Epidemiology Flashcards

1
Q

Epidemiology definition

A

Study of Distribution of determinants of health related states or events in specified populations and the application of the study to control health problems

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2
Q

Five questions to ask yourself in epidemiology

A
who has the health condition 
where is the health condition found 
when does the health condition occur
 why does the health condition exists 
how can Health condition be prevented
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3
Q

Three questions to ask yourself in disease specific epidemiology

A

What causes the disease
how is the disease transmitted
how do we break the transmission cycle

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4
Q

Objectives of epidemiology

A

Identify cause of health condition
determine extent of health condition in a community
study the natural history and prognosis of health condition
evaluate existing and newly developed preventive and therapeutic measures
provide foundation for public policy

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5
Q

Top 10 causes of death in Ghana

A
Malaria 
lower respiratory infection 
neonatal disorders 
ischemic heart disease 
Stroke
 HIV aids 
tuberculosis 
diarrheal diseases 
roads injuries
 diabetes
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6
Q

The five major cause of death in Ghana in children

A
Malaria 
diarrheal diseases 
respiratory infections 
anemia 
malnutrition
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7
Q

Type of prevention

A

primordial prevention
primary prevention
secondary prevention
tertiary prevention

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8
Q

Primordial prevention

A

You prevent occurrence of risk factors

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9
Q

Primary prevention

A

You prevent initial development of a disease

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10
Q

Secondary Prevention

A

You detect early existing disease to reduce severity and complications

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11
Q

Factors involved in interaction to form disease

A

Hosts
agents
environment

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12
Q

Host characteristics that could lead to disease formation

A
Age 
sex 
religion
Occupation
 marital status
 genetic profile 
immune status
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13
Q

Type of agent that could lead to disease fornation

A

Biological agents
chemical agents
physical agents n
nutritional agents

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14
Q

Environmental factors that could lead to disease formation

A
Housing 
crowding 
neighborhood 
water source 
toilet facilities
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15
Q

Transmission

A

Mechanism by which an infectious agents is transferred from one person to another OR from one Reservoir to a new host

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16
Q

Type of mode of transmission

A
Direct 
indirect 
intermediate host 
vectors 
zoonosis
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17
Q

Direct transmission

A

From human to human or auto infection

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18
Q

Indirect transmission

A

From single, multiple, or continuous exposure to one common vehicle

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19
Q

Intermediate host transmission

A

Transmission from snails, copepods,animals, worms

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20
Q

Vector transmission

A

From an insect to man

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21
Q

Zoonotic Transmission

A

Animal disease now presents in man

Transmissible by bites or food

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22
Q

How can a host resist to a disease

A

Through acquired immunity like infection vaccination or passive immunity from mother to child

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23
Q

Factors that can Impact the hosts immunity

A
Age 
sex 
pregnancy
 nutrition 
trauma
 fatigue 
herd immunity
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24
Q

Type of environment

A

Physical
biological
social

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25
Q

Physical environments

A

Nonliving part like air water soil temperature

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26
Q

Biological environment

A

Living things like plants animals micro organisms

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27
Q

Social environment

A

Man-made lake community culture government

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28
Q

Factors that can affect environment

A

Climate like temperature
seasonality which includes interaction of climate food culture
education with knowledge that can cause modified behaviors
resources like poverty

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29
Q

Susceptibility to disease

A

Measure of a person risk of acquiring a disease

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30
Q

Factors that determine susceptibility to disease

A

Genetics
nutrition
immune system

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31
Q

Stages of disease

A

Preclinical
subclinical
persistent disease
latent disease

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32
Q

Clinical disease

A

Disease with signs and symptoms

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33
Q

Carrier status is

A

Individual has disease organism but is not infected as measured by serological studies or by evidence of clinical illness

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34
Q

Levels of disease

A
Sporadic 
endemic
 hyperendemic 
epidemic 
pandemic
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35
Q

Endemic disease

A

Is this a bit chilly present within geographical area

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36
Q

Epidemic disease

A

Excessive presents of a disease from what is expected

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37
Q

Pandemic

A

Worldwide epidemic

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38
Q

What can cause a disease outbreak

A

A common vehicle exposure

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39
Q

Characteristics of an outbreak from a common vehicle with single exposure

A

Explosive (Sudden and Rapids)

limited (Only people that share a common exposure)

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40
Q

Herd immunity

A

Resistance of a group of people to a disease because a large proportion of the members of the group are immune

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41
Q

Conditions for herd immunity

A

Disease agent only in single host species
Direct transmission
Solid immunity after infection

