Managing Dengue Disorder In The Middle East Essay Sample For College


The World Health Organization (2009) regards dengue haemorrhagic as well as dengue fever as critical arthropod borne viral disorder. Annually, there are about half a million individuals who are admitted to hospitals because of the disorder and 50 million new cases of dengue infections. In the Middle East, the disease is less prevalent and it has been reported in countries like Yemen, Saudi Arabia as well as Pakistan.

Financial and human resource allocation is critical to effectively deal with this disorder in the Middle East. This paper will explore human resources and financial allocation to control and alleviate dengue disorder in the Middle East. In particular, this paper will examine the stakeholders involved, the economic impact of the disorder, U.S. global health policies associated with dengue, resources allocated to health care initiatives as well as the progress being made in dealing with dengue in the Middle East.

Stakeholders Involved in Fighting Dengue in the Middle East

Great efforts have been made by various charitable organizations and international organizations to fight dengue in the Middle East. Example of these stakeholders includes the World Health Organization (WHO), the U.S. government through its global health initiative as well as Pan American Health Organization (UNICEF, 2010).

Economic Burden of Dengue in the Middle East

There are notably two types of costs associated with dengue in the Middle East namely direct cost as well as an indirect cost. Lloyd (2003) describes direct costs as those costs that are entrenched in the health care system. They include prevention, treatment and the cost of diagnosis of dengue. Within direct costs, there are three major cost types: prevention, survey and reporting as well as medical care costs. Studies associated with the disorder are critical because they assist charitable organizations, international organizations as well as government agencies to monitor in addition to reporting deaths, outbreaks and cases of the disorder. Indirect costs entail the losses in terms of productivity as a result of the disease.

Lloyd further contends that the estimation of indirect and direct costs associated with dengue in the Middle East is an intricate process because it demands factoring all participants of the various economic sectors such as the society, employers, households as well as the public sector. Besides, there is also scarce literature regarding the exact economic burden of the disorder in terms of dollars in the Middle East. However, in Thailand, the economic costs associated with dengue are estimated to be US$ 109.16 billion.

U.S. Global Initiative and Funds allocated to fight dengue

Apart from being one the countries that fund the Global Fund, the United States government is arguably the greatest donor globally concerning global health. In 2010, President Barrack Obama proposed 63 billion U.S. dollars for six years as part of the U.S. global initiative to fight diseases such as dengue, malaria, tuberculosis as well as AIDS (Reporter’s Guide to U.S. Global Health Policy 2010). After consulting widely with the U.S. Congress, international and multinational institutions, the private sector, various governments, donors’ agencies, civil societies as well as partner countries, President Obama’s administration released a comprehensive document on how to adopt the global health initiative.

The GHI places more focus on promoting innovation and research, enhancing monitoring and measurement of progress, reinforcing health systems, promoting country ownership, reinforcing multinational institutions, integration and coordinating of programs as well as putting more emphasis on girls and women. Through this initiative, some of the countries in the Middle East will receive extra funds to speed implementation in addition to technical assistance that aims at minimizing the prevalence of dengue.

As opined by Lloyd (2003), the PAHO (Pan American Health Organization), initiated a plan that placed more focus on the role of social communication as well as community participation in 1997, as a critical component of national schemes. This plan called for 10% of the dengue management budget to support social communication as well as community participation.

Progress Being Made in Dealing with Dengue

In countries like Pakistan, there has been notable progress in her war against dengue. As revealed by Cunningham, Cunningham and Woodworth (2003), Pakistan has made a tremendous gain in its efforts to fight the disorder. U.S. global health initiatives, as well as the World Health Organization, have channelled a lot of money into this country and as a result, the prevalence of this disorder in Pakistan has considerably decreased. Mosquito nets, as well as drugs, have been supplied to Pakistan’s population and they have played a critical role in controlling the disease.


