Ch 10 & 11 PH surveillance, Epi in practice

Question 1

A reporting framework for emerging health threats is necessary for what functions?

Answer 1

systematic collection,
analysis,
interpretation,
and dissemination of health data

Question 2

development of a surveillance system requires what?

Answer 2

• clear objectives
• strict criteria for classifying and defining cases
• standardized reporting methods

Question 3

what are examples of passive surveillance systems?

what are their limitations?

Answer 3

• registries on drug reactions or cancer
• certified death data

-collection of data is through a large number of ppl, so the quality of data collected is variable

Question 4

why can you not use health facility data to estimate the true incidence of an outcome in a population?

Answer 4

• not everyone has access to healthcare
• people may seek care with natural healers or private clinics
• there may be minimal record keeping in low resource clinics

Question 5

what kind of data does “outcome registries” collect?

Answer 5

data on specific outcomes (T1DM)

• basic demographics,
• patient history,
• diagnosis,
• treatment,
• and health status

Question 6

what is purpose of “outcome registries”?

Answer 6

• monitoring of individual patients over time, remind them of regular check-ups and reviews of medication.
• identify research participants
• or volunteer to join an organization that provides support

Question 7

“outcome registries” allow for calculating what? evaluating what?

Answer 7

• outcome incidence, prevalence, and patient survival over time.
• analyze effectiveness of interventions, treatments, screenings
• improvement of health services delivered

Question 8

when is “sentinel surveillance” used/ needed?

Answer 8

when high-quality data are required that cannot be collected through passive surveillance.

Question 9

“sentinel surveillance” is made up of what?

Answer 9

health providers and diagnostic facilities with ability to collect and analyse the necessary data, and to participate in a reporting network.

Question 10

how are “sentinel sites” selected?

Answer 10

selected for their geographic location, disease specialization, and ability to accurately diagnose and provide high-quality data

Question 11

what are 3 forms of passive surveillance?

Answer 11

outcomes registries
notifiable outcome
health facility data

Question 12

what are examples of forms of “active surveillance”

Answer 12

case-finding techniques (e.g. contact tracing),
population surveys
external review of existing clinical records

Question 13

why is active surveillance not routinely used?

what situations is it appropriate?

Answer 13

it’s costly and labor intensive.

Used if

(a) there is a need to monitor the emergence or elimination of a new disease
(b) when many cases may not be accessing the formal healthcare infrastructure.

Question 14

why is active surveillance not routinely used?

what situations is it appropriate?

Answer 14

it’s costly and labor intensive.

Used if

(a) there is a need to monitor the emergence or elimination of a new disease, and info needed urgently
(b) when many cases may not be accessing the formal healthcare infrastructure.
- identify problems with existing passive surveillance
- collect data on the prevalence of known risk factors for adverse health outcomes

Question 15

“early warning systems” collect data on what? and for what purpose?

Answer 15

collect data on epidemic-prone diseases, to plan, prepare, and rapidly respond to indicators of outbreaks

Question 16

what is the function of surveillance in elimination programs?

what are elimination programs?

Answer 16

function is to monitor progress and early detection of cases.

elimination programs used to eliminate vaccine-preventable diseases.

Question 17

what is the function of surveillance in elimination programs?

what are elimination programs?

Answer 17

function is to monitor progress and early detection of cases.

elimination programs used to eliminate vaccine-preventable diseases.

example– global polio eradication initiative

Question 18

what is the DALY metric?

Answer 18

The disability-adjusted-life-year (DALY) metric was developed in the 1990s, equivalent to one lost year of healthy life, either through premature death or living with a disability of specified severity and duration

Question 19

what is the DALY metric?

Answer 19

The disability-adjusted-life-year (DALY) metric was developed in the 1990s, equivalent to one lost year of healthy life, either through premature death or living with a disability of specified severity and duration.

DALYs are primarily used for economic analyses and enable the comparison of the burden of disease across outcomes, risk factors, and geographical regions.

