Public Health Quiz: Epidemiology Concepts
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Questions and Answers

The total concentration of a substance in a body is called the ______.

body burden

Which of these is a step in establishing the existence of an outbreak?

  • Examine past death and hospital records for expected number of cases. (correct)
  • Conduct surveillance on the vaccine efficacy of the virus.
  • Eradicate the infectious agent causing the outbreak.
  • Develop a broad-spectrum drug to treat the outbreak.

    • Positive confounding biases the observed association towards the null.

    False (B)

    What is the main ethical principle that justifies the use of control groups in clinical studies?

    <p>Equipoise</p> Signup and view all the answers

    Match the following terms with their corresponding definitions:

    <p>Surveillance = Ongoing systematic collection, analysis, and reporting of health data. Vaccine Efficacy = Measured as 1 - RR (relative risk) of disease transmission to and from vaccinated compared with control groups. YLL (Years of Lost Life) = Sum of [deaths at each age] x [expected years of life remaining at that age] Epidemic Threshold = Point where disease in question becomes epidemic.</p> Signup and view all the answers

    Which of these is NOT a characteristic of an individual who is a carrier of an infectious agent?

    <p>They always experience severe symptoms of the disease. (C)</p> Signup and view all the answers

    What is the purpose of establishing an outbreak existence?

    <p>It saves resources and prevents unnecessary public panic.</p> Signup and view all the answers

    Which of the following is NOT a component of constructing a case definition?

    <p>Cost of treatment (B)</p> Signup and view all the answers

    The Cochran-Mantel-Haenszel test analyzes stratified contingency tables, assuming a homogeneous effect of other variables on the confounding variable across strata.

    <p>True (A)</p> Signup and view all the answers

    What is the primary objective of a line listing in disease surveillance?

    <p>To document individual cases with information like name, onset, symptoms, diagnosis, and other relevant details.</p> Signup and view all the answers

    A person who has recovered from an illness but can still transmit the pathogen is considered ______.

    <p>convalescent</p> Signup and view all the answers

    Prevalence is calculated by dividing the number of cases by the average population or the incidence.

    <p>True (A)</p> Signup and view all the answers

    ___ is the ability to produce results under ideal conditions, while ___ is the ability to produce results with minimal resources.

    <p>Efficacy, Efficiency</p> Signup and view all the answers

    Which of the following is NOT a characteristic of an intermittent common source outbreak?

    <p>Cases typically occur within one incubation period (A)</p> Signup and view all the answers

    Match the following terms with their definitions:

    <p>Antigen = Substance that stimulates antibody production Antibody = Protein produced in response to an antigen Prevalence = Proportion of individuals with a disease at a specific time Incidence = Number of new cases of a disease over a period of time</p> Signup and view all the answers

    What is the term used to describe the situation where a pathogen becomes present in a new host species?

    <p>Emergence</p> Signup and view all the answers

    Antigenic drift refers to significant changes in viruses' surface proteins, leading to the emergence of entirely new strains.

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

    Which of the following is a disadvantage of a cohort study?

    <p>It is difficult to demonstrate cause and effect between treatment and outcome (D)</p> Signup and view all the answers

    The term ___ refers to the process by which a pathogen is no longer present in a population.

    <p>Elimination</p> Signup and view all the answers

    Which of the following is NOT a characteristic of a good research question?

    <p>Based on personal opinions and beliefs (C)</p> Signup and view all the answers

    In a case-cohort study, both cases and controls are sampled from a prospective cohort.

    <p>True (A)</p> Signup and view all the answers

    What is the difference between a vertical and a horizontal transmission of a disease?

    <p>Vertical transmission occurs between generations, such as from mother to child. Horizontal transmission occurs between individuals of the same generation, such as through contact or vectors.</p> Signup and view all the answers

    The ______ postulates are a set of criteria used to establish a causal association between an exposure and a disease.

    <p>Evan's</p> Signup and view all the answers

    Match the following epidemiological study designs with their descriptions:

    <p>Case-Control Study = Cases who developed the outcome during follow-up are compared with a random sample of the cohort. Prospective Cohort Study = Cases and controls are drawn from a prospective study. Cross-Sectional Study = Data is collected at a single point in time to assess both exposure and disease status. Transversal Study = Data is collected at a single point in time to assess both exposure and disease status.</p> Signup and view all the answers

    What is the purpose of exclusion criteria in research?

