disease dilemmas Flashcards
1
Q
what is an epidemic ?
A
- a disease that speads rapidly but within a countained area
2
Q
what is an infectious disease and non infectious disease
A
- a disease that can spread through the enviroment and one that cant
3
Q
what is a communicable disease vs non comunicable disease
A
- esentully an infectious vs non invesctous disease
- spread from one person to another through a variety of ways that include: contact with blood and bodily fluids, surfes, breathing in an airborne virus; or by being bitten by an insect.
4
Q
what does endemic mean
A
- a desease regularlly occuring in an area
5
Q
what is adisease transmitted by animals called
A
- A zoonotic disease
6
Q
give a example of an epidemic and why it dint spread to become a pandemic
A
- out break of ibola in west affrica in march 2014
- west affrica is less developed and has more rural areas. this means it is less effected by teh affets of Globalsiation such ascontant air traval and comunting. therefore the disease did not easilly spred - manged to be contained
7
Q
what does contagious mean
A
- spread from one person or to another, by direct contact with them or indirrect ( sneeze)
8
Q
what does TB stand for
A
Tuberculosis
9
Q
describe the patterns of malaria transmittions and why
A
- primarrily between the troppics
- This is because malaria is transmitted via mosquetos. Mosquetos breed in water and can only survise in hot areas + liek hot hudid conitions
1. africa - deprivation + perfect cliamte
2. sub sarharan africa - 90% of malaria deaths and cases worl d wide
10
Q
what type of disease is malaria
A
Infectious and comunicable (zoonotic) but not contagous
11
Q
where has malaria been erradicated and why
A
- Affective public health measues in AC’s such as US states bordering the Gulf of Mexico and Austrailia
12
Q
what type of disease is HIV
A
An infectious,comunicbale and contagous disease
13
Q
hoe many people are at risk of malaria
A
3.2 billion
14
Q
in 2015 how many people were infescted by HIV
A
35 million
15
Q
where is HIV primarrily located + why
A
Sub saharan arfica
* little contraseption
* prosetution
* sharing needles
* intergenrational relations
* lack of tretemt as expenive
* lack of eduction as under developed
* stigmas around homosexullty ( safe sex not takked of)
16
Q
what type of disease is TB
A
- infectious, highly contagous
17
Q
In 2013 how many deatsh and cases of TB were there
A
- 1.3 million deatsh 9 million cases
18
Q
where is TB previlant
A
- all across teh golbe but predominatly LIDC’s ( sub saharan africa)
1. links with HIV - weeken amunse system - contct TB and that will kill them
2. ( highly trnmittable though air )
3. can be cured and vaccinated ( why in LIDC’s) ( this is unlik malaria and HIV)
19
Q
what esentually is diabetes
A
a defficiancy of insulin
20
Q
what type of disease is diabetes
A
Non comunicable disese
21
Q
how many peopel world wide have diabetes and how many die of it each year
A
- 250 million
- 4 million
22
Q
where is diabetes most common
A
- North america
- south asia and east asia
- EDC’s followed by AC’s
23
Q
what are the two types of diabestese
A
- Type- genetic primarilly but there are some (early epigenetic factors involved aswell - dont need to metion)
- type 2 - developes in adult hood from poor diet and inactiverty and obeseity - epigenetic
24
Q
why si diabetese fround predominantly in the places it is
A
- Northamerica- high rates of obeseity, lack off physical exersize from epoepel working in more mangement and office jobs, poor diet of prossed high fat and sugar foods
- Asia- rapid transition to a processed food high fat high carb diet taht theyre not at all cuturally suited to
25
What is a CVD
Cardiovascular disease
26
give a list of CVD's
* heart disease
* strokes
* hypertension ( high bood presure )
27
who does CVD predominantly effect
aging populations in AC's and EDC's emeging
* russia, north america easetern europe ( diet and smoking)
28
when standardised by age where are the highest CVD death rates
* russia
* subsaharan affica
* the arabian peninsula
29
how many deatsh is CVD responcable for per year
17 million
30
what pecentage of CVD deaths happen in low and middle income countires
* 80%
31
what the primary cause of an early death from a CVD and what causes this
* tabbaco consumption
1. this in influneced by cultual attitudes so in russia smoking in teh more and tehy are amung the highest deaths and case rate from CVD's
32
whats the model that maps the spread of cumularive disease infection rate over time
The Hagerstarand model
33
what are the 4 stages of the disease outbreak model ............
**the hagerstarnd model **
* primary phase
* expansion
* condensation
* saturation
1. with saturation its never quite flat as so few diseas are erradicated
34
what is the neighbourhood effect
* people who live in closer proximerty have a greater chance of catching teh disease
1. the extent of the effect is usually describes by the number of peopel living in a 5km grid square
35
d
d
36
whats is network diffusion + give an exmapel
* Network diffusion occures when a disease spreads via social networks - its larger one place to another (kinda liek diaspora networks in migration but specific groups
2. HIV with sexual networks in west africa amung postitutes and truck drivers and then sexual networks
37
what is contagious diffusion
* contagous diffusion relies on dirrect contact with an indervidual with the disease
1. west africa ibola 2014, ( why its spred was so slow)
38
what is higharchical diffusion + example
ordered spread of diseassed e.g from lareg cities to rural small villaegs / largest countries to snallest
1. H1N1 virus ( influensa/flue) starteing 2009 in nexico tehn following major air travel roots startin
39
name aother pandemic not covid
H1N1 influensa 2009
40
where did covid originate
* its a disease froma wet market in wuhan china - or a lab leak
41
how many passangers dows WAN ( world air transportantion network ) transport a day
12.3 million people
42
when was covid anounced as a pandemic
11th march 2020
43
list the 4 types of diffusion of diseases
* higherarchical
* net work
* contagous
* expansion
* relocation
44
what is expantion diffusion ( draw it) + example
when a diseases diffuses dirrectly outwars from the place of the outbreak. the closes areas being effected most rappidly
1. an example would eb an outbreak of TB
45
what is the fist disease case called
* the outbreak
46
what is relocation diffusion + example
when the disease leaves teh area of original outbreak and begin to spred faster in anew area.
