Epidemiology class.
1. Background on Malaria, background on outbreaks, background on malaria for children 5 and under.2. Incidence- occurrence of a given malaria condition in a population (Children 5 and under) within a specified period of time. The risk of developing Malaria.3. Prevalence- the proportion of a particular population (Children 5 and under) found to be affected by Malaria. How widespread the Malaria is. 4. Mortality Rates- Mortality Rate of Malaria in children ages 5 and under. A mortality rate is a measure of the frequency of occurrence of death in a defined population during a specified interval. 5. Proportions- Epidemiology Proportions of Malaria in children 5 and under.
Incidence
At the peak of perinatal HIV transmission in 1991, there were 1,650 reported new
diagnoses of HIV transmitted from mother to child (CDC, 2006). In 1991, the U.S. midyear
population of infants below the age of 1 was 4,003,780 (Census.gov, 2017). Using these
numbers, the incidence of perinatal HIV at the height of the epidemic was determined to be
approximately 41.2 new cases of perinatal HIV per 100,000 infants. With increasing access to
ART, knowledge of the efficacy of pre-exposure prophylaxis (PrEP), and education about
infection risk, this number has rapidly declined, reaching a record low of 69 new diagnoses of
perinatal HIV in 2013 (CDC, 2006; Taylor, 2017). With a midyear population of 3,931,346
infants under the age of 1 (Census.gov, 2017), the incidence of perinatal HIV in 2013 was
determined to be 1.75 cases of perinatal HIV per 100,000 infants, nearly 24 times lower than at
the height of the epidemic in 1991. A comparison of the overall incidence rates of perinatal HIV
in the U.S. in both 1991 and 2013 is shown below in Figure 1.
New Cases of Perinatal HIV
per 100,000 Infants
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1991
2013
Year
Prevalence
Similar to the decline in incidence, pediatric prevalence of perinatal HIV experienced a
4.5-fold decrease between 2000 and 2014. Of 56,202,128 children 13 years old and younger in
the U.S. in 2000, 9,993 were living with HIV/AIDS, corresponding to a prevalence of 17.8
children with perinatal HIV per 100,000 children 13 and under (Census.gov, 2017; CDC, 2000).
In 2014, there were 56,835,112 children 13 and under in the U.S., 2,355 of which were living
with HIV/AIDS (Census.gov, 2017; CDC, 2014). Therefore, the prevalence of perinatal HIV in
2014 was 4.14 children with perinatally-transmitted HIV per 100,000 children 13 and under in
the population. A comparison of the prevalence rate of perinatal HIV in children in 2000 and in
2014 is shown in Figure 2 below.
20
18
16
14
12
Children with Perinatal HIV per
100,000 Children 13 and Under
10
2000
2014
Year
Figure 2. Decline in Pediatric Prevalence of Perinatal HIV in the U.S. Between 2000 and 2014.
Mortality
At the start of the global HIV/AIDS pandemic, an HIV diagnosis was considered by
many to be a death sentence, as no viable treatment yet existed due to the lack of knowledge
about the etiology of the disease. In 1992, considered the peak year for HIV/AIDS infection, an
estimated 33,590 U.S. residents died of HIV/AIDS-related illnesses (CDC, 1993). Using the
1992 population at midyear according to the U.S. Census Bureau (256,514,224 persons), this
corresponds to an overall mortality rate of 13.1 people dying of HIV/AIDS-related illnesses for
every 100,000 people in the population. Deaths attributable to HIV have decreased drastically
since the start of the pandemic, with 6,721 deaths occurring due to HIV in 2014 in the U.S.
(CDC, 2017). Using the population at midyear in 2014 (318,563,456 persons), an overall
mortality rate of 2.11 people dying of HIV/AIDS-related illnesses for every 100,000 people in
the population, around 6.2 times lower than the mortality rate at the peak of HIV/AIDS in 1992.
Little data are available concerning the exact number of deaths attributable to perinatal
HIV in the beginning of the HIV/AIDS epidemic in the United States. However, mortality rates
of HIV in persons younger than 21 have plummeted in recent years from 7.2 deaths per 100
person years in 1994 to less than 0.8 deaths per 100 person years in 2006 (NIH, 2009). As
mentioned before, over 90% of pediatric HIV/AIDS cases in the U.S. are acquired through
perinatal transmission, so these numbers are likely comparable to the rates of perinatal HIV
mortality. Data from 2014 are available, however, showing 63 deaths of perinatally-acquired
HIV in individuals of all ages in 2014 (CDC, 2015). Using this number and the U.S. population
at midyear in 2014, the mortality rate for perinatal HIV in the U.S. was calculated to be 0.02
deaths per 100,000 people in the population.
In addition, data from the CDC shows, as mentioned above, that 63 deaths in 2014 were
directly attributable to perinatal HIV, and there were 11,520 people with perinatally-acquired
HIV in the population. Using these numbers, the case fatality was calculated to be 0.55 deaths
from perinatal HIV per 100 people with perinatal HIV in the population.

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