Maternal and Child Health Quiz

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Questions and Answers

What is the primary source of data for estimating the maternal mortality ratio?

CDC

WHO (correct)

UNICEF

NHS

Which of the following is NOT considered a direct cause of maternal death?

Infection (sepsis)

Hypertensive disorders of pregnancy

Maternal haemorrhage

Chronic illness (correct)

What was one of the major initiatives started in 2003 to monitor maternal and child health?

Maternal Health Initiative

Countdown to 2015 (correct)

Global Health Initiative

Countdown to 2020

Approximately how long after delivery does the highest risk of maternal death occur?

24 hours Signup and view all the answers

What is considered one of the most preventable causes of maternal death?

Unsafe abortion Signup and view all the answers

Which system is used to describe the staging of cancer?

TNM system Signup and view all the answers

What does the tumor grade indicate?

How similar the cancer cells are to normal tissue Signup and view all the answers

Which imaging technique is NOT typically used for cancer detection?

Ultrasound Signup and view all the answers

What is measured by cancer incidence?

The number of new cases occurring in a specific population over time Signup and view all the answers

What is the significance of the term 'carcinoma in situ' in cancer staging?

Abnormal cells are present but have not yet spread Signup and view all the answers

The average risk of dying from a specific cancer is measured by which metric?

Mortality Signup and view all the answers

Which of the following factors can influence differences in cancer incidence across populations?

Screening and diagnostic practices Signup and view all the answers

What is the purpose of systematic screening for cancer?

To reduce mortality among asymptomatic individuals Signup and view all the answers

What is one of the common causes of stillbirth?

Congenital abnormalities Signup and view all the answers

Which condition is classified as a Type 2 diabetes characteristic?

Inability of body tissues to respond to insulin Signup and view all the answers

Which risk factor is associated with cardiovascular diseases?

Hypertension Signup and view all the answers

What is the significance of maternal infections during pregnancy in relation to stillbirth?

They are one of the common causes of stillbirth. Signup and view all the answers

Which characteristic is indicative of diabetes according to WHO criteria?

Fasting blood glucose ≥7mmol/l Signup and view all the answers

What is a significant epidemiological concern related to Type I diabetes in low-income countries?

Unclear incidence and high mortality in children Signup and view all the answers

Which factor has NOT contributed to the rise of Type II diabetes?

Increased physical activity Signup and view all the answers

Which condition is NOT typically a complication related to childbirth?

Excessive labor duration Signup and view all the answers

What is the stillbirth rate calculated against?

Total number of births (live births plus stillbirths) Signup and view all the answers

What age range is covered by the neonatal mortality rate?

0-27 days old Signup and view all the answers

During which trimester is a birth categorized as a stillbirth?

Any trimester after miscarriage < 1 trimester Signup and view all the answers

What is the perinatal mortality rate based on?

Total number of births (live births plus stillbirths) and early neonatal deaths Signup and view all the answers

Which type of mortality rate is defined for infants aged 0 to 364 days?

Infant mortality rate Signup and view all the answers

Which statement accurately describes the inclusion of stillbirths in health targets?

Stillbirths were not included in either SDGs or MDGs targets. Signup and view all the answers

Which of the following best describes the infant mortality rate?

Comprises neonatal and post-neonatal deaths Signup and view all the answers

What is the focus of neonatal mortality statistics?

Deaths within the first 27 days of life Signup and view all the answers

What characterizes COPD in individuals?

Exacerbations that lead to significant breathlessness Signup and view all the answers

In which regions was the Burden of Obstructive Lung Disease (BOLD) study conducted?

North European and LMIC sites Signup and view all the answers

What is a significant finding of the PLATINO study regarding COPD prevalence in men?

Prevalence rates range from 11% to 27% Signup and view all the answers

What impact does breathlessness have on individuals suffering from COPD?

It hinders their ability to perform daily activities Signup and view all the answers

What trend is observed regarding asthma prevalence in different countries?