Conclusively, it is evident in the paper that there are about half a million individuals who are admitted to hospitals because of dengue and 50 million new cases of dengue infections. In the Middle East, the disease is less prevalent and cases of the disorder have been reported in countries like Yemen, Saudi Arabia as well as Pakistan. To effectively deal with this disorder, financial and human resource allocation is critical. This paper revealed that there are two types of costs associated with dengue in the Middle East namely direct costs as well as indirect costs. Direct costs are those that are entrenched in the health care system.

They include prevention, treatment and the cost of diagnosis of dengue. Within direct costs, other three major cost types exist as prevention costs, survey and reporting as well as costs related to medical care. Studies associated with the disorder are critical because they assist charitable organizations, international organizations as well as government agencies to monitor in addition to report deaths, outbreaks and cases of the disorder. Indirect cost entails the losses in terms of productivity as a result of the disease.


Cunningham, W. P., Cunningham, M. A., & Woodworth, B. (2003). Environmental Science: A Global Concern. New York: McGraw-Hill.

Lloyd, L. S. (2003). Best Practices for Dengue Prevention and Control in the Americas. Web.

Reporter’s Guide to U.S. Global Health Policy (2010). The Basis of Global Health. Web.

UNICEF (2010). UNICEF Annual Report 2009. New York: UNICEF.

World Health Organization (2009). Dengue: Guideline for Diagnosis, Treatment, Prevention and Control. Geneva: World Health Organization.

Decreased Visual Functioning Among The Elderly

Vision loss is a common health care problem among the elderly in different countries. Research shows that one in every three individuals aged 65 years and above may be experiencing visual loss. The aim of the paper is to discuss the three main causes of vision loss among the elderly (Silverstone & Lighthouse International, 2000).


Glaucoma encompasses several disorders that occur due to the damage of the optic nerve. It is a major cause of blindness in some countries. Research indicates that more than one million Americans aged 65 years and above have experienced vision loss because of glaucoma (Marengo & Comoglio, 2011). Additionally, glaucoma has caused more than 75% of blindness in Americans aged above 65 years. The primary open angle glaucoma accounts for 10% of all blindness in the U.S. and affects both women and men at the same rate. Some of the risk factors associated with this form of glaucoma include; increasing age, diabetes, increased myopia, family history and hypertension (Silverstone & Lighthouse International, 2000).


Cataracts causes blindness in different individuals around the world. In addition, it is a common cause of vision loss among the elderly. Research shows that old people are more vulnerable to cataracts. Some of the symptoms of cataract include glare, blurred vision and monocular diplopia (Silverstone & Lighthouse International, 2000). Cataracts refer to the opacification of the lens, which affect the vision function. Some of the common forms of cataract include; the nuclear cataract that arises due to the opacification of the central lens, the cortical cataract that occur when radial spokes stretch from the sides of the lens and the posterior subcapsular cataracts that damage the central visual axis located at the posterior cortical layer (Marengo & Comoglio, 2011).

AMD is one of the leading causes of vision loss in individuals aged 65 years and above. Advancing age is one of the common factors that cause AMD among the elderly. Some of the AMD’s common symptoms include; central scotoma, blurred vision, difficulty in reading and image distortion (Silverstone & Lighthouse International, 2000). The exudative type of AMD causes severe vision loss. The other type of AMD is the nonexudative, which is very common among individuals with vision loss. In addition, the nonexudative AMD rarely causes severe vision loss. The geographic atrophy and the drusen are the main types of nonexudative (Marengo & Comoglio, 2011).

Drusen are yellowish deposits, which occur in both eyes. Other factors affect on the drusen, thus leading to vision loss. The geographic atrophy is the one that leads to severe vision loss associated with this form of AMD (Marengo & Comoglio, 2011). The atrophy occurs on the retina as well as at the epithelium. It leads to distorted or blurred vision and driving or reading difficulties. It entails the growth of vessels that are abnormal on the retina space (Marengo & Comoglio, 2011).

