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Pharmacy Year 4 > Global Health 3 Topics > Flashcards

Global Health 3 Topics Flashcards

1
Q

Give 6 treatment options for malaria.

A 
Quinine
Atovaquone
Proguanil
Sulfadoxine-pyrimethamine
Amodiaquine
Artemisinin
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2
Q

What is considered the most effective treatment against malaria?

A

Artemisinin combination therapy with lumefatrine

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3
Q

What was the first drug effective against P. falciparum?

A

Quinine

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4
Q

How many infections of malaria were recorded in 2010?

A

216 million

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5
Q

How many deaths due to malaria occur yearly?

A

0.6-0.8 million

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6
Q

What is the estimated cost of malaria to Africa yearly?

A

$12 billion

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7
Q

What percentage of malaria cases/deaths occurred in Sub-Saharan Africa in 2018?

A

Sub-Saharan Africa was home to 93% of malaria cases and 94% of malaria deaths

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8
Q

What is the trend in malaria mortality rates?

A

29% reduction in malaria mortality rates globally since 2010

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9
Q

Which strain is the most common cause of malaria?

A

P. falciparum

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10
Q

What is the trend in uptake of insecticide treated mosquito nets?

A

50%of all people at risk were protected by an ITN in 2017 compared to 29% in 2010

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11
Q

Which 6 countries account for the largest number of cases of malaria?

A

Nigeria 25%
Congo (DRC) 12%
Uganda 5%
Côte d’Ivoire, Mozambique and Niger were 4% each

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12
Q

What proportion of malaria deaths are children under 5?

A

67% of all malaria deaths in 2018

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13
Q

What is the cost of an insecticide treated mosquito net?

A

$2 and lasts 3-4 years

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14
Q

What is the cost of a course of malaria vaccines?

A

$39.80 per vaccinated child

$5 per dose

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15
Q

What are the 3 key impacts climate change will have on malaria?

A

Temperature increase has been shown to increase mosquito abundance tenfold for every 0.1°C
260-320 million more people affected by malaria by 2080 as result of new transmission areas
Additional rainfall and water pooling as a result of typhoons leads to fresh mosquito sites
Drought could also increase cases if water stored in homes becomes mosquito breeding sites

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16
Q

What is the 4th leading cause of death in children under 5?

A

Diarrhoea at 8.6%

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17
Q

Which countries have the highest diarrhoea related child mortality rates?

A

Chad and Niger between 450-600 per 100,000

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18
Q

What proportion of cases of diarrhoea are due to rotavirus?

A

40%

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19
Q

How many child deaths due to rotavirus occurred in 2013?

A

215,000

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20
Q

What proportion of people have limited access to drinking water and sanitation?

A

Worldwide, 780 million individuals lack access to improved drinking-water and 2.5 billion lack improved sanitation.

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21
Q

How many deaths due to cholera occur every year?

A

130,000

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22
Q

How many deaths due to dysentery occur every year?

A

100,000

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23
Q

What is the first line treatment for cholera?

A

Doxycycline

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24
Q

What is the first line treatment for amoebic dysentery?

A

Metronidazole with pyromycin or lodoquinol

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25
Q

Name 3 treatment options for resistant dysentery.

A

Ampicillin
Co-trimoxazole
Fluoroquinolone

26
Q

What benefits do zinc supplements have in diarrhoea?

A

Zinc supplements reduce the duration of a diarrhoea episode by 25% and are associated with a 30% reduction in stool volume

27
Q

Describe the 3 key findings from Haller et al.

A

The most cost-effective intervention across all sub-regions was disinfection at point of use
Piped water supply and sewer connection would achieve maximum health gains but investment and recurrent costs would also be quite important
The expected annual cost of chlorination at point of use was from $3 million

28
Q

What is the trend in expenditure on vaccinations in low income countries?

A

In 2000, the annual expenditure on vaccination in low-income countries averaged $6 per live birth, but by 2015, it will exceed $30 per live birth

29
Q

What is the cost of rotavirus vaccinations to low income countries?

A

In 2015, GlaxoSmithKline offered to provide its vaccine at $2.50

30
Q

What are the cost considerations for implementation of the rotavirus vaccine?

A 
Cold chain
Waste management
Transport for outreach and distribution
Training of volunteers and refresher courses
Supervision
Media information/education
Evaluation and monitoring
Service delivery
31
Q

Which countries have the largest number of diarrhoea associated deaths?

