Epidemiology and Methodology - Research Paper Example

The Impact of Chlamydia and the Roles of the Society Introduction Although communicable diseases are seen to be more prevalent in developing countries, the burden of these diseases can also be felt even in the developed ones. In fact, diseases like AIDS, tuberculosis, malaria, and dengue are equally affecting several countries around the globe irregardless of their demographic characteristics and socioeconomic status (Boutayeb, 2006). Such trends can also be observed especially in terms of sexually transmitted diseases. According to a research, however, this pattern is observed among developed countries because the practice of premarital and multiple-partners sex is undoubtedly more common in developed countries than in the developing ones due to the society’s visibly permissive attitude towards it (National Research Council, 2005). Consequently, the prevalence of sexually transmitted diseases has also increased. In an annual report of a screening programme by the Department of Health, it has been noted that Chlamydia trachomatis infection has become “the most commonly diagnosed bacterial sexually transmitted infection in the genitourinary medicine (GUM) clinics in the United Kingdom” (Department of Health [DH], 2004). As a result, the government has formulated several policies through publicly-funded researches with the aim to prevent further spread of the communicable chlamydial infection due to its social and economic negative impacts. In connection, this paper will attempt to determine specific proposed policies and their effectiveness in countering the negative social, health, and economic impact of chlamydial infections with regard to the epidemiologic trends by employing a qualitative research methodology which will specifically discussed later. The Epidemiology of Chlamydial Infections in the UK In the United States, the Centers for Disease Control and Prevention (CDC) has accounted that people with chlamydial infections have recorded the most frequent case reporting for a sexually transmitted disease (CDC, 2010). The first annual report of the National Chlamydia Screening Programme (NCSP) pointed the same trend about chlamydial infections in the United Kingdom which led to its formulation in 2003 (DH, 2004). The NCSP was founded by the Department of Health in England due to the threatening health patterns caused not only by chlamydia but all the sexually transmitted diseases observed in both publicly and privately-funded surveys including those from the World Health Organization (WHO), the national government, as well as some organizations like AVERT (WHO, 2001; “STD Statistics,” 2010). In the last decade, the data on the prevalence of chlamydial infections in the United Kingdom have steadily risen that it has become “the most common sexually transmitted infection (STI) diagnosed and treated” in the region (Health Protection Agency [HPA], n.d.a). In the year 2000, uncomplicated chlamydia ranked second to genital warts among the five most common sexually transmitted diseases (STDs) affecting the population which also include gonorrhea, herpes, and syphilis (“STD statitics,” 2010). As the NCSP was commenced three years later, the government noted that chlamydia was highly prevalent among men and women of under 25 years of age. Statistics showed that a rise of 8% from the existing cases was documented in only one year (DH, 2004). A year later, females of ages ranging from 16 to 19 years registered the highest rate of prevalence ever recorded. This led to the conclusion that the high risk populations for chlamydial infection are those who are young and sexually active adult: specifically, the women who are between 16 and 24 years old, and the men of ages between 18 and 29 years old. The Department of Health, however, noted that these numbers may not be actual as only those who have only reported account for the figures were analyzed. They predicted “a large proportion of cases” were and are still unreported due to the tendency of the disease to remain asymptomatic even after weeks or months from inoculation (DH, 2004). Policies to prevent further transmission of the condition to uninfected individuals and control of morbidity among the infected ones are essential as chlamydia infection can even lead to pelvic inflammatory disease (PID) and infertility. What’s more is that it can not only be transmitted through sexual contact but is also passed from an infected mother to her child during pregnancy which can result to higher morbidity rate; the possibilities of ectopic pregnancy, early delivery, and low birth weight are also high among the women with chlamydial infection (DH, 2001; NCSP, n.d.). In 2009, records from AVERT showed that from being the second most common STD in the UK, chlamydia took over the first rank and is now the most common bacterial STD affecting the British population. National statistics present that between 2008 and 2009, the prevalence rate of chlamydia infection increased to 7% (HPA, n.d.b). Decade-long data, moreover, serve evidence to this as the Health Protection Agency indicated an increment of 71% from the baseline data collected in 2000 (HPA, n.d.c). Still, unreported cases by chlamydia victims who are asymptomatic may greatly alter current information on this. Education and