Global Health

Question 1

what are the following definitions of:

(a) probability of a child born in a specific year or period dying before reaching the age of 5
(b) probability of a child born in a specific year or period dying before reaching the age of 1

Answer 1

(a) UNDER 5 MORTALITY RATE - probability of a child born in a specific year or period dying before reaching the age of 5
(b) INFANT MORTALITY RATE - probability of a child born in a specific year or period dying before reaching the age of 1

Question 2

name the top 5 cause of under 5 mortality both globally and in Africa alone

Answer 2

globally -

1. preterm birth complications
2. pneumonia
3. intrapartum-related complications
4. diarrhoea
5. neonatal sepsis

Africa -

1. diarrhoea
2. pneumonia
3. malaria
4. preterm birth complications
5. intrapartum-related complications

Question 3

outline the risk factors, prevention and treatment of pneumonia

Answer 3

risk factors - malnutrition, over-crowding, indoor air pollution and parental smoking

prevention - vaccinations, breastfeeding and good hygiene

treatment - access to community health or hospitals

Question 4

outline the causes, prevention and treatment of diarrhoea

Answer 4

causes - contaminated water and food source

prevention - safe drinking water, good hygiene, sanitation, breastfeeding and vaccination

treatment - oral rehydration solution (ORS), zinc supplements

Question 5

how does HIV present in childhood?

Answer 5

recurrent diarrhoea
oral candidiasis
meningitis
failure to thrive
lymphadenopathy
fever
encephalopathy
chronic parotitis

Question 6

name the diagnostic tests for HIV at:

(a) <18 months
(b) >18 months

Answer 6

(a) <18 months - virological PCR for HIV DNA or RNA

(b) >18 months - serological rapid antibody test

Question 7

name the staging for HIV:

(a) clinical
(b) immunological
(c) virological

Answer 7

clinical staging: 1-4

immunological staging: CD4 count

virological staging: viral load

Question 8

name the HIV treatment

Answer 8

HAART: Two NRTIs plus one NNRTI or protease inhibitor

abacavir and lamivudine + efavirenz or kaletra

Question 9

name the presentation and risk factors for TB

Answer 9

presentation: chronic cough, fever, night sweats, weight loss

risk factors: HIV, malnutrition, household contact

Question 10

outline the TB investigations and treatment

Answer 10

investigations: acid-fast bacilli, CXR, Mantoux
treatment:

2 months of Isoniazid, Rifampicin, Pyrazinamide +/- Ethambutol

4 months of isoniazid and rifampicin

(2 RIPE 4 RI)

Question 11

name the vaccination for TB

Answer 11

BCG vaccination

Question 12

how do you get malaria?

Answer 12

plasmodium parasite from female anopheles mosquito

Question 13

name the most severe form of malaria

Answer 13

P. falciparum - rapidly progress to severe cerebral malaria, seizures and coma

Question 14

name the malaria investigation, treatment and prevention

Answer 14

investigation - blood film microscopy or rapid diagnostic test

treatment - artemisinin-based combination therapy (ACT) for 3 days

severe - IM or IV artesunate

prevention - insecticidal nets

Question 15

severe acute malnutrition is diagnosed by the following:

(a) mid arm circumference of

Answer 15

(a) mid arm circumference of < 115mm
(b) weight for height < -3SD
(c) OEDEMA of both feet