George Mason University Health Diseases Case Study Please see attachment for instructions and example. if any question let me knoww Assignment Instructions

George Mason University Health Diseases Case Study Please see attachment for instructions and example. if any question let me knoww Assignment Instructions
Policy brief
Page Limit & Formatting: 3.5-4 typed, double-spaced pages with 1” margins on all sides. The
works cited page doesn’t count towards the 4 page limit. Use 12 pt Times New Roman Font. If
your assignment is more than 4 pages long only the first four pages will be read and graded. If
you submit a PDF I will return it to you and count it as late until you submit a version in Word.
Citations: Use appropriate APA style in-text citations and include a works cited page in APA
style.
You are a policy advisor to the president of a low or middle income country. You have been
asked to prepare a policy brief for the president about a health issue of your choice. This policy
brief should be short enough that you can share it with the president in the car on the way to
her next meeting (i.e. about 4 double spaced pages long).
Your paper must include the following components:
A.
Abstract
•
Provide a brief summary of your entire policy brief. If the president doesn’t have time to
read the whole brief this should summarize it for her.
B.
Background of the problem.
Answer the following:
• What is the nature and magnitude of the problem?
• Who is affected by it?
• What are the risk factors for the problem?
C.
Impact of the problem. What are the economic and social consequences?
D.
Recommendation for the president
•
•
What priority steps do you recommend be taken to address the problem?
What is your rationale for these recommendations (explain why)? Note that your
recommendations should be based on evidence from other countries, the WHO, etc.
Grading Rubric for Policy Brief Assignment
Abstract
Background
Impact
2
The abstract is
not a well
presented
summary of the
entire policy
brief
The background
does not clearly
and fully
presents the
scope of the
problem using
information from
relevant sources
The impact of
the problem is
not clearly and
fully presented
and is well
supported using
information from
relevant sources
Recommendation
The
recommendation
is not presented
clearly and is not
based on other
successful
programs
Use of high
quality sources
and APA style
No high quality
sources were
used and APA
style is not used
correctly for intext citations and
the works cited
page
3
The abstract is a
somewhat well
presented
summary of the
entire policy brief
The background
somewhat clearly
and fully
presents the
scope of the
problem using
information from
relevant sources
The impact of the
problem is
somewhat clearly
and fully
presented and is
well supported
using
information from
relevant sources
The
recommendation
is presented
somewhat clearly
or is not based
on other
successful
programs
Few high quality
sources were
used and APA
style is used
somewhat
correctly for intext citations and
the works cited
page
4
The abstract is a
mostly well
presented
summary of the
entire policy
brief
The background
mostly clearly
and fully
presents the
scope of the
problem using
information from
relevant sources
The impact of the
problem is
mostly clearly
and fully
presented and is
well supported
using
information from
relevant sources
The
recommendation
is mostly
presented clearly
and is based on
other successful
programs
5
The abstract is a
well presented
summary of the
entire policy
brief
Some high
quality sources
were used and
APA style is used
mostly correctly
for in-text
citations and the
works cited page
Many high
quality sources
were used and
APA style is used
correctly for intext citations and
the works cited
page
The background
clearly and fully
presents the
scope of the
problem using
information from
relevant sources
The impact of
the problem is
clearly and fully
presented and is
well supported
using
information from
relevant sources
The
recommendation
is presented
clearly and is
based on other
successful
programs
Haiti and Waterborne Diseases
Abstract
In Haiti, waterborne diseases are prevalent throughout the country as a serious health
concern. Diseases are caused through the ingestion of water contaminated with fecal matter.
Severe symptoms and death can occur in anyone who contracts a diseases, although those living
in poverty are more likely to be exposed to contaminated water. Waterborne diseases both cause
and contribute to a poor economy, and education can be affected by and counteract these
diseases. However, providing citizens with water sanitization techniques and improved
sanitization facilities can easily prevent waterborne diseases. Diminishing waterborne diseases
will allow Haiti to focus health care efforts elsewhere and can contribute to increased education
and an improved economy.
Background
Around the world, waterborne diseases resulting from poor sanitization and poor quality
of drinking water account for 3.1% of all deaths and 3.7% of DALY’s (Ashbolt, 2004). In Haiti,
waterborne diseases are very prevalent among the population, primarily due to contaminated
drinking water. Since there are alarmingly high rates of open defecation in Haiti, drinking water
becomes contaminated from human fecal matter that is either deposited directly into water
sources or contained in surface run-off (Patrick et al., 2013). Since approximately one half of
Haiti’s population collects its water from open sources—springs, rivers, and lakes—water is
easily contaminated, and disease is present throughout the country (Patrick et al., 2013).
