Global Health

Question 1

Define “Under 5 Mortality Rate”

Answer 1

Probability of a child born in a specific year or period dying before reaching the age of 5.

Question 2

Define “Infant mortality rate”

Answer 2

Probability of a child born in a specific year or period dying before reaching the age of 1.

Question 3

Define “Live Birth”

Answer 3

Any sign of life after birth irrespective of gestation

Question 4

What are the top five causes of under 5 mortality globally?

Answer 4

Preterm birth complications
Pneumonia
Intrapartum-related complications
Diarrhoea
Congenital abnormalities

Question 5

What are the top five causes of under 5 mortality in sub-saharan Africa?

Answer 5

Pneumonia
Preterm birth complications
Intrapartum-related complications
Diarrhoea
Malaria

Question 6

What are the biggest killers across the board from the ages of 1 month – 5 years in sub saharan africa?

Answer 6

Pneumonia
Diarrhoea
Malaria

Question 7

What is a very important public health treatment for diarrhoea and how does it work?

Answer 7

Oral rehydration solution - works on the sodium glucose co-transport system creating an osmotic pull of water - instantly absorbed into jejunum - avoids IV fluids in mild and moderate dehydration

Question 8

Give some common presentations of HIV in children

Answer 8

• Recurrent or severe common childhood illnesses e.g. otitis media, diarrhoea
• Recurrent oral candidiasis not responding to treatment
• Recurrent severe bacterial infections e.g. meningitis
• Failure to thrive or growth failure
• Generalised lymphadenopathy, hepatosplenomegaly
• Persistent fever
• Encephalopathy

Question 9

What are the diagnostic tests for HIV in:

• < 18 months of age
• > 18 months of age

Answer 9

<18 months of age: virological PCR for HIV DNA or RNA

>18 months: serological rapid antibody test

Question 10

What is the current treatment for HIV?

Answer 10

HAART: Two NRTIs plus one NNRTI or protease inhibitor

• Nucleoside reverse transcriptase inhibitors e.g. abacavir and lamivudine
• Non-nucleoside reverse transcriptase inhibitors e.g. efavirenz for >3yr olds
• Protease inhibitor e.g. kaletra for <3yr olds

Question 11

What investigations can you do for TB in children?

Answer 11

Acid-fast bacilli (low yield in children)
Interferon-Gamma Release Assays
Chest Xray
Mantoux

Question 12

Malaria

• What is the parasite?
• What is the most severe form?
• Presentation?
• Investigation?
• Treatment?

Answer 12

Plasmodium parasite from female anopheles mosquito
P. falciparum most severe
Presentation very variable
- Fever
- Pallor
- Non-specific malasie
Do blood film for microscopy or rapid diagnostic test.
Treatment with artemisinin-based combination therapy (ACT) for 3 days.
Severe malaria treat with IM or IV artesunate until can tolerate oral.

Question 13

Define:
- Kwashiorkor
- Marasmus
What is the difference in treatment?

Answer 13

Kwashiorkor = sufficient calorie intake, but with insufficient protein consumption,
Marasmus = energy deficiency
NO distinction made between kwashiorkor or marasmus as treatment the same.

Question 14

What are the four most common non-communicable diseases in adults?

Answer 14

Cardiovascular disease
Cancers
Diabetes
Chronic respiratory diseases