Epidemiology Research: Biomarkers, Surveillance, and Control Studies

This assignment delves into key epidemiological concepts, examining prevalence and incidence as crucial measures in disease investigation and policy formulation, illustrated with examples of obesity and coronavirus outbreaks. It explores observational study designs, focusing on work-related factors and mental health, and proposes a research title assessing new drug regimes for colon cancer patients. The assignment further analyzes sensitivity and specificity calculations, disease surveillance strategies, particularly for vector-borne diseases in urban settings, and a case study appraisal of an encephalitis outbreak. It also evaluates a study on biomarkers in dengue clinical outcomes and assesses a randomized control study, encompassing study design, methodologies, and limitations. The document covers various aspects of epidemiology, offering a comprehensive overview of research methodologies and public health challenges.

UNIVERSITY
Task
Epidemiology research
Student name
Tutor

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Module 1
Prevalence and incidence are a common phenomenon in epidemiology and disease
investigation assessment impact. Prevalence measures a disease condition over a period of
time either at a given point in time of periodic prevalence. Periodic prevalence provides a
better measure of the disease with its load case having new cases and dates between the time
frames. It is often more meaningful when reporting the number of cases as a fraction of the
total population. Incidence measures the rate of new or diagnosed cases of the diseases. It is
beneficial when reported as a fraction of the general populations, (Rotham, Greenland &
Lash, 2008; Woodward, 2013).
In this case, policy formulations are best formulated based on prevalence rates of
obesity. This gives the actual observation of all the live cases during the time of assessments.
Prevalence estimation is key and plays a crucial role in policy formulation. This will inform
assessment on the number of the population likely to face obesity
The second scenario entails the number of the of corona-virus outbreak incidence in
Australia offering meaningful information of the disease occurrence trend. Incidences report
on such diseases establish disease occurrence at a particular point in time. This will be crucial
in offering an assessment of the status of the disease in the population, thus offering a better
approach to the management of the coron-avirus outbreak.
Module 2
Topic 1
Observational studies are designs which offer a description of patterns of disease
occurring in various setups. The descriptive study design will be beneficial in this scenario so
as to assess the association of work-related factors and mental health, (Von Elm et al., 2007).
Descriptive studies are crucial in providing knowledge about workload and mental health.
This design is beneficial in public health fields in assessing segments of populations whom
education and prevention programs can be targeted and further aid in the allocation of
resources to mitigate the health impact being observed.
Topic 2
Title of your research: assessment of new drugs regime offers better nursing outcomes
than generic drugs in cancer management for cancer patients diagnosed with colon cancer.
Intervention: patients diagnosed with cancer with not less than 3 months of medication
history.
The comparator (placebo/active component): administration of new drug regime and
generic drug treatment option for cancer

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Allocation concealment: the patients will be given a unique number which identifies
then both groups are treated equally and the two groups separated ready for treatment
allocation. The control and cancer group patients will be offered the same treatment options
which are similar in shape, colour, and size which acts as a placebo.
Sequence generation (Random/non-random): random selection of the study subjects
will apply to be applicable in this study assessment
Blinding: The participants will be single-blinded as they will not know which
medications they have been provided. The nursing person in charge will monitor and
document in the checklist patient progress and feedback to assess health outcomes.
Module 3
Topic 1
True positive a=360; this refers to the positives which were correctly labeled as having
the disease
False positive b=230; these entail the negatives which were incorrectly labeled by the
tests.
False negatives c=390; these entails the positives which were wrongly labeled as
negatives
True negatives d=20; these are true negatives which were correctly labeled by the tests.
Sensitivity = this is a measure of actual positives having the disease which are correctly
identified.
Specificity = this refers to the proportion of actual negatives measurement which is
correctly identified
Sensitivity = A/(A+C) X100
= 360/(360+390)%
= 48%
Specificity = D/(D+B)X100
= 20/(20+230)%
= 80%
Topic 2; surveillance
Disease surveillance is an epidemiological event which the diseases are monitored in

