This question and answer was specifically prepared for students preparing for ND

in WAHEB to releif them from phobia and tension of WAHEB questions.

Moreover, i want to get you informed that WAHEB questions are nothing but the
same with school examination even at times school examination questions are
tougher than WAHEB questions but the predicament faced by most students
regarding WAHEB questions are inability to take fully in charge, take control and
interprete WAHEB questions before attempting them.

WAHEB questions, at times are logical but simple, therefore, it requires your
psychological approach to interprete the questions accordingly and after
thorough and careful interpretation then take in charge of the questions and
solve them respectively and accordingly.

Sequel to the reasons stated above, this is why this material is prepared to assist
students and provide them with indispensable clues to use when attempting
WAHEB questions without stress. This material will also help you to get suggested
answers to some past questions in the previous examination.

This material solved different WAHEB past questions and gave their suggested
answers to the questions.

In conclusion, I beleived by the time you get acquainted with questions and
answers in this material, I assure you that excellent await you in your ND exams.
Good luck.

Incase of any difficulty, you can call me on this number for clarification:
07039107790

1
 TABLE OF CONTENTS

1. FOOD HYGIENE AND INSPECTION

2. WATER SANITATION AND SUPPLY
3. PUBLIC HEALTH LAW AND ETHICS
4. IMMUNOLOGY AND PUBLIC HEALTH
5. PRINCIPLE AND PRACTICE OF FIRST AID
6. PRIMARY HEALTH CARE DELIVERY SYSTEM

2
 PAST QUESTION 2015

FOOD HYGIENE AND INSPECTION (EHT209)

QUESTION 1

(1a) Identify ten (10) equipment and materials that can be used in the abattoir,
slaughter house and slaughter slab operation-------------------------10marks

(1b) Describe the functions of any five (5) of the equipment/materials mentioned
in (1a) above ------------------------------------------------------------------10marks

SUGGESTED ANSWER

(1a) The equipment and materials used in the abattoir, slaughter house and
slaughter slab include;

 Stunning gun, electrical head tongs or simple stunning equipment for direct
flow
 Knives/ sticking- 15cm sharpened on both sides, skinning- 15cm curved
 A sharpening steel
 Oil or water sharpening stone
 Scabbard and belt for holding knives
 Meat saw- hand or electric and cleaver
 Black and tackle or chain hoist strong enough to hold the weight of the
animal to be slaughtered
 Pritch, chocks or skinning rack (dressing cradle)
 A strong beam, tripod or track 2.4-3.4m high
 Spreader; gambrel or metal pipe
 Several buckets
 Working platforms
 Pot or system for boiling water
 Bell scrappers
 Torch or flame for singeling
 Hand wash basin
 Implement sterilizers
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 Equipment for waste management and disposal.

(1b)

(1) IMPLEMENT STERILIZERS: These are stainless-steel boxes holding hot (82oc)
water, shaped to suit particular equipments such as knives, cleaners, sairs
e.t.c. Knife sterilizers should be placed in position where every operator
who uses a knife has immediate access. Handlers as well as blades must be
sterilized. Each operator should have at least two knives. Failure to sterilize
all knives and equipment regularly will result in carcass contamination.
(2) TORCH: This helps to provide enough illumunation during animal
slaughtering especially during early morning or at the night for proper
slaughtering, removal of internal parts from the carcass, proper cutting and
to also prevent accidental injury to the butcher.
(3) SEVERAL BUCKETS: These are used for sevaral purposes ranging from
fetching water for carcass washing, fetching water for washing and rinsing
of the slaughter slab, fetching water for washing of drainage system for
proper flow of liquid waste. Buckets are also needed for temporary storage
of visceral parts romeved from the animal. Buckets are also used to convey
some parts of the carcass to the market especially where the market is
close to the slaughter house. Buckets are used for personal hygiene of the
butchers.
(4) KNIVES: Knives are used by the butchers for cutting of the carcass into
pieces, knives are also used during dressing of the carcass, knives are used
to remove carcass skin for boiling, Knives are also used to remove carcass
flesh from the body. Knives are also used for slaughtering of live animal.
The knives used are of different sizes and shapes, Knife is one of the
valuable equipment mostly used in abattoir and slaughter house.
(5) WORKING PLATFORMS: These are various tables used for dressing of
carcass, cutting of carcass and it also provide avenue for selling of the meat
right at the slaughter house. The tables also provide base for varoius
containers holding meat. The table contains the weighing scale for meat
measuring.

4
 QUESTION 2

2. Explain any ten (10) importance of post-mortem inspection in the prevention

and control of meat/food borne diseases.--------------------------------20marks

SUGGESTED ANSWER

(1) It helps to ensure that all meat intended for human consumption shall be
prepared, stored and marketed under hygienic conditions, therefore
preventing and controlling meat/food borne diseases.
(2) It helps to protects the honest butcher or meat retailer from unfair
competition. If there were no meat inspection many retailers would be too
conscious to sell diseased meat to the public which would promote the
occurence of meat/food borne diseases.
(3) It help to prevent substitution e.g a foetal calf for a marketable calf or
diseased animal for healthy animal, Therefore with the help of post-
mortem inspection, these acts are prevented
(4) Post-mortem inspection helps to prevent fraudulent act of some butchers
or meat seller which otherwise might promote the spread of meat/food
borne diseases.
(5) It ensures that flesh and organs that have been condemned shall be
disposed off sanitarily and where practicable in an economic manner.
(6) Post-mortem inspection helps to detect outbreak of animal plaques and
other diseases and urgent measures are put in place to ensure such meats
do not get to the market for public consumption
(7) Post-mortem inspection of carcass ensure that only healthy and disease
free meats are released to the market for human consumption.
(8) Post-mortem inspection also prevent cross contamination of meat which
subsequently helps to prevent and control of meat/food borne diseases.
(9) During post-mortem inspection carcass with disease organs are removed
and prevent such from getting to the market.
(10) Post-mortem inspection also makes recommenedation to the animal
owners, butchers, or meat handlers on the hygienic way of handling animal
5
 and carcass in such a manner and way that they will not be infected but
remain wholesome and edible for the public.