It is increasing in several countries Signup and view all the answers

Which demographic is primarily involved in the BOLD study?

Adults over 40 years old Signup and view all the answers

What is one of the notable characteristics of asthma in lower-middle-income countries (LMIC)?

It is more severe than in high-income countries Signup and view all the answers

What age-related trend is observed in the prevalence of COPD?

Prevalence increases markedly with age Signup and view all the answers

What is characterized by reduced death rates of communicable diseases and increased rates of disorders linked to urbanization?

Epidemiologic transition Signup and view all the answers

During the epidemiologic transition, which group of conditions tends to see a decrease in mortality rates?

Communicable diseases Signup and view all the answers

Which classification group includes communicable diseases, maternal and perinatal disorders?

Group 1 Signup and view all the answers

What does the 'double burden of disease' refer to in less developed areas?

Coexistence of communicable and non-communicable diseases Signup and view all the answers

What is the main public health concern associated with the epidemiologic transition?

Managing chronic diseases and injuries Signup and view all the answers

What type of diseases predominantly sees an increase during the epidemiologic transition?

Non-communicable diseases Signup and view all the answers

What is required to address the combined burden of disease globally as mentioned in the content?

Resources for prevention, control, and palliation Signup and view all the answers

Which of the following statements about mortality trends during the epidemiologic transition is true?

Mortality from group 2 and group 3 conditions tends to increase. Signup and view all the answers

Study Notes

Lecture 2: Introduction to the Epidemiology of Non-Communicable Diseases

Non-communicable diseases (NCDs) are a broad range of conditions not transmitted person-to-person.
Key focus areas for global NCDs are cardiovascular disease (CVD), cancer, type 2 diabetes mellitus, and chronic obstructive pulmonary disease (COPD).
Other NCDs include injuries, mental disorders, and reproductive disorders; some have infectious origins, like HPV.
NCD prevalence increases with age; shared risk factors cause common co-morbidities in older individuals.

Outline

Introduction to NCDs and the Global Burden of Disease (GBD)
Epidemiologic transition
NCD risk factors (upstream and downstream)
Epidemiology of:
- Reproductive health
- Cardiovascular disease and Type 2 diabetes
- Cancer
- Respiratory diseases (COPD and asthma)

What are Non-Communicable Diseases?

Non-communicable diseases cover a wide range of conditions not transmitted from human-to-human.
Major focus is on CVD, cancer, type 2 diabetes mellitus, and COPD.
Other NCDs include injuries, mental disorders, and reproductive disorders, some that can be of an infectious agent origin.

Non-Communicable Disease Epidemiology

Epidemiology tends to focus on specific diseases (cancer, cardiovascular, respiratory) rather than a combined category of non-communicable diseases.
Key determinants of chronic diseases are heavily influenced by globalization, specifically unhealthy diet, physical inactivity, and tobacco use.
The Global Burden of Disease study provides a crucial initiative to collect comparable data on health loss due to diseases, injuries, and risk factors globally. This initiative offers significant collaborative efforts from global health institutions, researchers, and policymakers.

The Global Burden of Disease

Infectious diseases and neonatal conditions dominated global health loss in 1990.
By 2015, lower respiratory infections were the leading global cause of death after communicable diseases and neonatal conditions.
Disability-Adjusted Life Years (DALYs) are a combined measure of premature mortality (Years of Life Lost, YLL) and non-fatal health outcomes (Years Lived with Disability, YLD) which evaluate the overall global health burden.

Epidemiologic Transition

NCDs are on the rise globally as countries undergo the epidemiologic transition.
Death rates from communicable diseases typically decline, while rates of disorders related to urbanization and affluence increase.
WHO classifies diseases into three groups for mortality: communicable diseases, non-communicable diseases and intentional or unintentional injuries.

