global health final review

In simple terms, stunting refers to what measure?

Height-for-age

Which of the following is the largest cause of the burden of disease in low- and middle-income countries?

Household air pollution

Which intervention is the most appropriate, cost-effective measure for caring for stable, low birth weight infants in very resource-limited settings?

Kangaroo mother care

Select all that are emerging and re-emerging infectious diseases:

Marburg Dengue Ebola SARS Plague Cholera

The leading (number 1) cause of death for people aged 5-14, as percentage of total deaths, globally is:

Road injuries

The case fatality rate is:

The proportion of people with a disease that die from the disease

The lack of vitamin A is associated with the development of a condition known as xeropthalmia. The person with this condition is first likely to get _______________ and later the eye dries out which can lead to permanent blindness.

night blindness

Which is likely to be least related to the social determinants of women's health?

Breast cancer

It is important to know how communicable diseases spread. An example of waterborne disease is:

Cholera

The following term best refers to: "A complex, multi-party, intra-state conflict resulting in a humanitarian disaster which might constitute multi-dimensional risks or threats to regional and international security."

Complex humanitarian emergency

Which measure would have the least impact on decreasing alcohol consumption in a low-income country?

Education and counseling by health care providers

One Health was coined in the early 2000s to describe a growing movement that emphasizes to improve the health of at least one member from each household.

False

Select all that apply: World Health Organization lists 22 diseases as neglected tropical diseases. Select the neglected tropical diseases:

Leprosy Ascariasis Trachoma Leishmaniasis Dracunculiasis Trichuriasis

One of the conditions that can result from prolonged or failed childbirth is:

Obstetric Fistula

Which of the following would be THE MOST important way to improve the health of infants in rural communities of low-income countries?

Promote exclusive breast feeding for the first 6 months

The term neonatal refers to what?

The first month of life

Diarrhea is the second leading infectious cause of young children deaths, and is caused by a number of different infectious agents, including bacteria, viruses, protozoa, and helminths.

True

Maternal death is the death of a woman while pregnant, during delivery, or within 42 days of delivery.

True

The global burden of cancer has continued to grow as more people in more places continue to live longer and the burden of communicable diseases decreases in these populations.

True

Unsafe abortions are highest in Middle Africa.

True

Which statement about the burden of disease from environmental factors is false?

A. The Global Burden of Disease study 2016 estimated that unsafe water was the 18th leading risk factor for deaths globally, but the 8th leading risk factor in low-income countries and the 12th leading risk factor in lower middle-income countries. B.Household air pollution was the eighth most important risk factor in 2016 for deaths globally, for both sexes and all ages. However, it was second most important risk factor in low-income countries and the sixth most important risk factor for lower middle-income countries. C. In 2016, ambient particulate matter pollution was the sixth leading attributable risk factor for death globally. D. There is no evidence at all linking indoor air pollution with adverse pregnancy outcomes, such as low birth weight. (answer)

Select all true statement/s about the links between environmental health, human health, and the Sustainable Development Goals (SDGs)

About a quarter of all Disability Adjusted Life Years in 2016 were attributed to environmental health risks, including lack of safe water and sanitation, poor hygiene, and indoor and outdoor air pollution. Environmental health issues are a substantial barrier to good health and human productivity in many settings and disproportionately affect the poor. Thus, they pose a major barrier to reducing disparities.

Among the following world regions, Iron deficiency (Anemia) related deaths in children under five years is highest in:

Africa

Iron fortification can help to address what problem?

Anemia

Which of these would be among the FIRST things that would be done to address the health effects of a complex humanitarian emergency?

Assess the size and composition of the displaced population and establish a system for disease surveillance

One can ensure that relief agencies work in a coordinated fashion and focus on the most cost-effective activities by:

Being evidence-based and transparent with each other and the affected community

Low birthweight is:

Birthweight less than 2500 grams

Select all that apply:

Cervical cancer is a much larger share of all cancers in Africa than elsewhere. Liver cancers are uniquely important to Africs Lung cancer deaths are not an important share of total cancer deaths in Africa.

Which country has a very large number of internally displaced people?

Colombia

Select all that are true about diabetes:

Diabetes was the 14th leading cause of death in 2016 in low income countries. (Global Burden of Disease Study). According to the Data from International Diabetes Federation, Africa has the lowest prevalence rate of Diabetes (in the International Diabetes Federation Regions 2017 and 2045). Only about 63 percent of those with diabetes are actually diagnosed in high-income countires and that in low-income countries, only about 23 percent of those affected after diagnosed. About 80% of all of all deaths from diabetes occur in low-and middle-income countries.