Question 20

define– monitoring

Answer 20

• systematic and routine collection of evidence about the effectiveness of a specific health program
• using measurable intermediary and final objectives
• enables a program to adapt and improve, and to reduce disparities in access.

Question 21

what are some ways data is collected in “monitoring”

Answer 21

• cross sectional studies
• cohort studies
• active, passive surveillance

Question 22

define– process indicators

Answer 22

• quantifiable markers of each stage of the process
• For a complex intervention, each step necessary for effective delivery should be monitored
• identify bottlenecks or failures in the system
• ex: success of a vaccination programme will depend on: (a) procurement of a quality-controlled vaccine; (b) delivery of viable vaccine to health centres; (c) sufficient training of health workers on vaccine administration and counselling; (d) availability of viable vaccine, disposable needles and syringes at the time of attendance; (e) attendance of the target group (e.g. infants) for vaccination; and finally (f) protection provided by the vaccine.

Question 23

define– coverage

Answer 23

Coverage is a commonly used measure of the proportion of the eligible population that is reached by the intervention

Question 24

what is the function of “outcome indicators”

Answer 24

identify indicators of outcome that can be used to assess whether the programme appears to be having any health impacts.

especially when it’s not possible to measure things like mortality (infrequent) or long to occur (cancer)

Question 25

healthcare evaluates what aspects of a program?

define each term?

Answer 25

a programme’s effects and effectiveness

effect is whether the program was able to carry out/ deliver the intended intervention
- measured via coverage

effectiveness is whether it made an impact on public health
- lower rates of malaira

Question 26

• describe the purpose and types of public health surveillance

Answer 26

Passive and active surveillance.

Passive
- health facility data, outcome registries, notifiable outcomes

Active
- Population surveys, chart review, contact tracing

identify disease outbreaks and epidemics, monitor time-trends, and identify population-level risk factors for an outcome

Question 27

• discuss the importance of registries and notifiable outcomes for surveillance

Answer 27

• helps to identify pts that need follow up
• identify potential research subjects
• know effectiveness of interventions
• improve quality of care
• respond to infectious transmission of dz

Question 28

• distinguish process and outcome indicators for monitoring health interventions

Answer 28

process indicators are measurable things to assess how well each step of the intervention is working. identifies bottlenecks of failures in the system

outcome indicators are when it’s not easy or takes a long time to measure the actual desired outcome (death, cancer), this is a substitute to know if the program is working to improve public health

Question 29

• identify methods for evaluating public health programmes

Answer 29

adequate evaluations
program’s effect
program’s effectiveness

plausibility studies

• comparing outcome frequency in the population before and after introduction of the program;
• those who did and didn’t receive intervention

Question 30

• discuss the role of epidemiological data in informing public health policy and practice

Answer 30

• gives evidence based data to make decisions
• plan and prepare for emergencies
• prevent re-introduction of eliminated disesase
• prevent global outbreaks

Question 31

with non-scientific reports, what are some key questions to consider when assessing its validity?

Answer 31

• repeatable
• published in a notable scientific journal
• use of rigorous scientific methods

Question 32

what is publication bias?

Answer 32

authors are more likely to report statistically significant outcomes and omit non-significant ones

Question 33

what are some implications of poor science?

Answer 33

• flawed research wastes limited research funding
• gives false hope to desperate ppl
• damages reputation of useful treatments

Question 34

what is a systematic review?

what is the function of a systematic review?

Answer 34

assess existing evidence

collects relevant published research on a topic, and summarizes the evidence.

Question 35

when trying to turn research results into policy and practice, need to focus on….

Answer 35

• communicating the results in a way that’s easily understood to policy makers and those who provide funding

Question 36

what contributes to inequities in global health?

what developments are trying to address the inequity?

Answer 36

• differences in environment, economies, infrastructure, govt

improving with–

• more sharing of data and technology
• mobile tech
• research and surveillance raises awareness

Question 37

What are some sources of environmental pollution affecting health?

Answer 37

• air pollution

- electromagnetic fields