information dissemination about chlamydia was relatively poor and infrequent as pointed out in a nationally-held survey in 1999 (DH, 2001, p. 8). Impliedly, this was considered as one of the main reasons of the increased occurrence of chlamydial infection. Nevertheless, despite reports of increased incidence of the condition, an agency reported that the: “knowledge of Chlamydia increased sharply between 2000/01 and 2006/07... Eighty four per cent of men in 2006/07 recognized that Chlamydia is a sexually transmitted infection, compared with 35 per cent in 2000/01... For women, the figures were 92 per cent and 65 per cent respectively.” (National Statistics, 2007, p. 1) Research Methodology There are already a vast number of researches that have been done to facilitate the identification of specific trends and patterns concerning social issues about health. Conversely, these trends and patterns can also be used as basis for future researchers to determine what interventions are needed to promote the ones that can help the society and alter those that do not which, at the same time, necessitate the support not only from the affected population but from each member of the society. Consequently, this paper will incorporate the Functionalist theory in determining the what probable policies can be formulated as specific epidemiological trends surface regarding chlamydial infections and its negative impacts to the population. Functionalist theory, according to Comte, appraises that each member of a society, despite their innate or personal, physiological, and cultural differences, is tasked with specific activities which contribute to the overall function of the society to maintain the equilibrium within it (Wysocki, 2008, p. 19). This means that even only a part of the society is affected in a phenomenon, each member of it (e.g., government official, health worker, or a plain citizen) has a role to play to maintain the standard state of the community as a whole. Nevertheless, the application of this theory entails a qualitative research design that will herald the data needed in identifying the patterns and trends of sexual behavior, specific characteristics, the needs of, and the use of associated health services by the main population being affected by chlamydia. To do so, one-on-one, unstructured, formal interviews will be employed. This method, as outlined by Devender and Devender-Graves (2007, p. 24), will indicate the best data that can be gathered from an interview so long as the interviewer “knows what she’s doing.” Additionally, a free-flowing conversation allows clarification of the issues discussed which can come from both the interviewer and interviewee; this is specifically useful since the topics involved (e.g., sexual behavior and practices, etc.), although are relevant social issues on health that are major determinants to the spread of chlamydial infections, are confidential and complicated (Bates, et al., n.d.). Unless the interviewer is without enough knowledge about the topic and the goal of the interview, significant information on the issue, as guided by a formulated interview guide, will be extracted from the participants and which will be used in the interpretation and analysis of what functions shall be assigned to each member of the society as well as to the social groups formed by these members to prevent further spread of the chlamydial infections, especially among the members of the main population at risk for the condition. Such steps, then, will allow authorities to establish relevant and evidence-based public policies. Furthermore, this type of interview will reveal particular trends and patterns that will provide a view on how each of the factors mentioned above are faced and considered by the rest of the members of the society which will ultimately aid in the achievement of the purpose of this paper; that is, to formulate applicable policies based on the epidemiological trends that will surface during the data collection, interpretation, and analysis in controlling and preventing the spread of one of the most prevalent communicable diseases (chlamydia). With this, it is believed that the need to undergo the complex processes of manipulating the collected data is hailed unnecessary as this research will only serve to describe and report on the observed trends concerning the variables of this study. Participants and Sampling Method. This research paper will implement a non-probability convenience sampling method in selecting a research sample of 20 young adults that have been infected with chlamydia based from the available list of data kept by involved agencies (e.g., local community health clinics, GUM clinics, public agency on Health, etc.). Specifically, this paper will include the affected individuals of the age range 16 to 29 years old which cover that of the high risk population. Equal number of male (10) and female (10) participants will be chosen to maintain fairness of the data collected, and so that it may impartially represent the situation of the affected individuals within the context of gender. Please refer to Appendix A for the sample size determination. Data Collection and Data Analysis. The collection of data involved in this research paper will particularly focus on extracting relevant useful information from the field