CAT 1 OCTOBER 2023 EHS 123/BPH 124

FACULTY OF SCIENCE AND TECHNOLOGY

EHS 123/4
DISEASES OF PUBLIC HEALTH/COMMUNICABLE AND NON-
COMMUNICABLE DISEASES
QUESTION 1

ANS…

Sarah's situation can serve as a practical example to discuss the classification of infectious diseases.

Infectious diseases can be classified in various ways. One common classification is based on the causative
agents, which can be bacteria, viruses, fungi, or parasites. In Sarah's case, her illness is characterized by a
high fever, fatigue, and muscle aches. These symptoms are often associated with infectious diseases
caused by viruses or bacteria.

1. Viral Infections: Many viral infections can present with these symptoms. For instance, influenza (the
flu) is caused by influenza viruses and is known for high fever, fatigue, and muscle aches.

Viruses are tiny infectious agents that can only replicate inside living host cells. They come in a wide
variety and can cause different types of illnesses. Some viruses, like the common cold viruses
(rhinoviruses), are relatively mild and present with symptoms such as runny nose, sore throat, and
fatigue. Others, like the human immunodeficiency virus (HIV), can lead to more severe and chronic
conditions.

2. Bacterial Infections: Bacterial infections can also lead to similar symptoms. For example, streptococcal
infections, like strep throat, can cause high fever and fatigue.

Bacteria are single-celled microorganisms that can cause various diseases. They are classified into
different groups based on their characteristics. Bacterial infections, such as tuberculosis, often involve
symptoms like prolonged fever, fatigue, and muscle aches. Bacterial infections can be treated with
antibiotics.

3. Parasitic Infections: Some parasitic infections might cause fever and fatigue as well. Malaria, caused
by the Plasmodium parasite, is a notable example.

Parasites are organisms that live on or inside other organisms, known as hosts, and depend on them for
nutrients. These can include protozoa, helminths (worms), and ectoparasites like ticks and lice. Parasitic
infections can lead to a range of symptoms, and the specific symptoms can vary depending on the type
of parasite involved. For example, as mentioned earlier, malaria, caused by the Plasmodium parasite,
leads to symptoms like high fever and fatigue.

4. Fungal Infections: Fungal infections are less commonly associated with these symptoms, but certain
fungal infections can result in fever and fatigue, such as histoplasmosis.

Fungi are eukaryotic microorganisms that can cause infections. Fungal infections can be superficial, like
athlete's foot, or systemic, affecting the entire body. Systemic fungal infections can sometimes cause
fever and fatigue, although they often involve other symptoms such as skin rashes, cough, and difficulty
breathing.

Sarah's healthcare provider would need to conduct tests to determine the exact cause of her illness,
which may involve blood tests, cultures, or other diagnostic methods. Once the causative agent is
identified, the appropriate treatment can be initiated.

This practical example underscores the importance of understanding the classification of infectious
diseases in the field of public health, as it helps healthcare professionals like Sarah's doctors diagnose
and treat patients effectively.

In Sarah's case, her healthcare provider would need to consider her medical history, recent travel,
exposure to potential pathogens, and the prevalence of specific diseases in her region to narrow down
the possibilities. Diagnostic tests, such as blood tests, cultures, and molecular assays, can help identify
the causative agent. Accurate classification is crucial to determine the appropriate treatment, whether
it's antiviral medications, antibiotics, antiparasitic drugs, or antifungal agents.

Understanding the classification of infectious diseases is fundamental in public health because it guides
epidemiological investigations, helps in the development of preventive measures, and ensures timely
and effective treatment for patients, like Sarah, who are suffering from infectious illnesses.

QUESTION 2

ANS…

Title: Water-Related Diseases and Prevention Strategies

Introduction:

- Briefly introduce the importance of researching water-related diseases.

- Mention the focus on four specific diseases.

1. Cholera:

- Prevalence: Cholera is most prevalent in developing countries with inadequate sanitation and clean
water infrastructure. Regions in Africa, South Asia, and parts of Latin America are particularly affected.

- Hosts: Cholera primarily affects humans, as it is a waterborne disease.

- Agents: Vibrio cholerae, a bacterium, is the causative agent. It produces a toxin leading to severe
diarrhea and dehydration.

- Environments: Cholera thrives in areas with poor sanitation, where contaminated water sources are
common, such as rivers and lakes.

- Predisposing Factors: Factors include consuming contaminated water or food, living in crowded and
unsanitary conditions, and lack of access to clean drinking water and proper sewage systems.
 - Prevention and Control: Prevention strategies include improving sanitation and access to clean water,
promoting hygiene practices like handwashing, and using oral cholera vaccines in endemic areas.