A

India and Nigeria, contributing 42% of all child deaths in 2015

32
Q

How many deaths occur yearly due to suicide?

A

800,000

For every death, there are 20 attempts

33
Q

Where has the highest suicide rate?

A

Guyana

Lithuania, South Korea and Russia are in the top 5

34
Q

What proportion of suicides in 2016 occurred in low income countries?

A

79%

35
Q

What proportion of under 20s who commit suicide have suicide related internet history?

A

25%

36
Q

What proportion of under 20s who commit suicide have previous service contact?

A

40%

37
Q

What percentage of violent deaths is attributable to suicide?

A

50% male

71% female

38
Q

What is the most common form of suicide?

A

Hanging

39
Q

What proportion of suicides by self-poisoning were not with the patient’s own medication?

A

50%

40
Q

What key introduction largely reduced inpatient suicides?

A

Collapsable curtain rails reduced inpatient suicides by 60%

41
Q

What proportion of those under crisis resolution home treatment teams misuse drugs or alcohol?

A

56%, with very few under specialist care

42
Q

Where are the highest suicide rates seen in the UK?

A

Rural and coastal areas of North and South West

43
Q

How many people visit a community pharmacy a day in the UK?

A

1.6 million

44
Q

What is the population of Guyana?

A

777,000

45
Q

What are the key contributors to suicide in Guyana

A 
High prevalence of alcohol abuse
Symptoms of mental illness attributed to witchcraft
Deep poverty in rural areas
Domestic abuse
<10 full time psychiatrists in 2015
46
Q

Describe the reason for high suicide rates in Belgium.

A

The only Western European country to have high rates, likely due to legality of assisted suicide

47
Q

Describe the reason for high suicide rates in the elderly in South Korea.

A

They believe they do not wish to be a financial burden on their families

48
Q

What is the suicide rate in Guyana?

A
  1. 2 per 100k in 2016

29. 2 per 100k in 2019

49
Q

What is the average suicide rate in the EU?

A

11 per 100k

50
Q

Describe the interventions the government of Guyana tried to put in place to combat suicide.

A

Attempted to distribute lockable cabinets for pesticides

Regulations to ban the most toxic pesticides are most effective approach- Gunnell et al, 2017

51
Q

How many deaths per year are due to self-poisoning with insecticides?

A

110-168k

Mew et al

52
Q

Describe 4 interventions made by charities in Guyana to reduce suicides.

A

Reach out to police, family, survivors to educate
Training for religious leaders and social works due to their bearing in societies
Information campaigns in local newspapers to challenge misconceptions
Foundation offered to connect citizens with mental illness to professionals, received 50 calls in 14 days

53
Q

What is the cost for a rapid diagnostic test for malaria?

A

50 cents including the pharmacist time to administer

54
Q

What is the wholesale cost for primary malaria treatment?

A

Artmesinin combination therapy costs $2.40 for a 3 day adult course

55
Q

What seasonal malaria chemoprevention treatments are offered?

A

Monthly courses of amodiaquone and sulfadoxine-pyrimethamine for children under 5

56
Q

What may be given for treatment and prevention of malaria in pregnant women?

A

Quinine and clindamycin for first trimester
Intermittent preventative treatment of sulfadoxine-pyrimethamine for pregnant women areas and infants in high transmission

57
Q

How much do water purification tablets cost?

A

200 tablets at £14 on high street

58
Q

How much would a deep water well cost?

A

$8000
Serving 2000 people
Includes cost of sanitation training
Lasts 20 years

59
Q

How much does ORT cost?

A

10 cents per packet

60
Q

What are the saving benefits of zinc supplements in diarrhoea?

A

Study in Colombia estimates a 25% saving on treatment- Mejia, 2015

61
Q

Describe the trend and potential causes of suicide in Greenland.

A

Prior to the 1960s, suicide was rare in Greenland.
Today, rates vary, but are typically between 35 and 50 each year.
Although this is similar in other Arctic populations in Alaska, Canada and northern Scandinavia, it is more than four times greater per capita than in Denmark.
Studies suggest that it became a public health issue primarily affecting men as the country become more urban, and traditional skills were valued less.
About half of those committing suicide are between the ages of 10 and 30.
While the number of people dying by their own hand in Greenland fell in 2017, there was a rise in attempted and threatened suicides

Pharmacy Year 4 (3 decks)

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