Public Health Disease Response and Surveillance

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Questions and Answers

What is the primary purpose of disease response?

  • To develop new vaccines and treatments
  • To prevent the spread of infectious diseases (correct)
  • To provide medical care to patients
  • To study the causes of diseases

Which of the following is NOT a typical component of a disease response strategy?

  • Quarantine
  • School closures
  • Movement restrictions
  • Development of new antibiotics (correct)

What is the main aim of disease surveillance?

  • To study the effects of diseases on the population
  • To educate the public about diseases
  • To monitor the spread of diseases (correct)
  • To develop new treatments for diseases

What is the essential capability of a disease surveillance system?

<p>Data analysis (B)</p> Signup and view all the answers

Which of the following is a characteristic of emerging infectious diseases?

<p>They are caused by unknown or previously undetected infectious agents (D)</p> Signup and view all the answers

What can cause a previously controlled disease to re-emerge as a health problem?

<p>The emergence of resistant strains of the causative organism (A)</p> Signup and view all the answers

What is the most important factor in preventing the spread of infectious diseases?

<p>Public health measures (C)</p> Signup and view all the answers

Which of the following is NOT a way to improve disease surveillance?

<p>Reducing the reporting of disease cases (C)</p> Signup and view all the answers

What is the difference between quarantine and isolation?

<p>Quarantine is used to separate people who may have been exposed to a disease, while isolation is used to separate people who are sick (B)</p> Signup and view all the answers

What is the role of disease response and surveillance in public health?

<p>They are both essential to preventing and controlling the spread of diseases (A)</p> Signup and view all the answers

What is the primary purpose of specifying a time range in a cause of death record?

<p>To ensure the causes are listed in the correct order. (B)</p> Signup and view all the answers

Which of the following should never be entered as an underlying cause of death in a Certificate of Death?

<p>Specific organ failure (D)</p> Signup and view all the answers

What are "ill-defined causes of death" under ICD-11?

<p>Vague categories including signs, symptoms, and abnormal findings (D)</p> Signup and view all the answers

Which of the following is NOT considered a "garbage code" under ICD-11?

<p>Specific Organ Failure (A)</p> Signup and view all the answers

What is the primary concern with using "Mechanistic Terminal Events" as a cause of death?

<p>They lack specificity and are of little value for mortality statistics. (A)</p> Signup and view all the answers

In which sequence should the causes of death be listed on a Certificate of Death, in terms of time?

<p>Underlying, Antecedent, Immediate (A)</p> Signup and view all the answers

What is the main concern with ill-defined conditions being entered as the underlying cause of death?

<p>It can lead to inaccurate statistical data. (C)</p> Signup and view all the answers

Which of the following BEST describes the purpose of identifying the underlying cause of death?

<p>To understand the primary event that led to death. (C)</p> Signup and view all the answers

What is a common error when reporting the underlying cause of death?

<p>Reporting specific organ failure as the underlying cause. (D)</p> Signup and view all the answers

Why is it important to record the cause of death accurately?

<p>To provide accurate data for public health purposes. (B)</p> Signup and view all the answers

What is considered primary data in public health studies?

<p>Data obtained by the investigator through surveys and interviews. (C)</p> Signup and view all the answers

Which of the following describes secondary data?

<p>Previously existing information gathered by another researcher. (B)</p> Signup and view all the answers

Why is the quality of secondary data sometimes questionable?

<p>The original data collection methods and objectives are unknown to the investigator. (A)</p> Signup and view all the answers

What type of documents must be accomplished to report vital events?

<p>Pertinent public documents related to civil registries. (A)</p> Signup and view all the answers

What type of diseases must be reported to health authorities according to the law?

<p>Diseases that are notifiable upon the recommendation of the Department of Health. (C)</p> Signup and view all the answers

What is an example of primary data collection?

<p>Conducting a survey on community health behaviors. (C)</p> Signup and view all the answers

Which statement about community health indices is true?

<p>They provide essential information about community health status. (D)</p> Signup and view all the answers

Which aspect of morbidity and mortality data sources is critical for effective public health decision-making?

<p>They should be comprehensive and well-documented. (B)</p> Signup and view all the answers

What should be reported as the immediate cause of death in cases of external injuries?

<p>The fatal derangement resulting from bodily trauma (D)</p> Signup and view all the answers

What must be included in the certification of deaths due to infections?

<p>Any known underlying disease and the manifestation (B)</p> Signup and view all the answers

When is it appropriate to record 'primary unknown' on the Certificate of Death?