2. Typhoid Fever:

- Prevalence: Typhoid fever is prevalent in regions with poor sanitation and hygiene standards, often
seen in parts of Asia, Africa, and South America.

- Hosts: Humans are the primary hosts for Salmonella Typhi, the bacteria causing typhoid.

- Agents: The disease is caused by Salmonella Typhi, which is transmitted through the ingestion of
contaminated food and water.

- Environments: Contaminated water and food sources, particularly in areas with inadequate sanitation
facilities.

- Predisposing Factors: Poor sanitation, limited access to clean water, and consumption of
contaminated food are key factors.

- Prevention and Control: Strategies include providing clean drinking water, improving sanitation, and
administering typhoid vaccines in endemic areas. Promoting good hygiene practices is also crucial.

3. Giardiasis:

- Prevalence: Giardiasis is widespread globally, but it is more common in areas with inadequate water
treatment and sanitation, including some rural regions and developing countries.

- Hosts: Humans are the primary hosts for Giardia intestinalis, a parasite.

- Agents: Giardiasis is caused by the parasite Giardia intestinalis (or Giardia lamblia).

- Environments: Giardia is transmitted through contaminated water sources, often from agricultural
runoff or inadequately treated drinking water.

- Predisposing Factors: Poor water treatment, inadequate sanitation, and poor personal hygiene
contribute to giardiasis transmission.

- Prevention and Control: Measures include water filtration and purification, promoting safe drinking
water practices, and educating communities on personal hygiene and food safety.

4. Schistosomiasis:

- Prevalence: Schistosomiasis is endemic in tropical and subtropical regions, particularly in Africa, parts
of Asia, and South America.

- Hosts: Humans are the definitive host, and freshwater snails serve as intermediate hosts in the
Schistosoma lifecycle.

- Agents: Schistosomiasis is caused by various species of the parasitic flatworm Schistosoma.

 - Environments: Transmission occurs in freshwater bodies like rivers and lakes, where infected snails
release larvae that penetrate human skin during contact with contaminated water.

- Predisposing Factors: Frequent contact with contaminated water, such as for bathing or fishing, and
lack of proper sanitation are key factors.

- Prevention and Control: Strategies include mass drug administration with praziquantel, snail control,
improved sanitation, and health education to reduce exposure to contaminated water.

Emmanuel can use these expanded explanations to provide a comprehensive overview of each water-
related disease, addressing their prevalence, hosts, agents, environments, predisposing factors, and
prevention and control strategies.

QUESTIONS 3

ANS…

To pinpoint the source of the cholera outbreak and confirm if water contamination is the potential
source, public health authorities should employ the following investigative techniques and strategies:

1. Epidemiological Investigations:

- Epidemiologists will conduct detailed interviews with affected individuals to collect information about
their daily routines, food consumption, and water sources.

- By identifying commonalities among cases, such as specific locations or practices, authorities can
narrow down potential sources of infection.

2. Water Sampling and Testing:

- Water samples should be collected from multiple locations, including the city's harbor, public water
supply, and private wells in the affected neighborhood.

- Laboratory testing will aim to detect the presence of Vibrio cholerae in these samples using culture
techniques or molecular methods like PCR.

3. Environmental Assessments:

- Health inspectors and environmental health experts will examine the living and working conditions in
the densely populated neighborhood.

- They will look for indicators of inadequate sanitation, such as open sewage, waste dumping, or
polluted water sources that could facilitate the spread of cholera.

4. Contact Tracing:
 - Contact tracing involves interviewing cholera patients to identify their movements and interactions in
the days leading up to their illness.

- This helps create a timeline of potential exposure points, such as communal gatherings, seafood
markets, or specific water sources.

5. Mapping Cases:

- Geographic information systems (GIS) can be used to visualize the geographic distribution of cholera
cases.

- Clustering of cases around a specific area may indicate a common source, such as a contaminated
water supply or a central seafood market.

6. Hydrological Investigations:

- Understanding the local hydrology is vital. Investigators need to trace the flow of water from the
harbor to the affected neighborhood.

- This involves mapping drainage patterns, sewage systems, and any potential cross-contamination
points.

7. Testing Seafood and Food Supply:

- Collect and analyze samples of seafood, other food items, and water used in food preparation.

- This testing can determine whether contaminated seafood or foodborne transmission played a role in
the outbreak.

8. Surveillance and Early Warning:

- Enhance surveillance systems to detect and report new cases promptly.

- This can include training healthcare providers to recognize cholera symptoms, increasing laboratory
capacity for rapid testing, and establishing clear reporting protocols.

