Chlamydia trachomatis - The Most Common Sexually Transmitted Infection in Australia - Nursing Assessment Answer

Nursing Assessment Answer

Question 1

Chlamydia trachomatis is the most commonly notified sexually transmitted infection in Australia. Disease occurrence is highest in 15-25-year-olds. Following table provides hypothetical results of the frequency of Chlamydia in two communities:

Explain briefly which community has a larger Chlamydia problem and why?

Question 2

A total of 311 university students studying Engineering participated in a hypothetical study on sexual health. The students were recruited in the study when they were in the first year of their undergraduate degree. They were questioned about their sexual activities and sexual health behaviors at baseline and were also tested for the most common sexually transmitted infections, including Chlamydia trachomatis.

Of the 311 students, nine tested positive for Chlamydia at baseline examination. The students at-risk of acquiring Chlamydia were followed up for the following two years. During this follow up period, another 18 became positive for Chlamydia. Not everyone stayed in the study for the entire length of 24 months; 160 students were followed up for 18 months, 35 for 14 months, 50 for 6 months, and 15 for 3 months while the rest completed the entire two year study period. Calculate the incidence rate of Chlamydia and express your answer per 100,000 person-months.

Question 3

In January 2013 a group of 3132 injectable drug users agreed to be tested for HIV at a local clinic and 105 persons were found to be HIV positive. The same group was examined again in January 2015 and 155 new cases of HIV were discovered. It was learned that of the 105 HIV positive persons diagnosed at the 2013 examination, 15 died, all in 2014. Otherwise, all persons examined in 2013 came to the second examination. Calculate and interpret them:

1. Point prevalence of HIV in the examined group at baseline.

2. Point prevalence of HIV in the examined group in January 2015.

3. Two-year period prevalence of HIV in the group.

4. Cumulative incidence of HIV in the group.

Question 4

Prevalence of undetected diabetes in a population to be screened is 1.5%, and it is assumed that 10,000 persons will be screened. The screening test will measure blood serum glucose content. A value of 180mg% or higher is considered positive. The sensitivity and specificity of this screening test are 22.9% and 99.8% respectively.

What is the predictive value of a positive test?

What is the predictive value of a negative test?

Question 5

 A new serologic test is being devised to detect a hypothetical chronic disease. Three hundred individuals were referred to a laboratory for testing and these included 100 diagnosed cases (from an earlier gold standard test). The new serological test yielded 200 positives of which only one-fourth were true positives. Calculate the sensitivity, specificity and predictive values (both positive and negative) for this new serologic test. (It will be helpful if you fill in a 2x2 table before calculations)

Question 6

Two physicians examined the same 100 patients and recorded the presence or absence of a heart murmur in each patient. Now suppose that:

• For 7 patients, the first physician reported the absence while the second physician reported the presence of a murmur;
• For 3 patients, the second physician reported the absence while the first physician reported the presence of a murmur;
• For 30 patients, both physicians agreed that a murmur was present;
• For 60 patients, both physicians agreed that murmur was absent;

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