In summary, the paper has discussed the main causes of vision loss among the aged. These cause’s influences on vision function to varying degrees and they may range from visual impairment to severe visual loss. Increasing age and family history are some of the risk factors that affect vision function among the aged.


Marengo, C., & Comoglio, M. (2011). Risk of Disability in Elderly Diabetic Patients. Seed Medical Pub.

Silverstone, B., & Lighthouse International. (2000). The Lighthouse handbook on vision impairment and vision rehabilitation. Oxford: Oxford University Press.

Women And HIV Resource Availability: Challenges And Needs


HIV was discovered in the 1980s and has since spread all over the world. It has been established that the disease is more prevalent in women and people of low social standing. In North Carolina, the distribution of the infected people is skewed towards the minority populations such as African Americans (AA) and the Hispanic population of low socioeconomic status. AA Women in this state have, therefore, a higher transmission rate and are more affected than their counterparts in the population.

This study aims at showing how strategies such as providing education, emotional support, resource outlets, and counseling can be used to help in lowering HIV infection rates. The paper will focus on the population of African American female minorities in North Carolina who are affected by HIV. It will in particular focus on Burke and Caldwell Counties.


The purpose of the studies was to establish the demographic dynamics of HIV, treatment interventions and adherence rates, risky behaviors, possible interventions, and try to relate these factors to the contraction rates and prevalence of HIV. The research on the demographics focused on how race and socioeconomic factors affect the prevalence rates of HIV. This then gave insights on what kind of intervention was appropriate for these groups.

The treatment and adherence rates were also examined in some of the cases and analyses were done on their adherence behaviors. Some of the studies looked at the risky behaviors associated with HIV and some of their causes. Further, there were studies to find out what kind of interventions could be applied in the areas under study to empower the vulnerable groups on how to avoid infection and how to live positively for those infected already.

Integrated Review of studies

The study that I read gave insights into the availability of resources and the disproportionate contraction rates of minorities and AA females living with HIV. The purpose of the study was to identify the risk factors and behaviors associated with HIV.

Major sample characteristics

The sample areas covered the whole of the United States with special attention to North Carolina and its’ rural areas. The minority groups under observation included AA, Latinos, and Mexicans. The socio-economic status of those sampled was also considered because it was believed that prevalence was higher among people with low socioeconomic statuses.

The HIV pandemic has highly affected the African American population in North Carolina. This situation has largely been associated with the low social-economic status of the female population in the rural areas of the state. Reports indicate that about 26,168 cases diagnosed with human immunodeficiency virus (HIV) are still living (Center for Disease Control and Prevention, 2013). This figure is one of the highest in the United States. The rate of new infections is also high. The report continues to state that in the year 2011 alone, there were 1,563 newly diagnosed cases of women living with HIV. Although all ethnic groups in the state are affected by the problem, the group that beats the rest in the prevalence and the rate of a new infection is the African American group (Healthy People, 2013).

One of the factors affecting adherence to treatment and the outcome of the treatment of HIV is the socio-economic status of the people living with the condition. Reports on the income for the people in the state of North Carolina showed that the average income in Burke County in 2010 was $37, 225 which was well below the national level (Census 2010 Data: Population, 2013). The average income in Caldwell County was $45,151 for the same year which was significantly higher than Burke County and closer to the national average (Caldwell County Quickfacts from the US Census Bureau, 2013).

In the year 2011, 42 people were living with HIV in Burke County compared to 91 people in Caldwell County who represented a prevalence rate of 1.2% (Caldwell County Quickfacts from the US Census Bureau, 2013). Burke county was ranked 90th with a rate of 1.1 (Census 2010 Data: Population, 2013). In the US in general, African Americans represent 68% of all the cases diagnosed with HIV (Healthy People, 2013). These cases were reported at a rate of 62.8 per 100.

