HLTH 4011 EXAM 3 ECU

Latinos and infants

Which specific persons were mentioned as being vulnerable to the specific outbreak of whooping cough in the pertussis outbreak?

Califorinas central valley, home to many latino farm workers (fresno county)

Which specific places were mentioned as being vulnerable to this specific outbreak of whooping cough?

The peak season starts in the summer with July & august

Which specific times of the year were mentioned as being vulnerable to whooping cough?

5,000 to 7,000 cases in a normal year

The endemic level of a health-related event is the level that is expected at any given time. This is also referred to as the baseline level. What was mentioned as the endemic level of whooping cough in the U.S. in a normal year?

Boosters are recommended in middle school, adolescence and through adulthood as immunity

What were the public health-related recommendations/interventions mentioned to decrease the incidence of this specific outbreak of whooping cough?

5 essential activities for disease surveillance

1. identify, define, and measure the health related problems of interest

2. collect and compile data about the problem

3. analyze and interpret the data

4. Provide these data & their interpretation to those responsible for controlling the problem

5. Monitor and periodically evaluate the usefulness and quality of surveillance to improve it for future use

Registries

method for documenting or tracking events or persons over time

permanent record of persons or events

registries of vital events

birth registration, marriage registration and death registration

registries used in preventative medicine

immunization registries

disease specific registries

blind, birth defects, cancer

registries of persons at-risk or exposed

atomic bomb survivors, world trade center survivors

Notifications

Reporting of certain diseases as specified by law, regulation, or agreement (ex. cholera, plague, lead poisoning)

typically made to a state or local health agency

Reasons for underreporting

lack of awareness of:

- responsibilities to report

- which disease to report

- how or whom to report

improve awareness

simplify reporting

provide incentives

provide frequent feedback

CDC recommendations for improving notifiable disease surveillance

Sensitivity

A/A+C

true false

the ability of surveillance to detect persons with the health problem.

the proportion of people with a health condition (cases) that are correctly identified by a screening or a case definition

(__/__+__)

(_____ positives and ______ negatives)

Specificity

D/B+D

true false

-the ability of surveillance to detect persons not having the health problem (non-cases) it is intended to detect

-the proportions of persons without a health condition (non-cases) that are correctly identified by a screening or case definition

(__/__+__)

(_____ negatives and ____ positives)

True positives

A

has

Cell ____

A positive test for a person who ____ the disease

False negative

C

negative

Cell ____

A ____ test for a person who actually has the condition

True negative

D

negative

Cell ____

A _____ test for a person who does not have the condition

False positive

B

positive

Cell _____

A _____ test for a person who actually does not have the condition

sensitivity

num: Cell A

denom: Cell A&C

specificity

num: Cell D

Denom: Cell B&D

Specificity rates

positives

-range from 0% to 100%

-the higher the value, the more specific the surveillance in detecting non cases

- if 80% or above there are no false ______

sensitivity rates

negatives

-range from 0% to 100%

-the higher the value, the more sensitive the surveillance is in detecting cases

- if 80% or above there are no false _____

Purposes of field investigations

control prevent

______ the outbreak and _____ additional cases

Alternative causes of suspended outbreaks

Population

Case definition

Diagnostic test

Notification

Case Definition

-standard set of criteria for deciding whether an individual should be classified as having the health conditions

-Start by identifying cases via healthcare practitioners & facilities where a diagnosis is likely to be made

descriptive epidemiology

Once patients are identified and basic info collected ----> characterize the outbreak by person, place, and time

the importance of descriptive epidemiology

characterize the outbreak

infer who is at risk

provide clues about the cause, source and modes of transmissions that can turn into testable hypotheses

Time

epi curve

visual display of outbreaks magnitude & time trend

3 different epi curves

1. point source

2. continuous common source

3. propagated

Point souce

-persons are exposed to the same exposure over a limited, defined period of time

-shape of curve rises rapidly and contains a definite peak at top (ex. foodborne illness)

Continuous Common Souce

-similar to point source but exposure to the source is prolonged over an extended period of time

-decline may be sharp if common source is removed or gradual is outbreak is allowed to exhaust itself

(ex. john snow)

Propagated

- cases serve as a source of infection for subsequent cases

- shape of curve usually contains a series of successively longer peaks

(ex. flu, chicken pox)

place

spot maps (small outbreaks) area maps (larger outbreaks)

demonstrated clusters and patterns

person

described via host characteristics/ possible exposure

(ex. age, sex, race, medical status occupation)

how to calculate attack rate

ill exposed/ total exposed

ill unexposed/ total unexposed

how to calculate RR

exposed attack rate/ unexposed attack rate

Sensitivity

Which term in our text/slides refers to the proportion of persons with a health condition that are correctly identified by a screening or case definition?

Control the outbreak and prevent additional cases

According to our text/slides, what is the primary purpose of conducting a field investigated?

1. change in population

2. change in reporting (notifications)

3. change in detection (diagnosis)

4. change in case definition

List the occurrences mentioned in our text/slides that could lead to an observance of more cases of disease/disorder than expected

Continuous common source

The illustration of the cholera outbreak in John Snows' study is most consistent with what epi-curve type?

Disease surveillance

What is the primary wat that clusters (suspected outbreaks_ are detected?

relative risk

2

If ____ ____ is greater than ____ it needs further investigation

When to implement control measure

control and prevention measures should be implemented ASAP

SPSS

statistical analysis program used

leave it blank

what do you do when you have missing data?

other surveys and pilot test feedback

revision strategies utilized in group project?