PUB 310 ~ Exam 3

In 2021, the WHO estimated that there were how many cases and deaths from malaria globally?

- 247 million cases - 619,000 deaths

What is an epidemiologic transition?

- A shift seen in the disease pattern of a population - Decrease in disease and death due to acute, infectious diseases - Increase in disease and death due to chronic, non-communicable diseases

What are the factors that can be categorized based on what is being affected?

- Agent: Uncontrolled energy - Host: Person being injured - Environment - Situation and circumstances surrounding the event

What is a carrier?

- An individual with an inapparent infection - Carriers can be important in the spread of infectious disease - Outbreaks have been documented due to individuals that chronically carry organisms in respiratory tract, blood, stool, and genital tract

What are the components of intentional injuries?

- Assault - Domestic violence - War - Homicide - Suicide

What are some environmental public health interventions for injury prevention?

- Barriers along highways - Stop signs - Childproof locks - Staircase gates

Tissue repair process

- Bleeding at the site of the wound - Inflammation - increased blood flow and cells to repair damage - Repair - Fibroblasts build collagen to connect the tissue and strengthen the site

Characteristics of P. falciparium

- Causes most severe disease and responsible for most deaths - Found in tropical/subtropical areas, especially Africa

Malaria is most severe in what populations?

- Children under 5 - Pregnant women - Nonimmune populations

What does direct transmission include?

- Direct contact - Direct spray of respiratory fluids - Mother to child

What are passive strategies?

- Do not require individuals to make decisions - Protective mechanism is already in place

What are the five E's for the types of interventions?

- Education: Seat belt safety, don't drink and drive - Engineering: Car design, road design - Economic: Traffic fines for unsafe driving habits - Enforcement: Tickets and jail time for unsafe driving habits - Empowerment: Encouraging personal control over one's health

What are the 3 plasmodium life cycles?

- Exoerythrocytic Cycle (human liver cycle) - Erythrocytic Cycle (human red blood cell cycle) - Sporogonic Cycle (mosquito cycle)

What are the vector factors?

- Extrinsic incubation period - Life span - Habitat - Susceptibility to pesticides - Feeding practices

Vector factors of Anopheles Mosquitoes

- Feed indoors or outdoors (or both) - Rest (after feeding) indoor or outdoors - Preferred source for blood meal (humans vs. animals) - Preferred breeding environment - Insecticide resistance

What does indirect transmission include?

- Food borne - Water borne - Airborne - Vector borne

Characteristics of P. Vivax

- Found in Asia, Latin America, and some parts of Africa - Most prevalent malaria parasite (due to population density) - Has dormant liver stages that can re invade the blood months or years following initial infection

What is the epidemiologic triangle regarding injury control?

- Host - person injured - Agent - uncontrolled energy - Environment - situation/circumstances surrounding event

What is the basic reproductive number (R0)?

- In a completely susceptible population, this is the number of individuals that one infected person typically passes the infectious disease along to - Higher the R0, the higher level of immunity required to attain herd immunity in a population

How does malaria increase the risk for adverse pregnancy outcomes due to malaria infection of the placenta?

- Increased low birth weight babies - Increased stillbirths

What is an inapparent infection?

- Individual has a documented infection (proved by lab results) BUT that person remains healthy - If an inapparent infection can be transmitted from person to person → can play a role in the spread of infection

What is an alternative to diagnosing malaria?

- Malaria Rapid Diagnostic Tests (RDT) - Does not involve demanding technical skills or special equipment - Detects malaria antigens in blood within 15-30 minutes

Anopheles mosquito

- Malaria is transmitted only by the genus Anopheles - Anopheles are found worldwide except Antarctica (Malaria endemic regions/areas where malaria has been eliminated - Adult female requires protein derived from blood meal for egg production; malaria vectors are only female

Characteristics of fungi

- May be single or multicellular - Cells contain DNA and other specialized organelles - Surrounded by a rigid cell wall - more than 100,000 species but very few cause disease in humans

What are the different types of mechanism injury?

