Global Health Final

What is the most important factor in the spread of TB from lower-income countries to higher-income countries?

Immigration

What is the most important milestone achieved in global health over the last 50 years?

Decrease in the under-5 mortality rate to 65 per 1,000 children

Which statement about the present status of global health is true?

About 146,000 deaths occurred from measles globally in 2013.

Which country is considered low income, according to the World Bank definition?

Liberia

Which of the following represents an upper-middle-income country according to the World Bank classification?

Turkey

Which of the following is not a Millennium Development Goal?

Combat heart disease, diabetes, and other diseases

Which of the following was not a feature of smallpox?

Diagnosis was made by laboratory testing since the rash was not distinct.

A country with gross national income per capita of $1,000 is classified by the World Bank as a…

Low-income country

Which of the following is a Millennium Development Goal?

Between 1990 and 2015, halve the proportion of people who suffer from hunger.

Which statement about global health is false?

Global health refers to an area of study, research, and practice that aims to improve health in low-, middle-, and high-income countries.

What is least likely to be a determinant of health?

Government policies

Life expectancy at birth is:

The average number of years a newborn could be expected to live, if current mortality trends were to continue for the rest of the newborn’s life

The denominator for infant mortality rate is:

1,000 live births in a given year

The numerator for neonatal mortality rate is:

The number of deaths of infants under 28 days of age in a given year.

In which World Bank region would you expect the maternal mortality ratio to be the highest?

Middle East and North Africa

The maternal mortality ratio is:

The number of women who die as a result of pregnancy and childbirth complications per 100,000 live births in a given year.

What would you expect to happen to the incidence and prevalence of a disease if a new drug were discovered that prevented mortality from the disease but did not cure it?

Incidence unchanged, prevalence increases

Which sentence conveys information that is most useful for policy making?

Ischemic heart disease was the leading cause of DALYs in high-income countries, accounting for 8% of total DALYs in 2010.

Which of the following are most likely to be the top three causes of DALYs in sub-Saharan Africa?

Malaria, HIV/AIDS, lower respiratory infections

Which country is most likely to have a "population pyramid", with a wide base and progressively tapering tip (triangle shaped)?

Niger

Which statement about health and maternal education is false?

Studies in the Philippines have shown that even better educated mothers were unable to keep their children healthy in locations without safe water supply.

Which group is most likely to have the lowest measles immunization rate?

Poorest 20% population of West and Central Africa

Which statement about health equity is true?

It is a multidimensional concept that includes issues of fairness within and across countries.

Which of the following is most likely to have the lowest life expectancy at birth?

An aboriginal Australian female

Among which of the following would you expect to have the greatest disparity in the rate of stunting in under-5 children?

Rural vs. urban Latin America and the Caribbean

In which area would you expect to have the highest rates of contraception use among women aged 15-49?

Urban East Asia and the Pacific

Which statement about measles vaccination by income quintile is true?

The gaps in vaccine coverage between income groups are greater in West and Central Africa among the same groups in South Asia.

Which statement about health expenditure and outcomes is false?

Cuba spends a relatively high share of its GDP on health and has a low life expectancy.

Which one of the following is not considered private health spending?

Social security system

What would buy you the most health gained for the least cost?

Childhood vaccination

CRC

Protects the rights of children on subjects from discrimination to health to education

ICESCR

Focuses on the well-being of individuals with their right to work in safe conditions and to enjoy the highest standard of physical and mental health

ICCPR

Discusses rights of equality, liberty, and freedom of movement and expression

UDHR

Basis for most of the treaties and documents related to human rights

Respect for persons

Informed consent

Beneficence

Assessment of risks and benefits

Justice

Selection of subjects

T of F:
The institutional review board, or research ethics committee, review the regal requirement for clinical research with human subjects.

True

T or F:
In the Tuskegee study of untreated syphilis in Alabama, the participants did not receive any treatment for syphilis during the course of the study, which raised ethical concerns.

True

Which of the following represents a human rights issue for patients with HIV/AIDS?

Employment discrimination, coercion of people to get tested for HIV, disclosure of HIV status to spouses or sexual partners. (All of the above)

Which statement about the Tuskegee study is false?

The public Health Service allowed the participants to receive effective treatment when penicillin became widely available after WWII

What does not represent international research ethics guidelines?

Declaration of Alma Ata

Assessing risks and benefits fulfills with ethical principle, as listed in the Belmont report?