1. chorella 2010 hati from nepalise UN aid wokers
47
fd
f
48
s
j
49
exapalin the primary disease thats easonal varriation effects
* malaria
50
what solely physical factors effect disease outbreaks/ distrabustion
* temperature
* precipitaion,
* relife
* water sources
* ( seasonal variation )
* ( climate change )
( metioned sepertly in sec, also relate in your answer)
51
what is mean by disease vector
a living organism that can tranfure disease between humans or from other animals to humans
52
what three diseases that you need to know about are eefeted by seasonal varriation and how
* bilhartzia- ( type of worm that burrows from sains out and then into your foot) thrives under condition 10-30C
* malaria - mosqiyooes can only survise in walm tempertures and breed in water so just prior to the monsoons there is a spike in cases and in summer + no cases in cold highland regeins
* Influensa - cold and flue season in the autum and winter months in northern regains. influensa spreds more quickly as more people are inside in close proxemity, inhancing the neighbourhood effect
53
what 2 physical factors exasturbate other physical factors and affect desease distrabution
* seasonal variation
* climate change
54
what does climate chage do to physicl factors effetcing disease + 3 example
* increase tempertures= incresed humidity of the atmosphere and incresed rainfall
1. lyme disease expanding northwards because of the walmer conditions in the US - there are even the first reported cases in canda
2. malaria incresed outbreaks
3. increased natural disaters - hailti and chlorella
55
how has incresed malaria outbreaks due to climate change effected etheopia
* 52% of the pupulation are at risk
* kills 70,000 a year
* doent discriminate with age gener etc
56
where does bilharzia come from
* parasites in fresh water sails snails
* leave and go into water where burrows into peoples feet
* leaves in urine and fesise
57
how does climate chage effect bilharzia
* drys out water souces
* peopel are forced to use contaminated water
* lake malowi has it
* effects LIDC's more as easy to treat with right health care and rest
58
what is an example of bilhartzia and reclocation deiffusion ( because of migration )
* someone got it from lake malawi moved/ went back to croatia, ecreeted in a lake and there is an outbreak ther now.
59
what effects teh spread of zoonotic diseases
| 4 examples for the points
* when the movement of wild animals is unristricted by physical or political broundries eg mountian ranges or roads and citys
1. TB in the tundra with Thrax migration
* if domestic animals can be infected
* live markets and consumption of meat
1. covid
* if pets and live stockcanot be vaccinated (LIDC's)
* if there is limmited cotrole over ferral animals like
1. dogs with rabease or
2. rats with the plague
* shared animal human sanitaiona nd drinking water
60
what si teh epiodemeological transition model
* describes how countries are effected by disease depending on their level of developmet
61
where are non comunicable diseases most presant
* EDC's
62
how many stages are their to the epiodemeological transition model
4
63
what are teh stages to teh epiodemiological transition model
* stage 1 -
1. no health care
2. low life expectacy 30 years
3. moratllity is from comunicable diseases
4. non countires at this stage but soem groups such as mongolian herds men
* stage 2-
1. some healthcare
2. life ex rises 50 years
3. still main cause of death is CD as people dont live long enough for NCD
4. uganda (LIDC's)
* stage 3
1. life expectacy rised to 60-70 years
2. india
healthcare and eduction can prevent most CD
4. mortallity is predominatly NCD and its at this point NCD sike the most
* stage 4
1. NCD are cured and delayed in their onset
2. life ex is high 80-70
3. most deaths are from delayed NCD
4. japan
64
stat for were most cansa deaths occure
70% in EDC's
65
when was the haiti eath quake
* january 2010
66
what type od a disease diffusion was teh haiti chlorella out break
relocation diffusion
67
what % of peopel lived bellow teh poverty line in hati in 2010
* 80%
68
give 2 stats that prove hati is poor
* poorest country in the western world and 80% of peopel live bellow poverty line
69
how did chlorella spread inhailt
* UN Nepalise aid workers sewage leek into the meille river
70
what is the river in haiti chorella originate din and spred in
* meille river
* Artibonite river
71
what were the impcts of chlorella in haiti
* 682,000 cases
* 8,700 deaths
* 40 per week
72
what are mitigation strattergies tahst can prevent the pread of water born deseases
* propperly cook see food
* proppert treate water
* sewage at least 30m from water
* hand wahing
73
give an example of a mittiagtion stratergie to limit th espred of disease in haiti
* red cross- provided 300,000 peopel living in cpas after teh earth quake with uncontaminated water (trucks) - still had to be treated after they got it to prevent other disease
74
how does chlorella kill
* gives you dyarea and then you die of dehydration
75
whitch insitutions were central in mittigating the effect of the chorella otbreak in haiti
* thered cross
* The CDC - centre for disease controel
76
what to do with the water cycle made the chlorella outbreak in hati worse
* there was exess flooding from the rain of the rainy seasn and they are worse today because of deforrestaition
* thsi allowed for the spread of contaminated water
77
what human factors made the haiti chloreela outbreak worse
* close living conditions becuse of the refugree camsp after the earth quake due to houses being destroyed from poor infatsucture
* Poor so poor health care
* unsable governemnt and poor so slow reponce- relired on aid and humaniterian effort
78
give an example of the CDC helping in haiti
* Vaccination rates for children are nearly twice as high than before the earthquake
79
How can air polution cause disease
* when fossil flues wood and vegitation is burnt it releases PM 2.5
* they penatrate deep into peoples lungs
* this causes serrious NCD specifically CVDs liek hear disease and lung disease lung cansa asma brochitus etc
* 1/5 lung casa cases now are non smokers
* lung cansa has incresed 70% in delhi
80
how much has lung cansa incresed in delhi
70%
81
how many lung cansa cases in delhi are now non smokers
1/5
82
where is delhi interms of the demographic transition model
* EDC
* industial econmy
* secondryand terciarry secotor
83
why is disease becomming harder to takle in LIDC's and why
* they hae the double burden of having to deal with CDs and NCD - known as double burden
* with globalisation there is a norm of poor diet smoking stress and inativerty spredding deacreasing peoples health and weekeing their imune system
84
give an example of double burden and why its a praticularly serrious problem
* in the Mahama refugree camp ruanda 5% of cases are NCD and are rising
* they are offten not treated as when CDs are an issue alot more people can be saved and cured as they are cheaper and more efficiennt to deal with somehting wicth has to be taken into account with LIDCs that have a very low health care budget.
