Health and Epidemiology: Infectious Disease paper

Health and Epidemiology: Infectious Disease paper

Health and Epidemiology: Infectious Disease paper

Infectious Disease Paper
This paper analyzes syphilis. Syphilis is a sexually transmitted infection caused by Treponema pallidum. Syphilis transmission occurs through anogenital, vaginal, or orogenital contact, which makes it a sexually transmitted disease. The disease can be transmitted transplacentally to cause congenital syphilis. The Centers for Disease Control and Prevention (CDC) reports that syphilis cases in 2022 in the United States were 203500 while congenital syphilis cases were 3755. The 5-year percentage change in syphilis rates in the United States was 78.9% as of 2022. This represented an increase in the rates of syphilis from 133739 in 2018 to 203500 in 2022. Similarly, the 5-year percentage change in congenital syphilis in 2022 was 183.4%. This rate could be seen in the rise of congenital syphilis cases from 1325 in 2018 to 3755 in 2022 (CDC, 2024). The Syphilis rate is high among men who identify themselves as gay, or bisexual, and men who have sex with men. Syphilis caused 6498 deaths between 1968 and 2015 in the United States. Syphilis incidence rate was 11.9 cases per 100,000 people in the United States in 2019 (Amerson et al., 2022). This represented a five-fold increase in syphilis incidence rate in the country.

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Patients affected by syphilis experience a range of symptoms. Syphilis symptoms usually appear 10-90 days after being exposed to the infection. The symptoms include painless chancre at the site of T. pallidum inoculation, which can resolve within 3-6 weeks without any treatment. Patients also experience regional lymphadenopathy. Patients develop symptoms of secondary syphilis 2-8 weeks after chancre disappearance. The symptoms include alopecia, condyloma lata, mucous patches, and skin rashes. Patients can also develop tertiary syphilis months or years after the initial infection. The symptoms include aortic valvulopathy and aneurysm, meningitis, stroke, seizures, aphasia, hemiplegia, and tabes dorsalis (Tudor et al., 2024). Congenital syphilis presents with symptoms such as nasal cartilage destruction, frontal bossing, saber shins, snuffles, Clutton joints, and Hutchinson teeth.
Untreated syphilis can cause cardiovascular and neurological complications. This includes stroke, meningitis, cranial nerve plasis, dementia, and tabes dorsalis. Patients can also develop aortic regurgitation, carotid ostial stenosis, and aortitis. Intramuscular benzathine penicillin G 2.4 million units is used to treat primary, secondary, and early latent syphilis. Intravenous penicillin G aqueous 18-24 million units daily for two weeks is used to treat neurosyphilis. Weekly benzathine penicillin G 2.4 million units intramuscularly for three weeks is used for latent and tertiary syphilis and patients with HIV (Tudor et al., 2024).
Determinants of Health
Social determinants of health influence the syphilis rate and disease burden in society. Social determinants of health are factors that influence an individual’s family’s or population’s health. Studies have shown that several social determinants of health play a role in syphilis. One of them is living conditions. Syphilis affects people experiencing homelessness disproportionately. Those involved in substance use and abuse also have a higher rate of syphilis compared to non-drug users (Jenks et al., 2023). Socioeconomic characteristics also contribute to the increasing syphilis rates in America. This includes factors such as poverty, being incarcerated, and experiencing hardships in accessing the needed healthcare services for syphilis diagnosis and treatment. Factors such as poverty increased barriers to accessing syphilis care because of cost-related challenges that patients experience (Mendez-Lopez et al., 2022). In addition, poverty worsens barriers to healthcare access and utilization by patients diagnosed with syphilis.
Belonging to a certain gender, identity, race, or ethnic group is also a social determinant of syphilis. Syphilis rates are high in racial and ethnic minority groups. Factors such as discrimination, structural racism, and stigma are associated with high syphilis rates in racial and ethnic minority groups (Johnson et al., 2022). Sexual identity and orientation also influence syphilis rates in America. For example, evidence shows that syphilis cases are high among men who have sex with men, gays, and people who identify themselves as transgender. Factors such as serosorting, use of stimulates before or during sex, condomless sex, transactional sex, multiple sexual partners, and expanded sexual networks contribute to high syphilis rates in this population (Mendez-Lopez et al., 2022).
Epidemiological Triad
The epidemiological triad can be used to understand the dynamics involved in syphilis spread in the population. The epidemiological triad is a model that helps understand health problems by focusing on the relationship between the agent, host, and the environment. The agent, host, and environment form the three corners of the epidemiological triangle. The agent refers to the microbe that is causing the disease. The agent in syphilis is T. pallidum (Mercuri et al., n.d.). Agent factors such as virulence, infectivity, and pathogenicity influence a patient’s susceptibility to syphilis infection.
Host in the epidemiological triad refers to the organism that harbors the disease. Human beings are the main hosts of syphilis infection. Patient factors influence their susceptibility to syphilis. They include immune status, sexual behaviors, existing comorbidities, age, race, gender identity and sexual orientation, and re-infection with syphilis. It also includes pregnancy, as seen in congenital syphilis. The environment in the epidemiological triad refers to the external conditions that favor disease transmission (Cohn & Harrison, 2022). The environmental factors in syphilis include social determinants of health such as poverty, access to healthcare, income, homelessness, substance abuse, incarceration, and social-sexual networks that contribute to unsafe sex practices in society.
Role of the Nurse Practitioner
Nurse practitioners play several roles in the prevention, diagnosis, and management of syphilis in the populations they serve. According to the American Association of Nurse Practitioners (AANP), nurse practitioners provide acute, primary, and specialty care to patients from diverse backgrounds with different needs. Nurse practitioners assess, diagnose, order, and interpret laboratory and diagnostic tests, initiate treatments, manage treatment plans, and evaluate them for their effectiveness (aanp.org, n.d.). They also provide holistic, patient-centered care that improves health outcomes for their populations.
Nurse practitioners apply the above roles in the management of infectious diseases. For example, they use their knowledge and skills in diagnosis to screen, diagnose, initiate treatments, monitor, and evaluate the effectiveness of the adopted treatment. Nurse practitioners also collect data about infectious diseases, and analyze, interpret, and monitor to determine the disease burden and severity in the population. Health promotion interventions such as health education, screening, timely diagnosis, and treatment are important in infectious diseases. Nurse practitioners provide these services to ensure timely diagnoses and treatment to prevent the progression of infectious diseases in the population. They also report infectious diseases to the respective authorities to guide decision-making and implementation of population-centered health promotion initiatives (Rosa et al., 2020). Lastly, nurse practitioners follow up on patients diagnosed with infectious diseases to determine treatment response and the need for additional interventions.
Conclusion
Syphilis is an infectious disease with high incidence and prevalence in the United States. Syphilis is associated with complications that affect the health and well-being of the patients. Social determinants of health influence syphilis rates in the population. The epidemiological triad helps understand the relationship among host, environmental, and agent factors in syphilis. Nurse practitioners should be proactively involved in implementing population-centered interventions to address infectious diseases.

