Community Medicine Review Flashcards

Comprehensive vocabulary flashcards covering the key principles, indicators, and programs in Community Medicine as presented in the Marrow Edition 8 transcript.

Annual Growth Rate (AGR)

The difference between the birth rate and the death rate ($AGR = BR - DR$).

Dependency Ratio

A formula measuring the ratio of the dependent population ($< 14$ years and $> 65$ years) to the independent population ($15-64$ years), expressed as: $\frac{\text{Age } < 14y + \text{age } > 65y}{\text{Age of } 15-64y} \times 100$.

Total Fertility Rate (TFR)

The average number of children a woman would have if she survives to the end of her reproductive life; India's target is $< 2.1$ and the current rate is $2.0$ per NHFS-5 data.

Net Reproduction Rate (NRR)

The total number of daughters a newborn girl child will bear in her lifetime assuming Age Specific Fertility Rates and Age Specific Death Rates; the target for population stabilization is $NRR = 1$.

Sample Registration System (SRS)

A dual/biannual system conducted every $6$ months at the PHC/District and State/National levels to match and triangulate data for assessing vital indicators like CBR and IMR.

Pearl’s Index

The most common method to assess the failure of contraception, calculated as: $\frac{\text{Number of accidental pregnancies}}{\text{Total woman years of exposure}} \times 100$.

Lactational Amenorrhoea

A natural physiological response providing temporary contraception post-delivery; often supplemented with Progesterone Only Pills due to its high failure rate.

Mirena

A third-generation hormonal intrauterine device (IUD) containing Levonorgestrel ($52\,mg$) that releases $20\,mcg/day$ and is effective for $5-7$ years.

Centchroman (Chhaya)

A non-steroidal selective estrogen receptor modulator (SERM) developed by CDRI Lucknow, taken twice weekly for the first $3$ months and then once weekly.

Mission Parivar Vikas (MPV)

A scheme by the Ministry of Health and Family Welfare (MoHFW) that promotes contraceptive use and recently added MPA (Antara), Centchroman (Chhaya), and POPs to its basket of choices.

Infant Mortality Rate (IMR)

The number of infant deaths per $1000$ live births ($\frac{\text{No. of infant deaths}}{\text{Live births}} \times 1000$); currently assessed at $28$ in India (SRS 2022).

Maternal Mortality Ratio (MMR)

The number of maternal deaths per $1,00,000$ live births; India's target by 2030 is $< 70$ and the current ratio is $97$.

Anemia Mukt Bharat (AMB)

A strategy implemented under the National Nutrition Mission using a $6 \times 6 \times 6$ framework to target beneficiaries from $6$ months to $49$ years through iron and folic acid supplementation and deworming.

Kangaroo Mother Care (KMC)

Skin-to-skin contact between mother and baby used to maintain the baby’s body temperature, promote emotional bonding, and improve nutritional and ambulatory outcomes.

Moderate/Acute Malnutrition (Wasting)

A condition indicated when the weight-for-height (WFH) is low ($< -2SD$) as per Waterlow’s classification.

Mid Upper Arm Circumference (MUAC)

An age-independent indicator measured using Shakir’s tape in children over $6$ months; a value of $< 11.5\,cm$ (Red color) indicates Severe Acute Malnutrition.

RMNCAH+N

A comprehensive strategic framework covering Reproductive, Maternal, Newborn, Child, Adolescent Health, and Nutrition.

Integrated Management of Neonatal and Childhood Illness (IMNCI)

An integrated approach to identify, classify (Pink/Yellow/Green), and treat childhood illnesses through assessment, parent counseling, and follow-up.

Open Vial Policy

A guideline allowing certain multi-dose vaccines to be used up to $28$ days after opening; it excludes BCG, Measles/MR, and live JE vaccines.

Shake Test

A physical test used to check if freeze-sensitive vaccines (DPT, Hep B) have been damaged; a cloudy/smooth white solution is usable, while a clear solution with thick sediment is not potent.

Ice Lined Refrigerator (ILR)

The top-opening storage unit in the cold chain that maintains temperatures between $+2^{\circ}C$ to $+8^{\circ}C$; heat-sensitive vaccines like OPV are kept at the bottom.