QUESTION 3

(3a) Enumerate five (5) lymph nodes and their location in a named food
animal----------------10marks

(3b) State the importance of lymph nodes in meat inspectio------------10marks

SUGGESTED ANSWER

(3a)

s/n LYMPH NODES LOCATION IN ANIMAL BODY

1 Paratoid lymph node
2 Retropharyngeal lymph node
3 Submandibular lymph node
4 Supremammary lymph node
5 Inguinal lymph node
6 Popliteal lymph node
7 Auxillary lymph node
8 Crevical lymph node
9 Femoral lymph node
10 Illiac lymph node
Located in front and below the ear
Located in the head
Located in the lower jaw
Located in the breast
Located in below the abdominal cavity
of the animal
Located in the upper thigh (femur) of
the animal
Located in the pelvic girdle of the animal
Located in the neck of the animal
Located in the femur
Located on the back of the animal

(3b) The importance of lymph nodes in meat inspection include

(1) Lymph node is a colourless fluid that contains lymphocyte (white blood
cells) which help to filter and destroy invading bacterias

6
 (2) Lymph node is a major attention during post mortem inspection because it
serves as indicator to know whether a carcass is infected or not.
(3) Swollen lymph node indicate infection by micro-organism and this facilitate
the judgement of the carcass inspector as to either condem the carcass or
not.
(4) Lymph node helps to ascertain the state of healthiness of the carcass.
(5) Lymph node can also serve as a sample for bacterialogical examination of
the carcass in the laboratory.

QUESTION 4

There has been constant outbreaks of meat related diseases from the only
slaughter house in your community. In order to prevent re-occurence you were
assigned to carry out detailed inspection of the slaughter house and advise the
local government chairman through a comprehensive report.

(4a) Enumerate ten (10) requirements of a standard

abattoir-------------------------------------10marks

(4b) Briefly describe any five (5) requirements you have enumerated in (a) above.

SUGGESTED ANSWER

(4a) The requirement of standard abattoir include

(1) Provision of slaughter slab constructed with hard and durable material
(2) Provision of larraige for keeping of live animal for ante mortem inspection
before slaughtering
(3) Provision of potable water source for washing of carcass, washing of
equipment, personal hygiene of the butchers and environmental sanitation.
(4) Provision of various offices
(5) Provision of cloak room
(6) Provision of slaughtering equipment and material
(7) Provision of lightening both natural and artificial
(8) Provision of waste disposal facility
(9) Provision of sanitary conveniency for seperate sexes

7
 (10) Provision of sanitary drainages.

(4b).(1) SLAUGHTER SLAB: Slaughter slab is one of the key component of a

standard abattoir, it is the concreted floor made of gravel, sand, and cement
mixed in appropriate ration. It must be made durable and hard to stand the test
of time. Slaughter slab is meant for animal slaughtering before taking the product
derived from it, is being taking to the market, for sale. Slaughter slab must be
washed thoroughly at the end of each slaughtering to keep it tidy and prevent
cross contamination of carcass during slaughtering.

(2) LARRAIGE: Larraige is a designated place within the abattoir where live animal
are kept for physical examination before such animals are slaughtered. Larraige is
very critical in a standard abattoir to prevent outbreak of meat borne diseases,
because larraige provide avenue for meat inspectors to examine the physical
status of the animal before releasing them for slaughtering.

(3) POTABLE WATER SUPPLY SOURCE: Water supply source is very important
component of a standard abattoir because water is needed for various purposes
before slaughtering, during slaughtering and after slaughtering. For instance
before slaughtering potable water is needed to feed the live animal, during
slaughtering potable water source is needed for washing the carcass, washing the
feaces from the carcsass, washing blood from the carcass, after slaughtering
water is also needed for washing the surface of the slaughter slab, the drainages
e.t.c

(4) CLOAKROOM: Cloakroom is a room within the abattoir where workers change
their house cloth into the working uniform. This is so essential, because this
prevent zoonotic infections. Therefore, cloak room is an essential component of a
standard abattoir.

(5) SANITARY CONVENIENCIES: Sanitary conveniency such as sanitary toilet,

sanitary urinals, sanitary bathroom. These are essential to provide comfort for the
users. There must be seperate toilets for both sexes and the hygienic condition of
each toilet must be paramount to the users so as to prevent infections.

8
 QUESTION 5

5. Write notes on the following;

(5a) Meat borne diseases

(5b) Inferior Meat

(5c) Wholesome edible offals

(5d) Emergency slaughter

SUGGESTED ANSWER

(5a) MEAT BORNE DISEASES: Meat borne diseases are diseases or disorders or
illensses contracted through eating of meat that harbours a particular infectious
agent. Therefore, meat borne diseases signify an illness in which meat is used as a
medium of transferring the causative agent from the source to man and not a
medium for multiplication. Examples of meat borne diseases are Teania saginata,
Teania solium, rhabdo virus, Lassa fever virus e.t.c

(5b). INFERIOR MEAT: This is referred to as the meat that has failed all the needed
sanitation conditions and has been found to contain substandard contents. Meat
quality has five dimensions sensory quality, nutritional quality, technological
quality, hygienic and toxicological quality and immaterial quality. Pre-slaughter
handling causing stress and pain can result in inferior meat quality. Bruised tissue
is an aesthetic and hygienic problem. It is usually trimmed away reducing yield as
well as frequently leading to downgrading. Blood slash is an example of meat
quality problems, this is as a result of stunning.

