Epidemiology HPV and Teenage Girls

Posted: September 3rd, 2013

Epidemiology HPV and Teenage Girls

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Epidemiology HPV and Teenage Girls

Many teenage children, especially girls in the United States and other developed nations are engaging in sex at much younger age and thereby increasing the chances of contracting sexually transmitted diseases. The Human Papilloma Virus (HPV) is one of the highest causes of sexually transmitted diseases. The age group found to have the highest prevalence is surprisingly teenage children. This increases the rates of cervical cancer in the United States and other industrialized nations. Epidemiology is the study of health and disease in a given population. The study focuses on establishing the cause and effect of the health aspect or disease. This study attempts to analyze on how the ailment or infection manifests and spreads in population at risk (De Villiers, et al, 1987).

A proper solution would be coming up with the relevant prevention and treatment procedures. Epidemiology is different in comparison to other medical fields in that the study concentrates on a given society or groups as opposed to an individual. With this regard, this study is most effect in the study of Human Papilloma Virus among teenage girls in a given community. This field directly influences public health policy in that the effort of preventing the spread and pandemic of the Human Papilloma Virus, epidemiologists track cases of the disease and determine the various strains in the development of relevant and effective vaccines (Villa, & Franco, 1989).

Epidemiology focuses on two basic tenets. The first is the evaluation that human disease never transpires at random. The second tenet is that the development of derives influence from causal factors considered generally preventable and in essence mitigating the prevalence of the disease. The Epidemiology of studying infectious diseases attempt to analyze the contribution of different factors contributing to the transmission and acquisition of the infection. In addition, these studies evaluate the factors that favor the endemic transmission of HPV. The study is also concerned with realizing relevant interventions, such as the immunization of all teenage girls against the ailment.

There are various steps that epidemiologists follow while conducting their studies concerning the prevalence and the realization of the relevant interventions concerning HPV and teenage girls. The first step in the epidemiologic approach focuses on establishing if the disease exists. Conducting a comprehensive research is very laborious and consumes many resources. This raises the need for making a case on the relevance and importance of the research. The second step is the confirmation of the homogeneity of events. During this step, the researcher draws all the conclusions from the homogenous cases with any arising from the inhomogeneous cases raising suspicion. The events or occurrences of the HPV are only true cases of the ailment.

The third step involves the collection of all the events. The documentation of the events is necessary for investigating the various risk factors. One sources the events from censuses or records from health care centers. The events are characterized in accordance with either incidence or prevalence rates. The fourth step involves describing the above events in relevance to the epidemiological factors. These factors include the predisposing factors, enabling/disabling factors, precipitation factors, and the reinforcing factors. The fifth step entails searching for patterns and trends common with most of the HPV patients. Cases that contain similarities are given attention that may provide the major risk factors for contracting the virus. This may involve the use of epidemic curves in the realization of these risk factors. The sixth step is the formulation of a hypothesis followed by conducting a test on the hypothesis. The final step involved in the epidemiologic approach is the publishing of the findings.

There are various methods used during epidemiologic studies where one is descriptive method whereby the information gathered is categorized in terms of time, place, and person. The second method is the analytic method whereby either a case-control or a cohort study is adopted into the study. The third method is purely experimental where the study involves an organized approach in finding a solution to the problem. From the above methods, the most relevant in conducting an epidemiologic study concerning HPV and the teenage girls is the experimental approach. This is whereby a solution to the disease resistance and mitigation is identified through the confirmation of the existence of the disease among a given population. Next is the development of a case definition, the evaluation of the collected information according to time, place, and person, coming up with a hypothesis, building up, executing the necessary control and prevention measures, and finally evaluating the appropriate control and preventive measures (Schiffman, 1992).

The epidemiologic triangle is used in research to evaluate the relationship between the host, the agent, and environment. In this case, the hosts are the teenage girls infected with the disease; the agent is the Human Papilloma Virus whereas the environment is the setting under which the teenage girls expose themselves to the virus. This conceptual framework is effective in developing the transmission dynamics of the sexually transmitted pathogen. The objective in using the triangle is to break at least one of the vertexes of the triangle and in the process discontinuing the cycle and therefore mitigating the spread of the disease.

The agent is the disease-causing organism. This is usually a microbe, an organism is too minute for it to be visible by the naked eye. Currently, measures aimed at mitigating the spread based on severing the relationship between the host and the agent. Accomplishment is made by having the potential patients take up vaccines and in the process prevent the continuity of the cycle. Aspects of the environment and time, such as educating the masses on proper behavior also severs the association between the host and environment and thereby mitigating the spread of the disease. Additional research on these relationships is still ongoing whereby researchers use study designs such as, cohort studies, ecologic, and surveillance studies, and traditional randomized calculations. The increase in meta-analysis whereby data from the various studies takes into consideration the study of new research questions is used (Kjaer, et al, 1988).