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42
Q

Incubation period

A

Time interval between contracting an infection and onsets of clinical illness

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43
Q

Epidemic curve

A

Distribution of time of onset of disease

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44
Q

Attack rate formula

A

Number of suspected person exposed to illness who became ill/ number of persons exposed overall

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45
Q

Case distribution

A

Case distribution on terms of time and place

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46
Q

Control measures of epidemics

A

Control of current outbreak

Prevention of future oitnreak

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47
Q

System used when there’s several possible causal agents to an outbreak

A

Cross tabulation in outbreak investigation

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48
Q

Prevention definition

A

Measures not only to prevent occurrence of disease such as risk factor reduction, arrest it’s progress , reduce its consequences once established

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49
Q

Levels of prevention

A

Primordial
Primary
Secondary
Tertiary

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50
Q

Primordial prevention

A

Prevention of risk factors

Change in social and environmental conditions

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51
Q

Primordial prevention important for what type of diseases

A

Chronic diseases

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52
Q

Primordial Prevention définition

A

Prevention of the emergence of living patterns that contribute to increased risk of disease

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53
Q

Types of primordial Prevention

A
Legislation 
taxation 
code of practice
 health promotion 
Avoidance of risks
 genetic counseling 
diet nutrition
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54
Q

Primary prevention Purpose

A

Limits the incidence of disease by controlling causes and risk factors

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55
Q

Two strategies of primary prevention

A

Average risk population strategy

high-risk individual strategy

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56
Q

Advantages of average risk population strategy

A

It’s radical

large potential for a whole population

behaviorally appropriate

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57
Q

Disadvantages of average risk population strategy

A

Small benefits to individuals

poor motivation of subjects

poor motivation of physicians

benefits to risk Ratio low

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58
Q

High-risk individual strategy advantages

A

Appropriate for individuals

subject motivation

physician motivation

favorable benefits to risk ratio

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59
Q

High-risk individual strategy disadvantages

A

Difficulty in identifying high-risk individual

temporary effects

limited effects

behaviorally inappropriate

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60
Q

Secondary prevention

A

Cure patients and reduce the more serious consequences of this is through early diagnosis and treatment

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61
Q

At what time In disease timeline do you use secondary prevention

A

During onset of diseaSe and normal time of diagnosis

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62
Q

What type some type of secondary prevention

A

Opportunistic or targeted screening

Improving uptake of services

allowing affordable self-care

Clinical services

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63
Q

What are the clinical services in secondary prevention

A

National technical guidelines

available clinical and preventive services

quality of care

institutional capacity

available and affordable drugs and diagnostic tests

quality of generic drugs

drugs prophylaxis

laboratory available

personnel available

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64
Q

Tertiary prevention

A

Reducing the progress of complication of an established Disease
Try to reduce impairment,
disabilities, suffering,
and promotes patients adjustments to incurable conditions

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65
Q

Some type of tertiary prevention

A
Surgery
 prosthesis 
occupational therapy
 physiotherapy
 speech therapy
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66
Q

What are the 3 steps in epidemiology

A

Count number of events in population

Divide number of events by number of person in that population

Compare rate from different population and infere about existing differences

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67
Q

Types of measures used in health and disease

A
Count 
Proportion
Ratio
Rate
Prevalence
Incidence
Mortality rates
Cumulative incidence 
Risk
Incidence density
Adjused rates 
Public health indices
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68
Q

What is count

A

Number of cases of a disease or health problen being studied

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69
Q

What is proportion

A

Fraction in which numerator is included in denominator

Usually expressed as percentage

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70
Q

Why are counts still useful in epidemiology

A

For some disease even one case is still a problem like smallpox

Can lead to investigations of usual disease

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71
Q

What is a ratio

A

Fraction in which the numerator is not included in the denominator

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72
Q

What is rates

A

Numerator over a denominator over a perdiod of time

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73
Q

What is prevalence

A

Proportion of individuals in a population who have the disease at a specific point in time or over specified period
Numerator has new and old cases

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74
Q

What is incidence

A

Number of cases at particular time who newly have the disease
Numerator has only new cases

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75
Q

When is prevalence useful

A

In case of chronic disease

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76
Q

When is points prevalence useful

A

In case of episodic prevalence

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77
Q

When is period Prevalence useful

A

In case of lifetime prevalence especially suitable for cases in which type of onset of illness is not known especially for psychiatric cases

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78
Q

Incidence rates definition

A

Number of new cases of disease in a group over a certain time. Over the amount of personal time during which the new cases arose