Vaccine Vial Monitor (VVM)

A label on a vaccine vial containing a chemical indicator (inner square) that changes color when exposed to cumulative heat, indicating if the vaccine is discarded or usable.

Incidence

The number of new cases of a specific disease occurring during a given time period in a population at risk.

Case-Control Study

A retrospective, analytical epidemiological study that moves from effect (disease) to cause by comparing cases with controls to find the Odds Ratio.

Cohort Study

A prospective, longitudinal study that moves from cause (risk factor) to effect (disease) to determine incidence and Relative Risk ($RR$).

Confounder

A third variable associated with both the risk factor and the disease that creates a spurious association; managed through matching, randomization, or stratification.

Sensitivity

The probability of a screening test correctly identifying individuals who actually have the disease ($\frac{TP}{TP+FN}$).

Specificity

The probability of a screening test correctly identifying individuals who do not have the disease ($\frac{TN}{TN+FP}$).

Type 1 (α) Error

The mistake of rejecting a true null hypothesis, often referred to as a False Positive error.

P-Value

A probability value ranging from $0$ to $1$; a result is considered statistically significant if the P-value is $< 0.05$, leading to the rejection of the null hypothesis.

Standard Error of Mean (SEM)

A measure of the precision of the sample mean calculated as $\frac{SD}{\sqrt{n}}$, where $SD$ is the standard deviation and $n$ is the sample size.

Cluster Sampling

The method of choice for many health programs involving the random selection of naturally occurring groups or clusters within a large homogeneous population.

CBNAAT / Gene Xpert

A cartridge-based nucleic acid amplification test used for the sensitive and specific diagnosis of Tuberculosis and resistance to Rifampicin, providing results in $90$ minutes.

Multi Drug Resistant TB (MDRTB)

Tuberculosis showing resistance to at least both Isoniazid ($H$) and Rifampicin ($R$).

TLD Regimen

The preferred first-line ART regimen for PLHIV weighing $> 30\,kg$, consisting of Tenofovir ($300\,mg$), Lamivudine ($300\,mg$), and Dolutegravir ($50\,mg$).

Sentinel Surveillance

A strategy in the HIV program to find the 'bridge' population (like truck drivers or migrants) that transmits the infection from core high-risk groups to the general population.

Annual Parasite Incidence (API)

The best epidemiological indicator for the burden of malaria, calculated as: $\frac{\text{Confirmed cases in a year}}{\text{Population under surveillance}} \times 1000$.

Aedes Aegypti

Known as the Tiger mosquito, it is the vector for Dengue, Zika, and Yellow Fever; it is an anthropophilic daytime biter that breeds in artificial water containers.

Kala Azar (Visceral Leishmaniasis)

A disease caused by $. Donovani$ and transmitted by the sandfly ($Phlebotomus argentipes$), primarily found in Bihar, West Bengal, and Uttar Pradesh.

Acute Flaccid Paralysis (AFP) Surveillance

The monitoring of children under $15$ years for sudden paralysis, requiring two stool samples collected $24$ hours apart within $14$ days of onset to rule out wild poliovirus.

Syndromic Surveillance

A component of the IDSP where health workers monitor $6$ key syndromes (like fever with localized sign or jaundice) every fortnight to detect potential outbreaks.

Ayushman Bharat (PMJAY)

The world's largest health insurance scheme providing $5$ lakh rupees per family per year for secondary and tertiary care hospitalization to $10$ crore vulnerable families.

Multi-Purpose Worker (MPW)

A health worker developed by the Kartar Singh Committee ($1973$); the male MPW focuses on vector control and water quality, while the female MPW focuses on maternal and child health.

Biological Oxygen Demand (BOD)

The most common measure of sewage strength, defined as the amount of oxygen consumed by $100\,gm$ of sewage in a specified time at $20^{\circ}C$ for aerobic digestion.

Plumbism

Lead toxicity characterized by Basophilic stippling of RBCs, Burtonian lines on gums, and wrist/foot drop; defined clinical features manifest at blood lead levels $> 40\,mcg/dL$.