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terms of how it is spread, monitored and established. Main critical role of disease surveillance
is to predict, observe and minimize the harm caused due to the outbreak, epidemic and encase
of a pandemic situation and further to increase knowledge on the factors which might
aggravate the occurrence of the disease. it is further a continuous process of assessing the
occurrence of diseases and health-related events. It offers an appropriate and immediate
intervention for controlling the disease. it further entails an ongoing assessment of the
collection, assessment, and interpretation of information obtained from data from public
health actions. Disease notification systems play a crucial role in disease surveillance. It
timely reports on the occurrence of a disease using the designated tools. Disease surveillance
has been used for effective prevention and managing diseases and utilized especially in
controlling epidemic diseases. Effective disease and notification system allow for the
detection of outbreaks which prompt an immediate intervention for the reduction of
morbidity and mortality case, (Kulldorff, 2001).
Mandatory reporting has been entrenched in the disease reporting notification
protocols. World Health Organization has laid in place mandatory requirements for reporting
the following causes as they occur; plaque, cholera, yellow fever, typhus, and relapsing fever.
Disease surveillance thus entails the collection of information, assessment, and interpretation.
The collected information can be utilized in various ways; they can be used to evaluate
control and prevention of health measures, monitoring changes of infectious agents, aid in
planning and resource allocation to a particular disease and identification of high risks
populations. For an effective collection of surveillance information, the information being
sought needs to be standard.
Assessment of vector-borne diseases in my field of expertise portrays a global threat of
emergence of diseases such as malaria and Zika viruses due to rapid urbanization and
movement of people in the urban set ups. The vector-borne disease accounts for an estimate
of about 17% of all infectious diseases which results in an increased burden of disease-
causing over a million deaths annually, (WHO, 2017). The occurrence of this disease is
occasioned by complex factors such as environmental changes like the changing climates
which have a significant impact on disease transmission.
The vector-borne disease has been observed to re-emerge in urban settings as cases
have been observed especially rise in Aede borne diseases such as dengue, zika and
chikungunya diseases. Urban challenges have portrayed to be a significant factor in the
spread of this diseases due to unplanned development of urban setups and increase
globalization (Simons, Farrar, Nguyen, Willis & Dengue, 2012).

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Observed challenges in urban disease surveillance system have shown a lack of
awareness among the different stakeholders. Improved understanding by the people.
Enhancing behavior change among the urban residents in identifying and controlling
breading sites for the mosquito is key crucial engagement in the management of vector-borne
disease surveillance and managing occurrences and prevalence rates. Thus utilization of
effective tools for collecting assessment and information dissemination is a key factor.
Further innovative of new tools of combating the disease due to increased resistance and
residual identification of infections proves to be the biggest barriers in managing and
enhancing vector born disease surveillance in the urban settings.
Module 4
Case study appraisal by Parashar et al., (2000)
1. Did the study address clearly focused issue; Yes
The paper addressed an assessment on the outbreak of encephalitis which occurred
between the years 1998-1998 in Malaysia and it was linked to para myoxivirous Nipah which
had an infection on beings, human, dogs, and cats. The study focused on the issue clearly
focussing on the effects of a virus was causing on the population at larger. Most patients in
the study were farmers and were characterized by respiratory and neurologically symptoms
which were observed from pig farmers. The virus of interest was Nipah virus which is closely
linked to the Hendra virus associated with disease outbreaks on horses and humans in
Australia.
2. Did the authors use an appropriate method; Yes
The study used case-control study with case-patients being defined as persons with
serological evidence having Nipah Infection. Inclusion as case-patients was used to recruit
patients hospitalized with encephalitis. Control subjects were obtained using two sets of
subjects that is community farm and controls and case farm controls. Thus the study utilized
case-control assessment of the subjects to assess the subjects, fitting the model of case-
control study designs.
3. Were the cases recruited in an acceptable manner; Yes
The study patients were recruited accurately with a selection of the cases from the
community set up while the controls selected from community subjects. Case farm control s
were selected from farming activities associated with the infection
4. Were controls selected in an acceptable manner; Yes
The controls were selected in an acceptable manner; this was done using two sets of
controls from the community and case farm controls. The community farm controls were