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79
Q

Why is it important to know characteristics of person and the time in the incidence rates

A

Because the denominator exclude any individuals had already disease of interest or are not capable of developing the disease in a specific period of time

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80
Q

What is incidence density

A

Number of new cases of disease in specified period of time over the number of person time at risk during the period

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81
Q

What is cumulative incidence

A

Number of new cases of disease in specific time over the total number of disease-free individuals at the beginning of the specified time

What is the probability that an individual disease-free beginning of time. Will develop the disease in that given period time

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82
Q

What is the relationship between prevalence and incidence

A

Prevalence depends on incidence rates and duration of the disease

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83
Q

What are two examples of public health rates

A

DALYs

QALYs

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84
Q

What is DALYs

A

Disability adjusted life years which is the measure of the burden of disease on a population and the effectiveness of intervention

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85
Q

What is QALYs

A

The quality adjusted life years which is the adjustment of life expectancy taking into account the presence of chronic conditions causing appointment disability or handicap

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86
Q

What is the only event in life with long-term probability of one with certainty for a living person’s

A

Death

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87
Q

Counts as a mortality measure

A

Count the number of deaths from particular disease

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88
Q

Rates in mortality measure

A

Number of deaths due to particular disease over a group over a period of time

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89
Q

What is the annual mortality rates

A

Is the all cause mortality rate for sub groups based on age or gender or area

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90
Q

What is the cause specific mortality rates

A

It is it is it specific mortality rates which is limited to a particular diagnosis

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91
Q

Case Fatality rates

A

Proportion of persons with a particular disease that die from the disease

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92
Q

Proportionate mortality

A

Proportion of all deaths caused by specific diseases in a period

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93
Q

Years of potential life lost

A

Measure of premature mortality

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94
Q

Mortality rates

A

Incidence rates of the witches number of deaths over mid yyear population

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95
Q

Crude mortality rates

A

Ratio of number of deaths during the year over average population in that year

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96
Q

Age specific mortality rates

A

Natality rate calculated for specific age bands

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97
Q

Age adjusted mortality rate

A

Process to even out the effect of different age distribution went to a more mortality rates from two different populations are being compared

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98
Q

Odds of disease

A

Number of new cases of disease in. Time over the number of persons with did not become a case during the time. But could have potentially become cases

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99
Q

What are some public health indices

A
Crude mortality rates
 birthrates 
fertility rates
 infant mortality rates 
neonatal mortality rates 
maternal mortality rates
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100
Q

What are the two big divisions of epidemiological studies

A

observational

experimental

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101
Q

What are the two division of observational epidemiological studies

A

Descriptive

analytical

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102
Q

What are the possible study done in descriptive observational epidemiological studies

A
Case Reports
Case series
Cross sectional 
Prevalence studies
Ecological studies
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103
Q

What are the different type of observational analytical epidemiological studies

A

Case control
cohort studies

cross-sectional

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104
Q

What are the different type of experimental epidemiological studies

A

Clinical trials
field trials
community trials intervention

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105
Q

What are the different components of epidemiological studies about

A

Study factor
study subjects
exposure
Health outcome or disease

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106
Q

Is observational studies manipulated randomized?

A

Neither

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107
Q

Is experimental studies manipulated or randomized

A

Yes both

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108
Q

Is quasiexperimental studies manipulated or randomized

A

manipulated but not randomized

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109
Q

What factor can have a relationship with disease

A

Exposure

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110
Q

In observational studies who determines the exposure

A

The subjects

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111
Q

Why are most epidemiologic studies observational

A

Because experimental studies are mostly impractical and unethical

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112
Q

Advantages of observational studies

A
Natural setting
No ethical concern
Low Cost
Convenience 
Data already existing
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113
Q

Disadvantages of observational studies

A

No randomization

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114
Q

What is descriptive studies

A

Study that presents occurence and distribution of disease

Organizes and summarizes data accordiing to person , place and time

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115
Q

3 questions in descriptive study

A

Who has been affected
Where have they been affected
When have they been affected

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116
Q

When is descriptive studies for individual useful

A

To show individuals healths characteristics
estimate disease frequency
extent of public health problem
identify populations at greatest risk
estimate time trends
planning and health care resource allocation
suggest hypothesis about causation

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117
Q

What’s do you use to perform descriptive study analysis

A

Tables
rates
Measures of central location of dispersion
graphic charts maps

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118
Q

How do you determines where whos at risk in descriptive study

A
Demographics (Age, sex,ethnicity)
socioeconomic background (Education ,occupation ,access to services )
Other factors (blood group ,vaccination status ,smokers)
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119
Q