(5c) WHOLESOME EDIBLE OFFALS: Depending on the context, offals may refer to
those parts of an animal carcass discarded after butchering or skinning. Therefore,
Wholesome edible offals can be referred to as parts or organs entrail of
butchered animal that are considered good for human consumption. This include
the heart, the kidney, the liver, the spleen, the tongue.

(5d). EMMERGENCY SLAUGHTER: This is a special killing that is carried out on

animal without proper inspection by the veterinary officers. This is carried out as
9
a result of a suffering from the animals, injured animal or tiredness as a result of
long transportation. But after emergency slaughter the carcass and all parts must
be held for inspection with the head and all viscera except the stomach, bladder
and intestine held by the natural attachment. If all part are not kept in this form,
the entire carcass may be condemned.

10
 PAST QUESTION 2016

FOOD HYGIENE AND INSPECTION (EHT209)

QUESTION 1

(1a) With the aid of a well labeled diagram describe the liver of any food
animal---------------10marks

(1b) Explain five (5) functions of the liver of any food animal---------------10marks

SUGGESTED ANSWER

(1a) Liver is an important organ in vertebrate animals and some other animals. In
human, it is located in the upper right quadrant of the abdomen, below the
diaphragm. While in other lower animal it is located almost at some region as
man within the ribs. The liver is an accessory digestive gland that produces bile,
an alkaline compound which helps the breakdown of fat. Bile aids in digestion via
the emulsification of lipids. The gallbladder, a small pouch that sits just under the
liver, stores bile produced by the liver which is afterwards moved to the small
intestine to complete digestion. The liver is a highly specialized tissue consisting of
mostly hepatocytes which regulates a wide variety of high volume biochemical
reactions, including the synthesis and breakdown of small and complex
molecules, many of which are necessary for normal vital functions.

(1b) FUNCTIONS OF LIVER include

(1) Detoxification of various metabolites

(2) Protein synthesis
(3) Production of biochemicals necessary for digestion (bile)
(4) Hormone production
(5) Storage of vitamin
(6) Regulation of glycogen storage
(7) Decomposition of red blood cells
(8) Helping to fight infection

11
 QUESTION 2

(2a) Describe refrigeration as a method of food preservation----------10marks

(2b) Explain five (5) advantages and disadvantages of refrigeration as a method of

food preservation--------10marks

SUGGESTED ANSWER

(2a) REFRIGERATION: Food items are usually refrigerated at temperature of 40 oc

at this temperature, the growth of micro-organism is completely inhibited
thereby preventing the food from spoilage or deterioration. The activities of
micro-organisms e.g bacteria, yeast and moulds are adversely affected by low
temperature. Low temperature also prevents autolysis or inhibit the action of
autolytic enzymes naturally present in food. Examples of food to be refrigerated
include; meat, tomatoes, fruits such as orange, guaver, banana, cashew, water
melon e.t.c. The cooked food can also be refrigerated to keep them safe for
consumption. Refrigerated foods still maintain their qualities, freshness, texture,
appearance.

(2b) ADVANTAGES

 Refrigeration techniques minimizes enzymes and microbial activities,

therefore refrigerated foods are of good quality.
 Refrigerated foods are always available even during off season and the
nutritive value remains intact.
 Refrigerated foods still maintain thier freshness even after been
refrigerated
 Refrigerated food are free from contaminants
 Refrigerate foods are safe for consumption

DISADVANTAGES

 Electric refrigerator often cause food spoilage during power flunctuation

 The mechanism of refrigerator is quite expensive.
 Refrigerator is expensive

12
  Refrigerated food may serve as source of disease transmission especially
where light is unstable
 Refrigerated foods serve as source of obnoxious odour incase of
flunctuated electricity.

QUESTION 3

3. Discuss five (5) conditions that would make you condemn carcass in
abattoir-----------------20marks

SUGGESTED ANSWER

(1) Evidence of Bacillus anthracis the causative agent of Anthrax in the blood of
the carcass
(2) Evidence of contaminated slaughter slab where the animal is slaughtered
(3) Presence of Abscess
(4) Evidence of Tuberculosis
(5) Liver rot
 Evidence of bacillus anthracis in the blood of carcass is an evidence of
systemic infection that is infection that has affected the entire body of the
carcass. This agent is a deadly bacteria that spread and kill faster, so once
this is detected in the carcass, the whole carcass should be comdemned by
burning or buried far away from the community. One of the visible sign of
anthrax in carcass is the changing of the blood colour from red colour to
red black colour.
 Evidence of contaminated slaughter slab: If paraventure, the slaughter slab
where the animal is slaughtered is heavily contaminated, This can massively
contaminate the carcass and this might result into outbreak of meat borne
infection in a community where such carcass is consumed, so to avoid this,
when noticed or discovered that the slaughter slab is contaminated, so also
the carcass should be condemned. Such carcass should be prevented entry
into the market for public consumption.
 Presence of Abscess during postmortem inspection: It is a localized
collection of pus seperated from the surrounding tissue by a fibrous

13
 capsule. The most common bacteria in liver abscess is staphylococcus
pyogenes, streptococcus species. Therefore, the presence of abscess in
some of the vital organs indicate that such animal is infected with bacteria
infection and such carcass should be condemned.
 Evidence of Mycobacterium tuberculosis the causative agent of bovine
tuberculosis especially in the lungs and other respiratory organ, since
mycobacterium tuberculosis can spread so fast and affect the entire
carcass, therefore, the evidence of this bacterium in the lungs of thecarcass
indicate infection and such carass should be condemned.
 Liver rot: Liver rot is a common disease of cattle and sheep caused by
harmful micro-organism and other toxic substance in the animal body. An
affected cattle and sheep at first appear to put on flesh, but soon the
appetite is interfered with and there is gradual wasting. The animal become
thin and emaciated and the abdomen is distended due to enlargement of
the liver and once this is noticed, such carcass should be condemned.