<p>When the primary site of neoplasm is not known (C)</p> Signup and view all the answers

What is indicated when the physician is uncertain of the manner of death?

<p>Undetermined Intent (D)</p> Signup and view all the answers

Why is it important to indicate the specific site of neoplasm on the Certificate of Death?

<p>To assist in the identification of underlying causes (D)</p> Signup and view all the answers

What should be reported regarding deaths due to infections when the source of infection is unknown?

<p>Write 'cause unknown' (C)</p> Signup and view all the answers

What is the definition of fetal death as related to the content?

<p>Demise prior to the complete expulsion of a product of conception (C)</p> Signup and view all the answers

What is the primary purpose of reporting notifiable diseases?

<p>For surveillance and monitoring of important communicable diseases (D)</p> Signup and view all the answers

What does elimination of a disease entail?

<p>Reduction to zero incidence in a specific geographical area (C)</p> Signup and view all the answers

Which of the following is true about disease control?

<p>It reduces disease incidence to a locally acceptable level (D)</p> Signup and view all the answers

What is a limitation of the data source for diseases reported by health authorities?

<p>Quality of diagnosis based solely on clinical grounds (C)</p> Signup and view all the answers

What does disease response include?

<p>Implementation of activities to control further spread (A)</p> Signup and view all the answers

What is the role of volunteer health workers and midwives in rural areas concerning disease diagnosis?

<p>They primarily use symptom diagnosis (D)</p> Signup and view all the answers

What legislative act mandates the reporting of communicable diseases?

<p>The Law on Reporting of Notifiable Diseases (Republic Act 3573) (D)</p> Signup and view all the answers

Which of the following best describes eradication of a disease?

<p>Permanent reduction of worldwide infection incidence (B)</p> Signup and view all the answers

What type of data is collected from health personnel to report notifiable diseases?

<p>Clinical and symptom-based data (B)</p> Signup and view all the answers

Which of the following is NOT a component of disease response?

<p>Elimination of all medical services (B)</p> Signup and view all the answers

Flashcards

Primary Data

Data collected firsthand by the investigator for their specific study.

Secondary Data

Data obtained from other researchers, not originally collected for the current study.

Morbidity Data

Information that indicates the prevalence of diseases in a community.

Mortality Data

Information that indicates the number of deaths in a community.

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Community Health Indices

Measures that indicate the health status of a community.

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Notifiable Diseases

Diseases that must be reported to health authorities when diagnosed.

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Reports of Occurrence

Documents that provide information about the prevalence of notifiable diseases.

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Civil Registries

Official documentation of vital events like births, deaths, and marriages.

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Disease response

Activities implemented to control infection and prevent outbreaks.

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Movement restrictions

Limiting people's movement to control disease spread.

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Quarantine

Separation of individuals who may have been exposed to a disease.

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Isolation

Separation of confirmed sick individuals from healthy ones.

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Disease surveillance

Systematic collection and analysis of health data for public health planning.

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Data analysis

Interpreting collected health data for informed decisions.

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Preventive measures

Actions taken to avoid health risks and prevent disease outbreaks.

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Outbreak control

Strategies to manage and reduce the spread of infectious diseases.

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Personal protective equipment (PPE)

Gear used to protect health workers from infection.

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Emergency contexts for diseases

Situations where diseases pose significant public health threats necessitating urgent response.

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Time Interval in Death Certificate

A range of time between the cause and death used to verify order of causes.

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Correct Order of Causes

Underlying cause precedes antecedent and immediate causes in death sequences.

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Ill-defined Causes of Death

Vague categories and conditions insufficiently detailed for public health.

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Reporting Errors in Death Certificates

Common mistake of listing specific organ failure as the underlying cause.

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Garbage Codes

Ill-defined categories that lack meaningful information on the cause of death.

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Mechanistic Terminal Events

Final biological pathways explaining lethal effects, which shouldn't be reported.

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Underlying Cause

The primary condition leading to death; should be documented clearly.

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Antecedent Cause

A condition that occurs after the underlying cause but before immediate cause of death.

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Immediate Cause

The final event directly leading to death, usually closest to the death event.

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Public Health Importance

Detailed causes of death are crucial for health data and interventions.

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Elimination

Reduction to zero of a disease's incidence in a specified area with ongoing interventions.

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Eradication

Permanent reduction to zero of a worldwide disease's incidence due to deliberate efforts.

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Disease Control

Reduction of disease incidence to an acceptable level through deliberate measures.

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Mandatory Reporting Act

Law requiring immediate reporting of communicable diseases for public health.

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Clinical Diagnosis

Diagnosis based on patient symptoms rather than lab tests.

