Exam 2

• What statistic tells you how deadly a disease outbreak is and how is it calculated?

  case fatality rate

  = (# of deaths from disease) / (total cases with a disease outbreak)
• *What are control strategies to combat communicable diseases and what modes of transmission do they target?

  Vaccines, water filters, herd immunity, ring vaccinations
• What are similarities and differences in the epidemics of ebola in West African and SARS?

  Ebola- most contagious at end stage of disease; virus; spread with contact of bodily fluids, re-emerging disease, quarantine infected people

  SARS- most contagious at beginning stage of disease; virus; airborne virus; emerging disease; quarantine infected people
• What are examples of general strategies to combat communicable diseases? What determines the best strategy for controlling a particular communicable disease?

  -vaccination-"sneeze in your sleeve"

  -mosquito/flea control-water sanitation

  -behavior change education
• What are examples of vaccine-preventable diseases?

  Cholera

  Hepatitas B

  Human papilloma virus

  Measles

  Rotavirus

  Tuberculosis (TB)

  Yellow fever
• What are key features of HIV/AIDS, TB, and Malaria: agent, transmission mode, if a vaccine exists, if preventable, if curable?

  HIV/AIDs:

  -virus

  -spread through bodily fluids or from mother to child

  -no vaccine exists

  -preventable through safe sex

  -no cure but HAART treatment

  
  

  Tuberculosis:

  -bacteria

  -spread through air borne droplets

  -BCG vaccine

  -preventable if treat those already infected

  -cure exists

  
  

  Malaria:

  -protozoa agent

  -transmitted through mosquitoes

  -no vaccine

  -preventable with bed nets and controlling mosquitoes

  -cure exists but reinfection possible
• What are non-communicable diseases (NCDs), general causes, and patterns of development?

  -diseases associated with modernity (industrialization and urbanization) or toxins and toxicants

  
  

  -usually caused by genetics, behaviors, and the environment and develop slowly over time

  
  

  -not spread from person to person by an infectious agent

  -prevalence increases with aging
• What the top causes of maternal mortality in low and middle income countries?

  hemorrhaging
• Explain what the "three delays" are that lead to maternal mortality?

  1. Delaying in recognizing complications and seeking care

  2. Delay in transportation of mother to hospital

  3. Delay in emergency obstetric care
• What are some of the factors shown in the video about Sri Lanka that contributed to its positive maternal health outcomes?

  More skilled birthing attendants; breastfeeding right away
• What are obstetric fistulas and female genital mutilation/cutting (FGM)?

  Female genital mutilation- removal of external female genitalia

  Obstetric fistulas- Crush injury to bladder or colon wall from obstructed birth
• *What are obstetric fistulas and female genital mutilation/cutting (FGM)?

  Female genital mutilation- removal of external female genitalia

  Obstetric fistulas- Crush injury to bladder or colon wall from obstructed birth
• *How are neonatal mortality, and infant mortality calculated?

  Neo-natal mortality: (# of neonatal deaths <28days/# of live births during the year) x 1000

  Infant mortality: (# of infant deaths <365/ # of live births during the year) x 1000
• *What are the top two causes of neonatal and the top two causes of post-neonatal-to under 5 deaths?

  Neonatal- Sepsis, Preterm birth

  Post- neonatal- to under 5- Pneumonia & Diarrhea
• What are key MCH interventions (such as ORT) that can reduce child mortality and what conditions are they used for?

  Nutrition for pregnant women

  ORT- oral rehydration therapy

  Immunizations

  Vitamain A suppliements
• In the case study of Nepal in your book, what was the intervention, what were barriers to acceptance, and what solution was used to overcome barriers?

  Giving Vitamin A supplements while also giving out Polio vaccines- possible because of Nepalese Ministry of Health Initiated Economic and geographic barriers Solutions where to get more organizations involved to spread the Vitamin A.
• How do distributive, social, and market justice differ and affect access to care?

  Distributive- All get an equal amount regardless of need

  Social- All receive care, but amount varies by need

  Market- Amount received depends upon how large their financial contribution has earned them, or what their resources avail them
• *What document established the basic doctrine of universal human rights and included health defined as a human right?

