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Principles Of Epidemiology Question Paper

Principles Of Epidemiology 

Course:Master Of Public Health

Institution: Kenyatta University question papers

Exam Year:2009



KENYATTA UNIVERSITY
UNIVERSITY EXAMINATIONS 2009/2010
FIRST SEMESTER EXAMINATION FOR THE DEGREE OF MASTER OF PUBLIC
HEALTH, MASTER OF HEALTH MANAGEMENT AND MASTER OF POPULATION HEALTH
HPH 702: PRINCIPLES OF EPIDEMIOLOGY
DATE: MONDAY, 23RD NOVEMBER 2009 TIME: 9.00 A.M. – 12.00 P.M.
========================================================================================
INSTRUCTIONS: Answer ALL questions in section A and any THREE in section B.
Use diagrams/illustrations and relevant examples to elucidate your
answers.

SECTION A
1. Epidemiology is the basic science of Public Health. Discuss. (10 marks)

2. What is herd immunity? Explain the conditions necessary for herd immunity
to occur in a population. (10 marks)

3. Using relevant examples, outline the various categories of causal relationships.
(10 marks)

4. Distinguish between experimental and observational studies in epidemiology
while highlighting the strengths and weaknesses of each. (10 marks)

5. Define public health surveillance and highlight its critical components. (10 marks)

SECTION B
1. a) Using the epidemiological triad, explain the various determinants of disease
and suggest how the balance may be modified in a bid to reduce transmission
of diseases. (20 marks)

b) On January 1, 2008 there were 20 medical students with swine flu
and there was a total of 600 students in the class. These 20 students were
immune from contracting swine flu again during the next nine months.
From January 2, 2008 through April 2, 2008, 30 more students developed
swine flu and the class size remained at 600.
i) What was the cumulative incidence of swine flue from January 2, 2008
through April 2, 2008? (Show your work.) (3 marks)

ii) What was the prevalence of swine flu on January 1, 2008?
(Show your work.) (3 marks)

iii) Explain various factors that may influence the prevalence of
disease. (4 marks)

2. A Research determined in a case control study that 20 of 100 patients with bladder
cancer smoked cigarettes while 40 of 600 patients with bladder cancer smoke
cigarettes.
a) Calculate the appropriate measure of association for developing bladder
cancer in smokers vs. non-smokers. (Show your work) (5 marks)

b) Interpret the measure of association you calculated in question (a) above.(5 marks)

c) Using relevant examples, explain the various guidelines you would use to
ascertain that there exists a causal relationship between smoking and cancer
of the bladder. (10 marks)

d) Explain the various ways of expressing prognosis of disease. (10 marks)

3. a) In a population of 700 people of whom 100 had hearing problems and 600 did
not, an audiometer was used to screen the population and the results indicated
that 80 of the patients with disease and 140 of these without the disease were
labeled as positive by the screening method.
i) Summarize this information in a 2 x 2 contingency table. (2 marks)

ii) Calculate the sensitivity of the screening method. (2 marks)

iii) Calculate the specificity the screening method. (2 marks)

iv) Calculate the accuracy of the screening method (2 marks)

v) Calculate the positive predictive value. (2 marks)

vi) Highlight the public health significance of the false positives
and false negatives giving relevant examples. (5 marks)

b) Write an essay on the attributes used to evaluate surveillance systems.(15 marks)

4. Write an essay on the applications of cross-sectional studies in community
health and clinical practice. (30 marks)

5. The changing social and scientific context in which epidemiology is practiced
has been affected by the need to uphold ethical and professional issues. Discuss.(30 marks)






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