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Symptom Diagnosis

Reporting only signs and symptoms of diseases without formal diagnosis.

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Health Surveillance

Ongoing systematic collection and analysis of health data.

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Contact Tracing

Identifying and notifying individuals who may have been exposed to an infectious disease.

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External cause of death

An outside event or agent causing bodily trauma leading to death.

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Immediate cause of death

The fatal derangement resulting from bodily trauma, reported last.

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Undetermined Intent

Indication used when the certifier is unsure of the manner of death.

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Reporting infections

Includes listing the body site, causative agent, and any underlying diseases.

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Neoplasm primary site

The original site of cancer that is critical for public health strategies.

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Fetal death

Demise of the fetus before complete expulsion from the uterus, regardless of pregnancy stage.

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Study Notes

Sources of Morbidity and Mortality Data

  • Students will be able to identify sources of morbidity and mortality data used in public health studies and epidemiological investigations.
  • Students need to complete pertinent public documents related to civil registries of vital events.
  • Students must determine community health indices with public health significance.

Sources of Data - Primary Data

  • Investigator collects data directly, firsthand for the study's objectives.
  • Examples include surveys, interviews, tests, or examinations on subjects to determine if they meet case definitions of specific diseases.

Sources of Data - Secondary Data

  • Data gathered by other researchers for different purposes.
  • This information might be helpful but the quality depends on how it was collected, the objectives of the data collection, and how individuals are categorized.

Reports of Occurrence of Notifiable Diseases

  • Certain diseases are legally required to be reported to health authorities, per DOH recommendations.
  • These reports provide information on the morbidity status of a community.
  • Reports are typically submitted weekly for surveillance and monitoring of communicable diseases. Data is submitted by rural health units (RHUs), city health offices (CHOs), provincial health offices (PHOs), and municipal health offices (MHOs). Reporting is mandated by Republic Act 3573.
  • The quality of diagnoses can be limited, especially in rural areas with limited facilities. Clinical diagnoses are often based on signs and symptoms, with less emphasis on lab testing.

Epidemic-Prone Diseases

  • Detailed list of diseases are included

Elimination and Eradication

  • Elimination: Reduction to zero incidence of a specific disease in a defined area. This requires ongoing intervention.
  • Eradication: Permanent worldwide reduction to zero for a specific infection via deliberate efforts, such that intervention measures are no longer required.

Republic Act 11332

  • Disease control refers to reduction of disease incidence, prevalence, morbidity, or mortality to an acceptable level through efforts and continued intervention.
  • Disease response involves implementing specific activities to control further spread of infection, outbreaks or epidemics and to prevent re-occurrence including movement restrictions, school and business closures, quarantines, and travel restrictions.

Quarantine versus Isolation

  • Quarantine: Separates and restricts well persons exposed to a communicable disease to determine if they get sick. Has roots in the French word meaning "forty days".
  • Isolation: Separates sick people with communicable diseases from healthy ones to prevent the spread.

Disease Surveillance

  • Ongoing and systematic collection, analysis, and dissemination of outcome-specific data.
  • Public health practice in terms of epidemics, emergencies, and disasters.
  • Functional capacity for data analysis and timely dissemination is a critical component of a surveillance system.

Emerging and Re-Emerging Infectious Diseases

  • Diseases that have not previously occurred in humans, were limited to small populations in specific areas, have been recognized more recently, are caused by unknown agents, are caused by mutated or resistant strains, or which were previously significant health problems in the past and are now becoming more widespread.

Notifiable Diseases (Category I and II)

  • Detailed list of diseases, immediately and weekly notifiable .

Civil Registries of Vital Events

  • Continuous, permanent, and compulsory recording of vital events (occurrences and characteristics).
  • Primarily for legal documents and secondarily for statistical purposes.

Certificate of Death

  • Permanent legal record containing individual's death information.
  • Includes circumstances surrounding the death and is used for claiming benefits, inheritance, insurance, etc.
  • The cause of death, certified by a licensed physician, is vital for record-keeping. The cause of death, entered according to precise and correct manner into a certificate, establishes the cause of death for a particular individual.
  • Information is coded using the International Classification of Diseases Version 11 (ICD-11) and entered into a database by the Philippine Statistics Authority.
  • Consolidated mortality statistics provide a foundation for policies, plans, and programs for the country’s health.
  • Mortality data are critical for policy makers and planners to understand cause and patterns of mortality and trends.