  UDHR Article 25, section 1
• *What are examples of organizations concerned with human rights?

  Office of the U.N. High Commissioner for Human Rights

  Amnesty International Human Rights Watch
• *What are the focus of the Nuremberg Code and the Declaration of Helsinki?

  Nuremberg Code 1948- After Nazi experiments, this set the standards for physicians conducting research

  Declaration of Helsinki 1964- Gave principles for health research- informed decisions to participate, independent ethical review, Risks and benefits need to be considered
• *What is universal health coverage, what document is the basis for right to health care?

  All people have access to the health services they need without the risk of financial hardship when paying for them, the SDG 3.8 is the basis for the right to health care
• *What are key needed factors for universal health coverage?

  -A strong and efficient, well-run health system.

  -Affordable system for financing health services so people don't suffer financial hardship when using them

  -Availability of essential medicines and technologies

  -A sufficient capacity of well-trained, motivated health workers
• *What are six building blocks of health systems? What are examples of these that contribute to an effective health system?

  Health Service- Safe and effective care given

  Health Workforce- Trained, capable staff

  Health information systems- Reliable, accurate

  Medical Products- Essential medicine available; working equipment

  Health Financing- Public financing may be low

  leadership/ Governance- Accountable management and spending
• What are the three types of institutions running health systems?

  Public (government at any level)- hospitals

  Private (for-profit)- Cancer treatment centers of America

  NGO (non-governmental organization)- non-profits filling gaps BRAC in Bangladesh
• *What are 3 "prototypes" of health systems and what is a country with each type?

  -National Health Insurance: Germany

  -National Health Service: U.K

  -Pluralistic (Out of Pocket)- India
• *What are non-communicable diseases (NCDs), general causes, and patterns of development?

  Diseases not spread from person to person by an infectious agent. Causes are genetics, behaviors, environment
• Differentiate between clinical and public health foci in NCDs

  Clinical- Give advice to individual on prevention; Diagnosis of disease; Treatment; rehab

  Public- Identify opportunities for prevention of NCDs; Population level strategies to prevent & control; Universal health care
• What is a key intermediate biological factor in many NCDs?

  Obesity

  High blood pressure

  High blood sugar
• *What are examples of links between communicable and non-communicable diseases?

  Cancers

  Strep Group A throat infections
• *Which type of [preventable] heart disease affects children in low income countries, what is its cause, and how can it be prevented?

  Rheumatic heart disease- caused by untreated strep infection- can be treated with antibiotics- can be prevented by looking for damage early with echo cardiogram
• *How do income-levels of countries related to cancers caused by infectious agents versus by environmental/lifestyle?

  Low-income countries have more infectious causes

  Middle/high income countries have more environmental/ lifestyle causes
• *Worldwide, which cancer is the most common and the most frequent cause of mortality?

  Lung cancer is the most common and frequent cause of mortality
• *What are the "best buys" for preventing cancer?

  healthy level of moderation in your life when is comes to food and activity
• *What are risks associated with uncontrolled diabetes?

  heart disease, kidney damage, nerve damage, stroke, blindness, poor limb circulation leading to amputations
• Globally, what are cost-effective prevention foci for prevention of NCDs?

  reduce smoking, increase healthy diets with less salt, Increase physical activity, Get early cervical cancer screening, Hepatitis B vaccination
• What is the paradox of reducing communicable disease in relation to NCDs in low-income countries?

  Many survive childhood in developing countries but die at young age from NCDs.

  Past global aid was for specific diseases, not for primary health care systems, Young populations outstripping resources and jobs.
• *What are key terms related to communicable disease and what do they mean?

  Infectivity: how fast the disease spreads from person to person

  Virulence: how sick the disease makes a individual
• *What are characteristics of the host, agent, and environment that affect a person's risk of communicable disease, the severity, and transmission?


  Host- age, household, race, gender

  Agent- bacteria, fungi, helminths (worms), viruses, protozoa, prion

  Environment- where you work, low or high income countries