidemiologic Analysis to a Long-Term Care Problem

1. Description of Clostridia difficile

Clostridium difficile is a bacterium that brings about serious enteric problems such as

stomach colitis when one gets infected. The bacteria also have the chance of causing diarrhea

upon the people whom it affects. The disease mostly affects people who are older than 65 years,

given their rescinding immunity levels. Also, it affects those who have stayed at a given health

care setting for longer and are, therefore, exposed to the bacterium. Additionally, it also affects

people who have been treated by a wide range of antibiotics (Lessa, Mu, Bamberg, Beldavs,

Dumyati, Dunn & Wilson, 2015). These drugs, for the most part, will act against one another

and will, therefore, increase the chances of a person suffering from infection with the bacterium.

The disease is characterized by a sick feeling as well as individuals affected having a fever. The

people could also suffer from signs of dehydration, which could be experienced by having a dry

mouth and headaches. People suffering from the health problem may also experience a loss of

appetite.

To avoid being infected with the bacterium one can follow various recommendations that

are quite helpful. One of them includes finishing the drug regimen that has been prescribed.

Also, through drinking a lot of fluids, one can avoid a case of dehydration and be taking food

from time to time when the person feels hungry (Buffie, Bucci, Stein, McKenney, Ling,

Gobourne & Littmann, 2015). The bacterium infection is treated by taking a 14-day course of

antibiotics that have been proven to deal with the health problem. Infected people could control

the disease through avoiding visiting other places more until it has been conclusively proven that

they are well cured of the health issue. The Centers for Disease Control has indicated that nearly

half a million Americans are infected with the bacterium in a year.

APPLYING EPIDEMIOLOGIC ANALYSIS 3

2. Descriptive epidemiologic data

Some of the descriptive epidemiological data that I would put together to explain to the

management that concerns exist, would include the overall incidence and prevalence rates

concerning the disease.

During the previous year, cases were 3

In the new year, the cases are 10

The number of new cases = 10-3

= 7 new cases

The average population is given by













=322 residents









= 0.0217

APPLYING EPIDEMIOLOGIC ANALYSIS 4

The prevalence rate will be given by:





Therefore, the prevalence of the disease in the previous year was;





= 0.009259

The prevalence of the disease in the current year is;





= 0.03125

Explanation of the rates

The figures clearly show that there has been a rise in the number of cases of Clostridia

difficile infections by a factor of 0.0217. The case shows that the number of residents that suffer

from the disease is increasing, and this could necessitate a corrective action that may be

important in helping to reduce the situation to much lower levels. The figures relating to

prevalence rates also show that the number of residents with the infection at the facility is quite

high in the current year compared to the previous year. The prevalence factor figures for the

current year is a pit at 0.03125 compared to the one for the previous year which was quite low, at

0.009259.

APPLYING EPIDEMIOLOGIC ANALYSIS 5

3. Whether it is an outbreak

The case may be regarded to be an epidemic. The number of cases has gone beyond what

would be considered standard in the health facility. In the previous year, there were only three

such cases among the 324 residents. In the current year, however, there are ten such cases, yet it

is only May, having not even reached the middle of the country yet (Nieuwenhuijsen, 2015).

4. Research questions

There are various issues that I shall be interested in following through in a bid to get a

clear understanding of the problem. Also, to be in a position to create a proper action plan that

will play a big part in being able to deal with the problem in a manner that will raise a high

likelihood of stopping such occurrences from taking place. The questions shall be as follows;

i. Are patients usually checked for Clostridia difficile before being admitted to the

facility?

ii. Are there any regular checkups conducted on patients to identify any cases of

Clostridium infections among them?

iii. Are there any stringent measures put up to help address the problem of Clostridia

difficile infection at the health facility?

The questions will be quite important at looking the various elements that may be lacking in the

actions put up by the health facility for the purpose of dealing with the problem with due

effectiveness.

APPLYING EPIDEMIOLOGIC ANALYSIS 6

4. A 2X2 table for a case-control study to test the hypothesis

Factor

Disease

Total

Positive

Negative

Positive

a + b

Negative

c + d

Total

a + c

b + d

a + b + c + d

Factor

Disease

Total

Positive

Negative

Positive

Negative

298

300

Total

305

310

The paper will take into the assumption that of all the 10 cases reported, only 3 of them were true

positives and only 2 of them were false negatives. Therefore, the number of total positive with

Clostridia difficile would be 5.

Risk ratio will be given by the number of people tested positive for the health problem divided

by the number of individuals who are at a potential risk of getting the health problem.