The main risk factors for Tuberculosis (TB) include:

Exposure to a person infected with TB Living in crowded circumstances Undernutrition HIV/AIDS (all of the above)*

South Asia has the highest maternal mortality ratio.

False

The DALYs attributable to road injuries and TB are higher ranked for females than for males.

False

The Vitamin A program in Nepal aimed to reduce child morbidity and mortality by prophylactic supplementation of high dose vitamin A capsules to pregnant women aged 17-35.

False (It was not given to pregnant women but to children 6 to 60 months of age.)

Select all that apply: There is a widespread agreement on the key interventions required to roll back malaria. Select all that include:

Intermittent preventative therapy for pregnant women. Prompt treatment of those infected, based on confirmed diagnosis Long-lasting insecticide treated bednets (ITNs) for people living in malarial zones

The leading (number 1) cause of death among the communicable diseases as a percentage of total deaths, for all age groups in the low, lower-middle,upper-middle and high-income income countries is:

Lower Respiratory Infections

Select all that apply about the steps Sri Lanka took to address maternal mortality: (case studies)

Made use of its civil registration data to identify what areas of the country had the most significant problems with maternal mortality Sri Lanka introduced policies to expand the number of midwives Improved access to health services There were efforts from the government to improve health by improving sanitation and by measures to combat malaria and hookworm (progress in other health areas).

Select all that apply:

Men have a higher risk of heart disease than women who are premenopausal, but postmenopausal women have the same risk of cardiovascular disease as men. HIV/AIDS is the leading (number 1) cause of death and DALYs as a percentage of deaths and DALYS in Sub-Saharan Africa. Ischemic heart disease and stroke, generally referred to in burden-of-disease studies as cardiovascular disease (CVD), made up almost 27% of all deaths globally in 2016.

Select all that apply from the Global Burden of Disease Study:

Mental disorders contributed 4.8 percent of the total DALYs globally. Mental disorders are the largest cause of DALYs for the 15- to 49-year-old age group, globally and in high-income, upper-middle income, and low-income countries. As economic status (income levels) of countries improve (from low to middle to upper middle to high-income countries) the DALYs associated with mental disorders as a share of total DALYs for both sexes and all age groups rise/increase too.

Select all that are true:

On average, a child born in a low-income country has a nine times greater chance of dying in its first 28days than a child born in a high-income country. In Sub-Saharan Africa uniquely, malaria and HIV/AIDS are also significant killers of young children South-Asia has the second-highest rates for under-five mortality, and infant mortality rates, as defined by the World Bank Region. Sub-Saharan Africa has the highest rates of infant mortality rate, under-five mortality rate, as defined by the World Bank Region.

People from which of the following places are more likely to have Iodine deficiency?

People who live in mountainous areas

What best defines water-washed transmission of infection?

Person-to-person transmission because of a lack of water for hygiene

Who is most likely to be affected by poor environmental conditions indoors?

Poor women and children in low-income countries

Select all that apply: The most critical interventions to deal with undernutrition are:

Promote exclusive breastfeeding for all children until they are 6 months of age Ensure that pregnant women are well nourished and have sufficient amounts of needed micronutrients Encourage the provision of appropriate complementary foods for infants beginning at 6 months of age Focus on South Asia and sub-Saharan Africa Fight infection and illness through better hygiene, improved water and sanitation, and appropriate food and health behaviors.

Select all that apply: What are the measures families can take even in low-income communities, to protect the health of their young children:

Promote mental and social development by responding to child's needs for care and through talking, playing, and providing a stimulating environment. Ensure that every pregnant woman has adequate antenatal care. Give sick children appropriate home treatment for infections Breastfeed infants exclusively for up to 6 months. (mothers that are HIV-positive require counseling about possible alternatives to breastfeeding).

Select all that are true about sex-selective abortions:

Sex selective abortion appears to be more prevalent in India and China than in any other country. Naturally, one would expect that there would be about 105 males born for every 100 females. A consequence of sex-selective abortion is the skewed ratios of males to females in a number of countries, like India and China, where there are about 900 females born for every 1,000 males who were born (India) and 870 females were born for every 1,000 males (China). Generally, family size and preferences for males decreases as income and education rise. However, this has not been true in some countries, like India, where families have used available technology (ultrasound) to express their preference for males by engaging in sex-selective abortion.

Which WHO world region has the highest prevalence of underweight of children under five years of age:

South Asia

Select all correct statement/s (Case Studies)

The Agita Sao Paulo program in Brazil was designed to concentrate on feasible, low - or no-cost ways to achieve at least 30 minutes of moderate-intensity physical activity per day, most days of the week. The program was found to be cost-effective. The iodine deficiency issue in China was primarily addressed through a nation wide public education campaign. South Korea is one of the high-income countries. However, the obesity rate in South Korea is much lower than in other high-income countries primarily due to its adoption of traditional diet.