The most common waterborne diseases in Haiti are cholera, typhoid fever, cyclosporiasis,
worm parasites. The main symptoms of the bacterial disease cholera are diarrhea and occasional
vomiting (World Health Organization (WHO) 2014a). If untreated, cholera will lead to death in
50% of all cases (Farmer et al., 2011). Typhoid fever, another bacterial disease, causes high
fever, pain in the abdomen, constipation, and sometimes diarrhea (Olle-Goig & Rurz’s 1993;
Center for Disease Control and Prevention (CDC) 2014b). In a study conducted by Olle-Goig
and Rurz, ten percent of Haitians with typhoid fever died (1993). Cyclosporiasis is an endemic
parasite that causes those it infects to have loss of appetite, weight loss, nausea, and most
commonly, diarrhea (Cotruvo et al., 2004; CDC 2014a). Finally, whipworm and hookworm are
diseases caused by parasitic worms. Death is possible from these infections, but the worms most
commonly cause obstruction in the intestines or nutritional deficiency (“Worms in Haiti,” 2014).
In general, waterborne diseases affect all of Haiti’s population. However, there are some
risk factors that make contracting these diseases more common. First, those with poor sanitation
habits or lack of education about sanitation are more likely to contract waterborne diseases (OlleGoig & Rurz, 1993). People who get their water from a public well or stream also have higher
odds of contracting a waterborne disease because waterborne diseases spread through a
population that uses communal water sources quickly and explosively (Chin et al., 2010).
Anyone who drinks contaminated water is at risk, but it is more common for those living in
poverty to not have access to clean water (Skolnik, 2011, p. 146). Risk factors that make
someone more likely to consume waterborne diseases will greatly increase a person’s chance of
contracting a waterborne disease.
Impact
As a third world country, Haiti is very poor. Prior to the earthquake in 2010, Haiti’s
economy could only spend fifty-eight dollars per person per year on health care for citizens
(DeGennaro, DeGennaro, & Ginzburg, 2011). Post earthquake, economic conditions worsened
(DeGennaro et al., 2011). With an already suffering economy, health care services struggle to
afford caring for everyone who needs it. When a person contracts a waterborne disease, his
symptoms often require medical services. Every person who needs medication or hospital care
drains the economy of money that Haiti might not be able to afford. If waterborne diseases were
prevented, the health care system could apply the money used for waterborne disease treatment s
elsewhere. Additionally, those who become sick with a waterborne disease may not be able to
attend work, and hence they cannot contribute to the economy (Skolnik, 2011, p. 51).
Social consequences arise from waterborne diseases present in Haiti as well, primarily
through education and cultural practices. Education is linked to prevention of disease. When
people are educated about sanitation practices or appropriate health behaviors, they are less
likely to contact diseases (Skolnik, 2011, p. 50). Waterborne disease could decrease if Haitian
people are education about both the cause and prevention techniques. However, people who are
sick or must take care of sick family, they cannot attend school. Waterborne diseases in Haiti can
be prevented by education, but they can also be the cause of people not receiving education.
Recommendations
Although direct treatment of waterborne diseases using medications can be successful,
the most effective ways to control waterborne diseases in Haiti are to instill water sanitization
processes and create improved sanitization facilities. The first of these solutions, purging
drinking water of bacteria and pathogens, prevents Haitians from contracting waterborne
diseases. Two inexpensive techniques that could be used in Haiti are the use of BioSand filters
and solar disinfection. BioSand filters are very effective in diminishing the number of harmful
bacteria and parasites in water (Duke et al., 2006). These filters have been used in developing
nations around the world because they are locally built and inexpensive (Duke et al., 2006). Solar
disinfection is another effective technique used in developing countries because it only requires
clear plastic bottles and sunlight. Plastic bottles are filled with stream or well water and placed
outside where the sunlight kills harmful microorganisms contained in the water (Oates et al.,
2013).
Since pathogens from fecal matter cause waterborne diseases, the prevalence of these
diseases in Haiti would decrease if fecal matter were separated from drinking water. WHO has
mandated that sanitization facilities must be built in developing nations along improved
sanitization facility standards. The criteria require a facility that hygienically separates human
excreta from human contact (WHO, 2014a). One example of an improved sanitization facility is
a pit latrine, which follows WHO’s guidelines by creating a hole that waste falls into under a
concrete slab (Farmer et al., 2011).