How do you present data from who is at risk in Descriptive study

A

Tables or graphs

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120
Q

How important is age in descriptive study and why

A

Very important as it reflects susceptibility, differences in exposure ,latency incubation period

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121
Q

How does sex play into descriptive study

A
Men and women are different in 
susceptibility 
physiological response
 exposure due to habits, occupation 
service utilization
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122
Q

How do you present that comparing men and women in descriptive study

A

table

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123
Q

What information does place gives in descriptive study

A

Geographic distribution
cluster of cases
dissemination route

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124
Q

What means of presentation do you use to show place impact in descriptive study

A

Maps

Charts

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125
Q

How does time play into descriptive study

A

Variation of a time of health events which could be annual seasonal daily hourly
interested in onset of symptoms date of reporting

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126
Q

How do you present time data in descriptive study

A

But using X and why system which shows magnitude of the problem ,trends and potential evolution ,type of transmission

127
Q

How do you presents an outbreak

A

Epidemic curve

128
Q

How do you present seasonal trends

A

Linear graphic over weeks months or year

129
Q

How do you present secular trends

A

Using period Including several years which of those to predict evolution and study effective control measures over events

130
Q

Characteristics used in case report in individual descriptive study

A

Person ,place and time

131
Q

Characteristics used in case series in individual descriptive study

A
Age
 sex 
Place 
time numbers 
and proportions
132
Q

Characteristics used in cross-sectional survey in individual descriptive study

A

Describe defined characteristics

133
Q

Who isn’t of interest in a case reports

A

The individual is the units of observation available for study essentially the one with the unusual clinical picture

134
Q

How do you form a case series

A

By compilation of additional case report when initial case report

135
Q

What are the advantages of using case reports or case series

A

Use available clinical data
detailed individual data
suggest strong need for investigation
hypothesis generation

136
Q

What are the disadvantages of case reports or case series

A

May only reflect experience of one person or 1 clinician

no explicit comparison group

137
Q

How is the timing of cross-sectional study

A

Always retrospective

138
Q

Variable measured in cross-sectional study

A

Prevalence studies

Useful for events like chronic ,common ,or not fatal disease

139
Q

How do you classify participant in cross-sectional survey

A

By exposure and the disease status

140
Q

How do you analyze data in cross-sectional study

A

Using 2 x 2 table

141
Q

Benefits of cross-sectional study

A

Convenient
quick
inexpensive
can consider several exposures ,several disease
useful for Exploration
can generate hypothesis
can study entire population or a representative sample
provides estimates of prevalence for factors measured
standardize data collection tool I
access health studies and health care needs of a population
can be repeated to get trends

142
Q

Disadvantages of cross-sectional study

A

Cannot study time sequence
cannot study causality
estimate prevalence not incidence
possible bias because of any survivors available
better for generating hypothesis not for for testing hypothesis
not good for rare disease or exposure

143
Q

Who are the units of observation in ecological studies

A

Population or group of people

144
Q

What are dara used in ecological study to describe disease rates

A

Incidence rates
Prevalence
Mortality rate

145
Q

Data used to describe exposure rate in ecological study

A

Economic development measure
environmental measures
measures of lifestyle

146
Q

Advantages of ecological studies

A

Easy to do use
available data
generate hypothesis for additional study

147
Q

Disadvantages of ecological studies

A

Unable to examine data for individuals
no assurance that persons with exposure of interest are the same ones with the outcome of interest
association at the aggregate level may not reflect association of the individual level
No Adjustmentfor potential confounding factors

148
Q

What is the ecological fallacy in ecological studies

A

Observation made a group devil may not represent exposure disease relationship of the individual level

149
Q

When designing a cohort studies, what prefactor do you identify first in participants and what do you follow over time

A

You identify if they were exposed or not to something

You follow if they developed a specific disease over time or not

150
Q

How do you calculate incidence rate in cohort study for people that were exposed

A

people exposed and had disease / total of people exposed

151
Q

How do you calculate incidence rate in cohort study for people that were unexposed

A

people unexposed and had disease / total of people unexposed

152
Q

How do you calculate relative risk in cohort study

A

Incidence rate of people exposed / incidence rate of people unexposed

153
Q

Is there randomization in cohort study

A

No

154
Q

Types of cohort study

A

Prospective cohort study
Retrospective cohort study
Combined retro and prospective cohort study

