How do schistosome eggs enter the environment?

In urine or feces, and they hatch when they reach a freshwater body, such as a river, lake, or stream

The following play a role in the transmission of schistosomiasis: (choose all that apply).

freshwater snails

non-human primates

Schistosomiasis can affect infants and children as well as people in every other life stage.

true

In an endemic location, swimming in water that’s contaminated with human waste is a risk factor for schistosomiasis.

true

MDA is a major control strategy for both schistosomiasis and LF.

true

Improved access to water and sanitation infrastructure are important prerequisites to help reduce the burden of schistosomiasis.

true

Lymphatic filariasis (LF) cases occur in multiple countries, including those in Asia, Africa, and South America.

true

The following play a role in the transmission of LF: (choose all that apply).

mosquitos

Highly visible symptoms of LF mainly occur due to: (choose the single best response)

a large number of infective mosquito bites over the course of many years

Even without external LF symptoms, there may still be damage to lymphatic vessels and kidneys, and also changes to the immune system, even in children.

true

In the obstructive phase of LF, elephantoid organs develop and the disease is often highly visible.

true

LF may be accompanied by feelings of shame, fear, and embarrassment and may result in social exclusion.

true

The GPELF called for elimination of LF by the year 2020, but that target was not met. The new proposed target is __________.

2030

For LF, the drugs that would be used for MDA vary based on other parasites that are endemic in a particular location.

true

The GPELF calls for: (choose the single best response)

Both MDA to reduce the transmission of LF and clinical care for people who have disease symptoms

Morbidity associated with LF can include hydrocele and swelling of the legs and breasts.

true

_________________ is the main parasite associated with female genital schistosomiasis.

S. haemtobium

Schistosomiasis is now known to be associated with increased risk of transmitting and contracting HIV.

true

Scientists currently think there is a high likelihood that schistosomiasis may contribute to an increased risk of some cancers, such as bladder cancer, colorectal cancer, and liver cancer.

true

FGS can affect the following parts of a person’s anatomy (choose all that apply):

Fallopian tubes

Cervix

Ovaries

Uterus

Vulva

At a population scale, FGS is somewhat difficult to detect because of limitations of equipment, personal, and the lack of an accepted and standardized definition.

true

A __________________ causes trachoma.

bacterium

The microbe that causes trachoma is called ________________________

chlamydia trachomatis

Briefly describe the SAFE strategy.

S - surgery to correct the position of the eyelashes (trachomatous trichiasis)

A- antibiotics to clear the infection

F- facial cleanliness, face washing to remove eye and nose mucus that will attract flies

E- environmental improvement, particularly by improving access to water and sanitation (toilet facilities, cutting down on fly breeding)

A large proportion of cardiac deaths among young adults in Latin America are due to Chagas’ disease.

true

There is a vaccine currently in use for Chagas’ disease.

false

Chagas’ disease is mainly transmitted by a____________________.

triatomine

When Chagas’ disease is transmitted, the vector injects saliva that carries the parasite.

false

Sleeping under insecticide-treated bednets at night can help protect against malaria, but bednets don’t help address Chagas’ disease.

false

Most people infected with Trypanosoma cruzi will eventually die from the disease.

false

For Chagas’ disease, experts believe that vector control is one key aspect of the strategy to address Chagas’ disease in Latin America.

true

One effective strategy to prevent transmission of Chagas’ disease is through screening blood and organs that are being donated.

true

It’s possible to diagnose and treat people for Chagas’ disease during pregnancy.

true

Since vertical/congenital transmission is impossible for the organism that causes Chagas’ disease, screening babies is unnecessary.

false

Trachoma is endemic in countries in Africa, Central America, South America, Asia, and the Middle East, and it's also present in Australia.

true

With trachoma, the eyelashes may touch the eyeball and scratch it if scar tissue develops on the interior of the eyelid

true

Due to biological differences, women are about 4 times as likely as men to be blinded by trachoma.

false

What is the leading cause of blindness worldwide from an infectious agent?

trachoma

Two drugs (Benznidazole and Nifurtimox) to treat Chagas’ disease have been used for decades because both are safe and effective, but it would be ideal to develop new drugs in case of drug resistance in the future.

false

For advanced Chagas' disease, there is currently a recommendation to not offer treatment.

true

The word “malnutrition” includes the following:

undernutrition

overweight

obesity

micronutrient deficiencies

The following are commonly measured using standardized growth charts:

stunting

wasting

underweight

overweight

obesity

The “first 1000 days” refers to the time between when a child is born until shortly before their 3^rd birthday.

false

The new (2021) Lancet series of papers referred to in this unit on “Maternal and Child Malnutrition” categorized nutrition interventions as follows: (choose all that apply

being from the healthcare sector or from outside of the healthcare sector

being "direct" or "indirect"

“Stunting” refers to: (choose the single best response)

low height for age

“Wasting” refers to: (choose the single best response)

low weight for height

Stunting tends to occur most at the following time: (choose the single best answer)

in the first 3 months after birth

Wasting at birth and wasting in the first 3 months of life are relatively prevalent in LMICs.