Double Burden of Disease

Low and middle-income countries (LMICs) face a "double burden" of both communicable and non-communicable diseases.
Globally, combined burden requires combined resources for prevention, control, and mitigation.

NCD Risk Factors

Factors specific to the diseases and global factors (not under individual/country control) cause or contribute to NCDs.
Urbanization (industrialization/modernization/urban culture), alteration in diets, reduced physical activity, loss of traditional cultural values, and migration (rural to urban) are among the global factors.
Poverty significantly drives NCD rates in LMICs, influencing the burden.

NCD: Upstream and Downstream Determinants

Upstream determinants are macro-level factors (globalization, community influence) that affect health.
Downstream determinants are micro-level factors affecting individuals (genetics, age, individual behaviors, biological factors like blood pressure/lipid levels).

Life-Course Perspective

Individuals respond dynamically to macro-level factors throughout their lives, impacting their risk of NCDs.
These factors can significantly influence individual health determinants.

Neighbourhood effects
Compositional, contextual effects (social & dynamic features of the neighbourhood)
Integral effects (neighbourhood structural characteristics)
Social networking can impact things like obesity.

Built Environment and NCD Risk Factor Distributions

Built environment (human-made structures like parks) influences physical activity levels.
Urban design impacts access to exercise, fitness, and transportation.
Food environment factors (location, type of outlets, food quality/price) affect NCD risk factors.

Trade Agreements, Nutrition and NCD Risk Factors

Trade agreements influence NCD risk factors primarily through their effect on agricultural production, trade in foodstuffs, and food processing.
Trade agreements affect the food environment by influencing what foods are available.

Nutrition Transition

A nutrition transition has occurred in many countries, driven by urbanization, economic development, technological advancements, food processing, and media influences.
This transition has a progression through three stages: receding famine, degenerative disease, and behavioral change. Each stage has specific associated health outcomes and risk factors.

Agricultural Policies, Climate Change and NCD Risk Factors

Agricultural policies (input, production, trade) influence agricultural production and farmer income.
There's a complex relationship between agricultural policies, production practices, and diet.

Agriculture, Climate Change and Health

Livestock production contributes to climate change through deforestation, energy/water consumption, and emissions.
Food systems have a profound influence on health outcomes and climate, which are tightly linked.

Reproductive Health

Understanding the determinants of reproductive health is essential for successful reproduction and population health.
Reproductive health encompasses conception, pregnancy, childbirth, and the neonatal period. It's essential for good individual and population health.
Reproductive health issues include infertility, fetal death, stillbirth, birth defects, abnormal fetal growth, preterm delivery, maternal death, and neonatal death.

Reproductive Health: Maternal Mortality

Maternal mortality is the death of a woman while pregnant or within 42 days of termination, caused by (related to) pregnancy-related experiences or their management.
Direct maternal deaths are resulting from obstetric complications.
Indirect deaths are from pre-existing conditions exacerbated by pregnancy.

Reproductive Health: Estimates of Maternal Mortality

Maternal mortality rates vary significantly across countries. This variation in death rates is geographically uneven, with some regions experiencing much higher rates than others.

Reproductive Health: Stillbirth Trends

Rates of stillbirth vary significantly around the world, with some countries experiencing high rates of stillbirth.

Respiratory Diseases: COPD and Asthma

Chronic obstructive pulmonary disease (COPD) and asthma are prevalent respiratory conditions.
COPD involves airway dysfunction with persistent airflow limitation, often irreversible, and is not fully reversible.
Asthma symptoms can vary and are associated with different mechanisms and severity.

COPD and Asthma: Burden

Asthma is a significant global health issue with increasing prevalence in both high-income and low-middle-income countries.
Significant healthcare costs are associated with addressing and managing asthma.
Asthma prevalence varies across populations.

Asthma Prevalence

Prevalence of asthma symptoms (wheezing) varies widely.
Asthma is prevalent in low and middle-income countries and increasingly affecting many countries.