Search Strategies

While completing this review, I used a variety of search strategies. I used keywords like HIV, mental illness, and African American to gather my information and used CINAL search to find articles. In addition, I used the Center for Disease Control and Healthy people 2020 to gather current information.

According to Cook, McElwain, and Bradley-Springer (2010, p. 23), people living with HIV are involved in behaviors that placed the general population at risk of contracting the infection. This argument shows that more education is needed to prevent the spread of the infection in the population. The rural areas present a unique challenge in hindering the spread of the infection. Although there are resources available in these areas to help contain the situation, infection rates still soar.

Research Design

Research designs used were: Randomized control design, quantitative, qualitative, cross-section, and non-blinded randomized control trial.

The first research design used a quantitative design with questionnaires while the second used a cross-sectional study to identify drug discontinuation in those infected with HIV. A special group of the population is affected by the conditions existing in the rural areas. Although there has been a continued decline in the number of women living with HIV, there is a need to help them in the social sectors to ensure that the transmission rate is reduced (Phillips et al., 2011).

There are many barriers in these areas that hinder the adherence to the measures set in place to ensure reduced transmission and improved quality of life. These include financial, mental, stigma, family, lifestyle, abuse, education, and transportation issues (Cook et al., 2010). All future attempts to tackle the problem must be focused on understanding the barriers of noncompliance existing in the population. Developing programs to help minority women with treatment plans will further reduce the number of cases reported and reduce the burden of cost to society. Center for Disease Control and Prevention (2013) calculated that 16.6 billion dollars were spent on newly diagnosed HIV cases.

There are many programs to assist people living with HIV such as the ‘get real get tested program’ and other prevention programs. One purpose of this study is to get funding to develop programs in rural areas to decrease the number of new cases of HIV among African American women. A recent study found these people lacked insurance cover, complained of premium increases and the soaring price of ‘over-the-counter drugs above the reach of the affected women. These and more factors, according to Bingham (2009), play a role in the increase of HIV.

Several studies have shown a relationship between resource allocation and the needs of the people living with HIV (Tsai et al., 2013, p. 119). One such study by Rountree et al. (2011) aimed at establishing whether some races and ethnicities test more for HIV than others. Worth noting in this study is the high testing rate observed in the African American race, which may be a contributing factor to the high number of reported incidences (Lasry et al., 2011, p. 120).

Murri et al. (2009, p. 45) further studied the factors that influence the adherence to medication for the infected people. The results indicated that women have more factors affecting their adherence compared to their male counterparts.

The researcher in his study of barriers considered the areas of residence and levels of income. Some of the factors established to influence how these women seek medical help included: the long-distance traveled to get care, lack of housing, lack of HIV-trained medical practitioners, lack of mental health services, and lack of substance abuse treatment (Philips et al., 2011, p. 28). Rountree et al. (2011) claim that this situation affects the economy negatively and leads to heavy expenditures in the health sector.

Their study was a pilot conducted in domestic violence shelters. They used a survey as their sampling and most of the victims were African American women. In the research, Rountree et al. (2011) observed that women had an increased risk of infection. The study emphasized the provision of information to women to help keep them safe and lower the risk of infection. It also provided an insight into the absence of resources in the rural areas where it was conducted.

Murri et al. (2009) found major adherence problems in the study population. Another finding was that people who discontinued drugs had a higher CD4 cell count, higher HIV RNA, and was less likely to take non-nucleoside reverse transcriptase inhibitors (Murri et al., 2009). This observation was because the people who had their medication discontinued opted for a switch that helped them adhere to a medication of their own choice. This case demonstrates that the freedom of decision-making in treatment for these patients is important (Whiters et al., 2010, p.110).

Major components of interventions

Education is one of the major components in the prevention of the spread of HIV. According to studies done on the social status of the ethnicities in the state of North Carolina, the levels of education are lowest among the ethnic minorities such as the Hispanics and the AA (Rountree et al., 2011). This was an indication that the AA women were unable to utilize their resources because they lacked the know-how.