QUESTION 4

4. As an Environmental Health Officer, vividly outline the general procedure for

dressing the carcass of a food animal

SUGGESTED ANSWER

(4) Procedure for carcass dressing include;

* DECAPITATION: Beheading typically refers to the act of intentional decapitation

either as a means of murder or execution. It can be executed with an axe, sword,
knife , wire or by other more sophisticated means. It is the seperation of the head
from the body. It can also refers to occasion to the removal of the head from a
body that is already dead. This might be done to take the head as a strophy for
public display.

* EVISCERATION: This is the removal of viscera (internal organs especially those

in the abdominal cavity). This can refer to disembowliment, removal of the

14
internal organs of an animal. Evisceration is a rare but severe surgical
complication where the surgical incision opens and abdominal organs then
protrude or cone out of the incision, it is an emergency and should be treated as
such.

* SPLITTING OF CARCASS: This can be described as the process by which all other
parts of the food animals are properly seperated. After removing the upper and
internal organs all other parts are generously cut into sizes depending of the
desire of the owner or the consumer. Splitting may be difficult if needed
equipment is not used.

QUESTION 5

5. Write brief notes on the following

(a) Blown can----------------------------------------------------------------------5marks

(b) Food sanitation-------------------------------------------------------------5marks

(c) Food storage----------------------------------------------------------------5marks

(d) Food additive--------------------------------------------------------------5marks

SUGGESTED ANSWER

(5a) BLOWN CAN: It is a protruded can as a result of metallic reaction of the can.
It can aslo be caused by food rich in acid. Blown can is an example of spoiled can
food. And it is one of the visible sign during physical examination or inspection.
Blown can when discovered should be condemned.

(5b) FOOD SANITATION: These are sanitary measures put in place during food
harvesting, food processing, food transportation,and food cooking until the food
gets to the consumer table, the ensence of food sanitation is to ensure that food
are free from all agent of contamination and thereby safe for human
consumption so as to prevent food related diseases after consumption.

15
FOOD STORAGE: Is the process in which both cooked and raw materials are stored
in appropriate conditions for future use without any entry or multiplication of
micro-organisms. Proper stored food will protect food against contamination,
deterioration and damage. Food storage also allow food to be eaten for some
time typically weeks to month even year depending on the storing method.

FOOD ADDITIVES: These are the non-nutritious substances added to food to

improve the appearance, flavour, texture and state of the food. Examples are
maggi, salt, tyme, curri,.

PAST QUESTION 2017

FOOD HYGIENE AND INSPECTION (EHT209)

QUESTION 1

(1a) Define meat hygiene -------------------------------5marks

(1b) State five (5) sources of meat contamina------------------------5marks

(1c) State five (5) factors that may favour the growth of micro-organisms in meat
intended for human consumption --------------------------------5marks

(1d) Identify five (5) signs of spoiled meat--------------------------5marks

SUGGESTED ANSWER

(1a) MEAT HYGIENE: These are sanitary measures put in place to ensure that
meat and meat product are safe and that it production and processing satisfy
hygienic law. Meat hygiene referred to as sanitary measures put in place to
prevent contamination at all stages and to ensure that public consume
wholesome meat and also prevent meat borne diseases or meat related diseases.

(1b). The sources of meat contamination include but not limited to these below;

16
  Meat can be contaminated during processing i.e slaughtering when
slaughted on a dirty floor
 Meat can be contaminated during dressing when the internal has contact
with the external body and it is not properly cleaned.
 Meat can be contaminated during storage if not properly stored, micro-
organism can find is way into the well processed meat
 Meat can be contaminated during transportation from the slaughter house
to the market.
 Meat can be contaminated through the unhygienic nature of the butcher.
 Meat can also be contaminated through contaminated water during
washing
 Cross contamination can also occur during slaughtering.
 When feaces of the animal has contact with the body of the meat.

(1c). The factors that favour the growth of micro-organism in meat intended for
human consumption include;

 Temperature: For micro-organism to grow successfully, it needs certain

temperature either low or high temperature depending on the micro-
organism talking about.
 Moisture: This is another factor that favour the growth of micro-organism
in meat, but the absence of moisture micro-organism may not strive.
 Oxygen: micro-organism is a living entity, it requires oxygen to grow,
therefore, the presence of oxygen aid the growth of micro-organism.
 Accessibility to flies: When the meat is exposed to flies, this aid the growth
of micro-organism as quick as possible
 Meat handlers: Improper stored meat by meat handlers render such meat
to the growth of micro-organism, the dirty habit of meat handlers can also
promote the growth of micro-organism on meat.

(1d) Signs of spoiled meat include;

 Presence of unpleasant odour

17
  The meat become flaby and soft
 Greenish or brown colour
 Evidence of decomposition
 Dull appaerance

QUESTION2

(2a) Describe meat preservation---------------------------------------------3marks

(2b) List five (5) methods of meat preservation--------------------------5marks

(2c) Explain any two (2) methods listed in 2(b) above-----------------12marks

SUGGESTED ANSWER

(2a) MEAT PRESERVATION: These are strategies or set of treatments processes for
promoting and preserving the nutritious properties, state, texture and colour of
raw, partially cooked or cooked meats while keeping them edible and safe to
consume. Meat preservation becomes inevitable owning to the fact that meat is a
highly perishable products and soon becomes unfit to eat and possible dangerous
to health through microbial growth, chemical change and breakdown by
endogenous enzymes. Meat preervation is to ensure that meat is free from micro-
organism and other abnormality and still maintain the quality of the meat .