155
Q

What is propesctive cohort study

A

Following actual population

156
Q

What is retrospective cohort study

A

Using old data to study old population

157
Q

What is combined prospective retrospective study

A

Use data collected in past to define population expose and unexposed
Follows population defined in future

158
Q

Advantages of cohort study

A

High evidence rate
Clear time relationship established
Can study multiple outcome
Useful for rare exposures

159
Q

Disadvantages of cohort study

A

Can’t study multiple exposure
Expensive
Can lose follow up
Take long for results

160
Q

When is cohort study advised

A
Need longitudinal data overt time in sequence 
Exposure rare but outcome high 
Short time between exposure and outcome 
High funds available 
If minimized loss to follow up possible
161
Q

Type of risk in cohort study

A

Absolute risk
Relative risk
Attributable risk

162
Q

What is absolute risk in cohort study

A

Same as incidence rate in a group

163
Q

What is relative risk in a cohort study

A

Ratio of incidence rate of exposed to unexposed

164
Q

What is attributable risk

A

Increase in risk in exposed group compared to unexposed group
Incidence rate of exposed - incidence rate of unexposed

165
Q

What is a bias in epidemiological studies

A

Systematic error in design , conduct or analysis of a study resulting in mistaken estimate of an exposure effect over a disease

166
Q

Types of biases in cohort study

A
Selection bias 
Information bias
Bias in assessment of outcome 
Non response bias
Analytic bias
167
Q

Selection bias in cohort study

A

Whether exposed or unexposed groups have same background characteristics

168
Q

Information bias in cohort study

A

More information on diseased in restrospecive cohort study

169
Q

Bias in assessment of outcome in cohort study

A

More Diagnostics applied to exposed in measuring outcomes

170
Q

Non response bias in cohort study

A

People lost to follow up when not same disease experience as others

171
Q

Analytic bias in cohort study

A

Analytic methods not defined beforehand

172
Q

What is a cross sectional study

A

Observational study in which exposure and disease are determined at same point in time

173
Q

Can you determine temporal relationship between disease and exposure Erin cross sectional study

A

No

174
Q

Steps in designing cross sectional study

A
Define population
Gather data on exposure and disease 
Create groups 
- exposed have disease
- exposed, no disease
- not exposed, have disease 
- not expose , no disease
175
Q

What are the two ways to analyze cross sectional study

A

Prevalence of exposure in disease and no disease

Prevalence of diseases in exposed and not exposed

176
Q

Formulas for prevalence of exposure in disease and not disease

A

Exposure and disease / disease present in both exposed and non exposed

exposed and no diseas / no disease in both exposed and non exposed

177
Q

Formulas for prevalence of disease in exposed compared to not exposed

A

Exposed with disease / people exposed

Not exposed with disease / people not exposed

178
Q

What type of calculations do you use in cross sectional studies

A

Odds ratio

179
Q

Cross sectional studies usage

A

Determine prevalence of outcomes of interest
Determine burden of disease
Association between exposure and outcomes
Useful questions for further studies

180
Q

National cross sectional studies

A

Ghana demographic and health surveys

Ghana maternal health survey

181
Q

When do you do case control study

A

When cohort study not easily applicable

182
Q

Definition of case control study

A

Comparison of exposures, characteristics and behaviors of population with a particular disease to the same population without the disease

183
Q

In case control study is there
A - multiple outcome , one exposure
B - one outcome , multiple exposure

A

B

184
Q

Steps of case control study

A

Identify disease
Identify control group - non diseased people
Document exposure among cases and controls
Calculate odd ratio
Perform statistics , confidence interval

185
Q

How do you identify cases in case control study in health setting

A

Surveillance

186
Q

How do you identify cases in case control study in planned study

A

Hospitals
Disease registries
Other

187
Q

Do you use incident cases or prevalent cases in case control study

A

Incident

188
Q

Factors in picking case in case control study

A

Clinical criteria
Time
Place
Person

189
Q

Conditions to pick control in case control study

A

Should not have disease being studieD
Represent population of interest
Represent persons that could have been a case in the study if there is disease
Selected independently of exposure

190
Q

Why are controls important in case control study

A

Estimation of prevalence of exposure in population

Expected prevalence of exposure among cases if no association

191
Q

Sources of controls in case control study

A
Population based
Hospital 
Clinic 
Neighbors 
Friends
Other
192
Q

Sampling method used to chose control in study control study in community
Advantages ? Disadvantages ?

A

Probability sample or Random digit dialing

Best representation
Least biased if high participation

Time consuming
Expensive
Low participation
Biased if poor participation

193
Q

Advantages of choosing controls in same hospital or clinic as cases in case control study

Disadvantages ?

