Epidemiology of Hepatitis B
Hepatitis B is a disease that affects many people worldwide and can cause serious and potentially fatal complications. This paper will provide an overview of this disease, including demographic information, while discussing contributing determinants of health, the implications of the epidemiological triangle as it relates to the Hepatitis B Virus (HBV), the role of the community health nurse, as well as identify a national organization that addresses the disease and how it contributes to reducing the impact on society.
Hepatitis B is an infection caused by the Hepatitis B virus that multiplies in the liver, causing inflammation that can involve other ...view middle of the document...
Treatment, if required includes medications such as Interferon Alpha, administered three times a week subcutaneously, and the antiviral Lamivudine. Interferon Alpha has been associated with unwanted side effects whereas fewer side effects have been reported with Lamivudine, however, patients can become resistant to Lamivudine with continued treatment (Lavanchy, 2004). A vaccine is available and recommended for all infants, healthcare workers and those at high risk who have not been previously vaccinated. Receiving Hepatitis B immune globulin within 24 hours of exposure to the virus may provide protection against the development of infection in those not vaccinated (Mayo Clinic Staff, 2011).
HBV is the tenth leading cause of death worldwide with approximately 500,000 to 1.2 million deaths each year. There are 2 billion people infected and 350 million living with the chronic condition. The prevalence varies by region with the highest incidence being Southeast Asia, China, and Sub-Saharan Africa (Lavanchy, 2004). The United States is considered a low prevalence area where there are roughly 0.9 cases per 100,000 people, two-thirds of whom are foreign born. The mortality rate of those in the U.S is reported as 0.5 deaths per 100,000 people. Men are typically infected at a higher rate than women worldwide with the highest prevalence being within the 25-45 year old range for both genders. Over the past ten years the incidence in the U.S. has decreased by 67%. (Centers for Disease Control and Prevention [CDC], 2010).
Determinants of Health
The determinants of health are those factors that affect the health of an individual, community, or population. They fall under one three categories: Social and Economic environment, Physical environment, and Characteristics and Behaviors. The social/economic environmental factors that affect the transmission of HBV include sexual promiscuity, homosexuality, intravenous (IV) drug users, especially those who share needles, and sharing a living space with an infected individual. Physical environmental factors include imprisonment, healthcare workers, employment in a mental health institution, and unsanitary living conditions (World Health Organization [WHO], 2013). Characteristics and behaviors that place individuals at risk can include aspects of other categories such as having multiple sexual partners, engaging in IV drug use and the sharing of needles, however, poor self-esteem, depression, and anxiety disorders are a few characteristics that can lead to these behaviors (Mayo Clinic Staff, 2011).
Another way to view HBV is through the epidemiological triangle. This triangle encompasses three factors: A susceptible host, a causative agent, and the environment. All three factors must be present for a disease to cause illness. Any alteration to one of these factors will create a change in the link and disrupt the transmission of the virus (Maurer & Smith, 2013).