true

Between 2000 and 2015, stunting has _________________ in LMICs. (choose the single best response)

improved slightly

Stunting is generally more prevalent in LICs than in MICs

true

Zinc supplements should be given when a child has diarrhea.

true

Evidence strongly shows that adequate birth spacing can help improve the nutrition status of children.

true

Low iron intake and low intake of Vitamin B-12 can both causes forms of anemia.

true

Foods that contain high amounts of essential micronutrients such as iron, Vitamin B-12, Vitamin A, and iodine are often expensive, perishable (they spoil easily and quickly), and require refrigeration.

true

Iodized salt has been an enormously beneficial program, as well as being very cost-effective.

true

Stunting can prevent people from achieving their full mental and physical potential.

true

Geographically, ______________ is the global region most heavily impacted by stunting and wasting, as of approximately 2015.

South Asia

In comparison with other low-income countries, India has a much higher prevalence of wasting.

true

As of 2021, only high-income countries are expected to fully meet the 10 nutrition targets set by the 2012 World Health Assembly.

false

There is currently strong evidence to suggest that promotion of breastfeeding is a positive way to improve child nutrition.

true

One general trend we’ve seen with global data on malnutrition is that we don’t yet have enough information about the nutrition of school-aged children (kids over 5 years) and adolescents.

true

We have good evidence to recommend the following strategies to improve maternal and/or child nutrition

Therapeutic zinc supplementation for diarrhea

Small-quantity lipid-based nutrient supplements for kids

Ready-to-use supplementary food for acute malnutrition

Family planning and birth spacing

ITNs

Large-scale food fortification

Iron-deficiency anemia can be caused by the following:

Loss/removal of more RBCs than are replaced by the body

Inability to absorb dietary iron

Food sources don’t have enough iron

Pregnancy and menstruation, which come with increased demand for iron

Breastfeeding, which comes with increased demand for iron

Ischemia refers to

insufficient blood supply to a specific organ/body part.

The following are known risk factors for a heart attack (choose all that are correct):

low physical activity, high blood pressure, family history of heart disease, diabetes, smoking, stress, high blood cholesterol, older age

Stroke occurs when there is an interruption to or reduction in the blood supply to part of the brain.

true

The following can be signs of a stroke

difficulty with speech, difficulty walking, vomiting, facial paralysis

Diabetes is a metabolic disease; it might be due to problems with insulin secretion, problems with insulin action, or possibly both.

True

There are more than two types of diabetes: Type I and Type II cause most of the cases, and then there are other, rarer forms.

True

About 85-95% of diabetes cases are Type I diabetes.

False

Blindness and kidney failure are two negative health outcomes associated with diabetes.

True

In the video about diabetes in Kenya, Samuel talked about how a new health insurance plan has made it possible for him to have regular access to insulin.

False

In the video on breast cancer statistics with Hans Rosling, he talked about how lower rates of breast cancer in LMICs are also accompanied by lower death rates from breast cancer.

False

The review article by Ezzati et al. (2018) sought to evaluate some of the potential reasons that NCDs vary by region; the authors looked at genetic factors, differences in nutrition, infectious diseases, healthcare access, and poverty, among other factors.

True

In general, populations in LMICs tend to be younger than populations in high-income countries, which partly explains why NCD death rates are lower in LMICs when they are not adjusted for age.

True

Ezzati et al. (2018) adjusted for age and after doing so, they showed that NCDs tend to have higher death rates in tropical LMICs than they do in high-income Western countries.

True

Ezzati et al. (2018) showed that cancer death rates vary by region of the world; this is partly due to differences in cancer incidence and survival, as well as to widespread differences in risk factors such as tobacco, alcohol, diet, infections, etc.

True

Some types of cancer, such as cervical cancer, stomach cancer, and liver cancer, have their origins in infectious agents.

True

Environmental improvements such as water, sanitation, electrification, and refrigeration are needed to partially address the burden of cancer in tropical LMICs.

True

Ezzati et al. (2018) said that genetics do not account for the broad differences in NCD risk across regions, and that social and environmental determinants of health must be studied to truly understand risk factors.

True

Studies reviewed by Ezzati et al. (2018) show that fetal, childhood, and adolescent environmental and nutritional factors all influence the risk of NCDs.

True

Some NCDs are high in LMICs and tend to decline with increasing wealth; this is the opposite of what’s predicted by a simpler epidemiological transition model.

True

The relationship between infections and NCDs is unidirectional, meaning that infections can influence the risk of NCDs, but NCDs don’t influence the risk of infectious disease.

False

Ezzati et al. (2018) presented a list of more than 15 ways to effectively intervene and address NCDs in LMICs.

False

ARIs can refer to infections of both the upper and lower airways.

True

Children in LMICs average 3 to 6 episodes of ARIs per year, but for children in high-income countries, the number of episodes is closer to 1 to 2 ARIs per year.

False

The case-fatality rate for LRIs is higher for children who live in low-income areas compared with children who live in high-income areas

True

Most URIs are viral in nature, and most are self-limiting, but complications can be serious.

