Week 6 Epidemiological Analysis: Chronic Health Problem Assignment Purpose The purpose of this assignment is: Integrate knowledge and skills learned throughout the NR503 course Direct application of course objectives utilizing epidemiological analysis of a chronic health problem, along with state and national level data. Epidemiological Analysis- Chronic Health Problem Epidemiological Analysis- Chronic Health Problem Activity Learning Outcomes This assignment enables the student to meet the following course outcomes: See weekly outcomes from Weeks 1-6. Due Date This assignment must be submitted by Sunday, 11:59 p.m. MT at the end of Week 6. Total Points Possible This assignment is worth 200 points. Preparing the Assignment Requirements This paper should clearly and comprehensively discuss a chronic health disease. Select a topic from the list provided by your course faculty. The paper should be organized into the following sections: Introduction (Identification of the problem)

Epidemiological Analysis- Chronic Health Problem

Atopic dermatitis (AD) is an incurable chronic skin condition that affects people across all lifespans (Chiesa Fuxench et al. 2019). The disease has significant social, financial, and health impacts, necessitating concerted efforts to address AD adequately. This paper discusses the etiology, signs and symptoms, and pathophysiology of AD. Furthermore, it discusses epidemiology, screening guidelines, surveillance, and reporting and develops a plan for addressing the disease.

Background and Significance of the Disease

Chiesa Fuxench et al. (2019) report that AD is characterized by pruritus and inflammation that begins in early childhood. It is worth noting that an adult-onset variant of AD exists. Its course is intermittent and presents with exacerbations and remissions (Chiesa Fuxench et al., 2019). The other manifestations of AD include xerosis, lichenification, and eruption of eczematous lesions (Frazier & Bhardwaj, 2020). Also, AD is likely to present with peripheral eosinophilia and heightened immunoglobulin E reactivity (Frazier & Bhardwaj, 2020). The worst affected body parts include the limbs, neck, and face. The disease is uncommon in the regions around the axillae and groins (Frazier & Bhardwaj, 2020). Poorly managed AD predisposes patients to viral and bacterial skin infections, blepharitis, conjunctivitis, insomnia, anxiety, and depression (Kim et al., 2019).

The pathophysiology of AD is not well defined. However, various pathways have been postulated to cause AD. Firstly, the altered production of T cells results in the overproduction of Th2 cells compared to the other subsets of T cells (Kim et al., 2019). This triggers the secretion of type 2 cytokines, which promote the secretion of Immunoglobulin E (Kim et al., 2019). Furthermore, Th2 cells promote the secretion of interleukin (IL) 31, which elicits inflammation and pruritus (Sroka-Tomaszewska & Trzeciak, 2021). Also, IL-4 and 13 have been implicated in AD-associated inflammation and pruritus (Kim et al., 2019). Secondly, damage to the epithelial barrier allows antigen entry, hence the secretion of inflammatory mediators. For instance, filaggrin mutation predisposes people to AD by triggering the release of inflammatory cytokines such as IL-33 (Sroka-Tomaszewska & Trzeciak, 2021).

Various factors have been implicated in the etiology of AD. To begin with, the disease has a genetic predisposition. Notably, the presence of mutated filaggrin increases the risk of AD. Filaggrin promotes the proliferation of the epidermal barrier (Frazier & Bhardwaj, 2020). As such, mutations increase the risk of antigen entry and release of inflammatory mediators. Also, Staphylococcus aureus infection exacerbates AD ( Torres et al., 2019). This microorganism can act as a superantigen, hence predisposing patients to AD. Herpes simplex virus is the other microorganism that exacerbates AD ( Torres et al., 2019). Climatic conditions such as heat and dry conditions worsen skin dryness associated with AD. Also, perspiration worsens pruritus and triggers the inflammatory pathway (Frazier & Bhardwaj, 2020). Furthermore, environmental factors have been implicated. Examples include exposure to cigarette smoke, fragrances, and aeroallergens (Frazier & Bhardwaj, 2020).

Nationaleczema.org (n.d.) reports that about 9.6 million people aged below 18 years in the USA have AD. This represents a prevalence of about 15 percent among children and teenagers (Nationaleczema.org, n.d.). Approximately 3.2 million of this population has moderate to severe AD (Nationaleczema.org, n.d.). Furthermore, about 16.5 million adults in the USA have AD (Nationaleczema.org, n.d.). This represents a prevalence rate of about 7.3 percent(Nationaleczema.org, n.d.). Approximately 40 percent of this adult population has moderate to severe AD (Nationaleczema.org, n.d.). Nationaleczema.org (n.d.) reports that about 80 percent of cases are reported before the age of six years (early childhood). About 6 percent of the adult population report the onset of symptoms after 60 years (Chiesa Fuxench et al., 2019). The highest prevalence has been recorded among whites and multiracial adults (Chiesa Fuxench et al., 2019). Also, the prevalence is higher in adult women compared to adult males. On the other hand, children are affected equally regardless of their gender. The severity of the disease is higher among African American and Hispanic children than white children. In addition, children born in the USA have a 50 percent higher risk of getting AD compared to those born in other countries (Chiesa Fuxench et al., 2019).

After a comprehensive search of the scholarly databases, this writer was not able to find data on the prevalence or incidence of atopic dermatitis in all states. This indicate