    <p>To prevent confounding by excluding participants with potentially influencing factors (C)</p> Signup and view all the answers

    A descriptive study investigates the distribution of a problem by cases/outcome, frequency, exposure, time pattern, or environmental factors.

    <p>True (A)</p> Signup and view all the answers

    Diagnostic suspicion is an objective assessment of a patient's condition based on clear evidence.

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

    What is the main purpose of an age-adjusted rate?

    <p>To eliminate the effect of different age distributions among different populations.</p> Signup and view all the answers

    What is an example of an environmental determinant of health?

    <p>Examples include sanitation, air quality, access to clean water, climate conditions, and presence of disease vectors.</p> Signup and view all the answers

    The ______ is a measure of how many cases result in death.

    <p>case fatality rate</p> Signup and view all the answers

    Malaria is solely caused by a virus.

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

    The lowest dose observed that causes harmful effects is called the ______.

    <p>LOAEL</p> Signup and view all the answers

    Which of the following is a symptom of malaria?

    <p>High fever (A)</p> Signup and view all the answers

    Match the following individuals with their contributions to public health:

    <p>Antoni Van Leeuwenhoek = Developed microscopes and discovered microbes Florence Nightingale = Pioneer in nursing and sanitation practices Bernardino Ramazzini = Father of Ergonomics Mary Mallon = Asymptomatic typhoid carrier who infected many people Lemuel Shattuck = Promoted sanitation standards and tuberculosis prevention Alice Hamilton = First female faculty at Harvard and pioneer in occupational disease investigation Edgar Sydenstricker = Developed a system for collecting morbidity statistics in the U.S.</p> Signup and view all the answers

    What is the main characteristic of a choropleth map?

    <p>Choropleth maps use colors or patterns to represent the magnitude of a variable within pre-defined areas, typically political boundaries.</p> Signup and view all the answers

    What are the typical symptoms of an inflammatory response?

    <p>Heat, redness, pain, swelling (D)</p> Signup and view all the answers

    What are the main ways to prevent malaria?

    <p>Using insect repellent, covering arms and legs, and using a mosquito net are effective ways to prevent malaria.</p> Signup and view all the answers

    Measles can be transmitted through airborne droplets.

    <p>True (A)</p> Signup and view all the answers

    Flashcards

    Antibody

    Proteins produced in blood in response to antigens.

    Efficacy

    Ability to produce results under ideal conditions.

    Antigen

    Substance recognized as foreign that stimulates antibody production.

    Efficiencey

    Ability to produce results with minimal resources.

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    Relative Risk

    Comparative measure of risk between two groups.

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    Emerging Disease

    New diseases that rapidly increase in incidence or geographic range.

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    Prevalence

    The proportion of a population that has a particular condition at a specific time.

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    Point-Source Epidemic

    Outbreaks with cases occurring within one incubation period.

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    Positive Confounding

    Bias that makes the association stronger than it is by affecting the observed outcomes.

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    Body Burden

    Total amount or concentration of a substance accumulated in the body.

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    Epidemic Threshold

    The point where a disease's occurrence shifts to an epidemic level.

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    Vaccine Efficacy

    The effectiveness of a vaccine in preventing disease among vaccinated people compared to unvaccinated.

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    YLD (Years Lost to Disability)

    Measure of the burden of disease based on years lost due to disability from incidents.

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    YLL (Years of Lost Life)

    Total years lost due to premature death from a condition.

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    Hawthorne Effect

    When individuals change behavior due to awareness of being observed.

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    Eradication

    Complete termination of transmission of a disease agent.

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    Case Fatality Rate

    The proportion of deaths from a disease compared to the total cases of the disease.

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    In Silico

    Experiments conducted using computer simulations instead of real-life scenarios.

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    In Vitro

    Experiments conducted in a controlled environment outside of a living organism.

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    Crude Rate

    A measurement calculated without any adjustments for factors like age or population composition.

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    Age-Adjusted Rate

    A statistic modified to account for age differences in populations being compared.

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    Case Definition

    A set of criteria for identifying a disease case by clinical info and demographics.

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    Etiology

    The study of the causes of diseases and how they develop.

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    Convalescent

    An individual who has recovered from an illness but can still transmit it.

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    Exclusion Criteria

    Conditions that prevent certain individuals from participating in a study.

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    Measurement Bias

    Errors that occur when data collection methods lead to inaccurate results.

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    Cochran-Mantel-Haenszel Test

    A statistical test to analyze stratified data, controlling for confounding variables.