- Mechanical - Chemical - Thermal - Electrical

What is the "gold standard" technique for diagnosing malaria?

- Microscopic examination of smears of blood on glass microscope slides - Should be performed immediately to direct treatment - Requires significant technical skills

Characteristics of parasites

- Organism that lives in or on a host and gets its nourishment from or at the expense of the host - Range in size from microscopic to inches in length - Can cause diseases in humans - Burden of disease is heaviest in communities in the tropics and subtropics

What are the 5 malaria parasites?

- P. falciparum - P. Vivax - P. Ovale - P. Malariae - P. Knowlesi

Define eradication

- Permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts - Intervention methods are no longer needed - Example: Smallpox

In malaria endemic regions, what population are more likely to be bitten by malaria vectors?

- Pregnant women - due to higher body temp and CO2 release --> attracts mosquitoes - Increased risk of vector exposure when urinating at night outside of the home

Levels of prevention regarding injury control

- Primary - prevent the injury from occurring - Secondary - decreasing severity of injury - Tertiary - rehabilitation from injury

Define elimination

- Reduction to zero of the incidence of a specified disease in a defined geographical area as a result of deliberate efforts - Continued intervention measures are required - Example: polio

What are active strategies?

- Require individuals to make decisions about their behavior - May require a behavior change

Malaria treatment

- Should be initiated ASAP _ Variety of drugs are utilized in the treatment of malaria - Certain species in some geographic areas have become resistant to certain medications

Characteristics of bacteria

- Single-celled organisms - Cell contains DNA and ribosomes for making proteins - Surrounded by cell wall which determines size and shape --> spheres (cocci), rods, or spirals

What are the agent (pathogen) factors?

- Size - Requirements for replication - Motility - Hardiness in the environment - Susceptibility to mechanical or thermal processes - Type of immune response it generates

What are the components of unintentional injuries?

- Slips, trips, falls - MVA - Drownings - Burns - Poisoning

Characteristics of viruses

- Smallest among the microorganisms - Simple structure containing genetic material (DNA or RNA) and a protein coat

True or false: Individuals infected with severe malaria can move quickly to the brain causing cerebral malaria and death

- True - Case fatality rate is 15-25% for children in Africa

What are the at risk populations for malaria?

- Young children who have not yet developed immunity - Pregnant women whose immunity is lowered due to pregnancy - Travelers or migrants coming from areas with low or no malaria transmission and lack immunity

What are the two injury categories?

1) Intentional injuries 2) Unintentional injuries

What are the 4 types of microorganisms?

1) Viruses 2) Bacteria 3) Fungi 4) Parasites

When was malaria considered eliminated from the U.S.?

1951

How many malaria cases are diagnosed in the U.S. anually?

2,000 cases

What percentage of pregnancies in moderate to high transmission countries in the WHO African Region are exposed to malaria infection

32%

Number of unintentional falls increases as individuals age above ___ years

34

Rates of injury due to falls increase greatly starting at what age range?

40-44 years

Antibodies can be transferred from mother to fetus, providing the newborn with some protection for how long?

6-9 months

Unintentional falls are very common among individuals ____ years of age and older

65

The non-fatal trend reverses at what age? (the rate becomes higher in women)

65 years

What is malaria cause by?

A microscopic parasite that infects red blood cells

What are the factors that the vulnerability of a host to infection depends on?

Age, gender, ethnicity, genetics, physiology, immune status, diet and nutrition, physical activity, concurrent or preexisting infections, behavior

During the plasmodium life cycle, do you need the human, mosquito, or both?

Both!

What are microorganisms?

Diverse group of single-celled and multicellular organisms, most of which cannot be seen with the naked eye

What are unintentional injuries?

Event not pre-calculated or planned

What is the epidemiologic triangle?