A

Convenient
Same catchment area

Control disease may be linked to exposure
Hospitalized control may differ from general population

194
Q

Advantages and disadvantage of choosing controls in same neighborhood as cases in case control study

A

Inexpensive
Efficient
Confounding variables

Exposure related to neighborhood
Potential bias

195
Q

Advantages and disadvantages of picking controls bases on friendship with case in case control study

A

Convenient t

Bias
May share same exposure

196
Q

Advatanges and disadvantages of picking controls form hospitals and clinic in case control study

A
Easier to identify 
Less expensive 
Good participation rate 
Better recall of recent exposure 
Good source population 

Difficult to chose appropriate conditions and illnesses for control

197
Q

Advatanges and disadvantages of choosing neighbors or friend for case control study

A

High participation rate
Inexpensive

May Not representative
May Not suitable nominee
May not have name
May have common exposure

198
Q

Factors affecting of number of control in case control study

A

Availability
Ratio controls / cases
Cost vs power
Power calculation

199
Q

How to assess exposures in case control study

A

Questionnaires
Preexisting records
Biomarkers

200
Q

Odds ration calculation in case control study

A

(Exposed case x unexposed control ) / (exposed control x unexposed case)

201
Q

Statistics used to determine if odd ratio in case control study chance or accurate

A

P value from chi square

Confidence interval

202
Q

Chi square , confidence interval

A

Go practice

203
Q

Case control advantages

A
Quick 
Inexpensive 
good for rare disease
Good for disease with long latency
Study multiple exposure 
Fewer subjects 
Few ethical problems
204
Q

Case control study disadvantages

A

Can’t measure disease risk
Determination , selection, enrollment of appropriate control group
Recall or records for info on past exposure limited
Not good for rare exposure
Less familiar to non epidemiologist

205
Q

Non communicable disease definition

A

Chronic conditions that do not result from infection process and can’t be communicated

206
Q

Characteristics of non communicable disease

A
Prolonged course
Does not resolve spontaneously 
No complete cure
Complex etiology 
Multiple risk factors 
Long latency period 
Non contagious origin 
Functional impairment or disability
207
Q

Types of NCDs

A
CVDs
Cancer 
Chronic respiratory disease
Diabetes
Chronic neurological disorders
Arthritis / musculoskeletal diseases 
Unintentional injuries
208
Q

Social class most affected by NCD by 2030

A

Middle class

209
Q

Major NCD

A

Cardiovascular diseases

210
Q

Risk factor definition

A

Aspect of personal behavior , lifestyle , environmental exposure or hereditary characteristics associated with increase in occurrence of a particular disease, injury, health condition

211
Q

What is a modifiable risk factor

A

Behavioral risk that can be reduced or controlled by intervention which reduces risk of disease

212
Q

Main 4 modifiable risk factor

A

Physical inactivity
Tobacco use
Alcohol use
Unhealthy diets

213
Q

Non modifiable risk factors examples

A

Age
Sex
Race
Family history

214
Q

Cardiovascular common risk factors

A

Tobacco
Diet unhealthy
Physical inactivity
Alcohol

215
Q

Diabetes common risk factors

A

Tobacco
Diet unhealthy
Physical inactivity
Alcohol

216
Q

Cancer common risk factors

A

Tobacco
Diet unhealthy
Physical inactivity
Alcohol

217
Q

Chronic respiratory disease common risk factors

A

Tobacco

218
Q

4 metabolic risk factors

A
Raised blood pressure
Raise total cholesterol 
Elevated glucose
Overweight 
Obesity
219
Q

Main diseases of cardiovascular disease NCDs

A

Coronary heart disease
Cerebrovascular disease
Peripheral arterial disease
Congenital heart disease

220
Q

What are coronary heart disease

A

Disease of blood vessels supplying heart muscles

221
Q

What are cerebrovascular disease

A

Disease of blood vessels supplying the brain

222
Q

What are peripheral arterial disease

A

Disease of blood vessels supplying arms and legs

223
Q

What are congenital heart disease

A

Malformation of heart stricte existing at birth

224
Q

Main cause of cardiovascular disease

A

Atherosclerosis with fat deposition in blood vessel s

225
Q

Number 1 of cause of death globally

A

CVDs

226
Q

7.3million persons died because of …. And 6.2 died because of …

A

Coronar heart disease

Stroke

227
Q

Main economic classes exposed to CVD with 80% deaths pertaining to those grou0ps

A

Low and middle income

228
Q

By 2030 , how many people will die from CVD

A

25 million

229
Q

Major modifiable risk factors to CVDs

A
High blood pressure
Abnormal blood lipids
Tobacco
Physical inactivity 
Obesity 
Diabetes
Diet
230
Q