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    Risk Factor

    An attribute or exposure that increases the likelihood of developing a disease.

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    Acute Infection

    An illness with a rapid onset, typically lasting up to fourteen days.

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    Transstadial transmission

    Pathogen remains with vector during its life stages.

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    Evan's Postulates

    Criteria to establish the cause of a disease.

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    Case-Cohort study

    Study design where cases and controls come from the same cohort.

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    Determinant factors

    Social, economic, and cultural factors affecting health.

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    Vertical transmission

    Transmission of a disease between generations.

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    Prospective study

    Study that follows participants over time to observe outcomes.

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    Null hypothesis (H0)

    Assumes no association between exposure and disease.

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    Antoni Van Leeuwenhoek

    Pioneer of microscopy, discovered microorganisms.

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    Inflammatory Response

    Body's reaction to injury involving chemical signals.

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    Phagocytosis

    Process by which cells engulf and destroy pathogens.

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    Lowest Observed Adverse Effect Level (LOAEL)

    Minimum dose that causes harmful effects in studies.

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    Choropleth Map

    A map using color to represent data across areas.

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    Mary Mallon

    Known as 'Typhoid Mary,' asymptomatic carrier of typhoid.

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    Measles Symptoms

    High fever, cough, conjunctivitis, and runny nose.

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    Bernardino Ramazzini

    Considered the Father of Ergonomics, studied occupational health.

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    Study Notes

    Epidemiology

    • Epidemiology is the study of the distribution and determinants of health conditions or events among populations, and its application to control health problems.
    • Four purposes of epidemiology include control and prevention, research opportunities, training, and legal concerns.
    • Two basic types of epidemiology are classical and clinical.
    • Six tasks in epidemiology include public health surveillance, field investigation, analytic studies, evaluation, linkages, and policy development.
    • Five objectives of epidemiology are to identify etiology, determine the extent of a condition in a community, study its natural history, evaluate preventive methods, and provide a basis for public policy.

    Disease Occurrence

    • A cluster is an aggregation of cases grouped closely in space or time, regardless of whether the number of cases exceeds expectations.
    • An epidemic is the occurrence of more cases of a disease than expected in a given area or group of people over a specified period.
    • An epizootic is an outbreak or epidemic in animal populations.
    • An endemic is a disease agent or health condition that is constantly present at a continuous level throughout a population or geographic area.
    • A holoendemic infection has a high prevalence, beginning early in life and affecting most of the child population.
    • A hyperendemic has a high and continued incidence and prevalence.
    • A hypoendemic infection is constantly present at a low incidence and prevalence.
    • A mesoendemic affects a moderate proportion of the population at risk.
    • A pandemic is an epidemic over a very wide area (several countries or continents) affecting a large proportion of the population.
    • An outbreak is more cases of a disease than expected in a given area or group of people over a specified period.

    Types of Sources

    • Bimodal sources have two peaks.
    • Common-source outbreaks have all cases exposed to the same source.
    • Continuous outbreaks have prolonged exposure, a plateau, and more than one incubation period.
    • Intermittent common-source outbreaks have exposure to the common source at relatively random intervals.
    • Mixed outbreaks combine a common-source followed by propagated spread.
    • Point-source outbreaks have a common source and cases within one incubation period, with a clear peak and sharp decline.
    • Propagated/person-to-person/progressive outbreaks have cases that are sources for later cases, with successively larger peaks one incubation period apart.

    Natural History of Disease

    • Subclinical disease is the period from exposure to the onset of symptoms. Factors like dosage, host susceptibility, and the immune response affect the length of this period.
    • The incubation (prodromal) period is a subclinical period for infectious diseases.
    • The latency period is a subclinical period for chronic diseases.
    • Symptom onset does not always align with diagnosis.
    • Exacerbation is when signs and symptoms worsen.
    • The convalescent period is the recovery period after disease.

    Prevention

    • High-risk strategies focus on those with the highest risk.
    • Population-based strategies maximize the number of people reached by the intervention.
    • Primordial prevention prevents environmental risk factors that contribute to illness.
    • Primary prevention prevents exposure in at-risk individuals (e.g., vaccines, education, sanitation).
    • Secondary prevention occurs before symptoms onset and involves screening and treatment (e.g., PCR tests, notifications).
    • Tertiary prevention occurs during the symptomatic stage (e.g., treating secondary infections).
    • Quaternary prevention mitigates future interventions (e.g., rehabilitation).