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further used to identify the characteristics of farms which the humans inhabited. Case farm
cases were identified based on the associated farming activities.
5. Were exposures accurately measured; Yes
Exposure methodologies were selected using the computation of odds ratio and
comparing the exposures between cases and case farm controls were performed in stratified
analysis. The comparators were measured using stratified analysis from the stratum for the
cases and case-control from the farms.
6. Were the groups treated equally and potential confounders assessed
Stratification was performed on the study subjects. The treatment was performed
equally with farm characteristics being adjusted for potential confounders were adequately
adjusted in the study.
7. Treatment effect
The treatment was performed on the cases and comparable assessment was performed
on controls. The odds ratio was performed on the study subjects to assess the association of
the disease and its occurrence. Adjusted was made on the farm activities which showed
positive association on odds ratio.
8. The precision of treatment effects
The treatment tested for IgM and the IgG antibodies were tested in the laboratory.
Hendra virus antigens were tested in the lab before usage, this was cross-reacted on the Nipah
Antibodies were utilized. A 95% CI interval was used in the study.
9. Believe on the results; yes
The results revealed an association of human Nipah infection and with pig’s
environment because most of the patients were pig farmers due to isolation from the infected
pigs.
10. Benefits of the results; No
The results are beneficial in that it was able to disease outbreak occurrence early
enough. Those persons having close contact with pigs were high at risks of developing the
disease. Further, the results showed high risks farms activities which had a positive effect on
the disease.
11. How the results for other evidence of the study; No
The study was a case-control study investigating a disease outbreak. There was no
comparable studies and evidence to support the study results.
Module 5
The study by Low, Chiew & Ho (2015), assessed and evaluated five biomarkers which

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include neopterin, thrombomodulin, vascular endothelial growth factor-A, soluble vascular
cell adhesion molecule 1 and pentraxin 3 in assessing dengue clinical outcomes. in this
prospective study, the assessment of confounding factors was not taken into consideration in
the study. The study did not elaborate on how the confounding factors were accounted in
obtaining the association of the biomarkers and occurrence son dengue fever clinical
outcomes.
The study further aimed at comparing the results obtained with others obtained from the
other studies in the literature review. The result obtained was compared with other systematic
reviews and case-control studies undertaken previously being highlighted in the discussion
section of the study. However, the results could not be generalized to the general population
due to various limitations highlighted in the study. In the study, the key limitations which
hinder generalization of the results include, the inclusion criteria could not be inclusive, the
study used low sample size for the study participants and the setting of the study was
undertaken in a hospital thus could favor diseases cases and not represent the general
population.
Thus this shortcomings depicted in the research, make the study not to be reliable in
assessing the critical aspects of the study. Some of the data collection methods strategies
were faced with hiccup challenges limiting the general ability and thus rendering the study
results not the reliable.
Module 6
Randomized control study assessment by Cohen et al., (2012)
Domain Judgment support Judgment
Selection bias
Random sequence Patients were selected
randomly
There were no selection
biases in the study
Allocation concealment Double blinding of the
participants was performed
Concealment of the
subjects was done using double
blinding.
Performance bias
Participants blinding The subjects were
assessed using the completion of
the 5 item questionnaire tool.
Proper assessments of the
study participants were done
Detection bias
Blinding of outcome
assessment
The outcome in the study
was double-blinded with
randomization effect being
The outcome of the study
effectively assessed.

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undertaken in the study.
Attrition bias
Outcome of data Outcome measures used
in the study were the frequency
of coughing used as the primary
measure while secondary
outcomes were measured using
frequency in cough severity.
Outcome data assessed
using appropriate parameters
Reporting bias
Selective reporting There was no reporting
done selectively on the subjects
in the study.
Reporting was done
effectively and wholly and not
subjects were subjected to
selectively.

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References
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(2012). Effect of honey on nocturnal cough and sleep quality: a double-blind,
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164(1), 61-72.
Low, G. K. K., Gan, S. C., & Ho, S. C. (2015). Biomarkers in differentiating clinical dengue
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