Beneficence

All of the following fall under the six conditions that a clinical research protocol must satisfy to be ethical except…

Written consent

What does not represent ethical principles for allocation of scarce resources?

Priority to the better off

Perception of illness

People in sub-saharan Africa consider malaria normal

Perception of disease

The cause of illness is attributed to "evil eye" in many cultures

Folk Illness

The illness Empacho is caused by a variety of inappropriate food practices

Personal characteristics that influence behavior

Individual

Interpersonal

Interpersonal processes and primary groups including family, friends, and peers

Institutional

Rules, regulations, policies, and informal structures

Community

Social networks and norms that exist among individuals, groups, and organizations

Local, state, and federal policies that support disease prevention, early detection, control, and management

Public Policy

Which country? Polio vaccination

India

Breastfeeding

Burundi

Which country? Conditional cash transfers

Mexico

Birthing services

Peru

What portrays the "Western medical paradigm" explaining the cause of diseases?

Heart disease comes from smoking

Which example of traditional behaviors is conductive to good health?

Male circumcision

Which statement about illness is false?

Disease and illness are one and the same.

Traditional birth attendants are an example of what type of health system?

Indigenous

Which of the following is not a model of behavioral change?

Environmental model

What is the correct progression of behavioral change, according to the stages of change model?

Precontemplation, contemplation, decision, action, maintenance

The Tamil Nadu Nutrition Project best represents…

Community mobilization

What intervention is suitable for cities of low-and middle-income countries to reduce ambient air pollution?

Tightening emission inspections on vehicles.

T or F:
The reduction of diarrhea is the largest impact of improved sanitation.

True

Addressing ….. effectively is central to achieving the Millennium Development Goals

Environmental health

The most important environmental risk factor in low- and middle-income countries is …….

Household air pollution

Improved sanitation, if couple with hand washing with soap, would have the largest impact on the reduction of…..

Diarrhea

Which type of fuel creates the least amount of indoor air pollution?

Kerosene

Which water and sanitation intervention is the most cost-effective per DALY saved?

Hygiene promotion

Which statement about indoor air pollution is true?

Indoor air pollution can lead to a variety of respiratory problems.

What is not one of the top 3 environmental factors leading to disease in low- and middle-income countries?

Unhealthy urban lifestyle

What is the percentage of people worldwide with access to improved sanitation?

60%

What practice will likely improve children’s nutritional status?

Breastfeeding exclusively for six months.

T or F:
Exclusive breastfeeding for six months promotes better health and cognitive development for infants that timing in other foods during that period.

True

Obesity can have significant effect on an individual’s ……., which is harmful to children and their academic achievement.

Mental health

Protein

Milk, eggs, cheese, and meat

What foods is calcium in?

Milk and dairy products

What foods contain vitamin A?

Liver, eggs, and green leaf vegetables

Folic Acid

Green leaf vegetables and nuts

Which statement about nutrition is false?

Nutritional deficits in children under 2 years old can generally be overcome in later life by nutritional supplementation.

Which vicious cycle must be broken in order to improve the nutritional status of children in the medium and longer terms?

1) Poverty leads to lack of purchasing power, leading to poor nutrition, affecting the potential to work and generate income, leading to further poverty. 2) Lack of education leads to poor feeding practices, causing poor childhood nutrition, leading to poor mental development, leading further to lack of educational opportunities. 3) Malnutrition makes children susceptible to infections, which further decreases their nutritional intake, lading to further malnutrition.

What best represents chronic undernutrition?

Stunting

The window of opportunity for ensuring proper growth and development of children closes at the age of …….

2 years

Which nutritional supplementation promotes more rapid recovery from diarrhea?

Zinc

What is the most cost-effective approach to combating iodine deficiency?

Salt fortification

Which factor has a direct and profound effect on the health and survival of neonates, infants, ad children under 5 years of age?

Nutritional Status

Which set of diseases is covered through the administration of pentavalent vaccine?

Diphtheria, pertussis, tetanus, HepB, and Hib

T or F:
The expanded program on immunization effort launched by the World Health Assembly to vaccinate children worldwide.

True

T or F:
One of the great successes of the global polio eradication initiative was the elimination of polio in sub-Saharan Africa in 2014.

False

Neonates acquire …….. when their umbilical cord is contaminated by using an unsterile object to cut it.

Tetanus

The leading cause of death for children under 5 years of age in East Asia and the Pacific is ………

Pneumonia

The pattern of infant and neonatal mortality is highest among the …….. World Bank region.

