West Nile virus - Research Paper Example

? TOPIC: WEST NILE VIRUS FINAL PAPER DRAFT LECTURER: WEST NILE VIRUS FINAL PAPER DRAFT A. Health Topic There have been two majorlines of efforts that have been put in place in addressing the health topic of West Nile virus. The first of this has to do with a preventive approach that involves various interventions that ensure that the spread of the disease is stopped from populations that have been identified to be plagued with the disease (Luanda, 2010). This form of preventive approach has been common among smaller identified populations and has been implemented using decentralized approaches to health care as against centralized approaches. What this means is that stakeholders responsible for the preventive intervention always identify a smaller vicinity or community and put in place the interventions with the aim of stopping the spread of the disease within that intervention. Once there is success with a particular intervention, the process is replicated for new vicinity (Petersen and Roehrig, 2001). This is unlike a centralized approach where interventions are started at a national level and minimized to smaller communities. As far as preventive interventions are concerned, one method that stands out in addressing the issue is the environmental predictive model. The second approach to addressing the problem is the centralized approach, which works as an opposite paradigm to the paradigm discussed earlier. This is because in this approach, the stakeholders works out interventions on a national basis and spread the use of the national interventions to various communities. The difference with this second approach however has to deal with the fact that in using this approach, the stakeholders look for a more curative perspective to the disease rather than preventive. The notion and rationale behind this approach is that if the disease is not cured among people who have infections, prevention will be difficult because there will continue to be re-infections (Shortridge, Oya, Kobayashi and Duggan, 2010). A typical example of the national level preventive approach is the roll-back West Nile virus program, which is exclusively funded by the Ministry of Health and carried out in various localized hospitals and health centers (Asnis, 2002). It must however be place on record that the second approach is yet to yield an empirically accepted treatment for West Nile virus even though suggested management practices have been containable in affected persons (Klenk and Komar, 2003). Whiles using the two broad approaches above, different authors have made observations about the outcomes that each approach has produced. As far as the preventive model is concerned, it has generally been praised as being effective for long term management of the disease (Kramer and Bernard, 2001). This is because using a localize approach takes very long time for the interventions that work to be replicated all across the country. For example after the intervention has worked perfectly in one state, introducing it in a new state requires several research and development (R&D) that may study the new demographic data of the people in the state and how best they can respond to the intervention. What is more, the preventive intervention demands the use of a lot of quarantine methodologies that ensure that people who are diagnosed with the disease are not mingled with non-affected persons (Luanda, 2010). This is also a very difficult goal to achieve, as far as the preventive intervention is concerned. But clearly in states where the process has been used, Hubalek (2000) debates that the results have been highly tremendous in ensuring that cases that are seen as seen no more. With the national curative approach, various authors have praised it for its short term benefits, stating that it serves as an effective contingency approach that ensures that the health of affected people is secured and protected in the earliest while of diagnosing them with the disease (Wittich, 2007). This can therefore be termed as an intervention that is effective in preventing emergencies from arising among affected people. Due to the fact that this approach has not been able to yield a substantive treatment that can be accepted as universally effaceable in the treatment of West Nile virus, it has received some negative reviews from other authors who have said that the curative intervention lacks any promise for the future (Klenk and Komar, 2003). Particularly, this intervention has also been said not to lacking the core regard for customization whereby different areas will be investigated for the specific forms of interventions that works best for them before generalizing the interventions; as this is a centralized approach as against a decentralized approach, where much of the decision making is left with the local people (Asnis, 2002). Reading about the two major forms of interventions, there is one line idea that runs through and that is, each of the two has its own weaknesses and strengths. In such a situation, the best approach to take towards the health issue is by ensuring that there is a midpoint where the two forms of interventions are made to collide or coincide with each other. This is the first way the program can be improved. Given that one takes a long term approach and the other takes a short term approach, the two can be linked in such as way that whiles the curative approach is doing away with immediate health situations of West Nile virus, the preventive module would also be ensuring that cases that are eradicated are not repeated do not resurface in the affected persons. It is believed that if the two approaches are combined, it will help in creating a system where the weaknesses of one are complemented by the strengths of the other and vice