85
what his the max healthy level of PM2.5 in the air
10 micro grams per cubic meatre
86
how is disease in delhi linked to the water cycle
* PM2.5 are much much lower after the monsoons as water condenses around them falls as rain and cleans the air
87
when is the rainy season in delhi
* june-september
88
when expaining how disease is effected what should you foccus on
types of diseases they face, fatallity of diseases and infection rates
89
how does place effect rates of disese
* development
1. LIDC - hati
2. EDC- Delhi and polution
3. HIC
* population density (urban vs rural
1. neighbourhood effect
90
give an example of deforrestion / incresed runoff / flooding causing a disease outbreak
* chlorella in the amazon after the river madera flooded in 2014
91
what does endemic mean
The term "endemic" refers to a consitant presence of a disease or condition within a particular population, geographic area, or region. It indicates that the disease is **regularly** found and maintained at a relatively stable level within that specific area over an extended period.
92
what is a pandemic
disease out break on a global scle
93
other than wetness what do mosiqitos like
humidity
94
what is a pfl that keeps disease ramid in some countries
* **cycel of depivation**
* disease- detah + low produc and dedution
* little wealth
* liitle abillity to deal
* more disease
95
whats teh optimum temp for malaria to devlope
25-30C
96
what mosquitos carry malaria
Anopheles mosquitoes
97
whats teh fist stage of teh hagerstand model
primary phase /
1. slow initual groth
98
whats teh second phase of the hagastrand model
expansion )
1. expeinencial groth
2. incresed neighbourhood efefct
99
whats tehe third phase of the hagerstnd
consentration (
* slows expsndion
1.herd amunity
2.vaccines
3.eduction
100
whats teh final fase of the hagastrand model
saturation -
* fully levls - disease has been iradicted
101
draw the hagastrand model
_
(
)
_
102
how does presciptation influence desease distrabution
* water born infectious diseases
1. chorella - river which peopel use for sewage over flow ( increse with cliamte change and in wet season vs droughts)
2. typhus
* malaria
1. stagnent water breedign mosquitos ( increse with cliamte change and in wet season vs droughts)
2. ethopia low tranition actober - may vs high in during and after the rainy season, which lasts from June to Septembe in wet and sirght after wet season
3. ( infection rates are 73% higher in sptembre for instnce..)
* influensa
1. prefures less humid conditions ( may see decrese with climate change + increse in wintre ) ( also relates to neighbourhood effect)
2. H1N1 spred faster when it got to uk vs its orginial outbreak in mexico in 2009
* decreased P 25s in the air
103
how finectious diseases are more previlant in wintre but not beuse of temp dirrectly
neighbourhood effect
104
what causes haiti choreela
* 2010 eath quake
* nepalease aid workers seage leaking into locla river
105
what physical factors made haiti worse
* hazard of eath quake
1. brought aid workers
2. infastructure already destroyed ( taht there was) ( water and heigein - incresed spred)
* heavy precipitaion
1. hurricane thomas novembre 5th 2010 when earth quake was only jan 12th - this was seemingly most significnat as aid workers came stright after quake but novmbre ( 10 months after was when outbreak occured)
2. flood rivers that people used for sewage and latirnes + rapis
3. + when hati was sandy in 2015 when country was just recovering
* hati hot (av temp 24-32C') chorrella prefures temps 27-10 degrees to spred most rapidly.
106
case study for natural hazard effecting disese
Haiti
107
what type of diffusion was haiti
relocation then expansion
108
human factors effceting haiti out break
* aid workers - significant as ource
* low development
1. poor eduction and access to resources - use river for sewage and cooking and drinking etc and may not no how to proppely snitise it before - lack of even awareness of imortance of snitation
2. helth care etc
3. sanitation- lacko fwater and snaitaion infasturcture as cant aford + what was tehre not rebuilt after eath quake
* unstable gove
1. poor responce
* dependency on river
1. use rice padi feids for food which were flooded with contam water + river to transport goods
* no imunity
1. not expirence ( not endemic to area) so lack of inumity
* polulation
1. Haiti, Port-au-Prince capital ( mill peopel live there ) - 10th of population
2. speratly most pop depend on Artibonite River (320K) in lenth - allowed for quick spred and continous flow ( although not port-au- prince)
109
what type o scale outbreak was chorella in hait
epidemic
110
haiti capiatal
* Port-au-Prince,
111
whats the river in haiti called and how big
* artibonite
* (320km in lenth)
112
how significnat were the impacts of choreella on haiti sresidnet population
* 2,300 hospitaised per week
* slow and decrese development
1. ensights cycel of deprivation
1. significnat as already under developed ( GDP per cap was $760 and HDI 0.470)
2. 80% bellow pov line
3. 40% without acess tobasic health care
4. poorest coutnry in the west
113
why was haiti chorella significnat / very sad
* chorella is easly treated by rehydrating and othe basic medical aid so 14,000 shouldnt have dies
* highlest significnace of inequllity is disease risk
114
what is teh epiodemiological transition model
* a model taht represenst the change in the distrbution, infection rates and types of diseases taht emerge as places develop
115
draw the grphs of the epodeolofical tranition model will produce interms of CD and NCDs
* CDs (
^_
* NCD's /
116
what are the stages of the epiodemiological transition model list
* stage 1
* stage 2
* stage 3
* stage
117
what is a disease that AC and EDC counties tend to get called vs lIDC
* disease of afluence - NCD
* Disease of poverty - CD
118
who has the highest rates DA and why
* EDD's
1. polution form industrialisation
2. papid comersulisation and unhealthy habits becoming norms ( drinkign , smoking and junk food)
119
case study for an \EDd expirencing incresed disease risk / from polution
Delhi - capital of india
120
when is smog in delhi most prevelan t and why
* ( winter mounths and the dryy season)
* late October to early February
* farmers often burn crop residues in late October and November, resulting in the release of smoke and pollutants into the air
* in wet season water vapour will ondense around P25s and when it falls a srain will wash it out air - links to the water cycle
* Diwali Celebrations: The festival of Diwali, usually celebrated in October or November, involves the bursting of firecrackers. The resulting emissions from fireworks can worsen air quality and contribute to the smog - less signifcant
* where cold air gets trapped close to the ground, preventing the dispersion of pollutant
* more cars on the road in wintre perhaps
* Temperature inversions in wintre - coller air may be trapped near surface while walmer air above, this means polutions arnt cleared
121
how might disease caused from polution be reuduced from climate change ?