The ratio will, therefore, be;









APPLYING EPIDEMIOLOGIC ANALYSIS 7

= 18.6

Since the figure is found out to be more than 1, there is a high chance that the disease is

an outbreak in the health facility. Therefore, the various health professional found at the facility

need to put in necessary actions to ensure that the said problem is well handled and that there is a

low chance that more people could be affected further by the said problem. It may necessitate

adjusting most of the preventive action put in place to deal with the new occurrences in a better

way (Nieuwenhuijsen, 2015).

5. Recommendations to the facility

Given the kind of observations made with regards to the extent of which Clostridia

difficile has had a great impact on the health facility, there are various measures that the

management of the entity could put into action to ensure that there is a considerable reduction in

the spread of the disease among people. Such a case will help to ensure that people can attain a

high quality of life in the end (Lessa et al., 2015). Such a case will also ensure that people do not

get to spend immense amounts of money to deal with the given health problem and as such, they

shall reduce the burden that the disease may have upon the health care system. The reduction of

the infection rates of the health problem could also play a huge role in the prevention of loss of

work hours that people may experience, a factor that may have an adverse effect on the economy

and even upon the personal lives of such people.

One of the measures that may be put up to help prevent the health problem from

spreading could be through providing proper health talks upon individuals who may be deemed

to be at risk of the health issue. In essence, most of the people who may be targeted in such an

exercise could be individuals who have been under a particular health care setting for some time

APPLYING EPIDEMIOLOGIC ANALYSIS 8

(Lessa et al., 2015). The aspect lies in the fact that such people could be highly exposed to the

chances of getting the infection. It may also target those individuals who are known to be under

treatment with some antibiotics. In such a case, those in charge of providing the health talks will

explain to the people at risk or their caregivers on some of the methods that they may put in

place to prevent the situation of either contracting or spreading the said health problem.

Regular medical checkups are also another way that may help to reduce the chances of

people spreading the disease to others. Individuals who fall under the group of all those who are

under the risk of getting the disease could undergo consistent medical check-up. Notably, this is

to easily identify the health problem and deal with it in an appropriate fashion in a bid to prevent

the chances of others getting affected (Buffie et al., 2015). In such a case, where a given person

tests positive with Clostridia difficile, the individual could quickly be put under treatment to kill

the given bacteria and prevent them from having an effect upon other persons who may come

into contact with such a person. In the particular situation, it will be a great reprieve as it will

help reduce the number of individuals who suffer from the health problem by a significant

margin.

Another measure also lies in ensuring that there are clean surfaces that do not have any

form of contamination. The case is, especially necessary for people who are under a given health

care setting, or are old. The aspect will help to ensure that there is little chance of the bacterium

to thrive on such surfaces. The case will also play a huge part in ensuring that the people who

could be having the health problem run a very low risk of passing it on to other people and as

such, the cycle of infection will be reduced by a considerable margin (Lessa et al., 2015). In such

a situation, there is a huge chance that the people will attain higher qualities of life through the

prevention of obvious health problems that can be dealt with in a proper fashion.

APPLYING EPIDEMIOLOGIC ANALYSIS 9

People could also avoid contracting the health issue through following the different

guidelines established in health facilities when visiting the sick in hospitals. One of them

involves avoiding getting into personal contact with such people as one may not be aware of any

contact diseases that such a person could be having and may make the already severe problem,

worse (Lessa et al., 2015). Another aspect also lies in people taking necessary actions to ensure

that they do not expose children to health problems by avoiding taking children who are less than

12 years old with them while having hospital visitations. Such children are usually not mature

enough to be aware of the underlying factors that they may need to put in mind while on hospital

visitations. They could, therefore, endanger their lives by doing actions that could end up making

them contact the health problem.

Another aspect also lies in people who are known to have the health problem, not to share

towels and flannels with other people, even if they are members of their family (Lessa et al.,

2015). Such a situation could increase the chances of passing the health problem on to them as

the risk of spread of Clostridia difficile is usually very high. In situations where people take

given recommendations into consideration, there is a high chance that the likelihood of spread of

the disease could be minimized by a huge margin.

APPLYING EPIDEMIOLOGIC ANALYSIS 10

References

Buffie, C. G., Bucci, V., Stein, R. R., McKenney, P. T., Ling, L., Gobourne, A., ... & Littmann,

E. (2015). Precision microbiome reconstitution restores bile acid mediated resistance to

Clostridium difficile. Nature, 517(7533), 205-208.

Lessa, F. C., Mu, Y., Bamberg, W. M., Beldavs, Z. G., Dumyati, G. K., Dunn, J. R., ... &

Wilson, L. E. (2015). Burden of Clostridium difficile infection in the United States. New

England Journal of Medicine, 372(9), 825-834.

Nieuwenhuijsen, M. J. (2015). Exposure assessment in environmental epidemiology. Oxford

University Press, USA.

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