Overall, purifying drinking water and creating improved sanitization facilities are the two
best recommendations to control waterborne diseases because Haiti will have greater long-term
benefits if these diseases are prevented, not just treated. These techniques will decrease water
contamination by fecal matter and remove the fecal matter that is present in drinking water,
therefore preventing harmful pathogens from entering bodies. If waterborne diseases are
diminished, health care services can be concentrated on other diseases. Most importantly,
improving health will allow more Haitians to attend school and work; hence, diminishing
waterborne diseases can lead to a healthier population and contribute to a better economy.
References
Ashbolt, N. J. (2004). Microbial contamination of drinking water and disease outcomes in
developing regions. Toxicology, 198(1–3), 229–238. doi:10.1016/j.tox.2004.01.030
Centers for Disease Control and Prevention (CDC). (2014a). CDC – Cyclosporiasis. Retrieved
November 3, 2014, from http://www.cdc.gov/parasites/cyclosporiasis/
_____. Typhoid Fever: Technical Information – NCZVED. (2014b). Retrieved November 3,
2014, from
http://www.cdc.gov/nczved/divisions/dfbmd/diseases/typhoid_fever/technical.html
Chin, C., Sorenson, J., Harris, J. B., Robins, W. P., Charles, R. C., Jean-Charles, R. R., Bullard,
J., Webster, D., Kasarskis, A., Peluso, P., Paxinos, E., Yamaichi, Y., Calderwood, S.,
Mekalanos, J., Schadt, E., Waldor, M. K. (2010). The Origin of the Haitian Cholera
Outbreak Strain. New England Journal of Medicine, 364(1), 33–42.
Cotruvo, J. A., Dufour, A., & Rees, J. (2004). Waterborne Zoonoses: Identification, Causes, and
Control.
DeGennaro, V., DeGennaro, V., & Ginzburg, E. (2011). Haiti’s dilemma: how to incorporate
foreign health professionals to assist in short-term recovery while capacity building for
the future. Journal of Public Health, 33(3), 459–461. doi:10.1093/pubmed/fdq104
Duke, W. F., Nordin, R. N., Baker, D., & Mazumder, A. (2006). The use and performance of
BioSand filters in the Artibonite Valley of Haiti: a field study of 107 households. Rural
Remote Health, 6(3), 570.
Farmer, P., Almazor, C. P., Bahnsen, E. T., Barry, D., Bazile, J., Bloom, B. R., Bose, N., Brewer,
T., Calderwood, S., Clemens, J., Cravioto, A., Eustache, E., Jerome, G., Guapta, N.,
Harris, J., Hiatt, H., Holstein, C., Hotez, P., Ivers, L., Kerry, V., Koenig, S., LaRocque,
R., Leandre, F., Lambert, W., Lyon, E., Mekalanos, J., Mukherjee, J., Oswald, C., Pape,
J., Gretchko Prosper, A., Rabinovich, R., Raymonville, M., Rejouit, J., Ronan, L.,
Rosenberg, M., Ryan, E., Sachs, J., Sack, J., Surena, C., Suri, A., Ternier, R., Waldor,
M., Walton, D., Weigel, J. L. (2011). Meeting Cholera’s Challenge to Haiti and the
World: A Joint Statement on Cholera Prevention and Care. PLoS Negl Trop Dis, 5(5),
e1145.
Oates, P. M., Shanahan, P., & Polz, M. F. (2003). Solar disinfection (SODIS): simulation of solar
radiation for global assessment and application for point-of-use water treatment in Haiti.
Water Research, 37(1), 47–54. doi:10.1016/S0043-1354(02)00241-5
Olle-Goig, J. E., & Rurz, L. (1993). Typhoid Fever in Rural Haiti1. Bulletin of PAHO, 27, 4.
Patrick, M., Berendes, D., Murphy, J., Bertrand, F., Husain, F., & Handzel, T. (2013). Access to
Safe Water in Rural Artibonite, Haiti 16 Months after the Onset of the Cholera Epidemic.
The American Journal of Tropical Medicine and Hygiene, 89(4), 647–653.
doi:10.4269/ajtmh.13-0308
Skolnik, R. (2011). Global Health 101 (2 edition.). Burlington, MA: Jones & Bartlett Learning.
World Health Organization (WHO). Cholera. (2014a). Retrieved November 1, 2014, from
http://www.who.int/topics/cholera/about/en/
Worms in Haiti. (2014). Retrieved November 3, 2014, from http://crudem.org/worms-in-haiti/
Daniel Cruz
ABSTRACT
El Salvador is currently suffering an epidemic of dengue and chikungunya. There are 174,000
suspected cases combined and about 16,500 confirmed combined cases. The economic impact of
dengue alone costs the Americas around US $2.1billion annually. Since there are no effective
vaccines against either disease, the vectors must be eliminated to prevent further infections. The
mosquito is the primary vector. Eradicating the breeding sites and protecting the citizens from
mosquito bites should be the priority in order to stymie the epidemic. Money should be allocated
from the national budget in order to accomplish this. Early, uncoordinated efforts show
promising results.