* incresed presipitaion
1. water vapour condenses around P25s and when it falls as rain wasghes them out the air
122
what shoudl you call polutants
P2.5s not P25s
123
whats the impact of P2.5s in delhi
* 70% increase in lung cansa
* 1/5 who get lung cansa now dont smoek
* increse in general CVD
* 40% decrese in lucng function across pop
* slow developmetn
1. cycle of dep with eduction and time of cork
2. lead to social struugles for famillys
* stress on already porr helath servsies
* life expectanct is av 72 years vs 74 in mumbi which has less significnat polution
124
whats the level of ppm of P2.5s in delhi vs teh healthy levl
* av- 107 ppm of p2.5s
* healthy - 10 ppm - according to WHO
125
what are P2.5s
* polutant partical small enough to remin supended in teh air for long periods and penerate trh emembrain of your lungs
* carthnogenic
126
whats your case study for a comunicable disease in lidc and where
etheopia, malaria
127
main mosquitos that causes malaria
Anopheles
128
whats teh capital of etheopia + how high above sea levl is it
* Addis Ababa
* 2,300 m
129
whats eth geographical makup of etheopia
* mountians in the west
* desert in the east ( Danakil Desert)
130
whats teh anual malaria death rate
800k
131
what are the causes of malaria split into acording to the spec
* human
* enviromental
132
physical factors taht effect malaria in etheopia
* **temp**
1. op temp 25-30 degreese
1. **altitude** - (place) - temp drops 1c per M with altitude, estern etheopia have >10,000 cases vs trase amounts in mounternous cental and estern regions (addis ababa 2,300m + pop of 4.8 million people around 4% of pop)
* **rain fall**
1. seasonal variation ( June and September wt season)
1. **stagnent water** + **relief**
1. vector mosquito breeding grouds
2. transmittion is alo lower to a dgree in desert region s especilly in dry seanson
133
what should you call mosquitos in their sred of marlaris
vecotors
134
huamn factors taht effect malaria in etheopia
* **deprivation**
* this is jsut about the most significnat factor that efefct all othe factors
* resources
1. lack of health care servsied as gov poor
2. lack of doctors 1 doc per 5000 people
3. however now pharma comapies seloign mediction act cost value - still expenive
* eduction
1. peopel arnt aware of dangers or hwo to protect themself _ e,g dont work at nigth and sllep outside
2. lack of doctors 1 doc per 5000 people
* stage of developmet
1. 75% work in primary sector- workign outside, exposed to vector
2. individuals cant aford preventative things like mosquito nets or pestiside house sprays
* however etehopia doe have free basic health acre
1. lack of facillitys and care to be effectiev
* **missused of marlia drugs**
1. parisights becoming more resilliant - inadiquit dosage so parisight adaps and survivives
* **working conditions**
* majority primary secotor - outside exposed to vector, harvising tking place after dark when coller but vectors more active - also farmers will sleep in feilds
* **urbansisation**
1. more mosquito ( vector breading grounds0
2. addis ababa 4.8 mill pop
3. incresed pop density - fatsr spred
* **population movemtn** - (migration + flows of peopel place)
1. week popiltical power to prevent interegional migration - results in migrnat flows between countries making it hard to readicate for a particular nation- also in africa alot of nighbouring countries where as autrailia could eradicat epartyly as its an isolated iland.
2. intaregioanl migration from lowland rural aread to highland urban ( economic migranst ) - spred where want before.
* **irrigattion schemes ** ( link with water cycle and huamn intervention with it )
* irrigation cannels to uban areas dry out in heat. this leads to more breaing grounds for the mosquito vectors
135
what are teh key impact of malaria in ethopia
**secondry socio econ**
* cycle o f deprictaion - slow developemt - in all of subsarhan africa cost teh 12 bill in econ groths a yr- disporportinally effect rural - already poorest and most vunrbale
* 40% of health expenses and 12 % of clinic visists - sig
* damage touris - perception of pace - long term
* food scarsity - over pop of highlands - 1980 famine
**health**
* 70,000 deatsh a yr of 800,000 world wise ( lmost 1/8th - sig scale
136
give stats that show malaria is a significant thret to etheopia
* 2/3 of 120 mill population at rist - scale
* endemc to 75 % of malaria
137
where is marlaria least and most present in etehopia
* least central estern high lands
* most west low lands
* somwhat desert in east
138
whats your case study for a non comuniclabe disease in an EDC / AC
cansa in teh uK
139
whats your case study for a comunicable disease in an LIDC
malaria etheopia
140
what are teh causes of a disease in an AC acording to teh spec ( list)
* social
* economic
* cultural
141
what is is esimated taht casnsa rates have incresed in teh Uk due to social, economic and cultural reasons
* 23% for men and 43% for women
142
whata re teh socioeconomic and cultural reasosn for poor helath in the uk + exampels + expalin
* **diet**
2. 28% of adults obese vs 5% in etheopia
3. sevise indutry - fats food, processed food and sugar ( food as enjoyment), more meat cosnumption
4. carthononogenic
5. **cultural**
* **alcholhol consumption**
4. carthononogenic
5. mainign in deindustrialised lower income areas (glasgow) - **cultural**
6. average in uk consume 9 units of alchohol a week - scale
* **smoking**
4. carthononogenic
5. mainign in deindustrialised lower income areas (glasgow) - **cultural**
* **lack of exersize**
* sedientry = poor cardio vascualr helth and obesity
1. movemnt to terciary and quaternary sector = less amnual labour jobs - **socio economic**
2. 28% of adults obese vs 5% in etheopia
* **sunbathinhg**
* increse skin cansa rates
2. In 2017, there were around 16,200 new cases of melanoma skin cancer
3. this is **cultural** in that it links to desirbaillity of tan skin
4. also **economic** as Uk citoxens cana aford to go on holiday alot of them being AC
5. carthononogenic
**aging pop**
* 18% over 65
143
what are teh social economic impacts of disease in the uk
**econ**
* between early deatsh, time off work ( paid and unpaid ) and cost to NHS etc costs Uk econ £15 bill a year
* cost individual £570 a mouth - significnat as lower socioecon diporoportionally effected - keeps in cycle of deprivation
1. ( stuff liek time off work, petrol for appointemts, etra hetaing etc )
**social**
* isolation
* axety ( also from loss of income)
* mental and phyical healt probems
* increse inequllity ( link to place )
1. maintained NS divide and cycel of deprivation
2. regional and national scale
3. long term
4. mainains post code lottery
144
what is healthin equllity in teh UK often knwon as
* the post lottery
145
whata re the key patterns/insidence and previlance of disease int he uk ( both suvival and icindece)
