Module 6 *except for Screening* Flashcards
This is a type of surveillance that;s generally specific infectious diseases or cancers. It is most commonly passive notification by clinician/laboratory.
Indicator-based surveillance
This is a type of surveillance where organised monitoring of reports, media stories, rumours and other information about health events that could be a serious risk to public health.
Event-based surveillance
What are 3 indicators of disease for indicator-based surveillance?
- reports on disease rate
- passive notification by clinician/laboratory
- specific infectious disease/cancers (usually surveyed because a) they spread quickly and people must know what symptoms look like etc)
What are the 3 types of indicator based surveillance?
- passive surveillance
- active surveillance
- sentinel surveillance
The involves the routine reporting of data, particularly of notifiable diseases and involves disease registries and hospital data.
Passive surveillance
What are benefits of passive surveillance? (3)
- low cost
- data linkage (from different reports of data)
- covers wide area
What is the main limitation of passive surveillance?
Under-reporting (because there are asymptomatics and undiagnosed people which may not necessarily be detected by passive surveillance)
What are the 2 ways of carrying out active surveillance?
Serosurveillance
Health survey
This is the type of surveillance which monitors the presence or absence of specific substances in the blood serum of a population
Serosurveillance (sero = blood serum)
This is the type of surveillance which involves a groupwide surveillance to produce health data. It involves selected institutions or groups to generate health data, and monitors diseases/trends as well as outbreaks.
Sentinel surveillance
This is ongoing descriptive epidemiology: “information for action”
Where appropriate monitor “process” and “outcome”.
Epidemiological surveillance
What are the 4 main elements of surveillance? (DAID)
Data collection, Analysis, Interpretation and Dissemination
These are interventions that attempt to prevent disease from occurring. ie., reducing incidence of the disease
Primary prevention
These are interventions that reduce the impact of disease by shortening its duration. It reduces the severity and aims to prevent recurrence.
Secondary prevention
These are interventions which reduce the number or impact of complications and aims to improve rehabilitation. Usually good for preventing the worsening chronic, long-term diseases.
Tertiary prevention
Screening is an example of what prevention?
Secondary prevention
Taxation and immunisation are examples of what prevention?
Primary prevention
Specialist stroke rehabilitation units and diabetes monitoring programs are examples of what prevention?
Tertiary prevention
This is a primary prevention strategy where individuals in special need are identified. The preventive process then takes the form of controlling the level of exposure to a cause or provides protection against consequences of exposure of individuals.
High risk (individual) strategy (eg., loss of license for drunk driving - essentially strategies that affect the individual)
This is a primary prevention strategy which aims to reduce the health risks of the entire population.
Population (mass) strategy (eg., regulations and laws, essentially strategies that affect the population)
This is when a large number of people at small risk may give rise to more cases of disease than the small number who are at high risk.
Prevention paradox
What are disadvantages of population strategy?
- small benefit to individuals
- poor motivation of individuals
What are disadvantages of individual/high risk strategy?
- need to identify individuals
- might be against population norms
- hard to sustain behavioural change
This implies that a preventive measure that brings large benefit to the community may offer little to each participating individual.
Prevention paradoc
This is the idea whereby research provides evidence to guide your practice.
Evidence-based practice
What holds the most weight in hierarchy of evidence? (at the very top of the pyramid?)
Systematic reviews of RCTs
What holds the least amount of weight in the hierarchy of evidence? (at very bottom of pyramid?) - these often seem to have the most influence on people’s opinions.
Anecdotal evidence
What are the 3 factors/values that contribute to evidence-based practice?
- patient values and choice
- clinical expertise
- best available evidence
What kinds of study designs evaluates the commonality of a disease? Like, in terms of who is most likely to get it?
Cross-sectional and cohort studies
What kinds of study designs evaluates the potential causes of disease?
Cohort and case-control studies
Diagnostic accuracy studies involve diagnostic tests. Which study design does this belong in?
Cross-sectional studies
This is the entry of a microbiological agent into a higher order host and its multiplication within the host.
Infection
This is the ability of an organism to invade and multiply in a host.
Infectivity
This is the ability of an organism to produce clinical symptoms and illness. (proportion of those exposed who get ill)
Pathogenicity
This is the ability of an organism to produce serious disease. (case fatality rate)
Virulence
What are the 3 methods of transmission?
Direct, indirect (inanimate and live), and airborne
What are the series of events in the infectious process?
Infection»_space; Incubation period»_space; Clinical disease»_space; Recovery (Immune)
Which period is the infectious period of a disease?
Between (halfway through) incubation period and clinical disease
This is an unexpected increase in the incidence of a disease.
Outbreak
This is limited to a localised increase in the incidence of disease and usually arises in an area that had no cases for a long time.
Epidemic
This is the constant presence of a disease or infectious agent within a geographical area or population group.
Endemic
This is a type of endemic that has intense disease all year round - children are mainly affected and most adults are immune.
Holoendemic
This is a type of endemic that has intense disease with time periods of no transmission - persistent disease with all ages infected (so endemic hits at a specific time/season of the year)
Hyperendemic
This is when a disease affects a large number of people and crosses many international boundaries.
Pandemic
What two attributes indicate that an epidemic has occurred?
- so when cases are identified from a common source
- increase in the usual number of cases in a given time or place
This is constantly present in a population or region, and has relatively low spread.
Endemic
This is a sudden increase in cases spreading through a large population.
Epidemic
This is a sudden increase in cases across several countries and continents around the world.
Pandemic
This is the aggregation of relatively uncommon events or disease in space and or in time that are thought to be greated than could be expected by chance. Usually rare non0infectious diseases.
Clusters
This is a term that describes the transmission or spread from the intial case.
Secondary attack rate
What are some reasons (at least 2) on why we need to investigate outbreaks?
- to stop and further prevent illness
- to prevent further outbreaks
- address public concerns
- reduce direct and indirect costs
- identify new mechanisms of transmission
- identify new or emerging disease agents
What are the 3 types of outbreaks (in terms of their source) ?
- common/point source
- propagated source
- mixed source
This is an important tool to identifying certain aspects of an outbreak.
Epidemic curve
What factors influence the spread of disease? (6) PHEBES
- properties of agent
- sources of infection
- biological reservoires
- host factors
- exposure variation
- environment