(2b) Methods of meat preservation includes;

 Sundrying
 Smoking
 Canning
 Freezing
 Curing
 Refrigeration
 Dehydration
 Radiation treatment
 Antibiotic treatment
18
(2c) Explaination of the listed methods above

a. SUNDRYING: This is done by exposing the foods to direct energy from sun
ray. This operation will ensure that food articles are made free from
moisture or water. Drying is the removal or lowering of moisture content of
food so as to deprive microorganisms of water that is vital for organism
survival.

ADVANTAGES

 Sun drying helps to retard microbial activities by removing water from the
food
 It prolongs the shelf life of foods
 Dried food contains less weight and not bulky, therefore, they require less
storage space, less transportation cost

DISADVANTAGES

 Most food stuffs to loss their taste and freshness due to loss of water in
drying
 Drying leads to loss of valuable nutrients e.g vitamin after drying
 Sun dried food may become subject of contamination by micro-organism

b. SMOKING: This is the most common and popular method of food

preservation in the tropics. Food to be smoked are exposed or placed
directly under source of heat or fire. This is done to remove water content
from the food.
ADVANTAGES
 It helps to retard and destroy microbial activities
 It extends the shelf-life of foods
 It enhances the flavour of the food smoked

DISADVANTAGES

 The food can easily be burnt if not properly monitored

 Food items change colour or become darken in colour

19
  It exposes food items to contamination.

(c) REFRIGERATION: Food items are usually refrigerated at temperature of 40 oc at

this temperature, the growth of micro-organism is completely inhibited thereby
preventing the food from spoilage or deterioration. The activities of micro-
organism e.g bacteria, yeast and moulds are adversely affected by low
temperature. Low temperature also prevents autolysisor inhibit the action of
autolytic enzymes naturally present in food.

ADVANTAGES

 Refrigeration techniques minimizes enzymes and microbial activities,

therefore refrigerated foods are of good quality.
 Refrigerated foods are always available even during off season and the
nutrientive value remains intact.

DISADVANTAGES

 Electric refrigerator often cause food spoilage during power flunctuation

 The mechanism of refrigeration is quite expensive.

(d) OSMOTIC PRESERVATION: This type of preservation, sugar and salt are used.
Sugar solution of higher osmotic concentration posses a higher osmotic pressure
which help to withdraw water from micro-organism by the principal of osmosis
thereby rendering them dehydrated and prevented their growth.

(e) PASTEURIZATION: Pasteurization is the heating techniques employed to kill all

pathogenic organisms in a liquid food. This method is used in destroying bacteria
in milk. Pasteurization is the raising of temperature of milk from 76 0c to 780c to kill
micro-organismpresent in milk product.

(f) ANTIBIOTIC PRESERVATION: Antibiotics are chemical substances which are

capable of destroying and suppressing or inhibiting food spoilage micro-organisms

(g) RADIATION: Radiation is the sending out of rays of heat from the sun,
radioactive substance or from hot bodies. X-rays and Gamma rays are used in
industries for food preservation because of their germicidal properties. Therefore,

20
the absorption of radiation by food depends on the certain factors; nature,
sources and intensity.

(h) DEHYDRATION: In this method of preservation, moisture is removed from the

food stufss while heat energy is supplied to the food. This is carried out by
substantially lowering the water water content of the food under controlled
conditions which include temperature, humidity and air flow. Mechanical device
called dehydrater is used in transferring heat energy to food in the process of
dehydration.

(i) FREEZING: In this method of preservation, bacteria growth is drastically

reduced and activities of enzymes are cultailed. In freezing a relatively low
temperature of about 18oc is required. Freezing is capable of destroying most
micro-organisms in food stuffs which include meat, fish, vegetable, fruits e.t.c, are
deep frozen for preservation. Frozen foods retain their freshness, quality and
nutrient.

(j) CANNING: Canning is the process of preserving food by subjecting the food to
high temperature in a permanently sealed container by expelling air out of the
container. Cans are heated to a specific temperature and over a period of time
according to the size of cans and nature of food being canned. In other word,
canning can also be defined as a method of food preservation in which a carefully
selected and prepared food stuffs are put into cans and air is expelled from the
cans. The cans are hermetically sealed and then cooled.

ADVANTAGES

 Canned foods are available at all times

 The products are handy hence they facilitate transportation, stocking and
portion control
 The quality of canned product is high and dependable

DISADVANTAGES
 Acid food may cause internal corrosion
 Metallic poisoning may arise from poisonous metal of the tin or can

21
  High technical competence is needed to operate the mechanism of
canning.

QUESTION 3

(3a) Explain the importance of the following in an abattoir

(i) Drainage------------------------------------------------------------------5marks
(ii) Sanitary conveniences------------------------------------------------5marks

(3b) State five (5) signs of unhealthy animal----------------------------10marks

SUGGESTED ANSWER

(3ai) The importance of drainage in abattoir include;

(1) It prevents mosquitoes breeding

(2) It prevents emanation of obnoxious odour
(3) It helps to channel away all the liquid waste from the abattoir premises,
thereby promoting the aesthetic beautic of the abattoir
(4) It prevent puddle formation
(5) It prevent slippery ground.

(3bi) The importance of sanitary conveniences in an abattoir include

(1) It prevents indescriminate defeacation around the abattoir premises

(2) It prevents feaces related diseases
(3) It prevent obnoxious odour that might be caused by indescriminate
defeacation
(4) It prevents flies breeding
(5) It promotes the aesthetic beauty of the abattoir.