* regional and socio economic deivide
1. NS divide - NW - 637 cases/ 100,000 vs 571 in london ( south )
2. afluent women = 14.s% incresed survival rate tah non for bladder cansa
1. divide within areas
2. p to x3 cansa rate in some deprived areas
2. urban rural divide - access to sevises
* Age
1. in stage 4 of epiodemiologiacl trnasition model - lareg elederly pop +cansa is degenerative disease os more elderly hgher change of emergance in pop ( diproportiinally effects elderly)
2. 25-35 - 1/1,000 cases ( for men)
3. 75-79 - 30/1000
146
give the stats that describe the distrabution of cansa amoung young peopel vsolder in the uk
2. 25-35 - 1/1,000 cases ( for men)
3. 75-79 - 30/1000 - 75-79 (for men)
147
give an exaple of NS divide intems of cansa in the uk
1. NS divide - NW - 637 cases/ 100,000 vs 571 in london ( south )
148
whats teh maine internatinal orgnistaion in comabtting disease
* WHO
* ( folloed by NGOs)
149
what roel does the WHO play in providing interntionl stratergies to conbat disease
**ways**
* breifs - research, predction, gathering dats and cordinating suggetsed repsonce
* support governemts
**AO2**
* reliant on funds from AC's
* cant go everwhere ( polio afganistan an ..... prevnt iradiction_
150
case study for disease outbreak on a gloabl scale
Covid 19
151
where did Coid break out and how did it spred ? diffuse
* Wuhan china ( either lab leak or wet market)
1. links to place - more significnat as more countries develop and there will be more movemnt to quaternary sector and man made variants)
* originally zoonotic ( thought to have come from a bat)
* initually expanion diffusion then network/ higherarchical relocation acoross major golabl air networks and most to least coneted countrie + nail networks in china
* significnat as wuhan was gobal air trvale hub and very conected - only took a month ( 31st of decbre 2019 to 30th of jan 2020 to be anounced as a pandemic) (vs ebola that could be rellativly contained as emerged in rurla africa)
152
how amny people does teh world air transportation network transport a day ( WAN)
12.3 million people
153
what does covid say about disease spred in the modern day
* **migration**
* more diaspora links, gloablisation = peopel traveling much for for recreation and bussiness - fater spred
2. 12.3 million though WAN a day ( covid became pandemic sale within a month)
* intaregional migration
* 55% of world pop lives in cities and many in slums - increse neighbourhood effecta nd exansion diffusion and contagious diffusion - ovious during covid
1. in uk urban rural migation incresed 27% fromlondon to escape disease
2. stricked 2m distancing had to be envoked everywhere
* **place**
* same for globalisationa nd flows of peopel
* more urbanisation - increased neighbourhood
154
what were the impacts of Covid
* 680,000,000 cases
* 7 mill deatsh
**Socio econ**
* unemplyemnt
* global reseesion
1. The OECD estimated that global GDP declined by around 4.2% in 2020 due to the pandemi - sale both qunity and across globe ( more in AC's)
* slow developemt
* menatl helth crss
155
what was teh role of who in covid
* declaied public health emergency and encournaged to lock down ( 2020 jan 30th) - rapid respince ( 1m afetr outbreak)
* published reports and updates to help countries make dessiosn#
* sponcered investigtion into causes
* DECLAIRED IT A PANDEMIC 11th of march
156
when did who really declair covid a pandemic
11th of march
157
what syour case study for a NGo who has palyed a roel in delaing with adisease outbreak
red cross haiti
158
what did the red cross do in haiti = list some succeses
* delivered 300,00 clean drining water in capital of portu prince
* built 1300 latrines - helping 250,000
* provided medical supplies ( treated 17,800 cases in treatment units in POC caps)
* educted locals - door to door vists, radeo, news papers etc - effectie as easy to avoid
1. tell about early symptons
2. how to avid to pred to fmaily
3. how to boil water propperly
**succeses**
* 2011- 35,000 cases per month
* 2014 - 2,200 cases per month
159
medical imacts of chloreela in hati
* 820k cases
* 9,700deatsh ...
* 2,300 hospitaised per week
160
how did chorella in haiti decrese between what years arguably due to the red cross
* 35k cases a month - 2011
* 2,200 a month -2014
* ( rellitivly rapid)
161
list three medictaions found in nature and their gowign conditions
* morphine - pain reif
1. Opium is extracted from the latex of the opium poppy plan (seed)
2. needs walm humid conditions ( 30-38 degrees) - ivresed op to grow with climate change - link to carbon cycle + sunny
3. soil - neutal, well drained with good moisture retention
4. no frost
5. torpics
* cafein - Enhancing medication absorption, Headache relief, stimulant ( countre fatigue and drousyness e
1. coaca - tea leaves - coffee beans
2. 6.5 ph soil depp = well drined good moisture retention
3. torpics
3. (15°C)- (24°C), with no frost
* salicin -pain reif
1. bark of white willow
2. soil ph 5.5-8
3. river banks flood pains - greter op to grow with climate chnafe - link to water cyel + carbon
4. tempoate zones ( can survive frosts)
162
whats your case study for a medicla plant
the rosy periwinkle
163
where is the rosy peri winkele native
mangegascr ( only real natiev habitat)
164
whats teh medical significane of the rosy perriwinkel
* contains 70 alkailods
* one of which is Vincristin which treats child hood lukemia
1. survival rates incresed rom 10% in 1970 - 90% now
* also contains vinbalstine
1. treats hodkins lymphoma
2. the 5-year relative survival rate for Hodgkin's lymphoma is around 87% in the United States
165
what are the required growing conditiosn for the rosy perriwinkle
* no frost
* acidic soil, well drined but retin moisture
* 20-30 C'
* can gow and now does inamny torpic al region
* can grow in disturbed areas
166
hats teh interntional trade of teh rosy preyy winkle like
* 75 mill GDP
* ( agrubly stolen from manigascar ) - biopiracy
* Pfizer: They have been involved in the production of vincristine for childhood lucymia
167
what are teh issues with using teh rosy perriwinkle
**enviromental**
* over exploitation - could lead to extincion and less of it - 1g of vinbalstine needs 90kg of leveves
**socio econ + political**
* land apropriation - chlenege sov and territorial of state - power and borders - argubly Pfizer comendearing and buying up lareg land of mangegascr locals
* Bio piracy - e,g, - new agrremts
1. reveues of 160 mill but trase amount find tehre way back to manigascar - new leg is deling witn taht
168
whats your case study for a global impact of a pharmaceutical company + some general stats about them
**GlaxoSmith Klein**
* 6th largest
* 84 naufacturing sights over 36 countries
* 23 bill anual turn over ( vet rich + high profir margin)
169
what do GlaxoSmith Klein do ?