Other less important modifiable risk factor for CVDs

A
Low economic status 
Mental illness
Psychosocial stress
Alcohol use
Certains Medications 
Lipoprotein
231
Q

Non modifiable risk factors to CVDs

A
Âge 
Hereditary or family history 
Gender 
Ethnicity 
Race
232
Q

Novel risk factors for CVDs

A

Excess homocysteine in blood

Inflammatory markers like c reactive protein

Abnormal blood coagulation due to high fibrinogen

233
Q

Diabetes definition

A
Metabolic Disorder of 4 types 
Type 1 
Type 2
Gestational 
Pre diabetes
234
Q

What causes type 2 diabete

A

Modifiable risk factors

235
Q

Main type of diabetes

A

Type 2 - 90%

236
Q

Number of people worldwide with diabetes

A

347m

237
Q

Main economic classes that does because of diabetes

A

Low and middle

238
Q

Projected increase of diabetes by 2030

A

2/3 more

239
Q

How to prevent or delay diabetes

A

Healthy diet
Physical activity
Normal body weight
Avoid tobacco

240
Q

Major modifiable risk factors for diabetes

A
Unhealthy diets 
Physical inactivity 
Obesity 
Overweight 
High blood pressure
High cholesterol
241
Q

Other modifiable risk factors for diabetes

A
Low socioeconomic status s
Alcohol 
Stress
High sugar intake 
Low fiber intake
242
Q

Non modifiable risk factors for diabetes

A
Increased age 
Genetics 
Family history 
Race
Fat distribution
Low birth weight 
Autoantibodies
243
Q

Cancer definition

A

Abnormal cells that grow beyond usual boundaries and invade adjoining parts of the body

244
Q

Number of people that died due to cancer in 2008

A

7.6m

245
Q

Main economic class concerned with cancer death

A

Low and middle income (70%)

246
Q

Is it true that 30% of cancer attributable to behavior risk factors

A

Yes

247
Q

Cancer with most incidence

A

Breast

248
Q

Cancer with more mortality

A

Lungs

249
Q

Cervical cancer definition

A

Cancer of female reproductive system which can be squamous and glandular

250
Q

Main infection linked with cervical cancer

A

HPV (99%)

251
Q

Risk factors of cervical cancer

A
HPV
Smoking 
Immune deficiency 
Poverty
No pap screening 
Family history
252
Q

What is lung cancer

A

Cancer that forms in the lungs usually in cells lining air passages

253
Q

Does lung cancer affect more women or men

A

Men

254
Q

Two main types of lung cancer

A

Small cell lung cancer

Non small cell lung cancer

255
Q

Lung cancer risk factors

A
Smoking (cigarettes, cigars, pipes )
Second hand smoke 
Radiation therapy to breast or chest 
Asbestos, radon, chromium , nickels, arsenic , soot, tar
Air pollution
256
Q

What is breast cancer

A

Cancer that forms in the tissues of the reacts usually in the ducts or in the lobules

257
Q

Main sex affected by breast cancers

A

Women

258
Q

1/8 women affected with breast cancer, T or F ?

A

True

259
Q

Breast cancer risk factors

A
Hormone therapies
Weight and physical activity 
Race
Genetics 
Âge (most reliable )
260
Q

2nd most common cancer amongst men

A

Prostate cancer

261
Q

Risk factors of prostate cancer

A

Âge
Race
Obesity
Weight gain

262
Q

3rd most common type of cancer

A

Colorectal cancer

263
Q

Risk factors of colorectal cancer

A
Aging
Black race
Unhealthy diet
Low exercise
Diabetes 
Family history
264
Q

Economic class of countries more prone to death with chronic respiratory disease

A

Low income countries (90%)

265
Q

Risk factors of chronic respiratory disease

A
Cigarette 
Occupational dust and chemicals 
Environmental tobacco smoke 
Indoor and outdoor pollution 
Gènes 
Infections
Socioeconomic status 
Aging population
266
Q

COPD definition

A

Lung diseases that’s prevent proper lung inflation

267
Q

Type of COPD

A

Chronic bronchitis

Emphysema

268
Q

Number of people that died due to COPD

A

3millions

269
Q

Asthma definition

A

Recurrent attacks of breathlessness and wheezing

270
Q

Is asthma under diagnosed

A

Yes

271
Q

Can medications help control asthma

A

Yes

272
Q

Challenges in surveilling NCDs

A

Lag time between exposure and condition
Multiple exposure responsible for condition
One exposure leading to multiple conditions

