Epidemiology and Public Health

Research indicates that from the time of implant surgery, the cancer can develop after 2-28 years later, but the cancer’s incidence is very small compared to women who have the implants already. FDA reports that the probability of developing this cancer in breast implanted women in the US is 1:30000 to 1:3817 (The New York Times, 2018). All the women diagnosed of this cancer type had breast implants that were textured but FDA had not recorded this because a formal link has not been formally recognized between implant type and cancer development. Questions that are to be asked are what could develop causation, what ethical concerns related to textured implants use and what further studies could establish a strong link between cause of the cancer.

One manufacturer of these implants has paid for research about the cause lymphoma. It is the basic form of data presentation in form of tables, representing only a single epidemiological variable. These tables present basic information of data that can be analyzed faster and a conclusion drawn from the trends and relationship among the data. Multivariable tables are mostly used especially when data that is available is of two or more variables. They are sometimes referred to as contingency tables especially when the entries of all the main data are categorized by each variable present in the table. The two-by-two contingency tables are mainly applicable when 2 variables each having 2 categories are analyzed. The cross-sectional studies, random sample of participants are drawn and the information recorded in a systematic manner (Pearce, 2012).

Comparison of population with a characteristic can be made against population without the characteristic. The disadvantage of this study is that the there is no proof of which characteristics compared came before the other. For example, in study of diabetes prevalence in a community, it is not clear whether weight issue or diabetes came first. Therefore, this study design is weak and conclusions cannot be drawn about causes. However, a disadvantage of difficulty in collecting data from past exposures is present. Also, differences in controls and cases could be present pertaining factors and characteristics like age, wealth or gender. A problem of whether the exposure or disease came first is also present. Incidence of disease cannot be calculated in this study because before the study began, disease cases were already there.

This makes the study weaken. WHO in 2017 revealed that the period between 2014-2016 was characterized with considerable incidence increases in the America and South-East Asia, African regions and Western Pacific (WHO, 2018). In every 3. 2 billion persons residing in places with high incidences of malaria, 1. 2 billion have high risk of getting malaria. WHO reports that 214 million new malaria cases reported in 2015. falciparum and P. vivax causes most malarial infections worldwide. Most malaria burden within African tropics is linked to P. falciparum, while East and South Africa, and America are mostly affected by P. vivax (WHO, 2018). Malaria condition Malaria biology involves first the mosquito bite, which inoculates the sporozoites into human dermis. These enter the blood and within minutes, the sporozoites move to liver tissues and infect the liver cells.

This initiates asymptomatic exoerythrocytic stage of malaria infection that lasts about 1 week. Replication in hepatocytes happen and liver schizonts result. Merozites are formed from rupturing of hepatocytes and are released into blood and attack RBCs. P. falciparum can cause cerebral malaria, kidney failure, placental malaria and pulmonary edema due to the high parasitemia and presence of microvascular blockage in organ beds and brain, and inflammation. This is associated with highest morality rates in children and adults. Malaria mortality and morbidity Malaria is a great killer of children in Africa and other developing nations experiencing tropical climate. Most deaths from malaria happen at home, and records for these cases are not available. 3% (Hwang, Cullen, Kachur, Arguin, & Baird, 2014). WHO (2017) reveals that 216,000,000 new malaria cases were reported in 2016 and 211,000,000 cases reported in 2015.

Deaths due to infections from malaria were estimated to be 445 thousands in 2016, and 446 thousands in 2015 (WHO, 2017). High malaria burden is observed in Africa where, in 2016, 90% of malaria cases and 91% death cases from malaria came from Africa. 15 countries from Sub-Saharan Africa, excluding India, were responsible for 80% malaria burden globally. Sickle cell condition and traits protect the person from infections by P. falciparum, and therefore, these people have an advantage. Since this malaria type is very serious and has been causing death in Africa, sickle cell carriers are now found mostly in Africa. Those with African origin also tend to have this trait as compared to those in other population groups. Any disorders of hemoglobin and dyscrasias of blood such as G6PD, thalassemia and hemoglobin C, are more common and prevalent in malaria endemic areas and these conditions provide protection against malaria (Oscar, Kodjo, & Paolo, 2003).

The person may not present cardinal symptoms of malaria. In Sub-Sahara, newborns are always protected in their few months since birth by maternal antibodies. But the antibodies fade with time and children become prone to malaria disease and death may result. After age of 2 years, if they would have survived repeated malaria infections, they will develop semi-immunity that prevents them from acquiring severe malaria. In areas of high transmission, children are more prone to malaria attacks and therefore, interventions to manage and prevent malaria are directed to this population. Additionally, women tend to put on less clothes that expose most parts of their bodies compared to men. This character increase exposure to mosquito bites and therefore, women tend to be suffer malaria more than men.