(3b) Signs of unhealthy animal include

(1) Abnormal discharge from the body openings

(2) Abnormal gait of the animal

22
 (3) Restlessness
(4) Abnormal odour
(5) Emaciation
(6) Loss of appetite
(7) Dull appearance or inactiveness
(8) Peeling of body skin

QUESTION4

4. Describe ten (10) components of the layout of a standard abattoir-----20marks

SUGGESTED ANSWER

The components of the layout of a standard abattoir include

(1) Provision of slaughter slab constructed with hard and durable material
(2) Provision of larraige for keeping of live animal for ante mortem inspection
before slaughtering
(3) Provision of potable water source for washing of carcass, washing of
equipment, personal hygiene of the butchers and environmental sanitation.
(4) Provision of various offices
(5) Provision of cloak room
(6) Provision of slaughtering equipment and material
(7) Provision of lightening both natural and artificial
(8) Provision of waste disposal facility
(9) Provision of sanitary conveniency for seperate sexes
(10) Provision of sanitary drainages.

QUESTION 5

(5a) List ten (10) equipments/implements used for slaughter and dressing of food
animals in an abattoir and slaughter slab-------------------------------------10marks

(5b) Describe the procedure for cleaning a slaughter house---------------10marks

23
SUGGESTED ANSWER

(5a) The equipment/implement used for slaughtering and dressing of food animal
in an abattoir include

 Stunning gun, electrical head tongs or simple stunning equipment for direct
flow
 Knives/ sticking- 15cm sharpened on both sides, skinning- 15cm curved
 A sharpening steel
 Oil or water sharpening stone
 Scabbard and belt for holding knives
 Meat saw- hand or electric and cleaver
 Black and tackle or chain hoist strong enough to hold the weight of the
animal to be slaughtered
 Pritch, chocks or skinning rack (dressing cradle)
 A strong beam, tripod or track 2.4-3.4m high
 Spreader; gambrel or metal pipe
 Several buckets
 Working platforms
 Pot or system for boiling water
 Bell scrappers
 Torch or flame for singeling
 Hand wash basin
 Implement sterilizers
 Equipment for waste management and disposal

(5b) The procedure for cleaning the abattior include

 After slaughtering of animal on the slaughter slab early in the morning, hot
water with hard brush will be used to wash the surface of the slaughter slab
for easy removal of blood and residue on the floor.
 Then water with disinfectant will be used to wash and rinse the surface of
the slaughter slab, this is done to ensure total eradication of the slaughter
slab so as to prevent meat contamination.

24
  After washing and rinsing, the slaughter slab is exposed to direct sunlight
for easy and quick drying and access by animal is prevented.
 The drainages are washed with very thick and hard broom with hot water,
soap and disinfectant so as to prevent stagnant water which may later
breed mosquitoes and other vectors of medical importance.
 The feaces are properly disposed to prevent odour and flies infestation.
 The removed bones are taking to where it will be properly disposed off or
used as rwa material in recycling industry.
 Overgrown weed are cut to the bearest level in the abattoir to prevent
vermin harbourage
 The used sanitary toilets are properly washed with chwmical compound at
the end of each day’s work.
 The larraige must also be taken care of and ensure animal feaces are
removed from the animal, then their water are replaced.
 All the equipments and material used are washed and sundried before
using in the next day.

PAST QUESTION 2018.

FOOD HYGIENE AND INSPECTION (EHT209)

QUESTION 1

1. Discuss any five (5) methods of food preservation

SUGGESTED ANSWER

Food preservative methods include (a) Sun drying (b) Smoking (c) Refrigeration (d)
Canning (e) pasteurization (f) Osmotic preservation (g) Antibiotic preservation (h)
Dehydration (i) Freezing (j) Radiation.

EXPLAINATION

25
(A) SUNDRYING: This is done by exposing the foods to direct energy from sun
ray. This operation will ensure that food articles are made free from
moisture or water. Drying is the removal or lowering of moisture content of
food so as to deprive microorganisms of water that is vital for organism
survival.

ADVANTAGES

 Sun drying helps to retard microbial activities by removing water from the
food
 It prolongs the shelf life of foods
 Dried food are lesser in weight and not bulky, therefore, they require less
storage space, less transportation cost.

DISADVANTAGES

 Most food stuffs do loss their taste and freshness due to loss of water in
drying
 Drying leads to loss of valuable nutrients e.g vitamin after drying
 Sun dried food may become subject of contamination by micro-organism

(B) SMOKING: This is the most common and popular method of food
preservation in the tropics. Food to be smoked are exposed or placed
directly under source of heat or fire. This is done to remove water content
from the food.
ADVANTAGES
 It helps to retard and destroy microbial activities
 It extends the shelf-life of foods
 It enhances the flavour of the food smoked

DISADVANTAGES

 The food can easily be burnt if not properly monitored

 Food items change colour or become dark in colour

26
  It exposes food items to contamination.
(C) REFRIGERATION: Food items are usually refrigerated at temperature of
40oc at this temperature, the growth of micro-organism is completely
inhibited thereby preventing the food from spoilage or deterioration. The
activities of micro-organism e.g bacteria, yeast and moulds are adversely
affected by low temperature. Low temperature also prevents autolysis or
inhibit the action of autolytic enzymes naturally present in food.

ADVANTAGES

 Refrigeration techniques minimizes enzymes and microbial activities,

therefore refrigerated foods are of good quality.
 Refrigerated foods are always available even during off season and the
nutritive value remains intact.

DISADVANTAGES

 Electric refrigerator often cause food spoilage during power flunctuation

 The mechanism of refrigerator is quite expensive.

(D) OSMOTIC PRESERVATION: This type of preservation, sugar and salt are used.
Sugar solution of higher osmotic concentration posses a higher osmotic pressure
which help to withdraw water from micro-organism by the principle of osmosis
thereby rendering them dehydrated and prevent their growth.

(E) PASTEURIZATION: Pasteurization is the heating techniques employed to kill all

pathogenic organisms in a liquid food. This method is used in destroying bacteria
in milk. Pasteurization is the raising of temperature of milk from 76 0c to 780c to kill
micro-organismpresent in milk product.