References
aanp.org. (n.d.). All About NPs. American Association of Nurse Practitioners. Retrieved March 21, 2024, from https://www.aanp.org/about/all-about-nps
Amerson, E. H., Castillo Valladares, H. B., & Leslie, K. S. (2022). Resurgence of Syphilis in the US—USPSTF Reaffirms Screening Guidelines. JAMA Dermatology, 158(11), 1241–1243. https://doi.org/10.1001/jamadermatol.2022.3499
CDC. (2024, January 29). Sexually Transmitted Infections Surveillance, 2022. https://www.cdc.gov/std/statistics/2022/default.htm
Cohn, T., & Harrison, C. V. (2022). A Systematic Review Exploring Racial Disparities, Social Determinants of Health, and Sexually Transmitted Infections in Black Women. Nursing for Women’s Health, 26(2), 128–142. https://doi.org/10.1016/j.nwh.2022.01.006
Jenks, J. D., Nipp, E., Tadikonda, A., Karumuri, N., Morales-Lagunes, K., Carrico, S., Mortiboy, M., & Zitta, J.-P. (2023). Relationship Between Sexually Transmitted Infections and Social Determinants of Health in Durham County, North Carolina, United States. Open Forum Infectious Diseases, 10(7), ofad368. https://doi.org/10.1093/ofid/ofad368
Johnson, K. A., Snyder, R. E., Tang, E. C., de Guzman, N. S., Plotzker, R. E., Murphy, R., & Jacobson, K. (2022). Geospatial Social Determinants of Health Correlate with Disparities in Syphilis and Congenital Syphilis Cases in California. Pathogens, 11(5), 547. https://doi.org/10.3390/pathogens11050547
Mendez-Lopez, A., Stuckler, D., Marcus, U., Hickson, F., Noori, T., Whittaker, R. N., Jansen, K., Diaz, A., Henszel, L., Velter, A., Semenza, J. C., & Schmidt, A. J. (2022). Social and behavioural determinants of syphilis: Modelling based on repeated cross-sectional surveys from 2010 and 2017 among 278,256 men who have sex with men in 31 European countries. The Lancet Regional Health – Europe, 22. https://doi.org/10.1016/j.lanepe.2022.100483
Mercuri, S. R., Moliterni, E., Cerullo, A., Nicola, M. R. D., Rizzo, N., Bianchi, V. G., & Paolino, G. (n.d.). Syphilis: A mini review of the history, epidemiology and focus on microbiota.
Rosa, W. e., Fitzgerald, M., Davis, S., Farley, J. e., Khanyola, J., Kwong, J., Moreland, P. j., Rogers, M., Sibanda, B., & Turale, S. (2020). Leveraging nurse practitioner capacities to achieve global health for all: COVID-19 and beyond. International Nursing Review, 67(4), 554–559. https://doi.org/10.1111/inr.12632
Tudor, M. E., Al Aboud, A. M., Leslie, S. W., & Gossman, W. (2024). Syphilis. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK534780/

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Choose a topic from the list provided below. Apply the concepts of population health and epidemiology to the topic.

1) Pertusis

2) Rabies

3) syphilis

Introduction: Analysis of the communicable disease (causes, symptoms, mode of transmission, complications,

treatment) to include demographic break down that includes age, gender, race, or other at-risk indicators (data per demographics should include mortality, morbidity, incidence, and prevalence).

Determinants of Health: Define, identify and synthesize the determinants of health as related to the

development of the infection. Utilize HP2020.

Epidemiological Triad: Identify and describe all elements of the epidemiological triad: Host factors, agent

factors (presence or absence), and environmental factors. Utilize the demographic break down to further

describe the triad.

Role of the NP: Succinctly define the role of the nurse practitioner according to a national nurse practitioner

organization ( National Board of Nursing or AANP, for example) and synthesize the role to the?management of iinfectious diseases (surveillance, primary/secondary/tertiary interventions, reporting, data collecting, data analysis, and follow-up). This includes the integration of a model of practice which supports the implementation of an evidence-based practice.?