The type of epidemiology used in this research is primarily descriptive epidemiology. This involves researching on the frequency and distribution of risk factors in populations. This type of epidemiology prefers this study because it facilitates the assessment of the rates of new infections and the extent of the disease. This enhances the provision of hypothesis of etiologic research. In descriptive epidemiology, the first step involved the establishment on how common HPV infections are among teenage girls. Another step involves the assessment on how the HPV infections are burdening the healthcare system. This is important in evaluating if the present facilities are viable in dealing with the population and thus deliberating on the development of additional facilities. The state of healthcare system is highly important in dealing with any epidemic. A healthcare system burdened by a given disease is highly inadequate in dealing with the spread and new infections in the population. Research indicates that although the current healthcare system is not burdened by the HPV infections, the rates of new infections indicate that in the future, this may not be the case if the healthcare system is not developed from its current state. This poses a danger and thus provides the authorities with the relevant information required in planning for the future (Dunne, Et al., 2007).

The descriptive epidemiology further involved studying the persistence of HPV infections. Studies indicate that most of the infections are not persistent and tend to clear spontaneously. Cohort studies further find that few proportions of the reviewed teenage girls who are positive for a given HPV type are diagnosed with the same after subsequent specimens. However, this fails in providing conclusive information on whether the infections clear entirely the virus remains latent thriving in the basal cells in levels are undetectable by the facilities used. However, it is conclusive that the risk associated with those infected with subsequent cervical intraepithelial neoplasia increases with increase in the number of specimens that test positive for the virus. This indicates that the development of carcinogenic mainly supports the successive HPV infections for lengthy periods.

The most effective primary prevention to address the disease is through vaccination. Vaccines are tested to protect teenage girls against the contraction of the common types of HPV. The vaccines are administered in three doses given under a period of six months. These vaccines are highest in effectiveness if they are administered when the girls engage in their first sexual encounter or during high-risk chances of exposure to HPV. The teenage girls are administered with two vaccines (Cervarix and Gardasil), but only if they failed in getting the vaccine when they were younger. Other primary prevention involves the use of condoms and being faithful to one partner. Secondary and tertiary preventive measures are generally mainstays of cancer prevention strategies. Secondary prevention involves the diagnosis and treatment of preinvasive disease. This mainly involves taking the patient through screening tests. On the other hand, tertiary prevention involves the measures put in place to decrease the burden of established disease (Bosch, 2003).

The success of the vaccine in preventing the infection of the virus has led the governing authorities to enact laws that require all the teenage girls to undergo HPV vaccination. This is a drastic measure by the government in the aim of preventing future spread of the disease and in controlling new infections of other related diseases such as, cancer. Various legal and ethical and legal issues have met this. The mandatory vaccination raises the ethical and rights issue raised by parents on their concerns that the procedure acts in condoning sexual activity among the teenage girls. This is also considered an encroachment on the parental rights to making decisions for their children. Bioethicists have also raised ethical concerns regarding the compulsory vaccination laws. Their argument is that because HPV is not casually transmitted, the rationale is minimal in protecting the citizens from it in comparison to diseases such as, measles or pertusis. Because their ceases to be a potential harm to a third party, such laws are deemed unacceptably paternalistic. There is also the argument that because the virus is transmitted only sexually or using infected needles, the vaccines should be administered to those prone to such activates as opposed to all the children. Cultural issues are also raised include the feeling of negative stereotypes that perceive the African Americans to be the most sexually active and thus the nuance to concentrate vaccination activities on these communities (Baseman, Koutsky, 2005).

In conclusion, the HPV prevalence rates are still on the increase in most of the communities in the United States of America. This prevalence is especially among teenage children and specifically the girls. However, the government has enacted laws the require schools to mandatory immunize teenage children against the infection in the effort of controlling the infection rates. This action has been met with criticism in that the argument tends to invoke several moral and ethical issues both from the society at large and medical professionals.

References

Baseman JG, Koutsky LA. (2005). The epidemiology of human papillo-virus infections. J Clin Virol; 32 (Suppl.1):S16–24.

Bosch FX, de SS. (2003). Human papillomavirus and cervical cancer—burden and assessment of causality. J Natl Cancer Inst Monogr;31:3–13 [chapter 1].

Dunne EF, Unger ER, Sternberg M, et al. (2007). Prevalence of HPV infection among females in the United States. JAMA.;297 :813– 819

De Villiers EM, Wagner D, Schneider A, et al. (1987). Human papillomavirus infections in women with and without abnormal cervical cytology. Lancet; 2:703-706.

Kjaer SK, de Villiers EM, Haugaard BJ, et al. (1988). Human papillomavirus, herpes simplex virus and cervical cancer incidence in Greenland and Denmark. A population-based cross-sectional study. Int J Cancer; 41:518-524.

Villa LL, Franco EL. (1989). Epidemiologic correlates of cervical neoplasia and risk of human papillomavirus infection in asymptomatic women in Brazil. J Natl Cancer Inst; 81:332-340.

Harper DM, Franco EL, Wheeler CM, et al. (2006). HPV Vaccine Study Group. Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: Follow-up from a randomized control trial. Lancet; 367:1247-1255.

Schiffman MH. (1992). Recent progress in defining the epidemiology of human papillomavirus infection and cervical neoplasia. J Natl Cancer Inst; 84 (6):394–8.