* main drug is advair - asma drug - 1/4 of profits
* they work with save the children donating 50 mill worth of drug sto save 1 mill children in LIDc and under priverlaged comunities - e.g gel to decrese infections
* support WHO to help them reach targetsgets globally.
* research disease vaccines with little profit magin ( e.g in LIDC's ( TB, Malaria and ebola) ( howevr no stribes made interstingly) (althoug one of few compamies that doe sthis so activly)
* in 2018 they gave 800 mill vacine does 80 % to LIDC's
170
whats teh importance of GlaxoSmith Klein
* ethical policies
* research and development
* actions in third world
171
whata re teh stratergies for disease irradictation list accoring to spec
**top down**
* gobal ( campeigns ) - national govs, interntional ornagisations and lareg scale private investors ( and MNC such as glazo smith cline )
* National ( campeigns) - national gov, ( may have lep from other player sliek NGO's private invetsors or companies
**bottom up**
* grass roots ( campeigns )/ strats
172
what are your two points you msut mention in terms of grass roots stratergies/campeigns to tackle disease
* educting comunities and the roel of women
173
what your exmple disease for a grass roots stratergy / campein for irradictoon
* guinea worm
174
list the differnet scals disease errdiction can be doen at / capeings/ starats
**top down**
* international
* national
**bototm up**
* grass roost
175
whats your case study for a attempt at disease aradiction on a national scale
* mauritius
176
how to spell mauritius
mauritius
177
why are GlaxoSmith klein importnat
* **ethic policys** and **actions in teh third world**
1. return 5% of profits to country where they source their drug ingredients from
2. grant patent liecnet to LIDC's for their basic drugs to he;help them tackle diseases
3. cap prices of drugs in LIDC's to 25% of Uk prices
4. they invest 20% of frofits in lIDC's back into their helath infastructure
5. pharma companies too mcuh power can dont have to comply - Turing Pharmaceuticals increased the price of the medication from $13.50 per tablet to $750 per tablet overnight ( HIV meds)
* they work with save the children donating 50 mill worth of drug sto save 1 mill children in LIDc and under priverlaged comunities - e.g gel to decrese infections
* support WHO to help them reach targetsgets globally.
* research disease vaccines with little profit magin ( e.g in LIDC's ( TB, Malaria and ebola) ( howevr no stribes made interstingly) (althoug one of few compamies that doe sthis so activly)
* in 2018 they gave 800 mill vacine does 80 % to LIDC's
* **drug research and development**
* main drug is advair - asma drug - 1/4 of profits - improving quallity of life and potncial;y fatal attacks
* working in 36 countries
* thir covid vac = 10-21 vs astra zenica £4-8.10
* research disease vaccines with little profit magin ( e.g in LIDC's ( TB, Malaria and ebola) ( howevr no stribes made interstingly) (althoug one of few compamies that doe sthis so activly)
* emply 13,000 researchers
* sepnd 3 bill a year in research
178
give an expale of pharma companies having too much power
Turing Pharmaceuticals increased the price of the medication from $13.50 per tablet to $750 per tablet overnight ( HIV meds)
179
challenges of big pharam / limmiattions
* too much power over prices
1. Turing Pharmaceuticals increased the price of the medication from $13.50 per tablet to $750 per tablet overnight ( HIV meds)
2. covid vaccinecosts from $10-21 vs astro zeneco $4-8.10
* biopiracry
1. GSK only 5% of profits to country of origin
* side effects
q. in some cases advil can cause worse Asma and even be fatal
* over persription
1. scanle in US where they were bribing doctors overperscribing advil enven for common colds ( at end of the bay is bussiness)
180
what ar eyour expales for top doen errdiction strtergies / campeigns
* small pox
* polio
181
was small pox a successful eradiction
* yes - not in inal stage of haggerstrand model ( saturation ) fulyl eradictated
* before killed 300mill in 20th centuarry
182
how many did small pox kill in teh 20th centuarry
300 mill
183
when was small pox eradicted
1980
184
who was envolved in the erradiction of small pocs
* who campeign ( interntinal org)
1. began in 1967
* help and funding from USSR
185
how was small pox delt with
mass vaccination ( rapit to avoid variants)
186
wy was amll pox eaier/ able to be erradicted
* not vector transmitted so only ahve to tackle in humans
* easy to idenitify as peopel rapisdlydevelop symptons incuting chiken pock like pustuals.