Sub-Saharan

How does pneumonia spread?

Airborne droplets

Malaria

Mosquito bite

HIV

Mother to child

Round worm

Soil transmission

Diarrhea

Fecal-oral route

Which statement about the burden of childhood illness in the under-5 age group is true?

The rate of under-5 mortality in sub-Saharan Africa is about 25 times that in high-income countries.

What are the global top 3 causes of under-5 mortality?

Preterm birth complications, pneumonia, malaria

What was the aim of the school-based education HealthWise South Africa?

To reduce substance abuse and risky sexual behavior among adolescents

T or F:
The WHO defines an adolescent as person between the ages of 10 and 19 years.

True

T or F:
The conditional cash transfer program in Malawi highlighted the importance of addressing the mental health needs of adolescent girls.

False.

……, HIV/AIDS, and self-harm are the 3 leading causes of death of adolescents globally.

Road injury

WHO definition of adolescent

A person between the ages of 10 and 19 years

United Nations definition of youth

A person between the ages of 15 and 24 years

Convention on the rights of the child by the United Nations

A person under the age of 18

Leading causes of death for males, 10-19 age group, in low- and middle-income countries

Road injury and HIV/AIDS

Leading causes of death for females, 10-19 age group, in low- and middle-income countries

Communicable diseases and self harm

Leading causes of death for males and females, 10-19 age group, in high-income countries

Road injury and self-harm

High adolescent fertility

Sub-Saharan African and Latin America

Which country? Anemia

South Asia and Sub-Saharan Africa

Which countries? Smoking

Argentina and Indonesia

The United National Convention on the Rights of the Child defines a child as:

A person under 18 years of age

Early adolescence is defined as the period between:

Ages 10 and 14

The 3 leading causes of death among adolescents globally are

Road injury, HIV/AIDS, and self-harm

Which agency is responsible for protecting the rights of refugees?

UNHCR

What condition leads to the most common cause of death in refugee countries?

Diarrheal diseases

T or f:
Complex humanitarian emergencies are situations with excess mortality due to a combination of factors such as war or civil strife, food shortage, and population displacement.

True

Which situation is not considered a CHE?

Malaria epidemic

One of the primary goals of humanitarian disaster response is to:

Promote a return to normalcy

People who flee their homes or are forced to migrate during a disaster but stay in the country in which they were living are called…

Internally displaced persons

An indicatory commonly used to assess the health impact of a complex humanitarian emergency is…..

Crude mortality rate

The cause of mortality during a natural disaster is likely to be…….

An epidemic linked to lack of safe, water, sanitation, food, or access to health services. A lack of access to health care due to damage to health infrastructure. The direct result of the disaster on the health of individuals. (All of these are correct)

Which of the following statements is true?

Humanitarian workers have increasingly been the target of those who are fighting in a conflict area.

What would you do to ensure a safe and healthy environment for displaced people?

Provide urgent nutritional supplementation to severely malnourished children. Provide appropriate sanitation facilities and separate toilets by sex to provide safety for women. Help displaced persons return to their homes are quickly as possible. (All of these are correct)

Mass chemotherapy can be administered for all of the following, except:

Diphtheria

Case fatality rate is:

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

Reducing the incidence of a disease in a specific area to zero is termed…….

Elimination

All of the following are emerging infectious diseases, except:

Hepatitis B

Key factors contributing to the emergence and re-emergence of infectious diseases include:

War and famine, microbial adaptation and change, breakdown of public health measures. (All of these are correct)

Which of the following statements about HIV/AIDS is false?

Cambodia faces a generalized epidemic of HIV/AIDS

Which statement about the prevention and treatment of HIV/AIDS is true?

One cost-effective measure to reduce the material-to-child transmission of HIV is to avoid unwanted pregnancies of HIV-positive women through contraception.

Which statement about the prevention and treatment of TB is false?

The BCG vaccine is important in reducing the transmission of TB.

What is not a key intervention in controlling malaria in highly endemic regions of Africa?

Outdoor residual spraying of insecticides.

What is the most cost-effective intervention to address neglected tropical diseases in sub-Saharan Africa?

The rapid-impact package.

Which statement about ischemic heart disease is true?

It is the largest cause of death among all age groups in all regions except sub-Saharan Africa, East Asia, and the Pacific.

Which cancers are most closely associated with tobacco use?