Certificate of Death - Procedures

  • The clinical diagnosis by a physician is the basis for certifying the cause of death.
  • The most recent condition that leads directly to death is the immediate cause. Intervening conditions are the antecedent cause. The underlying cause is the initial disease or injury that began the series of events that led up to death.
  • Time intervals between the onset of causes should be recorded.

Infant Death

  • Detailed information regarding infant deaths, including causes of death, maternal conditions, and delivery method.

Ill-Defined/Non-specific Causes of Death

  • Vague causes of death and symptoms, with limited usefulness to the field of public health.
  • Should only be used when no other information is available.
  • Modes of dying(e.g., asphyxia, exhaustion, shock) are considered ill-defined conditions.
  • Reporting of mechanistic terminal events such as respiratory arrest, cardiac arrest, and cardiopulmonary arrest should be avoided as underlying causes because of the potential for an uncountable number of differential diagnoses.
  • Complication, such as pneumonia, sepsis, urinary tract infection, chronic bedridden state, and decubitus ulcers, should only be reported as part of a cause of death if a distinct, underlying condition exists.

Death of Women of Child-Bearing Age

  • New item on Certificates of Death: Maternal Conditions, important for determining cases relating to pregnancy relevant cases for maternal death reviews.
  • Maternal death refers to deaths during pregnancy, within 42 days, or related and aggravated by pregnancy but not from accidents.
  • Causes include postpartum bleeding, unsafe abortion complications, hypertensive disorders of pregnancy, postpartum infections, and obstructed labor.

Other Important Points

  • If death cause's certainty is low use appropriate qualifiers (probable/presumed)
  • Undetermined Natural Causes should be used as a last resort entry in medical certificates.
  • Always use "X" marks for checkboxes. Verify accuracy of information. Don't alter, use black ink, no rubber stamps.
  • Record only one cause of death per line in the "causes of death" section, including the immediate, antecedent, and underlying causes.
  • Underlying cause of death must be in Part I, in the lowest available line. Add lines if necessary.

Death Involving External Injuries

  • External cause (agent or force, physical or chemical),
  • Bodily trauma caused by the event, and
  • Fatal derangement as a result.
  • If uncertain, the certifier can indicate "Undetermined Intent".

Death from Infectious Diseases

  • Infectious disease manifestation or body site should be reported.
  • Causative agent or sources of infection (e.g., food, contaminated blood) should be reported.
  • Underlying conditions that could be linked to the infection and cause the demise, should be stated.

Death from Neoplasms

  • Specific site of the neoplasm is critical for public health prevention strategies.
  • Primary site to be stated, even when removed before death.
  • Secondary growth site should be reported as due to primary site, if present.
  • If the primary site is unknown, record “primary unknown”.
  • Primary site is often the underlying reason for the death.

Fetal Death

  • Demise before expulsion of the product of conception, regardless of pregnancy duration.
  • Death is indicated by no breathing, heart beat, umbilical cord pulsation, and/or voluntary muscle movement. Specific forms must be used for causes of death for fetuses 20 weeks gestation and older.

Periprocedural Death

  • Demise during or due to diagnostic, therapy, anesthetic, or operative procedures.
  • Includes misadventure, iatrogenesis, and errors.
  • Accidental deaths: the procedure would not have caused the death and would have occurred anyway.
  • Natural deaths: the procedure is not the cause of death but is inevitable/imminent.
  • Reports should be made to the authorities of the Philippine National Police (PNP) or the National Bureau of Investigation (NBI).
  • Violence or crimes causing death. This list includes stab wounds, gunshot wounds, suicide of any kind, strangulation, accidents resulting to death, assault, violence, undetermined cause.

Dead on Arrival

  • Death occurring in the ER after initial life-saving efforts, regardless of the patient’s time in the ER.
  • The ER officer will accomplish the certificate if a cause of death can be precisely specified.
  • Otherwise, the medico-legal officer of the hospital or the local health officer determines the cause and issues the certificate.

Certificate of Live Birth

  • Gravidity: The total number of pregnancies.
  • Parity: The number of pregnancies that reached viability.

Issues on Paternity (Illegitimate Children) and Legitimation

  • Laws regarding the surname and parental authority.
  • Legal recognition of paternity/non-paternity.
  • Rules regarding registration differences.
  • Rights of legitimate children.

Fetal Death in Utero

  • Definitions of "abortus" based on US National Center for Health (500g or <20 weeks gestation)

Obstetrical-Gynecological Code

  • Classification of pregnancies
  • Explanations of Gravidity and Parity (number of pregnancies and live births)

In Summary

  • Summary of the information discussed in the presentation.

References

  • Citations for each source of information.

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