versa (Eldridge, 1987). What is more, the program can be improved if various forms of best practices are incorporated into the proposed dual approach to the program. B. Populations Throughout the various works that were reviewed in line with West Nile virus program, there have been two major populations that have been identified, which are human population and animal population. The commonest animal population that has been used is population of birds, thought to be carriers and dispersers of the West Nile virus (Hubalek and Halouzka, 1999). the focus of researchers have gone to these animal carriers mainly as a method within the preventive approach to the disease by ensuring all possible sources of the disease are identified and adequately blocked from manifesting its effects on the human population (Kramer and Bernard, 2001). The relationship between bird infested cases within specific neighborhood and human infections have thus being found. This notwithstanding, the most frequent population has been the human population where in often times, researchers deal with either affected people or healthy people as a way of constructing control and experimental groups for subsequent experimentation of interventions to follow. Within the human population also, there has always been efforts aimed at testing the efficacy of different management interventions on people from different demographic backgrounds (Hubalek, 2000). Because greater percentages of the population focus on human populations, the trends shall be discussed in terms of the trends that exist with the human populations that have often been used. By this, there can be indications of two major trends that correspond directly to the two major forms of interventions that have been discussed earlier. In the first instance, nationwide populations were used were the centralized approach to intervention was employed. By this, reference is being made to the fact that the researchers who were testing the nationwide curative intervention always used sample sizes and populations that cut across all facets of the country. The commonest approach taken to achieve this was by ensuring that in all cases, the nation was categorized into various health zones (Petersen and Roehrig, 2001). From each of the identified health zones, a number of people were selected to be part of the population testing the interventions for nationwide results. Where there were localized approaches to interventions employed. The trend was that the researchers always used very minimal number of respondents as their respondents. This was because they often limited the population to one community, where patients on admission were mostly used in the population (Shilite, 2003). In either case, whether researchers use the nationwide trend of population or localized trend of population, they have always been concerned with using denominators of the populations targeted that can justify their concluding results. For instance, there have been control and experimental groups, each of which has different denominators of health measurements. For curative interventions, both the control and experimental groups have been made up of people diagnosed with various levels of West Nile virus. The essence of having two groups all diagnosed with the disease is to ensure that the efficacy of the intervention can be tested in one of the groups as against the other (Wittich, 2007). in line with this, interventions are designed to be made up of a management procedure that is believed to control the rate of re-infection of the virus within the affected people. After the intervention is devised, it is then applied on the experimental group, leaving out the control group. After a period of time, there is re-diagnosis of the denominations or variables of the state of the disease that prevailed in the two populations before the intervention. This latter test is named post-test. Where the post test shows that there has been improvement in the state of health of the experimental group, the intervention is concluded as being effective. Where no significant changes in the state of health of the experimental group are recorded, the intervention is regarded as not being appropriate (Wittich, 2007). For the localized and decentralized approach to intervention, the general idea of using experimental and control group to test the efficacy of interventions have been the same. The only difference however has to do with the fact that in selecting the group and experimental groups, different denominators and variables are considered. For example in the experimental group, there is always emphasis on people have been diagnosed as being infected with the disease. In the control group however, people who are health and free from the disease are used. In such a situation, the aim of the intervention is to ensure that the disease is blocked from spreading to the control group. To this end, the intervention is applied on both the experimental group and control group, while exposing the control group to possible factors that could naturally cause them to contract the disease (Shilite, 2003). Thereafter, efficacy of intervention is tested by measuring the level of resistance that control group develops toward the disease. The higher the resistance level, the more effective the intervention is said to be. C. Methodology There has always been a choice between qualitative and quantitative research methods when conducting research on the West Nile virus. Yet again, the two are always used in different research environments and for different research purposes. This time round, the selected between qualitative and quantitative research is not done based on the intervention type used as it has been found that the two research methods are easily interchanged between the curative interventions