Lung, esophageal

Which statement about tobacco smoking is true?

Men smoke more than women

Which person is more likely to suffer from cardiovascular disease?

An obese man who has high blood pressure and drinks a lot of alcohol

Which condition accounts for a large portion of the burden of cardiovascular disease worldwide?

Ischemic heart disease

What is the leading cause of death worldwide?

Cardiovascular disease

Which type of diabetes is associated with physical activity?

Type II

What is the most important step a country can take to reduce the burden of noncommunicable diseases?

Reduce tobacco consumption

Where would you expect to have diabetes contributing to the most DALYs in 2030, according to WHO projections?

Upper-middle-income countries

What would be the most cost-effective measure for reducing tobacco consumption?

Raise taxes substantially

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

Education and counseling by healthcare providers

What is a risk factor for poisoning in low-income countries?

Use of nonstandard containers for poisonous goods.

T or F:
Children under 5 account for 20 percent of drowning deaths in low- and middle-income countries.

True

What is a risk factor for road traffic injuries?

Increased use of vehicles.

What is a risk factor for burns?

Living in a crowded area.

Most important to deaths from unintentional injuries are:

Road traffic injuries

Which risk factor for road traffic injuries is predominantly found in low- and middle-income countries, as opposed to high-income countries?

Poor enforcement of speed limits, lack of motorcycle helmet use, poor road planning and design. (All of these are correct)

What approach would you recommend that low-and middle-income countries take to prevent and control unintentional injuries?

Carry out pilot projects based on what has worked in high-income countries, adapt to the local context, and expand more broadly with time.

Which action describes an arrangement for emergency transport?

Initiating a bicycle ambulance in Malawi

Installing speed bumps at selected places

Ghana

Which country is including daytime running lights on motor vehicles?

China

Which country disperses childproof containers to reduce childhood poisoning?

South Africa

Providing playpens to reduce the risk of drowning

Bangladesh

Person-focused, ongoing care that meets the health-related needs of the people

Primary care

Medical care provided by a specialist or facility upon referral by a primary care physician

Secondary care

Specialized consultative care, usually upon referral from primary or secondary medical care personnel, by specialists within a center with special facilities for treatment

Tertiary care

Actions and means adopted by a society to organize itself in the promotion and protection of the health of its population

Governance

Which intervention is included in the model primary care package of essential health services?

Prevention of HIV and malaria

When compared to high-income countries, which statement about healthcare expenditures in low-income countries is false?

Higher health expenditures as a percentage of GDP

What is not a health system building block according to WHO framework?

Social and financial risk protection

What is the best strategy in the short to medium term to combat the acute shortage of doctors who can perform cesarean sections in low-income countries?

Train nursing staff to perform cesarean sections

What is the least likely to be included in a primary healthcare package?

Cardiac catheterization

What would have the biggest impact on reducing the occurrence of obstetric fistula?

Effectively increasing the modern contraceptive prevalence rate to about 40% of all families

T or F:
Cooperation is required between countries to address the surveillance of diseases.

True

T or F:
UNAIDS is a global agency whose primary responsibility is dealing with diabetes.

False

…… is the agency that helps the U.S. and other countries plan and carry out disease surveillance, prevention, and control across a broad range of disease conditions

CDC/Centers for Disease Control and Prevention

Which United Nations Agency is primarily involved in the prevention and control of HIV/AIDS?

UNAIDS

The largest charitable foundation in the world is:

The Bill and Melinda Gates Foundation

Which organization is dedicated to promotion vaccination efforts as part of improving global health?

Gavi

What is the new anti-TB drug that has less toxicity and improved efficiency and should be used as an alternative to the current regimen for multidrug-resistant TB?

Bedaquiline

The "10/90 gap" is explained as:

Ninety percent of research expenditures is spent on the developed world, 10% on the developing world.

Which option best represents the ideal characteristics of drugs for use in low- and middle-income countries?

Easy to transport and store, oral administration, heat stable, single dose

What is a special challenge of expanding coverage of the HPV vaccine, compared to the six basic antigens of the EPI program?

Providing to adolescents, who are not normally the target group for childhood immunization

Tiered pricing is:

Charging different prices in different markets for the same product.

Which statement about pull mechanisms is least likely?

Examples of pull mechanisms are tax credits for research and development or handing over research findings to firms.

Which statement best apples to push mechanisms?

Reduce risk and encourage products development through lowering the costs of product development, with a focus on research and development.