(F) ANTIBIOTIC PRESERVATION: Antibiotics are chemical substances which are

capable of destroying and suppressing or inhibiting food spoilage micro-organisms

(G) RADIATION: Radiation is the sending out of rays of heat from the sun,
radioactive substance or from hot bodies. X-rays and Gamma rays are used in
industries for food preservation because of their germicidal properties. Therefore,

27
the absorption of radiation by food depends on these certain factors; nature,
sources and intensity.

(H) DEHYDRATION: In this method of preservation, moisture is removed from the

food stuffs while heat energy is supplied to the food. This is carried out by
substantially lowering the water content of the food under controlled conditions
which include temperature, humidity and air flow. Mechanical device called
dehydrator is used in transferring heat energy to food in the process of
dehydration.

(I) FREEZING: In this method of preservation, bacteria growth is drastically

reduced and activities of enzymes are cultailed. In freezing a relatively low
temperature of about 18oc is required. Freezing is capable of destroying most
micro-organisms in food stuffs which include meat, fish, vegetable, fruits e.t.c, are
deep frozen for preservation. Frozen foods retain their freshness, quality and
nutrient.

(J) CANNING: Canning is the process of preserving food by subjecting the food to
high temperature in a permanently sealed container by expelling air out of the
container. Cans are heated to a specific temperature and over a period of time
according to the size of cans and nature of food being canned. In other word,
canning can also be defined as a method of food preservation in which a carefully
selected and prepared food stuffs are put into cans and air is expelled from the
cans. The cans are hermetically sealed and then cooled.

ADVANTAGES

 Canned foods are available at all times

 The products are handy hence they facilitate transportation, stocking and
portion control
 The quality of canned product is high and dependable

DISADVANTAGES

 Acid food may cause internal corrosion

28
  Metallic poisoning may arise from poisonous metal of the tin or can
 High technical competence is needed to operate the mechanism of
canning.

QUESTION 2

2a. List six (6) factors necessary for sitting an abattoir ------6marks

2b. State seven(7) differences between abattoir and slaughter slab------14marks

SUGGESTED ANSWER

2a. Factors necessary for sitting an abattoir include

 Availability of water
 Availability of land
 Availability of animal and space for storage
 Accesible roads for intending consumers
 Availability of market for sales
 Availability of funds to construct it up to standard i.e 2.2 foundation
standard
 Availability of technical slaughter workers
 There should be connection to a public electricity supply if desirable
especially if chilling of carcass is being considered
 There should be sufficient space available to bury inedible waste and
condemned animals and provision for compost stacks
 The abattoir should not be located close to dwellings, schools, churches and
other public or commercial buildings due to possible nuisance from noise,
smell e.t.c
 Availability of equipments for slaughtering, sanitation and washing.

2b. 1. Abattoir is a public slaughter house designated for receiving live animal,
slaughtering of animal, inspection of live and dead animal (ante-mortem and
post-mortem), dressing of carcass e.t.c

29
 While

Slaughter slab is a component of an abattoir designed for slaughtering of live

animal.

2. Abattoir is the whole facility in the slaughter house

While

Slaughter slab is the concreted floor, hard and durable floor that provide
base for the butchers and the animal to be slaughtered

3. Abattoir is majorly owned by the government either local, state, or federal

government
While

Slaughter slab is commonly owned by individual, found within the

individual compound.

4. The construction of abattoir required skilled personnel and technical know

how
While

The construction of slaughter slab can be done either by skilled or unskilled

personnel

5. The construction of abattoir is quite expensive

While

The construction of slaughter slab is very cheap compared to abattoir

6. Abattoir has offices for ante-mortem and post-mortem inspection

While

Slaughter slab has no offices for ante-mortem and post-mortem inspection

7. Abattoir has cloak room for workers to change their clothes

While

30
 Slaughter slab has no cloak room for changing of cloth

8. Abattoir has other component like larraige, dressing room, offices, waste
disposal facility, water supply source.
While

Slaughter slab has no lairage, dressing room, offices

9. The number of workers in abattoir is very high compared to slaughter slab

While

The number of workers in slaughter slab is few compared to an abattoir

10.Abattoir is always constructed in a conducive environment far from the city

and accessible environment
While

Slaughter slab is found along the road, individual premises, around

indescent places

QUESTION 3

3(a) Explain three (3) methods of meat transportation and their effects on
meat---------------------15marks

3(b) State five (5) differences between fresh and spoilt meat------------------5marks

SUGGESTED ANSWER

3(a) Meat can be transported through the following means

i. WHEEL BARROW: Wheel barrow is the most commonest means of

transporting meat from the slaughter house to the market. Wheel
barrow is a metal container with a fixed tyre pushed by man. After
slaughtering and dressing of carcass the meats are put inside the wheel-
barrow and pushed to the market where the meats will be displayed for
sale to the final consumers.

31
 EFFECTS OF WHEEL-BARROW ON MEAT
 Possible contamination by pathogenic organisms
 Flies contamination
 Change in colour and texture due to exposure of the meat to open air.
ii. HEAD PAN: According to the name, it is curve cantainer filled will meat
placed on the head to the market where the meats will be displayed for
sale. It is commonest means of transporting meat in the tropics and this
method expose meat to alot of dangers.
EFFECTS OF HEAD PAN ON MEAT
 Spoilage as a result of enzymes, oxidation and micro-organisms
 Meat poisoning may also occur due to chemical contamination
 Cross contamination is also possible

iii. VEHICLE: Meats from the slaughter house can also be transported
through vehicle to the market for sale and most of these vehicles
commonly used are always in a deplorable condition, some bring out
excessive smoke which may affect the quality of the meat.
EFFECTS OF VEHICLE ON MEAT
 Quick decomposition of meat due to contamination with gaseous
contaminant and pollutants
 Meat poisoning may also occur during transportation of the meat
 Dust contamination which may reduce the quality of the meat
(iv) Motorcycle or Tricycle

