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YR1 Epidemiology in Practice > Lecture 16 - International health > Flashcards

Lecture 16 - International health Flashcards

1
Q

what are the classes of the main neglected tropical diseases (NTDs)?

A
  • protozoan infections
  • bacterial infections
  • helminth infections
  • viral infections
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2
Q

give examples of neglected protozoan infections

A
  • HAT
  • chagas disease
  • leishmaniasis
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3
Q

give examples of neglected bacterial infections

A
  • buruli ulcer
  • leprosy
  • trachoma
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4
Q

give examples of neglected helminth infections

A
  • ascariasis
  • hookworm infection
  • trichuriasis
  • schistosomiasis
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5
Q

give examples of neglected viral infections

A
  • dengue

- rabies

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6
Q

what are DALYs?

A

Disability Adjusted Life Years

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7
Q

how many DALYs are lost from NTDs?

A

56.6m

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8
Q

where is the highest prevalence of neglected tropical diseases?

A

Sub-Saharan Africa

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9
Q

what 3 NTDs have the most cases in Sub-Saharan Africa?

A

1) hookworm
2) ascariasis
3) schistosomiasis

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10
Q

what is schistosomiasis?

A
  • also known as snail fever/bilharzia
  • disease caused by parasitic flatworms called schistosomes
  • affects the poorest people
  • serious because anyone who swims in fresh water in Africa/does irrigation/domestic duties could become infected
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11
Q

describe the life cycle of schistosomes

A

1) eggs are eliminated with faeces/urine
2) eggs hatch if they are deposited in fresh water
3) larvae infect snails and reproduce
4) snails body is taken over and massive sexual reproduction occurs
5) larvae are released as free living larvae in thousands from each snail
6) each larvae can penetrate unbroken human skin
7) larvae migrate around the body to liver and mature into adults
8) adults pair in liver
9) adults migrate to blood vessels around the bladder and intestine and lay eggs (to be eliminated)

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12
Q

what are the health consequences of schistosomiasis?

A
  • blood in urine
  • malnutrition
  • anaemia
  • growth retardation
  • cognitive impairment
  • increased susceptibility to other infections
  • inflammation of organs
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13
Q

what are the life threatening consequences of schistosomiasis?

A
  • bladder cancer
  • portal hypertension
  • vomiting of blood
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14
Q

what is the treatment of schistosomiasis?

A

praziquantel: kills adult schistosomes

- off-patent = significant price cuts in 1990s making it more affordable

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15
Q

what is female genital schistosomiasis?

A
  • urinary schistosomiasis in females causes genital lesions as eggs are trapped in the cervix
  • lesions have been linked to increased risk of HIV
  • higher than expected HIV in Mozambique, Malawi, S. Africa and Tanzania
  • treatment of young females is essential
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16
Q

what are soil-transmitted helminth (STH) infections?

A
  • “worms”
  • lead to stunting and decreased school performance in children
  • most common infections of children worldwide
  • estimated that 44m pregnant women harbour hookworm infections so deworming greatly improves pregnancy outcomes, avoiding: increased maternal mortality, low birthweight
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17
Q

what are the treatments of STH infections?

A
  • albendazole

- mebendazole

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18
Q

what is onchocerciasis?

A
  • also known as river blindness
  • uses blackfly vector
  • causes blindness and severe skin disease
  • 37m infected (99% in Africa)
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19
Q

what are the treatments and controls of onchocerciasis?

A
  • treatment = mectizan

- control of blackflies = insecticides

20
Q

what is APOC?

A

Africal Programme for Onchocerciasis Control

21
Q

what is lymphatic filariasis?

A
  • transmitted by mosquitos
  • 120m infected
  • 40m with symptoms
  • annual treatment prevents transmission
22
Q

what are the treatments of lymphatic filariasis?

A
  • albendazole with mectizan in Africa

- albendazole with DEC in Asia

23
Q

what is blinding trachoma?

A
  • world’s leading cause of preventable blindness
  • 84m infected
  • 8m visually impaired
24
Q

what is the treatment of blinding trachoma?

A

zithromax

25
Q

what is albendazole used to treat?

A

helminths and LF

26
Q

what is melbendazole used to treat?

A

helminths

27
Q

what is mectizan used to treat?

A

oncho and LF

28
Q

what is praziquantel used to treat?

A

schistosomiasis

29
Q

what is combined therapy used to treat?

A

leprosy

30
Q

what is zithromax used to treat?

A

blinding trachoma

31
Q

what is the WHO recommended strategy for treating helminths, LF, schistosomiasis, oncho and trachoma?

A

mass drug administration (MDA) in areas where prevalence rates are above certain thresholds because diagnosis and treatment is impossible due to diagnostic costs but the drugs are safe and effective

32
Q

how are NTDs controlled?

A
  • mapping
  • strategic plans
  • health education material
  • training at all levels
  • distribution of drugs
  • treatments in schools/communities
33
Q

how do donated drugs get delivered to those who need them?

A
  • political will
  • training
  • transport
  • community drug volunteers
  • collaboration
  • money: costs approx $250m/year to deliver drugs
34
Q

list 4 success stories in the control of NTDs

A
  • LF in Zanzibar
  • trachoma in Morocco
  • guinea worm globally
  • schistosomiasis in Egypt
35
Q

what is dengue?

A
  • mosquito borne viral disease with a global tropical distribution
36
Q

how is dengue controlled?

A
  • diagnosis and case management
  • surveillance and outbreak response
  • sustainable vector control
  • possible vaccine in future
  • research
37
Q

what is rabies?

A
  • disease causing 55,000 human deaths/year in Africa and Asia
  • once symptoms develop death rate is 100%
  • most commonly from dog bites
38
Q

how is rabies controlled?

A
  • dog vaccination
  • human management of dogs
  • vaccination immediately after exposure
  • elimination targets
39
Q

what is buruli ulcer?

A

chronic skin disease that is endemic in 33 countries but highest in Ghana, Gabon and Australia

  • 5,000 cases/year
  • poor knowledge and reporting
40
Q

how is buruli ulcer controlled?

A
  • training of health workers
  • early case detection
  • antibiotic treatment
  • surgery if necessary
41
Q

what is leprosy?

A
  • a contagious disease that affects the skin, mucous membranes, and nerves
  • also known as Hansen disease
  • chronic disease
  • incubation period of 5 years
  • 95% of population have natural immunity
42
Q

how is leprosy prevented and controlled?

A

1) early detection and multi-drug therapy (MDT)
2) capacity building to sustain control
3) research

43
Q

what is podoconiosis?

A
  • also known as elephantiasis
  • swelling of feet and lower legs
  • essentially no treatment
44
Q

what is trypanosomiasis sleeping sickness?

A
  • transmitted by the Tsetse fly which has a sharp bite

- can be both chronic and acute killer

45
Q

how is sleeping sickness controlled?

A
  • early diagnosis
  • therapy for infected people
  • Tsetse control (baited traps and systemic insecticides in cattle in Uganda)

YR1 Epidemiology in Practice (11 decks)

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