    Causation

    • A cause directly influences the occurrence of a disease.
    • Rothman's sufficient cause concept identifies that some components contribute to a sufficient cause without being individually necessary.
    • A necessary cause is a component that must be present for the health problem to occur.
    • Bradford Hill's criteria for causation include strength of association, consistency, specificity, alternative explanations, temporality, dose-response, biological plausibility, and experimental evidence.
    • Koch's postulates for infectious disease causation require the microbe to be present, isolatable, capable of causing the disease when introduced, and re-isolated.
    • Evan's postulates focus on increased prevalence, frequency of exposure within those ill, higher incidence in the exposed, normal/log-normal distribution of incubation periods, host responses along a gradient, measurable host response to exposure, more frequent occurrence in exposed groups, and reduction of exposure leading to reduced disease likelihood
    • Direct Acyclic Graphs (DAGs) show causal connections between factors but assume that treatments have no effect on other study subjects.
    • GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) evaluates the quality of evidence behind clinical recommendations.

    Surveillance

    • Surveillance is the ongoing systematic collection, analysis, interpretation, and dissemination of health data.
    • Steps in surveillance include data collection, analysis, interpretation, dissemination, and linkage to action.
    • Objectives include identifying priorities, monitoring severity, detecting outbreaks, providing information to relevant bodies, and evaluating strategies.
    • Types of surveillance include active, medical, passive, sentinel, and syndromic.

    Transmission

    • Transmission can be direct, droplet, airborne, foodborne, waterborne, or vector-borne.
    • Vector transmission can be biological, cyclopropagative, developmental, fecal-oral, harbourage, iatrogenic, parenteral, propagative, transovarial, transstadial, or vertical.

    Calculations

    • Various epidemiological calculations, including absolute risk, absolute risk reduction, accuracy, attack rate, secondary attack rate, attributable number, attributable proportion, attributable risk, birth rate, case fatality rate, crude rate, age-adjusted rate, death rate, disability-adjusted life years (DALYs), death-to-case ratio, error, etiologic fraction, excess risk, fertility rate, herd immunity threshold, incidence, infectivity, likelihood ratio, low birth weight ratio, morbidity, natality, natural increase rate, number needed to harm, number needed to treat, odds ratio, pathogenicity, population attributable risk fraction (PARF), population prevented fraction, precision, positive predictive value, negative predictive value, prevalence, relative risk, reproductive rate, validity, sensitivity, specificity, and virulence, are discussed.

    Statistics

    • Statistical tests and models, including the Cochran-Mantel-Haenszel (CMH) test, McNemar's test, Fisher's exact test, Analysis Of Variance (ANOVA), and single substitution DNA base pair (SNP) mapping are discussed.
    • Methods for studying transmission of pathogens, such as whole genome sequencing and PulseNet are mentioned.

    Studies

    • Different study designs (observational, analytical, cohort, case-control, nested case-control, matched, case-cohort, case-crossover, etiologic, panel, longitudinal, descriptive, and cross-sectional) and their strengths and weaknesses in epidemiology are described.
    • Experimental/intervention studies include randomized controlled trials (RCTs), field trials, community trials, and quasi-experimental studies along with their strengths & weaknesses

    Errors and Bias

    • Random and systematic errors (bias) are discussed, including confounding (positive and negative), Hawthorne/observer effect, measurement/information/misclassification bias, ascertainment bias, compliance bias, confirmation bias, contamination bias, lead-time bias, length-time bias, overdiagnosis bias, ecological fallacy, funding bias, instrumentation bias, interviewer bias, misclassification bias (differential and nondifferential), observer bias, recall bias, response bias, social desirability bias, question-order bias, acquiescence bias, dissent bias, extreme responding, neutral responding/central tendency, Texas Sharpshooter, selection bias, allocation bias, attrition bias, collider bias, chronological bias, and diagnostic suspicion bias, among other types.

    Glossary

    • Various epidemiological terms, including definitions, types, and calculations, are defined.

    Miscellaneous

    • Key public health issues, types of visual data, relevant people, important historical developments, disease transmission, and prevention are briefly discussed.

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    Test your knowledge on key concepts of epidemiology in public health. This quiz covers topics such as outbreak existence, carrier characteristics, and ethical principles in clinical studies. Perfect for students or professionals looking to refresh their understanding of disease surveillance and prevalence calculations.

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