Global Health

Question 1

How high are the mortality rates with malaria

Answer 1

as high as 20%

highest risk with p.falciparum

Question 2

what should you do with a child if you suspect they have p. falciparum

Answer 2

admit to hospital

start chloroquine-resistant treatment such as artesunate (second line quinine)

Question 3

what is the main treatment for travellers diarrhea?

Answer 3

hydration

Question 4

what area is high risk for Dengue

Answer 4

Thailand

- mosquitoes breed in stagnant water

Question 5

what is the treatment for Dengue

Answer 5

supportive care

Question 6

what are the signs of Dengue

Answer 6

fever
chills
headache
myalgias
*classic erythematous reticulate rash over the thorax, face and flexion areas
Lymphocytosis, neutropenia and elevated aminotransferases

Question 7

what investigations would you do to rule out malaria and other life threatening infections

Answer 7

Complete blood count with diff
liver enzymes
electrolytes
creatinine
Malaria smears ± antigen detection testing, when available (immediately and at least 2 subsequent samples over 24 to 48 hours when the child has visited a malaria-endemic area) (do 3 thick and thin smears)
Blood culture 
Urinalysis +/– urine culture

Question 8

what are 4 risk factors for severe infection in a traveller

Answer 8

Being unvaccinated or incompletely vaccinated
Having a history of compromised or suppressed immunity (e.g., splenic dysfunction)
Low weight or poor nutritional status
Very young age (i.e., less than one month)

Question 9

what is the LEARN model for cross cultural communication

Answer 9

Listen, Explain, Acknowledge, Recommend, Negotiate

Listen – assess each patient’s understanding; find out patient’s expectations for encounter
Explain – explain your perceptions of the health condition, the patient may have a different take on health and illness based on cultural background
Acknowledge – be respectful of their views
Recommend – propose a treatment plan
Negotiate – reach an agreement on the plan using culturally relevant approaches

Question 10

what are some tips for working with interpreters (7)

Answer 10

1. speak with the interpreter prior to meeting to clarify expectations
2. sit in triangular shape
3. use interpreter to book next appointment
4. ask who is the most important person to direct your questions to
5. introduce everyone in the room
6. look at family members as you speak and try to speak to them directly
7. debrief with the interpreter after to ensure communications were fully translated

Question 11

what is cultural competence

Answer 11

Cultural competence includes providing effective health care across diverse cultures by working collaboratively and communicating effectively

Cultural competence is the ability to understand, communicate with and effectively interact with people across cultures.

Question 12

what is high context communication

Answer 12

indirect forms of communications
meanings are conveyed but not explicit, using body language, tone of voice and other cues
western cultures use low-context (Direct) forms of communication