Select all statements that are true about the prevention and treatment of TB.

The BCG vaccine reduces severe TB in children, but because children are not important transmitters of TB and due to variable efficacy of the vaccine in different settings, the vaccine has had little impact on the overall incidence or prevalence of TB. WHO recommends intensified case finding to ensure that all of those who are HIV-positive are tested for TB and all of those with TB are tested for HIV DOTS is a cost-effective approach to TB treatment (Case from China)

The code of conduct: principles of conduct for the international red cross and red crescent movement and NGOs in disaster response programs include:

The humanitarian imperative comes first Aid is given regardless of the race, creed, or nationality of the recipient and without adverse distinction of any kind. Aid priorities are calculated on the basis of need alone. Aid will not be used to further a particular political or religious standpoint to endeavor not to act as instruments of government foreign policy (all of the above)*

Select true statement/s:

The leading (number 1) risk factor for death for females (all ages) is high blood pressure in all income regions of the world (low-income, lower middle income, upper middle income, and high-income countries) The leading (number 1) cause of DALYs for females (all ages) in low-income countries is Malaria. The leading cause of death for males (all ages) is ischemic heart disease in lower middle income, upper middle income, and high-income countries and lower respiratory infections in low-income countries.

Why is exclusive breastfeeding for the first six months of a child's life so important?

The mother's milk has important antibodies that are crucial to the baby's healthy development

Which of the following describes a waterborne infection?

The pathogen is in water that is ingested

Select all that are true about handwashing with soap in Senegal (according to a 2004 study).

The rate of handwashing was 23 percent after going to the toilet The rate of handwashing was 18% after cleaning a child The rate of handwashing was 18 percent before handling food.

Select all true statement/s about Measles:

There have also been increasing number of measles outbreaks in high-income countries, reflecting declines in coverage of the measles vaccine associated with the anti-vaxx movement. The measles vaccine is safe, effective, and inexpensive - it costs less than $1.00 to purchase and deliver in low-income countries. There has been a substantial progress against measles in the last decade; even though measles was the 9th largest killer of children under 5 years of age globally in 2016.

What is one reason why mental disorders are an important contributor to the burden of disease?

They often begin at a young age and go on for a long time

Although natural disasters have been associated with considerable death and economic loss the impact of complex emergencies on health over the last decade has been considerably greater than that of natural disasters.

True

Biomass fuels and coal do not completely combust when they are burned. Instead, they leave behind breathable particles of a variety of gases and chemical products. The amount of these substances in a poorly ventilated home can exceed World Health Organization norms by more than 20 times.

True

High risk drinking, among other things, increases the risks for hypertension, liver damage, pancreatic damage, hormonal problems, and heart disease.

True

In all regions of the world, except sub-saharan Africa, the burden of non-communicable diseases is greater than the burden of communicable disease.

True

In the early stages of dealing with large numbers of displaced people in the Complex Humanitarian Emergencies, most deaths occur from diarrheal diseases, respiratory infections, measles, or malaria.

True

It is suggested that each adult in a camp (internally displaced people or refugees should get at least 2100 kilocalories of energy from food per day.

True

Norovirus is a type of viral waterborne pathogens.

True

The leading (number 1) causes of under-5 deaths in East Asia and Pacific, Middle East and North Africa, and North America, is Preterm birth complications while it is Malaria in Sub-Saharan Africa.

True

The use of Tobacco is increasing among men in low- and middle income countries and among women in all regions.

True

Select all air pollutant:

Volatile organic compounds Sulfur dioxide Carbon monoxide Smog

Select all that apply about Female Genital Mutilation (FGM):

When FGM is performed initially, it can result in terrible pain or shock. The World Health Organization has grouped female genital mutilation into four types, generally varying from excision of the prepuce, the fold of skin surrounding the clitoris, to excision of part or all of the external genitalia and the stitching and narrowing of the vaginal opening. It is estimated that half of the girls who undergo FGM will be cut before they are 5 years of age and the remainder will be cut before they are 15 years of age.

Select all that are true about immunization of children:

immunization is critical in global health because it is one of the most successful and cost-effective child health interventions that is available. GAVI is a public-private partnership that works to promote and strengthen immunization programs in low- and middle-income countries. 47 countries were eligible for GAVI financing in 2018. The number of undervaccinated children fell by 1.8 million between 2000 and 2017.

What is an internally displaced person (IDP)?

A person who has been forced to leave their home for reasons such as religious or political persecution or war, but has not crossed an international border

Who is a refugee?

A person who is outside his or her country of nationality and has a well-founded fear of persecution because of his or her race, religion, nationality, membership in a particular social group or political opinion