Factors associated with the agent, host, and environment can play a role in increasing or decreasing the risk of injury in a particular situation

What portion of the world's population lives in malaria-endemic regions and is at risk for malaria?

Half (50%)

What is secondary prevention?

Identify illness early or decrease severity of injury

What are intentional injuries?

Injuries resulting from purposeful human action, whether directed at oneself or others

Types of tissue involved in the injury will contribute to determining what?

Injury severity

The brain IS/IS NOT resistant to compression

Is not (no elasticity)

Epidemiologic transitions has not been seen in what areas?

Low income countries

From an early age, the rate of both fatal and non-fatal injuries is higher in what gender?

Males

Bone is MORE/LESS resistant to compression across long axis than cross section

More

Severe malaria is caused by what virus?

P. falciparum

What is the infectious period?

Period of time when infected individual is infectious' can transmit disease to others

What is primary prevention?

Prevent illness/injury before it occurs

What is tertiary prevention?

Slowing disease/ injury progression and managing disease/injury

Age is a strong/weak predictor of both intentional and unintentional injury

Strong

Gender is a strong/weak determinant of injury occurrence

Strong

What is the latent period?

Time between exposure to a disease and becoming infectious

What is the incubation period?

Time between exposure to a disease and the development of signs or symptoms of illness

Different tissues can/cannot accommodate different types of injuries

True

True or false: Different tissues in the body have varying abilities to absorb and dissipate energy without injury, until a critical threshold is reached

True

True or false: Disease that spreads more readily will require a higher level of immunity to attain herd immunity

True

True or false: Individuals with severe malaria may have severe anemia due to destruction of RBCs

True

True or false: Majority of injuries are NOT accidents

True

True or false: Malaria can result in a wide range of symptoms from asymptomatic or mild symptoms to severe disease and death

True

True or false: Malaria is the leading cause of morbidity and mortality in many developing countries

True

True or false: Malaria results in an often serious, and at times, fatal disease

True

True or false: Most injuries are predictable and preventable via public health interventions

True

True or false: Nonfatal motor vehicle injury rates are highest among younger drivers

True

True or false: Pregnant women are more likely to develop severe complicated malaria and experience death, then non-pregnant females.

True

True or false: Protective equipment helps to distribute mechanical energy across a greater surface area to prevent reaching the threshold

True

True or false: Semi-immune individuals can be infected by malaria parasites, but may develop less severe disease or be asymptomatic

True

True or false: Skin is resistant to compression but can tear

True

True or false: The epidemiologic transition has already occurred in developed countries

True

True or false: alcohol significantly increases risk of injury, causes impairments in both physical and cognitive functioning, and effects include willingness to take risks and decreased ability to respond to hazardous situations

True

True or false: unintentional falls is the leading cause of nonfatal emergency department visits for all ages

True

True or false: Regulations, policies, and laws can impact environmental conditions

True (example: headlight laws)

Underlying agent is ________ energy that is greater than what the tissues can absorb?

Uncontrolled

In 2021, 95% of malaria deaths took place where?

WHO African Region

What is herd immunity?

When transmission is based on contact between an infected person and susceptible person, and if the number of immune persons (due to vaccine and/or natural infection) is large enough that it is unlikely that a susceptible person will have contact with an infected person, the population is said to have herd immunity

Environmental factors has increased contact between the ______ and the ______

agent (uncontrolled energy); host

Pathogenic means..

disease causing

Those who engage in riskier behavior are more/less likely to become injured

more

Malaria is vector-borne transmitted by...

mosquitoes

After repeated attacks of malaria a person may develop...

partial immunity (acquired immunity)

According to the WHO, infectious diseases are caused by what?

pathogenic microorganisms, such as bacteria, viruses, parasites, or fungi; the diseases can be spread directly, or indirectly from one person to another.

What are the 4 environmental factors?

physical, biologic, socioeconomic, and cultural