The level of education can be used in several ways to improve the lives of persons living with HIV in North Carolina. One way would be to provide education to the black population among the infected. Rountree et al. (2011) established that the prevalence of the disease is indirectly proportional to the level of education attained by the individuals. North Carolina ranks ninth in the rate of infection and the number of people living with the condition.

This finding represents a significant population of the US. Out of the people affected by the pandemic, black Americans make up 66% half of which are women. This figure is, however, not representative as the number of women infected is far beyond half of the reported number of black Americans. An explanation for the differences in prevalence between the sexes in the same race includes biological differences, use of drugs, and the relative inability of women to negotiate for safe sexual practices (Cook et al., 2010).

Theoretical frameworks

Campaigns to promote education should be included in the strategies that organizations and the government of the state of North Carolina employ to reduce the prevalence of the disease. It has been found that the effects of education on the prevalence of HIV are profound and the adoption of health and sexual education in the curriculum especially in rural schools reduced the HIV infection rate. This can effectively be addressed by educating the people who are infected and their counterparts who are not. The sexual partners of the infected black American women are at a high risk of contracting the condition.

Education would ensure that they protect themselves. Another observation made in this population of people living with the condition is that, despite the provision of resources to curb the condition, the women are not taught the benefits of the medication, hence the non-compliance.

Most of the black American women living in North Carolina and infected with HIV are single mothers with no stable sources of income. This has led to some of them engaging in illegal activities such as prostitution to enable them to provide for their families.

Outcome measures

An important factor in the spread of HIV infection and the outcome for the infected population is the emotional support provided to the affected people. In North Carolina, several agencies and organizations are committed to providing emotional support to the people living with the infection (Cook et al., 2010). However, a survey on the emotional support of AA women revealed that they are not able to access the services offered by these organizations especially when living in rural areas.

One recognized source of emotional support for patients is their families, which are the first people of contact. A high number of AA women living with HIV in North Carolina have no families or are single parents; this means that they receive inadequate emotional support. The organizations providing support should therefore facilitate the creation of social groups for these disadvantaged women. These therapeutic groups could also help in reducing HIV-related stigma (Whiters et al., 2010). In most of the research done on the factors affecting the condition, stigma is recognized as having some of the most negative effects. To deal with stigma, the government and other organizations offering services to these patients have to encourage the formation of social groups for the infected so that they can share their experiences and help reduce stigma.

Counseling is another method that could be used in combating the prevalence and the high rate of transmission of HIV among women in North Carolina (Mobility and Mortality Weekly Report, 2005). Studies done on the effects of counseling indicate that the rate of transmission is reduced by increasing the number of people who are counseled. Some of the things that individuals need to be counseled about include the benefits of using their medication, how to live positively, and the measures they can take to prevent infection of their partners if not infected.

Major findings

The rates of infection are higher in the population that does not counsel its patients. North Carolina should ensure that the African American women in the rural areas living with the disease are adequately counseled. Counseling should also be done by use of interactions with their families and friends. They should also be encouraged to live a complete and fulfilled life and be made to understand that getting the infection is not the end of life. This information would go a long way in ensuring that the infection rates are reduced and that the infected women live a healthy life.

Other Factors/Unexpected Findings

There were no unexpected findings identified in all studies.

Strengths and Weaknesses

The studies had both strengths and weaknesses. Some of the strengths included: the use of different parameters for some sets of the population to get a clearer result. This was observed when African Americans under review were also classed according to their socio-economic status. Strength was the use of valid data sources like information from the CDC and the American census bureau.

The weaknesses included low response in some areas, limited sample sizes, and inadequately defined sample sizes. The samples were also limited as they focused on just a few ethnic and racial groups.