9. Public Awareness and Education:

- Community education efforts are essential to promote good hygiene practices and safe water and
food handling.

- Providing information on boiling water, handwashing, and safe seafood consumption can help reduce
the risk of infection.
10. Temporary Water Supply:

- If water contamination is confirmed in the public supply, authorities may need to provide alternative
sources of safe drinking water to the affected community.

- This could include distributing bottled water, installing water treatment facilities, or drilling new wells.

11. Genomic Analysis:

- Advanced genetic sequencing techniques can analyze the DNA of cholera strains.

- By comparing the genomic data of the outbreak strain with strains from other locations, investigators
can determine the origin of the outbreak and any related outbreaks.

12. Collaboration:

- Collaborating with local and international organizations can provide additional expertise, resources,
and support.

- Academic institutions and research organizations can assist with advanced testing and analysis.

In conclusion, these investigative techniques and strategies are interconnected and must be carried out
in a coordinated manner to effectively identify the source of the cholera outbreak and implement
appropriate interventions to mitigate its impact on the affected community.

QUESTION 4

ASN…

The emergency and re-emergency of communicable diseases in East Africa is a complex and multifaceted
issue. Several factors contribute to this challenge:

1. Inadequate Healthcare Infrastructure: Many countries in East Africa struggle with limited healthcare
infrastructure, making it difficult to respond effectively to disease outbreaks. Insufficient access to
healthcare services can lead to delayed diagnosis and treatment.

2. Poverty and Malnutrition: High levels of poverty in the region often result in malnutrition and
weakened immune systems, making individuals more susceptible to infectious diseases. Poor sanitation
and lack of access to clean water can also facilitate disease transmission.

3. Urbanization and Overcrowding: Rapid urbanization in East African cities has led to overcrowding,
inadequate housing, and unsanitary conditions, creating ideal environments for disease transmission.
Diseases like tuberculosis and cholera thrive in such settings.
4. Inadequate Vaccination Coverage: Inconsistent vaccination programs and low vaccination coverage
rates in some areas can lead to the resurgence of vaccine-preventable diseases like measles and polio.

5. Climate Change: Changes in climate patterns can affect the distribution of disease vectors, such as
mosquitoes that carry diseases like malaria and dengue. Shifts in rainfall patterns can also impact
waterborne diseases.

6. Antimicrobial Resistance: The misuse and overuse of antibiotics have contributed to the development
of antimicrobial resistance, making some diseases harder to treat and control.

7. Cross-Border Transmission: East African countries often share borders, and diseases can easily spread
across borders. Collaborative efforts in disease surveillance and control are crucial.

8. Lack of Public Health Education: A lack of awareness and understanding of disease transmission and
prevention measures can hinder efforts to control outbreaks.

9. Globalization and Travel: Increased global travel and trade have made it easier for diseases to spread
across borders. East African countries are not isolated, and movement of people and goods can facilitate
the transmission of diseases.

10. Vector-Borne Diseases: East Africa is particularly susceptible to diseases transmitted by vectors like
mosquitoes. Malaria is a persistent problem in the region, and climate change can expand the
geographical range of these disease vectors.

11. Civil Conflicts and Displacement: Conflict and displacement of populations can disrupt healthcare
systems and create conditions favorable for the spread of diseases. Refugee camps often have
overcrowded and unsanitary conditions, increasing the risk of disease outbreaks.

12. Healthcare Funding Gaps: Many East African nations face challenges in allocating sufficient funds to
their healthcare systems. Limited resources can lead to inadequate disease surveillance, prevention, and
treatment programs.

13. Disease Reservoirs: Some diseases persist in animal reservoirs, which can spill over to human
populations. Zoonotic diseases like Ebola, Lassa fever, and Rift Valley fever have caused outbreaks in East
Africa.

14. Cultural Practices: Certain cultural practices, such as traditional burial rituals or consumption of
specific wildlife, can increase the risk of disease transmission. It's essential to balance cultural
sensitivities with public health measures.

15. Weak Regulatory Frameworks: Regulatory oversight for food safety, pharmaceuticals, and healthcare
services can be lacking in some areas, allowing substandard or contaminated products to enter the
market.

16. Limited Access to Healthcare Services: In remote or underserved areas, access to healthcare services
may be limited, making it challenging for people to seek timely medical care when they fall ill.

To address these challenges, governments and international organizations must invest in healthcare
infrastructure, improve access to clean water and sanitation, enhance vaccination programs, and
promote public health education. Additionally, regional cooperation and data sharing are vital for early
detection and coordinated responses to disease outbreaks in East Africa.

Certainly, let's delve further into the factors contributing to the emergency and re-emergency of
communicable diseases in East Africa: