06-02-23 - Global Health (GI Infections) Flashcards
Learning outcomes
- Be aware of the complex nature of global health in today’s world
- Understand the importance of disease prevention and health promotion in improving global health
- Be aware of the universal need for clean water, sanitation and hygiene education
Top 10 causes of death globally.
What 3 ways can deaths be classified?
What are the 3 leading causes of death globally?
- Top 10 causes of death globally
- 55.4 million deaths worldwide in 2019
- Top 10 causes accounted for 55%
- ~2 million more IHD deaths in 2019 than in 2000
- 1.2 million fewer deaths from neonatal conditions in 2019 than in 2000
- Categorised as communicable, noncommunicable or injuries
- The 3 leading causes of death globally:
1) Ischaemic heart disease (non-communicable)
2) Stroke (non-communicable)
3) COPD (non-communicable)
Top 10 causes of death in low-income countries?
What is classed as a low-income country?
What are some examples?
How does cause of death differ?
What causes are classed as diarrhoeal causes?
How have these decreased in the last 20 years?
What are the 3 leading causes of disease in low-income countries?
- Top 10 causes of death in low-income countries
- Countries with GNI <$1,035 per person e.g. Afghanistan, Uganda, Ethiopia, Malawi, Haiti
- Communicable diseases much more common causes of death in low-income countries
- Diarrhoeal diseases - infection, malnutrition, contaminated water, poor hygiene
- Significant reduction in diarrhoeal causes of death since 2000 along with HIV/AIDS
- 3 leading causes of disease in low-income countries:
1) Neonatal conditions (communicable)
2) Lower respiratory infections (communicable)
3) Ischaemic heart disease (non-communicable)
Top 10 causes of death in high-income countries.
What is considered a high-income country?
What are some examples?
What are considered ‘diseases of wealth’?
What changes in causes have we seen since 2000?
What are 3 leading causes of death in high-income countries?
- Top 10 causes of death in high-income countries
- High income countries are Countries with GNI (gross national income) of >$12,536 per person e.g. UK, USA, Canada, France, Germany etc
- Fewer IHD and stroke deaths than 2000, all other causes increasing
other causes increasing - “Diseases of wealth” - largely noncommunicable, chronic conditions
- 3 leading causes of death in high-income countries:
1) Ischaemic heart disease (non-communicable)
2) Alzheimer’s disease and other dementias (non-communicable)
3) Stroke (non-communicable)
Child Mortality. In 2019 how many children under 5 died from preventable and treatable causes?
What is the second leading cause of death of children under 5?
What are other causes?
Are these preventable and treatable?
- Child Mortality
- In 2019, 5.2 million children under 5 died from preventable and treatable causes (WHO)
- Diarrhoeal disease is the second leading cause of death of children under 5
- Other causes: preterm birth complications, birth asphyxia/trauma, pneumonia, congenital anomalies, malaria
- All preventable and treatable
What is inequality and inequity?
- Equality = Same-ness, equal distribution e.g. of health resources
- Equity = Fairness, equal opportunity e.g. access to health service
Water, Sanitation and Hygiene (WaSH).
How are waterborne diseases such as cholera transmitted?
How much water is used per day by the average person in the US, France, India and Mali?
- Water, Sanitation and Hygiene (WaSH).
- Pre-requisite for health
- 785 million people - 1 in 10 - do not have access to water close to home (WaterAid)
- Inadequate or unsafe WaSH responsible for 829,000 deaths from diarrhoeal disease each year (WHO)
- Waterborne diseases such as cholera transmitted via contaminated water
- How much water is used per day by the average person in the :
1) US – 156 gallons
2) France – 77 gallons
3) India – 38 gallons
4) Mali – 3 gallons
How many people in the world do not have basic sanitation facilities?
What % of the world’s population is thought to consume food irrigated by wastewater?
- 2.0 billion (~1 in 4) people do not have basic sanitation facilities
- 10% of the world’s population is thought to consume food irrigated by wastewater
What 2 pathogens cause Acute watery diarrhoea?
What 3 pathogens cause dysentery (bloody diarrhoea)?
What 8 pathogens cause Persistent diarrhoea?