notes recorded by the interviewers from the one-on-one interviews executed with the chosen individuals. Data analysis, on the other hand, shall involve the consideration of the data collected in the context of the Functionalist theory. As trends are appreciated from the data collected, the researchers will be able to identify the factors and the roles played not only of the involved population but the rest of the members of the society, including particular groups (e.g., the government, education and health sector, private and public organizations) which have or have not done their functions in preventing the transmission of chlamydia; behaviors which led to its current state of being the most common STD in the UK. Equally important, the social patterns and trends on health and illness (esp. chlamydia) that may surface from this research paper will be utilized to identify evidence-based policies to counter the negative social, health and economic impact of chlamydial infections noting the specific functions or roles that must be played by the members of the British community. Verification. To establish a reliable and valid data for a qualitative research method such as what is applied in this research paper, few basic aspects are ensured in the application of the interview method: credibility, dependability, auditability and confirmability of the conducted research; that is, whether the analysis and conclusions acknowledged in the completion of this research project fit existing standards and guidelines. As standards are provided on how to verify the reliability and validity of the paper in several existing literature, this basically pertains to the “overall significance, relevance impact and utility of completed research” (Morse, et al., 2002). These concepts will be tackled in the context of the existing data on chlamydial infection, the epidemiological data collected, and the available sources of policies that have been based on these in different settings. The integration of the Functionalist theory into the research paper, finally, will also be considered within the same terms to build upon the bounds of reliability and validity of a research. References Bates, C. Droste, C. Cuba, L. & Swingle, J., n.d. One-on-one interviews: a qualitative assessment approach. [Online] Center of Inquiry in the Liberal Arts at Wabash College. Available at: http://www.wellesley.edu/NECASL/Pdf/ 11.10.08Mixed%20Methods%20presentation%20for%20web.pdf [Accessed 23 December 2010]. Boutayeb, A., 2006 March. The double burden of communicable and non-communicable diseases in developing countries. Transactions of the Royal Society of Tropical Medicine and Hygiene, 100 (3), pp. 191-199. Centers for Disease Control and Prevention (CDC), 2010. CDC fact sheet: chlamydia. Atlanta, GA: Department of Health and Human Services. Department of Health (DH), 2001. Better prevention, better services, better sexual health: the national strategy for sexual health and HIV. United Kingdom: Crown Copyright. Department of Health (DH), 2004 November. The First Steps: Annual report of the National Chlamydia Screening Programme in England, 2003/04. United Kingdom: Crown Copyright. Devender, J.V. & Devender-Graves, G.V., 2007. Savvy interviewing: how to ace the interview & get the job. Herndon, Virginia: Capital Books, Inc. Health Protection Agency (HPA), n.d.a. Genital chlamydia. [Online] Available at: http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/Chlamydia/ [Accessed 22 December 2010]. Health Protection Agency (HPA), n.d.b. STI Annual Data Tables: Table 1: Total number of STI diagnosis in genitourinary medicine clinics and community settings, UK & England 2008-2009. [Online] Available at: http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1215589015024 [Accessed 22 December 2010]. Health Protection Agency (HPA), n.d.c. STI Annual Data Tables: Table 4: Number of Selected STI diagnoses made at genitourinary medicine clinics in the UK and England: 2000-2009. [Online] Available at: http://www.hpa.nhs.uk/web/HPAwebFile/HPAweb_C/1215589013442 [Accessed 22 December 2010]. Morse, J., et al., 2002 Spring. Verification Strategies for Establishing Reliability and Validity in Qualitative Research. International Journal of Qualitative Methods, 1 (2), pp. 1-19. National Chlamydia Screening Program (NCSP), n.d. What if I’m pregnant. [Online] Available at: http://www.chlamydiascreening.nhs.uk/ys/pregnant.html [Accessed 22 December 2010]. National Research Council, 2005. The changing transitions to adulthood in developing counties: selected studies. Washington, DC: National Academies Press. National Statistics, 2007 October 29. Knowledge of chlamydia has increased over last six years: contraception and sexual health, 2006/07. London: National Statistics. STD Statistics and STDs in the UK, n.d. [Online]. AVERT. Available at: http://www.avert.org/std-statistics-uk.htm [Accessed 22 December 2010]. World Health Organization (WHO), 2001. Global prevalence and incidence of selected curable sexually transmitted infection overview and estimates. Geneva: WHO. Wysocki, D.K., 2008. Readings in Social Research Methods. Belmont, CA: Thomson Higher Education. Appendix A Identification of Samples A. Total Samples = 20 B. Samples per Gender = 20 / 2 genders C. Total number of samples representing each gender = 10 Read More