Using the Epidemiologic Triangle

Discussion 1 – Week 2
COLLAPSE
Using the Epidemiologic Triangle

The assigned readings this week outlined the basic concepts of epidemiology and discussed the concept of the Epidemiologic Triangle. Dr. Jacobs, in this week’s media presentation, also discussed how epidemiology helps a community to know itself. Dr. Guerra shared an example of how his community was able to effectively eliminate Hepatitis A infections through primary prevention strategies and the use of epidemiological assessment techniques.

To prepare for this Discussion, review Chapter 12 in the course textbook and the media program. Then, read the following case study:

This is Debbie’s first year working as a nurse at the local health department in a rural county. Most of her days are spent in the clinic seeing clients who often do not have health insurance.

Over the past month, Debbie has noticed that several young Hispanic men have come to the health department, each diagnosed with tuberculosis. Debbie is concerned about what the outbreak of tuberculosis among the migrant workers could mean for the community. Through a community health profile, Debbie identifies the group of migrant farm workers as being at highest risk for contracting tuberculosis.

Using the Epidemiologic Triangle concept, consider the relationship among causal agents, susceptible persons, and environmental factors. Then, respond to the following:

• As a BSN-prepared community health nurse, what steps should Debbie take next?

• How might information systems be used to support Debbie’s efforts?Support your response with references from the professional nursing literature.

Solution

Using the Epidemiologic Triangle.

The term epidemiology comes from three Greek root words: epi which means to befall, demos which means people, and logos which means the study of. Epidemiology, therefore, refers to the study of that which befalls people or in short, the study of diseases in populations. It is the analysis of the factors that determine the various health states in humans as well as the application of prevention and control methods to these determinants(Stanhope & Lancaster, n.d.). The case study of Debbie and the prevalence of tuberculosis in the immigrant population can be best studied using an epidemiologic triangle. This triangle shows the relationship between the disease-causing agent, the host for that agent and the environmental factors affecting that particular disease. These three factors, agent, host and environment, are the three tip points of the triangle.

Mycobacterium tuberculosis causes tuberculosis. Mycobacterium tuberculosis is a bacterium. The tuberculosis bacterium resides in the body of an infected human and is spread by air when an uninfected person inhales the infected droplets that are released into the air by an infected person’s sneeze or a cough. Debbie observed that the Hispanic immigrant workers were at the most risk of infection with tuberculosis. She placed this group of farm workers as the most susceptible persons, or what we can refer to as the host in the epidemiologic triangle.  Several environmental factors come into play with regards to the prevalence and spread of tuberculosis in Debbie’s community. The hosts are mostly immigrants; as such, this migration and change of environment made them susceptible to the disease. Since tuberculosis is spread through the air, the fact that all hosts worked on farms makes it very likely that the uninfected will come into contact with infected persons and ultimately infection with tuberculosis (Narasimhan, Wood, MacIntyre & Mathai, 2013).

To avert the spread of tuberculosis, Debbie should initiate a community health assessment program. This evaluation will help her to diagnose the infected workers and those whose symptoms have not begun showing, thus combatting the spread of the disease. For those already infected, Debbie and her health care team should practice case isolation and quarantine to prevent spreading. All immigrant workers should also be given the proper tuberculosis vaccine to prevent any new infections. Information systems are essential in helping Debbie fight this disease in her county. Information systems assist in the flow of information for public awareness, because Debbie will have to equip the susceptible persons with the proper lifestyle and hygiene methods to lower risk of infection. Some information systems such as electronic reporting systems can also be used for community health assessment to determine those infected.

References

Narasimhan, P., Wood, J., MacIntyre, C., & Mathai, D. (2013). Risk Factors for Tuberculosis. Pulmonary Medicine, 2013, 1-11. http://dx.doi.org/10.1155/2013/828939

Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.) Philadelphia: Mosby Elsevier.