True

Two common LRIs that affect children are pneumonia and bronchiolitis.

True

For children, pneumonia may be caused by a bacterial, viral, or fungal agent, and it’s often difficult for clinicians to determine the true cause.

True

It’s not possible for children to have mixed pneumonia infections where both viruses and bacteria are involved.

False

Bronchiolitis mainly affects people during the first year of life.

True

While early diagnosis and treatment of ARIs can be useful when collecting data for a research study, these actions do not generally improve outcomes for children.

False

The following are recommended for children to help address ARIs: (choose all that apply)

Reduced indoor air pollution, improved water supplies, reduced outdoor air pollution, hand-washing with soap, vaccination, improved child nutrition

Vaccines can be given to most children in LMICs for the following:

Pertussis, Tetanus, Measles, Polio, Diphtheria, Tuberculosis

The following can be used to prevent diarrheal disease in children: (choose all that apply)

Ensure access to good quality water

Hand washing with soap

Ensure access to good quality sanitation

Oral rehydration solution is occasionally used to address morbidity from diarrheal disease, but IV fluids are often a better choice.

False

For mothers who are nursing babies, breastfeeding should stop while a child has diarrheal disease because breastmilk is somewhat difficult for children to digest.

False

An ACE is an adverse childhood experience and includes a variety of traumatic experiences such as physical and sexual abuse and neglect, among others.

True

ACEs that remain unaddressed can cause serious long-term health outcomes later in life.

True

The worldwide prevalence of hookworm is around____________________ people.

440,000,000

Adult hookworms live __________ years if a person remains untreated.

1 to 15 years

The following morbidity is/are associated with hookworm infection: (choose all that apply)

Anemia, Growth Stunting

Some appropriate control strategies for hookworm include the following: (choose all that apply)

MDA, Address the risk of hookworm transmission during agriculture, Ensure access to and use of toilets/latrines, address poverty, end open defection

ACEs are associated with additional health complications such as depression, anxiety, immune system dysfunction, and hormonal changes.

True

ACEs affect brain structure and function.

True

ACEs alter how DNA is transcribed within the body.

True

Dr. Nadine Burke Harris argues for early and aggressive screening and treatment of ACEs.

True

Dr. Nadine Burke Harris argues that ACEs mainly affect marginalized populations, which is the reason that it's been somewhat difficult to draw needed attention to this issue.

False

The main difference between “intentional injuries” and “unintentional injuries” is the idea of predetermined/premeditated intent.

true

What did the government of Ghana do to inexpensively address a heavy burden of fatalities from speeding? (choose the single best response)

Installed speed bumps and rumble strips

What did Taiwan do to substantially decrease fatalities from motor vehicle accidents? (choose the single best response)

Mandated helmet use on motorcycles and enforced these laws

The following are among the main categories of UIs studied by Vecino-Ortiz et al. (2018) (choose all that apply):

Road traffic

Falls

Poisoning

Burns

Drowning

Vecino-Ortiz et al. (2018) performed primary data collection in order to draw conclusions in their study.

False

According to Vecino-Ortiz et al. (2018), there is an evidence-base to support the following to reduce UIs (choose all that apply):

Speed enforcement on roadways

Daycare for kids <5 years

Prevention of drunk driving

Swimming lessons for kids <14 years old

In one study, a comprehensive motorcycle helmet policy in Vietnam resulted in an RR of 0.54 with respect to head injuries. The following is a correct interpretation of these findings:

The risk of head injury was 46% lower in the group that experienced a comprehensive motorcycle helmet policy.

The sanitation-related SDG for 2030 calls for access to adequate and equitable sanitation and hygiene for all people, and an end to open defecation, paying special attention to the needs of women and girls and those in vulnerable situations.

true

According to a UN report from 2018, only about 40% of the global population has access to safely managed sanitation facilities.

True

“Basic sanitation” is defined as an improved sanitation option that is not shared with people outside of the household.

True

The following are considered improved sanitation options, according to the World Health Organization: (choose all that apply)

A KVIP latrine

A pit latrine with a slab

A pour-flush latrine

A flush toilet with a septic system

Open defecation means that human excreta is deposited in the environment or in open spaces, such as with solid waste (trash).

True

Shared sanitation facilities are those toilet facilities that are otherwise acceptable improved sanitation facilities, but they are shared between two or more households.

True

Unimproved sanitation fails to hygienically separate human excreta from human contact.

True

“Hygiene” is a term that refers to the following behaviors: (choose all that apply)

Safe food practices

Bathing

Hand washing with soap

Hand washing with soap is able to reduce an array of infectious diseases, including diarrheal disease and intestinal infections.

True

The following are true about the hand washing literature: (choose all that apply)

Hand washing has been studied for many decades

A female-friendly toilet has the following features: (choose all that apply)

It has proper lighting

It is available when needed

It has a place to dispose of used menstrual products

It is safe for people to use and has doors that lock

It has hooks / shelves for bags and to place menstrual products

What does the period emoji look like?

A blood droplet