- 2 pathogens that cause Acute watery diarrhoea:
1) Enterotoxigenic E. coli (ETEC)
2) Vibrio cholera (‘rice-water stools’) - 2 pathogens that cause dysentery (bloody diarrhoea):
1) Shigella
2) Campylobacter jejuni,
3) Salmonella - 8 pathogens that cause Persistent diarrhoea:
1) Cryptosporidium
2) Giardia
3) Campylobacter
4) E. coli
5) Salmonella
6) Shigella
7) Norovirus
8) Rotavirus
How many cases of childhood diarrhoea are there each year?
What is it most commonly due to?
What protozoa (1), bacteria (2), viruses (2), and parasites (2) cause diarrhoea?
- 1.7 billion cases of childhood diarrhoea each year
- It is most commonly due to contamination by faecal material
- Causes of diarrhoea:
- Protozoa (1)
- Giardia
- Bacteria (2)
- Campylobacter
- E. coli
- Viruses (2)
- Rotavirus
- Norovirus
- Parasites (2)
- Ascaris lumbricoides
- Cryptosporidium
What is incidence?
What is period prevalence?
What is point prevalence?
What is an example of each?
- Incidence: the number of new cases in a population over a fixed period of time
- e.g. How many people tested positive for COVID-19 in the last 24 hours?
- Period prevalence: the total number of existing cases in a population over a fixed period of time
- e.g. How many people have had COVID-19 in the UK since the start of the pandemic?
- Point prevalence: the total number of existing cases in a population at a specific time
- e.g. How many people currently have COVID-19 in the UK?
When was vibrio cholera a problem in the UK?
- Vibrio cholera was a UK problem as recently as the 19th century
Zimbabwe Cholera Outbreak 2008-9.
How many cases of cholera were there?
How many deaths were there?
What was the outbreak attribute to?
When did a further outbreak occur?
How many cases and deaths were there?
- Zimbabwe Cholera Outbreak 2008-9
- 98,596 total cases of cholera
- 4,369 deaths
- Outbreak attributed to poor sanitation, limited access to healthcare and poor healthcare infrastructure on background of political and economic crisis
- Further outbreak of a multi-drug resistant strain of V. cholerae in 2018-19 with 10,730 cases and 69 deaths (NEJM)
Haiti Cholera Epidemic 2010-2018.
When did it start?
How was it introduced to a river system?
How many cases of cholera and cumulative deaths since 2010?
- Haiti Cholera Epidemic 2010-2018
- 10 months after catastrophic earthquake in January 2010 V. cholerae introduced to Haiti - no prior exposure to the disease
- Believed to have been introduced to an extensive river system by Nepalese peace-keeping troops who were responding to the earthquake
- 819,777 cases of cholera, around 10,000 cumulative deaths since 2010
What are 2 ongoing cholera outbreaks?
- 2 ongoing cholera outbreaks:
1) 2016-2020 Yemen cholera outbreak: 172,769 cases and 50 deaths as of August 2020
* Backdrop of ongoing civil war in Yemen
2) Ongoing cholera epidemic in Somalia since January 2020: 6,720 cases and 34 associated deaths
* 46% of cases and 56% of deaths in under 2-year-olds
Global Burden of Neglected Tropical Diseases (NTDs)
What are 8 examples of NTDs?
How many deaths do hey cause a year?
- 8 examples of NTDs:
1) Schistomiasis – 280,000 deaths a year
2) Hookworm infection – 65,000 deaths a year
3) Ascariasis – 60,000 deaths a year
4) Trichuriasis – 10,000 deaths a year
5) Lymphatic filariasis - 0
6) Onchocerciasis - ND
7) Taenia and cysticercosis - ND
8) Food-born trematodiases - ND
What are the Millennium Development Goals?
- Millennium Development Goals:
- 8 international development goals agreed by U.N. member states, to be achieved by the target date of 2015:
1) Eradicate extreme poverty and hunger.
2) Achieve universal primary education.
3) Promote gender equality and empower women.
4) Reduce child mortality.
5) Improve maternal health.
6) Combat HIV/AIDS, malaria and other diseases.
7) Ensure environmental sustainability.
8) Global partnership for development
How does the water footprint of crop and animal products compare?
- Animal products generally have a higher water footprint than crop products, per ton of product AND per calorie
- “From a freshwater resource perspective, it is more efficient to obtain calories, protein and fat through crop products than animal products.” (Water Footprint Network)