Environmental attributes Poor populations in the rural places of endemic areas cannot develop or acquire proper housing and mosquito nets, which serve to protect them from exposure to bites of these mosquitoes. Because of poverty, these population is not exposed to knowledge and information about malaria, how it spreads, and presents, and treated. These people tend to use traditional techniques of managing diseases because they are not exposed to proper scientific knowledge, therefore, they are mostly affected by malaria. Inadequate finances for governments in endemic areas also contribute to spread and prevalence of malaria. Healthcare personnel in these countries are usually overworked and underpaid, and additionally, lack of supervision, training, equipment and drugs cause a serious problem in management of infections from mosquitoes.

The people residing in such affected areas understand the inabilities of their government to promote health, and therefore, they do not rely on public sector, but rather prefer private sector. But private sector is more expensive, and since these people are poor, they may opt traditional alternatives that are less effective. This promote increase prevalence of malaria. Poor countries, especially the developing nations, have low education level. This explains why malaria prevalence in these places is high. Lack of knowledge on malaria transmission, prevention, control, symptoms and treatment poses a huge setback that should be addressed through education and training. Medical practitioners should also be highly educated in malaria disease prevention, control and treatment so that they can be empowered to educate the local population on the same.

Temporal variation Rainfall create breeding sites for mosquito, where Anopheles mosquito lay eggs that develop to larvae, pupae and adult mosquitoes. After the primary exoerythrocytic period, Plasmodium malariae and falciparum cannot be found in hepatocytes, but P. ovale and P. vivax can remain in hepatocytes as hypnozoites without causing any symptoms. These hypnozoites can cause infection later after the symptoms have been addressed and treated. Erythrocytic period is responsible for malarial symptoms. Endophilic species prefer remaining within dwelling where they obtain blood meals and therefore, they are prone to lethal insecticide doses that are applied to control mosquitoes. Exophilic species are not prone to insecticides within dwellings of people. There has been research in mosquito resistance to insecticides. This biologic factor has brought discussion on which insecticides to use and to what extent.

Mosquitoes that develop resistance are those that have been chronically exposed to same insecticides for long, and their genetic makeup produce proteins that inactivate these insecticides. Warm wet climates are good for malaria prevalence because these parasites, especially P. falciparum, thrives well and its growth cycle is fastened by these warm climates. This explain the high malaria prevalence in Sub-Saharan Africa, and other areas where tropical climate is present. Poverty and lack of information and knowledge about malaria is a key factor in malaria distribution. Poor countries tend to lack adequate resources to manage malaria prevention, control, treatment and education. Principal gaps in Malaria distribution knowledge Most poor nations in Africa, Asia and Latin America have less knowledge and information pertaining malaria and its severity among children and pregnant women.

This explains why malaria is more prevalent in such areas. Poverty and less knowledge occur together. Poor nations report low education level, and therefore, prevention, control, and treatment of malaria is low. This poses a demand for help from developed nations to them control malaria by educating people, and provision of resources for malaria control. Resistance of P. falciparum towards combination of chloroquine and sulfadoxine-pyrimethamine in older children, and amodiaquine and sulfadoxine-pyrimethamine in younger children, has developed rapidly since 2000 (Marfurt, et al. Acquired immunity against plasmodia is present with P. vivax. After continuous treatment with anti-malarial drugs to eradicate erythrocytic blood stages, children develop some immunity against these plasmodia. 2 billion have high risk of getting malaria. 214 million new malaria cases were reported in 2015 (WHO, 2017).

From 2000 to 2015, malaria incidences had declined by 32%, and annual cases of symptomatic malaria reduced by 18% (WHO, 2016). Most of deaths caused by malaria were reported to be due to Plasmodium falciparum in Africa. Plasmodium species that cause malaria are. 9% of P. falciparum cases led to deaths. 3% of P. falciparum cases were grouped as severe. P. Malaria kills many children below age of 5, and it is estimated that after every 2 minutes, a child in this category dies of malaria (WHO, 2017). Malaria deaths in 2000 was 839 000, and in 2015, it was 438 000, representing a fall by 48% (WHO, 2017). Most deaths occurred in Africa (90%), followed by SE Asia (7%), and then Mediterranean (2%). Mortality rate of malaria is said to reduce by 60%, by 2015 from 2000 when population growth has been considered. Presence of Duffy chemokine RBC receptor promote malarial infections by P.

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