The studies identified many barriers to prevent the spread of HIV. They also identified social, emotional, mental, and physical barriers interfering with positive strategies for preventing the spread of HIV. According to Philips et al. (2011), people with mental illnesses are at risk of HIV. The studies also identified the risky behaviors that contribute to HIV contraction as lack of good judgment, awareness, and immorality.


In conclusion, the AA population was found to be disproportionately affected by the HIV pandemic in the US; this fact was also apparent in the state of North Carolina. Although the disease has affected a considerable portion of the population in this state, it was apparent that the better portion of the infected population consists of AA women. The research articles established that according to the Center for Disease Control and Prevention (2013), the situation was large because of the low social-economic status of the female population in the rural areas of the state.

There were two types of designed studies under investigation. The studies were cross-sectional and randomized samples. Some of the factors that the researchers considered to be the cause of the high infection rate among AA women in these areas were also discussed. The research articles revealed that according to Cook et al. (2010) and Phillips et al. (2011), some of the major barriers to reducing the pandemic include communication, education, and mental illness.

As revealed in the paper, it was proven that women in North Carolina state do not have access to adequate education, which is a tool that could enable them to understand how to deal with the HIV pandemic. In the articles, according to Cook et al. (2010, p. 23), people living with HIV are involved in behaviors that place the general population at risk of contracting the infection. This argument shows that more education is needed to prevent the spread of the infection in the population.

Moreover, it was established that women lack counseling and emotional support, hence their worsening health. The studies, therefore, sought to show how employing these strategies in the state of North Carolina would help to change the situation. The study successfully demonstrated how the implementation of these strategies could facilitate progress in addressing the pandemic in the state of North Carolina.

Reference List

Bingham, J. (2009). Annotated bibliography of NINNR findings on women’s health across the lifespan: 2009 update. JOGNN, 1(1), 699-702.

Caldwell County Quickfacts from the US Census Bureau. (2013). Quickfacts. Web.

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Cook, F., McElwain, J., & Bradley-Springer, J. (2010). Feasibility of a daily electronic survey to study prevention behavior with HIV infected Individuals. Research in Nursing & Health, 1(10), 221-234.

Healthy People. (2013). Healthy People. Web.

Lasry, A., Sansom, S., Hicks, K., & Uzunangelov, V. (2011). A model for allocating CDC’s HIV prevention resources in the United States. Health Care Management Science, 14(1), 115-124.

Morbitity and Mortality Weekly Report. (2005). HIV transmission among black women in North Carolina, 2004.MMWR, 54(4), 89-94.

Murri, R., Guaraldi, G., Lupoli, P., Crisafulli, R., Marcotullio, S., von Schloesser, F., & Wu, W. (2009). Rate and predictors of self-chosen drug discontinuations in highly active antiretroviral therapy-treated HIV-positive individuals. AIDS Patient Care & Stds, 23(1), 35-39.

Philips, D., Moneyham, L., Thomas, S., Gunther, M., & Vyavaharkar, M. (2011). Social context of rural women with HIV/AIDS. Issues in Mental Health Nursing, 32(6), 374-381.

Rountree, A., Goldbach, J., Bent-Goodley, T., & Bagwell, M. (2011). HIV/AIDS knowledge and prevention programming in domestic violence shelters: How are we doing?. Journal Of HIV/AIDS & Social Services, 10(1), 42-54.

Tsai, C., Karasic, H., Hammer, P., Charlebois, D., Ragland, K., Moss, R., &… Bangsberg, R. (2013). Directly observed antidepressant medication treatment and HIV outcomes among homeless and marginally housed HIV-positive adults: A randomized controlled trial. American Journal of Public Health, 103(2), 308-315.

Whiters, L., Santibanez, S., Dennison, D., & Clark, H. (2010). A case study in collaborating with Atlanta-based African-American churches: A promising means for Reaching Inner-City Substance Users with Rapid HIV Testing. Journal Of Evidence-Based Social Work, 7(1/2), 103-114.