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What effect would the following have on

(i) the incidence,

(ii) the prevalence and

(iii) the duration of disease and why?

(a) The introduction of a new drug that cures a previously incurable but non-fatal disease

(b) The introduction of a new drug that prolongs survival but does not cure a fatal disease

2. For each of the following calculate a summary measure of disease and identify what type of measure it is:

(a) 2,000 babies were born at a hospital during one year, of these 70 had a congenital defect. Nursing Assignment Help

(b) In a city with an average population of 1,200,000 people there were 18 new diagnoses of HIV infection in a one year period.

(d) 1500 people in a community answered a health survey and, of these:

i. 75 reported that they had diabetes

ii. 15 reported that they had been newly diagnosed with diabetes during the previous year

(e) In the US Nurses’ Health Study, 95,396 post-menopausal women reported their levels of physical activity in 1986 and were then followed for up to 20 years with a total of 1,203,929 person-years of follow-up. A total of 4,782 women have developed invasive breast cancer.

3. The following excerpt is from an official government report: ‘As at 30 June 2002, the number of people living with HIV in Australia was 13,120. This represents a prevalence rate of 65.6 per 100,000 population.’ Although the term prevalence rate is commonly used it is not strictly correct. Why not?

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4. What is the difference between an incidence rate and an incidence proportion (or cumulative incidence)?

5. In a group of 100 patients with diabetes, 20 already have hypertension. Over the next year 10 more develop hypertension. (Assume the hypertension is permanent and there are no losses or entries to the group of patients with diabetes.)

(a) What is the initial prevalence of hypertension in the group?

(b) What was the prevalence one year later?

6. In January 2001, 4,500 men aged 45-54 years joined a new health insurance plan and were offered a free health check, 1000 of the men were found to be overweight or obese. Ten years later the men were checked again and 700 men who were normal weight in 2001 were now overweight or obese, while 200 of those who were overweight or obese in 2001 had lost weight and were now in the normal range. Nursing Assignment Help

(a) What was the prevalence of overweight and obesity in the men in (i) January 2001 and (ii) January 2011?

(b) What was the incidence of overweight/obesity in this group?

7. The population of Australia in 2005 was 20,395,000 with 10,128,000 males and 10,267,000 females. At the end of 2004, 654,977 living persons had been diagnosed with cancer at some time in the last 23 years. During 2005, 22,017 males and 17,080 females died from cancer, 1119 males and 1062 females were diagnosed with pancreatic cancer and 964 males and 1062 females died from pancreatic cancer.

(a) What was the prevalence of cancer in Australia on 1 January 2005?

(b) What was the cancer-specific mortality rate in 2005?

(d) Estimate the case-fatality rate for pancreatic cancer.

(e) What proportion of all cancer deaths are due to pancreatic cancer?

8. HIV was introduced into Thailand in the mid-1980s. It rapidly spread among injecting drug users and young men visiting commercial sex workers. From 1990, an active campaign helped reduce the number of commercial sex encounters by half and increase condom use in commercial sex encounters from 15% to 85%. The problem of HIV in injecting drug users (predominantly males) was not addressed as Thailand has a very punitive attitude towards drug users. Preventing transmission between married couples has been much less successful. During 2000, there were 10,988 new cases of HIV in men and 14,223 in women. In December 2000, 434,323 men and 240,189 women were living with HIV/AIDS. The population of Thailand in 2000 comprised 30,015,233 men and 30,901,208 women. Nursing Assignment Help

(a) What was the prevalence of HIV in men and women in Thailand in 2000?

(b) What was the incidence rate of HIV in men and women in Thailand in 2000?

In 2001, there were another 11,132 new cases of HIV among Thai men and 13,970 among women. There were also 17,405 deaths from HIV among men and 12,362 among women

(c) What was the prevalence of HIV among men and women at the end of 2001 (assuming the total population has not changed)?

9. Define the following measures and summaries their practical utility in public health:

(a) A crude mortality rate.

(b) An age-specific rate.