273
Q

How can you reduce NCDs

A

Attacking risk factors

274
Q

Main risk factors leading to death

A
High bp 
Tobacco 
High blood glucose
Physical inactivity 
Obesity
275
Q

Tobacco kill 1/2 of its users, T or F

A

T

276
Q

Expected deaths by 2030 due to tobacco

A

8m

277
Q

80 % of smoker in which economical clas countries

A

Low and middle income countries

278
Q

Health effects of tobacco for users

A
Cancer 
Coronary heart disease
Disease of lungs 
Peripheral vascular disease
Stroke
Still birth 
Fetal complication
279
Q

Health effects of second hand smoke

A

Heart disease
Heart attack
Lung cancer

280
Q

Health effets of unhealthy diets

A
Coronary heart disease
Stroke
Cancer
Type 2 diabetes
Hypertension 
Liver gallbladder disease
Obesity
281
Q

Percentage of world population with not enough physical activity

A

31

282
Q

Reasons for Low physical activity worldwide

A

Aging pop
Transportation
Communication technology

283
Q

Health effects of low physical activity

A
Coronary heart disease
TPE 2 diabetes
Breast cancer 
Colon cancer
Premature mortality
284
Q

Percentage of world population that are episodic or heavy alcohol drinkers

A

11.5

285
Q

Is consumption of alcohol increasing or steady with time

A

Steady

286
Q

What is excessive drinking for a men ? A women ?

A

More than 2 beers per day for a men

More than 1 beer a day for a woman

287
Q

What is harmful binge drinking for a men ? A woman ?

A

More than 5 beers men

More than 4 women

288
Q

What is considered an excessive women drinker

A

8 or more drinks per week

289
Q

What is considered excessive drinking for men

A

15 or more drinks per week

290
Q

Immediate harmful effect of alcohol use

A
Reduced brain function 
Loss of body heat 
Fetal damage 
Unintentional injuries
Violence 
Coma 
Death
291
Q

Long term harmful effect of alcohol use

A
Liver disease
Cancer
Hypertension
Git disorders 
Neurological issues
Psychiatry issue
292
Q

Metabolic risk factors

A
Hypertension 
Cholesterol 
Blood glucose
Overweight 
Obesity
293
Q

Normal blood pressure

A

Systolic less than 120

Diastolic less than 80

294
Q

Prehypertensive measures

A

120-139

80-89

295
Q

Hypertensive measures

A

More than 140

More than 90

296
Q

Leading risk factors for stroke

A

High blood pressure

297
Q

Complications of hypertension

A
Heart failure 
Peripheral vascular disease
Renal impairment 
Retinal hemorrhage 
Visual impairment
298
Q

Source of sodium intake in 75% of cases inn the US

A

Restaurants and processed foods

299
Q

Source of sodium intake in 75% of cases inn the Japan , china

A

Cooking with high sodium products

300
Q

Recommended salt intake per day

A

Less than 5g

Or 2000 milligram

301
Q

Number of deaths due to high glucose

A

3.4m

302
Q

Leading cause of renal failure

A

Diabets

303
Q

Major cause of heart and renal diseases

A

Raised glucoses

304
Q

What is overweight and obesity

A

Abnormal or excessive fat accumulation that presents a risk to health

305
Q

BMI formula

A

Weight in kg / height in cm sqaured

306
Q

Overweight bmi

A

25-29.9

307
Q

Obesity bmi

A

More than 30

308
Q

Assessment of obesity and overweight

A

Bmi
Skinfold thickness test
Waist to hip circumference ratio

309
Q

Waist to hip circumference ratio for men and women

A

Men more than 102cm

Women than 88cm

310
Q

Health effects of obesiy

A

Coronary hear disease
Type 2 diabetes
Hypertension

311
Q

WHO global targets to reduce NCDs by 25%

A

Decreased blood pressure 25%
Smoking reduced by 30%
Reduce salt intake 30%
Increase physical activity 10%

312
Q

Stomach cancer types

A

Adénocarcinoma

313
Q

Risk factors stomach cancer

A

Smoking
Family history
H pylori
Diet

314
Q

Liver cancer risk factors

A
Sex
Âge
Chronic hepatitis 
Diabetes 
Cirrhosis 
Heavy alcohol 
Obesity