COPD: Burden

COPD is characterized by disability and is associated with frequent exacerbations, impact on daily functions (walking, washing, dressing), and sleep.
Associated high healthcare costs come from frequent hospitalizations and worsening of the illness.

COPD Prevalence

Prevalence of COPD, specifically stages 2 or higher, has been observed to increase with age.

Asthma: Genetic and Environmental Risk Factors

Certain genes contribute to asthma development.
Interactions with environment factors are influential in asthma development and severity.
Smoking, lower socioeconomic status, and exposure to pollutants, are risk factors for the development and exacerbation of asthma symptoms.

COPD: Genetic and Environmental Risk Factors

Genetic factors, like alpha-1-antitrypsin deficiency, impact susceptibility to COPD.
Risk factors include gender, age, socioeconomic status, smoking, and exposure to air pollution (especially indoor pollution from biomass fuels).

Cancer Epidemiology

Cancer encompasses various types of diseases and affects all age groups, although risk generally increases with age.

Cancer: Biology

Cancer develops from mutated cells, and several stages can occur in this progression.

Cancer Characteristics

Specific characteristics like resisting cell death, sustaining proliferative signaling, evading growth suppressors, activating invasion and metastasis, and inducing angiogenesis.

Cancer Types

Different cancers are categorized by their location and cell type. This helps in detailed analysis of their origin and progression.

Cancer Staging

Staging involves evaluating tumour size, lymph node involvement, and organ spread to create a stage classification.

Cancer Detection

Detection methods include clinical examination, imaging techniques (MRI, CT scans), endoscopy, and histological confirmation.

Cancer: Measuring Burden

The burden of cancer (incidence, mortality, and prevalence) can have several different expressions.
Incidence includes the new cases reported in a defined area.
Mortality measures the cases that resulted in death within a specific time frame.

Common Cancers: Trends

Cancer survival has improved due to improved diagnosis and treatments, but the overall number of cases continues to rise globally, with greater burdens in low and middle-income countries.
Key cancers like lung, breast, cervical, stomach, colorectal, and prostate cancers will be reviewed for trends, indicating the geographical distribution and incidence rates.

Cancer: Prevention

Cancer prevention involves addressing modifiable risk factors and improving early detection.

Cardiovascular Diseases and Type 2 Diabetes

Cardiovascular disease (CVD) is a range of conditions affecting the heart and blood vessels, including coronary artery disease, stroke, and angina.
Type 2 diabetes is a condition wherein the body struggles to regulate blood glucose levels efficiently.

Cardiovascular Diseases and Type 2 Diabetes: Epidemiology

The prevalence of diabetes and CVD is examined globally.
Epidemiological factors, including genetics, individual behaviors, and environment, are influencing factors in both conditions.

Cardiovascular Diseases: The Global Burden of Disease Study (2019)

CVD was a top 1 or 2 cause of death globally, regionally, and by sex analysis.

Diabetes Epidemiology

Type 2 diabetes is a major global concern.
The incidence of type 1 diabetes is unclear in low-income countries.

Cardiovascular Diseases and T2 Diabetes: Factors

Risk factors for CVD and T2D include changing lifestyles, prevalence of risk factors, hypertension, smoking, and the growing aging population.

CVD and T2D factors: Blood Pressure

High blood pressure (systolic pressure) and low blood pressure (diastolic pressure) are examined in relation to risk of CVD and T2D

CVD and T2D factors: Obesity

Obesity is linked to increased CVD and T2D risk.

CVD and T2D factors: Smoking

Smoking is a major risk factor for both CVD and T2D.

CVD and T2D factors: Cholesterol

Epidemiologic studies show a strong association between high levels of LDL cholesterol and lower HDL levels and CVD.

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Description

Test your knowledge on maternal mortality, cancer staging, and child health initiatives in this informative quiz. Dive into key concepts about the causes of maternal death and cancer detection methods. Perfect for those studying public health or midwifery.