There are currently two highly-communicable, virulent diseases currently ravaging El
Salvador. Dengue and Fiebre Chik (more globally recognized as chikungunya) are rapidly
inflicting pain and suffering on the 6.3 million people currently living in the country. There were
about 30,000 suspected cases of chikungunya in the country since September 2014 (reliefweb,
2014). However, the WHO and PAHO suspect 123,000 cases of Chikungunya at the end of
November, though only 157 have been confirmed (PAHO, 2014). There are about 51,000
suspected cases of dengue as of November 2014 yet only 16,000 have been confirmed, according
to PAHO. It is safe to say that dengue and chikungunya have reached epidemic levels (Sosa,
2014).
These are not minor diseases to be ignored. Both dengue and chikungunya cause acute
high fever and muscle and/or joint pain. They may also cause rashes throughout the body.
Persistence of these symptoms can lead to death, since both may present themselves with
hemorrhagic fevers, though this is more likely to occur with dengue (CDC, 2012). Chikungunya
generally leads to chronic pain and disability that may last years.
Those most likely to be affected are the children and the elderly; however anyone can
contract the diseases by being exposed to mosquito bites (CDC, 2014). Those who have been
exposed and become infected with dengue a second time are in more peril due to the higher
likelihood of severe symptoms. Those who are pregnant will require special care if they become
infected, for the child can also run the risk of being infected (PAHOpin, 2014).
There are several risk factors that can contribute to becoming infected with one or both of
these virulent diseases. The primary risk factor is living in a tropical area, of which everyone in
El Salvador does (CDC, 2014). The risk is higher if a person is homeless, thereby being exposed
longer to mosquitos. Another risk factor is having a compromised or weakened immune system.
This can happen due to a recent surgical procedure such as an organ transplant or bypass.
Anyone recently exiting any other illness will most likely have a weak immune response and
thus be more likely to become infected with either disease or both (PAHO, 2014).
This is a major issue due to the social and economic ramifications of contracting these
diseases. Common sense dictates that those with severe muscular and joint pain will not report to
work. This in turn leads to loss of productivity. There are also patient hospitalization costs
involved and sometimes mortality and morbidity costs as well (Misra, 2011). In all, the costs of
dengue alone, both directly and indirectly, when measured as accurately as possible, cost the
Americas about $2.1 billion US dollars annually (Shepard, Coudeville, Halasa, Zambrano, &
Dayan, 2011).
It is recommended that immediate action be taken to curb the threat. Since no vaccines
exist for either dengue or chikungunya, then the vectors must be targeted. The Aedes aeqgypi and
Aedes albopictus mosquitos are the specific vectors of these two diseases causing and
propagating the current national epidemic (PAHOpin, 2014). The best way to rid El Salvador of
mosquitos is to eliminate breeding sites. The public must be educated (via doctor/hospital visit,
schools, television, and radio) to get rid of any useless items at home that can be filled with
water. This would include discarded tires, buckets, plants in water and the like. Those in the
country that collect rain water should ensure that the water is properly sealed and covered when
not in use or when there is no rain (CDC, 2009). It would be advised for the Madam President to
allocate resources to completely dry up standing water locations and to fill with any leftover soil,
sand, or dirt from other construction projects, if deemed cost effective. The government can
subsidize certain mosquito control items such as screens for windows and doors. Mosquito nets
should also be distributed among the population in order to prevent mosquito bites. The
government should remind the citizens that to best prevent a crippling infection from either the
dengue virus or the chikungunya virus, citizens should wear long-sleeved clothing, and long
pants when inevitably travelling from home to work or between municipalities (CDC, 2009).
Socks and closed shoes are also being advised. The government can enforce this on the school
children that attend the public schools and for all government workers.
As the nation gears into war against this pest, early efforts following what is detailed
above are starting to show results (Sosa, 2014). The President is advised to continue with these
efforts and to reach out to neighboring countries to do the same.
Works Cited
CDC. (2009). Vectors. Retrieved December 4, 2014, from Centers for Disease Control and Prevention:
http://www.cdc.gov/dengue/resources/Vectorcontrolsheetdengue.pdf
CDC. (2012, September 27). Dengue. Retr…
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