* political and financial will ( it was a political race between russia and teh US in the cold war ( a bit like teh space race) to teh USSR was willing to fund teh endenvar depite huge huge costs - Us took on polio
* enough stabillity golbally at teh tiem to go in and administer vaccines - costs equiviallant to 700 mill today
187
what we can learn from small pocks eradiction
pandemics need global cordinated reponce to be most effctiev e
188
how many peopel died of polio a year before the vaccien
600,000
189
who runs the polio erradictoon campeign
* Global Polio Eradication Initiative (GPEI), which is a partnership between the World Health Organization and teh US began in 1988 as cold war repoce after ussr eradicted small pox
* more recently bill and melinda gate froundation has gotten envolved
190
spell small pocks
Smallpox
191
what was done to try errdicate polio
* 1988 start
* 2 vacines mass roll out
* costed billions
* mostly succesful - 20011 only in afganistan and pakistan as terrorism has mean vaccines cant be admistered safly - link to P&B
* could happen as easly admistred just swipeof teh arm
* also not zoonotoc / vector
* manditory shot for chidren in africa - bill melinda
* undermine soverignty of state and peopel - p&B
192
why type of diseases are relly hard to erradicate
* zoonotic
193
spell mauritious
mauritious
194
what was done in mauritious to try erradicta malaria
* ( succesful mostly)
**national gov**
* spray buildings
* death toll decrese to 0/10,00 in 1951 vs 6/10,000 1943 - rapid
* declaied arradcate din 1954 ( eaier as iland nation )
* cyclone in 1975 reintroduced ( reconstrution migrnat workers and stagent water from floods) - link to migartion
**benifits**
* maintianed sov
* effective
* rapid
195
how was guinea worm attempted to be delt with
196
spell guinea worm
guinea worm
197
what is guienea worm + how does it spred + effecst
* infectous parisight worm
* lavi in drinking water tehn hatch and goes into intesine orentre though woonds when people go in the water
* comes out of your foot after a few mounths cm by cm a day ( process can take weeks 0
* fatigue and deprivation cycle ( possibel deathy in elderly and thoes with pre existing helth condtions
198
where was grass roots strats tried to eradicte gunni worm ?
**Ghanan**
199
spell Ghanan
Ghanan
200
what wer ethe grass roots strats to try errdicate guni worm in guanan and how succesful
* NGO's eduction - cheifs empose sancitions to stop woonded peopel going in the river
**ecucting women **
* womanes cubs to edcuate women so they woudl sped meeage to children of future egns and men who needed to be workign - 500 female volentires - intimate and effetive
* in person viststs efective as only 20 lit rate
* women can also monetor childrens activerty
* how to propperly sterrlis ewtaer
**Sucess**
* 179,000 cases in 1989
* 0 cases in 2010
**AO2**
* long term as knowledge passes down generatinally
* small scal4
* sustainable
* maintain sov
* limmitaions becuse of cultural altitudes
1. 50% incease in cases in 2009 in NW as farmers delairs filters to be witch craft
* flighting in the north as also desruoted aid workers
201
why else was malaria had to erradicat efor ganna despite just ebing a national strat and then it coming in from other palces
* vector (zoonotic)
* no effective via ble malaria vaccine
202
why does dty season make guinea worm and bilhartzia worse
Water Sources: found in stagnant water sources, such as ponds, lakes, and shallow wells, where they are ingested by copepods (small water fleas). During the dry season, water sources become scarce and more concentrated, making it easier for people to come into contact with infected water sources and ingest the copepods containing Guinea worm larvae. tehy may not ahve luxuray of avoiding contaminated sources
203
why is tracking gunine worm hard an dits not jsut the fault of it being an Grass roots stratergy
* no vaccine or mediction to deal with it
204
physical barriers to disease spred
* ( borders ) ( maritien (iland nations)) (mountians) - why austrailia succes erad malaria in mid 20th cent
* herd imunity - why so bad in haiti ( not endemic)
205
socioeconomic barriers to disease spred
* rural isolated comunities - ebola 0214 west africa
* vaccines
* edcution, healthcare etc can help prent in AC's
206
spell spred
Spread
207
list teh phycal factors taht effect disease distraution
* precipitation
* relif
* water soruces
* temp
208
how does reif effect disease distracution
* ( undulation of teh land )
* altitude temp and malria
* stagenemt water and malaria
209
significance of water sources
* more after wet season - marliaria
* less in dry season ( forced to use contam) - bilhartzia and guinea worm
210
what is anothe rdisease trnasimited by mosquitos yu could mention
Dengue fever
211
how temp effects disease spred
* most C troptical diseases prefer walm conitions ( 25-30) malaria
* anopherles moscitos - 16 to 32 degrees Celsius
* ifluensa increse in wintere bsuse prefures cold dry and neighbourhhod efefct
212
what shoudl u call vector diseases
zoonotic
213
what increses the risk on zoonotic disease spred
* when there is not accination of pets / live stock
* proxemity and consuption of wild animals
1. wuhan wet market bats
* aniamls enhabiting urabn areas ( urbanisation)
3. rats, foxes, pigens racoons
4. cause of balck death in 14th centuary wiped out 1/3 of world pop
* ( physicla barriers) aniaml migrtion and interction with humans
1. wild birds and the transmission of avian influenza, commonly known as bird or avian flu - out break in 1990s
214
what increses the risk on zoonotic disease spred
* when there is not accination of pets / live stock
* proxemity and consuption of wild animals
1. wuhan wet market bats
* aniamls enhabiting urabn areas
3. rats, foxes, pigens racoons
4. cause of balck death in 14th centuary wiped out 1/3 of world pop
215
what are the stratergies to minimise disease **Impacts**
* national
* international
216
list national and interntional starats to minimise the impacts of disease
* **Uk Covid - national**
1. Testing and Tracing - NHS ap notify you when close contact
2. lock down and social distancing
3. age and unrabillity prioritisng vaccine scheme
4. 230,00 deths in teh uk atributed to covid estmated 1.2 mill if not scheme of gov liek loack doen and vaccine sin place
* WHO - Covid interntional
1. breifings :
2. The WHO serves as a central hub for sharing information - deaclir antinal emergency, pandemic and end etc
3. Risk Assessment and Early Warning
1. practical help:
3. Supply Chain Coordination: The WHO collaborates with partners and member countries to ensure the equitable distribution of essential medical supplies
4. Research and Development Collaboration: The WHO facilitates research collaborations and supports countries in their participation in global research initiatives
217
what causes the smogg in delhi
* emissions from coal buring poer sations, factories, veichles ( packed roads) ( industrial economy )
* buring of stubel in feilds in dry season - much worse - hard to policy + giv doesnt really wanto as much more econ effienct + reduces need for at fertalisers) - november
* peoepl use parfin stoves and wood or biomass heaters in winte especilly ( much more poluitng)
218
what are the stratergeis delhi is using to deal with P25s damaging helth
* ( gov is proritsing growth )
* all indirrect strats
1. legislation against bueing stuble in feilds ( dont want to eforce as effient = acts as fertalisers) ( also hard and epensive to police)
2. rapid spead cleaner en metro system in 14 citis to try help reduce relince of cars
**inernational**
1. whos drafted road maps to help deal with cansa - ignored
219
what are the two types of stratergies to try and tackle disease
* dirrect - dealing with health cosnern dirrectly
* idirrect - deal with cause of health cosnern ( publci health foccused)
220
insiad GDP per acp
* 2,300 ( but alsot of inequllity0
221
whats indias HDI
0.645
222
what dirrect strats are bing used in etheopia to tackle / reduce the impacts of malaria ( **mittiagate agist disease and respond to outbreaks**)
* **dirrect**
* indor spraying of insectersides -
1. 70 % decrese in infection rate ( sig)
2. could build amunity
3. rellatily cheap
* outdor spraying of insectersides
1. 70 % decrese in infection rate ( sig)
2. could build amunity
3. rellatily cheap
* anti malarial drugs
1. sig as 95% efefctive
2. only effective if early detection
3. only 385 of children treated still huge increse
4. expenisve - cycle of dep for etheopia econ
**AO2**
* 777 mill form bill and melinda gates foundtion to cover
* gets some of 4 bill of global fund
223
whats is the golabl fund
* funds disease errdiaction mainly of CD
* worth 4.2 bill
* funded by gov and large private sector
224
what indirrect stratergies are being used in ethopia to tackel mararia
* mosquito nets
1. only 26 % of people in afric ahev
2. have to be replaecd and cost
3. rellatily cheap
* eduction
1. longe term strat
2. now part of sillbus in schools, sympoms, how transmits and hwo to proetct ones self 11% of chldren dont get primary eduction
3. chren can teach comunity - PME
225
Uk dirrect strats to deal with Casnsa
* **from gov**
* compaulsary mass sreenign of bowel, cervial and brest canda anf incresing as one ages
* increased presision of radeo therapy and detection methods
1. e.g. mammograph for brest cansa screnign of 50-70 year olds - five-year survival rate for breast cancer in the UK is around 86%
* AO2 -
1. sproprat strategic dirrection of resources ( more at older peopel) and specific common cansas
1. 2. however expenisve - bowel cansa screenign costs 60 mill (olbly AC aford)
2. = ealy detection
3. cansa survival rate now around 50% in uk vs 41% in teh alst e 70s
4. free health care and kemo - can aford as AC - countries
5. many LICD dont have acess to expesive tec liek kemo and mammogrpahs
* **from cansa research UK**
* well funded as AC donors - 560 mill a year
* developing furutre tec lie genectic engeinearing to reduce ihenant cansa risks
* PARP inhibators prevent some types of cansas growing
226
give some indirrevt strats in teh uk to deal with Cansa
**from gov**
* eduction / imforationa dn capeigns, e.g risks, of smoking, alchohol, poor food "choises" etc - doesnt dela with ral issue which is pov and inequllity and failed to ignore lack of choise soem pwople have
1. manditory health edcution programs in schools
2. Be Clear on Cancer 2010 : Be Clear on Cancer is a series of campaigns that raise awareness of the signs and symptoms of specific types of cancer = early adoption
* legistaion
3. smiking legistion in late 2000s and early 2010 ( incluinf stopping iside and public spaces as well as warnign of images on pakages) in 2010 10% of men smoked vs 80 in in 1960 - luncg cansa reduces from 11/1000 to 6/1000 thoes years
* sugnificnat as estnated 38% of cansas are prevtable
* AO2- gov top doen huge significance
227
cansa spelling
cancer
228
why is hati relliant on NGO's
* poor
* needs help to break cycle of deprivatin
229
how mcuh has red cross giev to haiti
* close to 500mill
230
other than port - au - prince who did teh red cross supply with wayer
* refugree caps
* still had to boil water
231
how does WHO use breifs to provide internatinal strats to deal with disease outbreks
* identidy scale of out break and priority action areas and inform countries
* research health problems
* monetor sitution constantly
**exampels**
* covid
* world halth statsist very year publishes analising helth probalems around world - regular
AO2
* lareg scael - 194 meber counties and scienst + statistitans and researchers froma ll over world
232
how did WHO deal withoutbreaks though supporting gov
* 2015-14 libia mesals - helped train health care workers ( e.g to give vccien )
* chlleged as area of conflict
233
whos your exaple of an interntional ornagisation in a helth crisis
who
234
wy is who espeiclly important oday
* increased risk of pandemics = abillty for international cordianted reponce
235
what physical factors have a psositive an negtive efefct on disease reponce
* relif
* natural hazards
* exess water
* remotness of comunities
236
how natural hazrds effcets disease responce
**poss**
* resticts movemnt of peopel
* heavey raincan wipe out vectors
* can trigger larger and quicker mobalised responce as need aid for primary effects of disater too
1. chorella MSP nd red cross hyan chorella 2013 pliopines
**neg**
* conatminat water suppleis in first palce
1. ahiti all infstruture broek
* regugee caps - neighbourhhod effect
1. haiti ref cap at one point 20,000-40,000 peopel ( laregst after 2010) - facilitate spred of choreells
* damages infstruture reduce abillity to respond
237
howcan remotness of comunites effect the resonce to a disease outbreak
**poss**
* lisolate comunity slow spred giving aid more tiem
1. ebola west africa 2014
**neg**
* delay arival of medical supplies
1, gorka region of neapsl 2015 earth quake ( cut off land slide and chorella was becomgn issue)
* pupulation no aumity - sign with inceased global modbillity
* subsistance foarmers at risk of zoonotoc dieas
1. monoloan hurds men and etheopis malaria and degi feaver
238
* given an exaple of doubel burden
* south sudanses refugree cap Bibi Bidi in uganda now say 5% of all their cases of diseas are NCD but domt have aid to treat. this was from trase aount at start of conflcit jsut a declaid ago- double burden - this makes disease risk more significnat and harder to tavkle + many african countries dont have jemo
239
issues relating to harvi=sing rosy periwinkle + other natural medicines ( not huam )
* **conservation**
* may disapear with deforrestion (325km a day)
* rain forrest comtain 70% of all terrestrial planst - may never descover some vital medicnes
* 40,000 medical palnts threttened - 14 actully in dngered
**over harvesting**
* decrease biodiverity
* 80% of developing world relys on natural mediceines = huge demand - 5 bill
240
give an expale of a agreement that protecst costa reica from countries ahrvesting medicne from it
* in bio prodject - grentees 1 mill pridit for country and % of futuee profits too
241
who gives pharma comapnies the medicines
shamen