and the preventive intervention approaches. Where qualitative research is used, the researchers have always been concerned with the need to finding out how behavioral and socio-cultural characteristics of people can contribute to either the prevention of the West Nile virus or the control of it. It would be emphasized however that the qualitative approach has been very common with the preventive approach even though it has not been totally absent in the curative approach. Quite clearly, the reason is because the preventive approaches always target unaffected persons and present to them ways in which they can use behavioral cautions to ensure that they do not get infected. For the quantitative research method, it is often used where the researchers want to approach the prevention and control of the West Nile virus from a more medical perspective where specific medical interventions are developed for either preventive or curative purposes (Gruszynski, 2006). Most often than not, the quantitative research method is preferred for such situations because they help the researchers to undertaking specific measurements of health events in the affected persons (Hubalek and Halouzka, 1999). It would be noted that the quantitative research is more favorable in situations where the researcher wants to deal with numeric indexes and quantities of variables. When used with medical interventions therefore, there is always the opportunity to take specific medical records such as the dosages of medicines prescribed, number of times that affected people have exhibited certain symptoms or characteristics, rate of response to medical treatment among others (Eldridge, 1987). With the quantitative approach, it has been to be used in the curative interventions as much as it is used in the preventive interventions. Having said that the quantitative research method is popular among both the curative and preventive interventions, it would be remarked that the quantitative research method is more common and popular than the qualitative research method, as the latter is often preferred for the preventive interventions as against curative intervention. Because of this trend, the benefits or advantages associated with the quantitative method have been investigated. First and foremost, it has been found that the quantitative method helps in achieving research results that are more empirical and subject to universal interpretations as compared with the qualitative research. This is generally due to the numeric indexes that are introduced in both data collection and data analysis approaches (Gruszynski, 2006). For example when the dosages of drugs that are issued to patients are quantified using Standard International (S.I) units, they make the generalizability and for that matter reliability of the research work easier because the S.I units are always constant everywhere they are applied. This is unlike the qualitative approach that is subject to the researcher’s discretional interpretation, thereby limiting the reliability of results. Based on the different measures of reliability that the qualitative method and quantitative method produce, there has always been significant differences in the outcomes of the programs with respect t the methodologies. Commonly, there have been outcomes that are easily replicable in other research settings when quantitative research is used. This is because using quantitative research always makes it easier for the researchers to make known to the reader and future researchers, the exact quantities and variables that were used in producing specific results. This way, the need to replicating outcomes so as to test the viability of results has always been easier. When used for preventive interventions, the outcomes have always been such that the weakness of the preventive approach, which has been identified as being slow in its implementation, has equally been overcome (Shortridge et al, 2010). For example because the specific variables that brought about successes with the prevention approach are known, the only differences that come in when expanding the interventions are to ensure that the demographics of the new setting is containable for the said variables. In other words, the need to deal with trial and error approaches to preventing the disease is done away with. Last but not least, outcomes produced with quantitative research have always been said to be highly valid as the need to ensure validity of results is part of the requirements for conducting quantitative research. The validity of quantitative research is often ensure through the various forms of sampling techniques that the researcher uses, which takes away the control of the trend of responses away from the researcher to be the exclusive right of respondents. In such cases where the responses is guaranteed to be the exclusive response of what the respondents represent, validity is said to be enhanced, making it possible for stakeholders to confidently implement the outcome of the program to very large population sizes. References Asnis D. (2002). West Nile Infection in the United States: A Review and Update. Inf Med. 19(6):266-78, Kramer LD and Bernard KA, (2001). West Nile virus activity in the United States, 2001. Eldridge BF. (1987). Strategies for surveillance, prevention, and control of arbovirus diseases in western North America. Am J Trop Med Hyg. 37(3):77S-86S. Gruszynski K. R. (2006). The epidemiology of West Nile virus in Louisiana. 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Japanese encephalitis virus antibody in cold blooded animals. Trans R Soc Trop Med Hyg. 1977;71(3):261- 2. Wittich A. C. (2007). Spatial analysis of West Nile virus and predictors of Hyperendemicity in the Texas equine industry. Emergency Infectious Diseases. 11(10):1633-5 Read More