A critical review of a published epidemiological paper - Essay Example

?A critical review of a published epidemiological paper Malaria is one of the major health problems prevalent in the Third World countries; negatively impacting the people’s health as well as the development of the country has a whole. Malarial endemic conditions vary from country to country based on the malaria epidemiology and the level of the control program implementation in these countries. 300 – 350 million cases are found to be caused by malaria with a mortality rate of 2-3 million deaths per year. (World Health Organization 2010). Malaria is caused by the protozoan parasite Plasmodium and is transmitted by the anopheles mosquitoes. Malaria is caused by four species of protozoan parasites. Plasmodium falciparum, P. vivax, P.ovale and P.Malariae. P.vivax is the most wide spread form of malaria infection in the world. (Gbotosho et al. 2011). P.falciparum causes the most severe form of the Malaria and is responsible for most deaths and serious morbidity. It enters the blood cells at the gametocyte stage from the mosquitoes gut to the blood of the human during a blood meal. Malaria constitutes about 10% of the disease burden in Africa. Malaria is both a social and behavioral problem and that has to taken into account while perceiving and treating the disease. On the same lines, AIDS could also be considered as a social and behavioral problem or diseases, which is having major impacts throughout the world, particularly in Third World Countries. Human Deficiency Virus (HIV) infection causes the Acquired Immuno Deficiency Syndrome (AIDS) and the people who were exposed to this virus die due to the co-infection with opportunistic pathogens. There are two types of HIV virus; HIV type -1 and HIV type – 2. HIV-1 is found throughout the world. (Gunn and Pitt, 2012). Though there is no cure for AIDS, the antiviral treatment therapies like HAART have enabled the infected people to live for some more years. The current estimates states that around 30 million people are infected with HIV in the world. (Gunn and Pitt, 2012). This is one of the major diseases in the developing countries. The parasites help the virus to acquire well into the body and adapt to the body conditions and thereby leads to higher morbidity and mortality. These different diseases have some correlation, when it comes to co-infections. The areas with high rates of malaria also have the burden of HIV co-infection. The HIV-1 virus infection is promoted by the infected CD4+ cells delivered by the pathogens. HIV positive people present in the Malaria endemic regions are more vulnerable to Malaria. The HIV-1 infection increases the risk for malaria. The presence of malarial parasites in the blood of the HIV positive individuals is the starting point of co-infection of malaria with HIV. (Hochman and Kim 2009). Similarly plasma HIV viral load in the acute malaria infected individuals is high during the first eight weeks of infection. Thus, in a way “HIV fuels Malaria and Malaria fuels HIV”. (Singer 2009). This connection or coinfection has been focused in various studies conducted throughout the world, particularly in the Third World Countries. These studies are featured in number of journal articles. The article titled, HIV-malaria coinfection: effects of malaria on the prevalence of HIV in East sub-Sahara Africa written by Diago F. Cuadros, Adam J. Branscum and Phillip H Crowley, and featured in the International Journal of Epidemiology in 2011 focuses on this coinfection. So, this paper will do a critical review of that published epidemiological article, with the aid of other current journals, by first critically evaluating the evidence used in developing and implementing public health measures, then by critically discussing and distinguishing between research methodologies and methods used in health and public health research, then will evaluate and critically comment on the impact of public health policies in relation to the study and finally will prepare a research protocol Malaria prevalence in Pregnancy: a major public health issue Although, as mentioned above, Malaria occurs through out the world and in many Third World countries, as pointed out by the authors Diago F. Cuadros, Adam J. Branscum and Phillip H Crowley in the article HIV-malaria coinfection: effects of malaria on the prevalence of HIV in East sub-Sahara Africa, approximately 90% of these cases occur in the sub-Saharan Africa. They further point out the key correlation between Malaria and HIV. “This region has also experienced the greatest burden of HIV-1 infection, with an estimated 25 million infected individuals over the past two decades. The geographical overlap of these diseases has sparked much interest in their potential interactions.” (Caudros, Branscum and Crowley 2011). Although, Malaria affects people of all age groups and health conditions, it mainly affects the pregnant women. That is, the malaria has high infection rate in relation to the pregnant women. In the sub Saharan Africa surveys, it was found that the pregnant women infected with HIV have greater chance for the malarial infection, mortality and morbidity. Maternal anemia and low birth weight for the children are the major results of malarial women. (Michel et al. 2010). “Co-infection with malaria and HIV in pregnant women is particularly common in sub-Saharan Africa and has serious consequences for both mother and newborn child.” (Briand, Badaut and Cot 2009). Systemic and placental immunological changes are induced by the HIV infection. The occurrence of malaria was twice high in the HIV infected individuals as compared to the normal people. HIV infection in the malaria pregnant women causes increased parasite density, febric illness, severe anemia and low birth weight. (Ehiri 2010). The incidence of malaria is 1.2 fold higher in HIV -1 infected individuals and 2 fold higher in the AIDS patients. The cases of the children were very worse. The incidence of malaria was 6 fold and 9 fold higher in the malarial and malarial fatality children. (Ehiri 2010). The occurrence of malaria was very heavy in the patients with less CD4 count. The incidence of malaria was higher in the HIV patients with >500, 200- 499, Read More