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Hepatitis B is one of the most prevalent global viral infectious diseases. According to Mutimer & Oo (2011), more than 400 million people worldwide have chronic hepatitis B. A hidden danger of the disease is that it leads to liver cirrhosis, followed by liver failure (Mutimer & Oo, 2011). Not surprisingly, the global nursing community leverages new resources and develops new strategies to slow down the epidemic at least. The current paper is designed to explain the epidemiological complexities surrounding hepatitis B, and the role community health nurses can play in addressing these epidemiological concerns. It is possible to say that, even in the presence of such organizations as the Hepatitis B Foundation, community health nurses will be placed ideally to provide competent assistance and preventive services to populations at risk from hepatitis B.
Description of the Communicable Disease
Hepatitis B is one of the most prevalent chronic viral infections globally (Mutimer & Oo, 2011). The chief cause of the communicable disease is the hepatitis B virus (HBV), which “belongs to the Hepadnaviridae family of viruses. Its genome consists of partially double-stranded circular DNA” (Lin & Kirchner, 2004, p. 75). An acute infection is subclinical in almost 70 percent of patients (Lin & Kirchner, 2004). Moreover, 95 percent of adults with acute HBV infection are claimed to recover spontaneously without any treatment (Mutimer & Oo, 2011). The acute infection can be manifested through fatigue, nausea, epigastric pain, right upper quadrant pain, and low-grade fever (Lin & Kirchner, 2004).
By contrast, the evolution of a chronic infection comprises four distinct phases, from immune tolerance with high levels of replication in HBV DNA and up to the fourth or “immune” stage that results in HBsAg clearance (Lin & Kirchner, 2004). Twelve percent of individuals with diagnosed chronic hepatitis B eventually develop cirrhosis (Lin & Kirchner, 2004). Some patients develop hepatocellular carcinoma (Lin & Kirchner, 2004). All individuals with confirmed chronic hepatitis B are potentially infectious. Modes of transmission vary but typically include sexual contacts, mother-to-infant during birth, and direct contacts with blood (Lundy & Janes, 2009). Management is based on the use of interferon and nucleoside analogues (Mutimer & Oo, 2011). The importance of antiviral therapy is justified by the need to prevent the development of cirrhosis (Mutimer & Oo, 2011). Vaccination remains the predominant mode of hepatitis B prevention in infants and adults.
Determinants of Health and Hepatitis B
Social determinants of health play one of the chief roles in defining the patterns of the hepatitis B infection and its character. According to Beltran, Harrison, Hall, & Dean (2011), four health variables are related to the prevalence, incidence, and risks of hepatitis B: occupation, ethnicity, vaccination status, and residency. Income and social mobility also matter, since even low-risk behaviors cannot always secure individuals and entire population groups from acquiring the virus (Beltran et al., 2011). Actually, it is due to the complexity of social factors surrounding the virus that medical professionals find it difficult to develop and implement targeted preventive interventions. Vaccination is probably the most essential health determinant related to hepatitis B, since even one international trip can result in the development of the chronic virus with its complications for liver.
The Epidemiologic Triangle
The epidemiologic triangle facilitates the analysis of the major public health issues. It is particularly useful in explaining patterns of a disease as a compilation of three factors, namely an agent, host, and environment (Friis & Sellers, 2009). The agent of hepatitis B is a virus, whose viron is surrounded by a core protein coupled with the HBV surface protein, and whose genome includes double-stranded DNA (Lin & Kirchner, 2004; Mutimer & Oo, 2011). The only hosts for the discussed agent are higher primates and humans (Mutimer & Oo, 2011). The virus exists in blood and body fluids (Liaw & Chu, 2009). As a result, even the use of dirty syringes during tattooing can become a favorable opportunity for disease transmission.
The Role of the Community Health Nurse
Community health nurses play one of the most essential roles in slowing down and preventing the hepatitis B epidemic. According to Wheeler (2012), community health nurses are suited ideally to engage in all epidemiological, medical, and preventative activities as part of hepatitis B care. They can participate in vaccination, case analysis, testing, and follow-up visits to individuals after an acute phase of the disease or following vaccination. They can also provide continuous support to patients with chronic hepatitis B who receive medical treatment. The role of community health nurses is of particular importance in advocating vaccination to protect infants and adults from the risks of the chronic hepatitis B infection (Lundy & Janes, 2009). The administration of community-based reviews is equally important to ensure that all individuals with chronic hepatitis B attend clinics for regular lifelong monitoring of their health condition (Bowyer, 2014).
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Identifying a National Organization
The Hepatitis B Foundation is probably the central element of public care for individuals with hepatitis B. The mission of the organization is to find a cure for the disease and provide quality support to improve the health and wellbeing of individuals, who live with hepatitis B worldwide (Hepatitis B Foundation, 2014). The Hepatitis B Foundation actively participates in research, coupled with programs and strategies to raise hepatitis awareness and foster public recognition of the existing treatment and immunization options (Hepatitis B Foundation, 2014). For many individuals, the Foundation has become the primary source of information about the disease. The efforts and funds invested in hepatitis B research are likely to become a starting point in the development of new, safer medications and vaccines.
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