(3b) Diffences between fresh and spoilt meat include;

s/ FRESH MEAT SPOILT MEAT

n
1 Fresh and appealing to the It has a dull appearance
eye
2 It has attractive smell It has unpleasant odour
3. Very succulent to touch with Soft and flabby
fresh blood stain
4 Absence of decomposition Begins to decompose due to action of

32

5 It does not attract flies and
the colour remain intact
micro-organism
It attracts alot of flies due to
decomposition and bad odour and the
colour changes to greeyish or brown
colour

QUESTION 4

(4a) Identify five (5) sources of meat contamination----------------------5marks

(4b) Explain Five (5) strategies for the control of meat

contamination-------------------------------15marks

SUGGESTED ANSWER

(4a) The sources of meat contamination include but not limited to these
below;

 Meat can be contaminated during processing i.e slaughtering when

slaughtered on a dirty floor
 Meat can be contaminated during dressing when the internal part has
contact with the external body and it is not properly cleaned.
 Meat can be contaminated during storage if not properly stored, micro-
organism can find its way into the well processed meat
 Meat can be contaminated during transportation from the slaughter house
to the market.
 Meat can be contaminated through the unhygienic nature of the butcher.
 Meat can also be contaminated through contaminated water during
washing
 Cross contamination can also occur during slaughtering.
 When feaces of the animal has contact with the body of the meat.

(4b) Strategies for the control of meat contamination include

 Cleanliness is rule number one, washing of animal properly with clean

water

33
  The slaughter slab must be washed thoroughly and disinfected on daily
basis
 Meat must be washed only with potable water to avoid meat
contamination.
 Meat handlers must be free from communicable diseases before they could
be allowed to handle meat.
 All the equipments that must come in contact with meat must be washed
and disinfected before use.
 Any means of transportation to be used for conveying the meat must be
clean and free from contaminant and pollutant.
 Dressing tables must be free from cracks and meat residue before being
used for meat dressing and cutting.
 Avoid cross contamination by not allowing your finished product to come
into contact with surfaces that have been contaminated by raw meat.
 Before preparing any food, wash your hand thoroughly using soap and
water. Use a mild chlorine bleach solution ( one table spoon of bleach to a
gallon of water) to clean all surfaces and materials that will come in contact
with the meat.
 Meat should be prepared with clean pot.

QEUSTION 5

(5) Write note on the following;

(a) Safe food practices

(b) Food hygiene

(c) Food contamination

(d) Major sources of food contamination

SUGGESTED ANSWER

(5a) SAFE FOOD PRACTICE: These are food safety strategies adopted by food
handlers to ensure that food and food product are free from agent of food

34
spoilage and food contamination. This includes storing food in a covered
container, proper washing of food before cooking, making food stuffs inaccessible
to rats, cockroaches and other agent of contamination, safe food storage away
from chemical compound.

(5b) FOOD HYGIENE: This is defined as the sanitary measures, principles and
conditions that are necessary during food production, processing, storage,
distribution and preparation of food to ensure that it is safe, sound, wholesome
and fit for human consumption. Food hygiene deals with the prevention of
contamination of food stuffs at all stages of their production e.g from the time the
foods are produced to the time they are served for consumption.

(5c) FOOD CONTAMINATION: It is the presence of harmful micro-organisms and

toxic chemical in the food substance which render the food unwholesome or unfit
for human consumption or lead to a specific disease condition or poisoning when
such food is consumed, depending on the disease agent present in the food.
Biological agents causing contamination includes bacteria, fungi, helminthes e.t.c

(5d) MAJOR SOURCES OF FOOD CONTAMINATION: These are the chief origin of
food contamination and this include; water, air, contaminated equipment,
infected man, contaminated slaughter slab, contaminated conveyance,
contaminated tables e.t.c.

35
 2015 PAST QUESTION

INTRODUCTION TO IMMUNOLOGY (EHT213)

QUESTION 1

(1a) Differentiate between Active and passive immunity--------------------10marks

(1b) Explain the procedure for administering polio vaccine to a child----10marks

SUGGESTED ANSWER

(1a) ACTIVE IMMUNITY: Active immunity could be divided into two;

 ACTIVIVE NATURAL IMMUNITY: This is the type of immunity developed by

the body after being exposed to subclinical manifestation or clinical
manifestation (signs and symptoms of disease condition) and is cured from
such disease. It is the immunity developed by the host from the attack of a
disease and it last long in the host body. For instance if one is exposed to
measles virus and is cured from it, such person has developed active
natural immunity because once the person is cured from such disease, an
immune memory will be created in the host system and this immune
memory recognizes subsequent reintroduction of such virus.
 ACTIVE ARTIFICIAL IMMUNITY: This immunity is developed after
introduction of biological preparation called vaccine either live attenuated
or dead vaccine into the host body to trigger the host body to produce
specific antibody which fight against a specific disease in the host body.
Active artificial immunity is also called vaccination or immunization. It lasts
long in the host body.
WHILE
PASSIVE IMMUNITY: Passive immunity could also be divided into two;
 PASSIVE NATURAL IMMUNITY: This is the immunity transferred from the
mother to feutus during pregnancy or transferred from the mother to the
child during breastfeeding. It is short lived in the body.
 PASSIVE ARTIFICIAL IMMUNITY: This is the immunity gotten when already
made antibody prepared from animal source is introduced into the host

36
 body during outbreak of a particular communicable disease to stop the
development of such disease and stop the spread of such infection, it is also
administered to reduce the severity of an occurence in the host body. It is
short lived in the host body.

(1b) The procedure for administrine polio vaccine to a child include;

 Make the child comfortable

 Let him or her sit on her mother’s lap
 Draw the appropriate dose of the polio vaccine into the syringe to be use
 Make use the syringe is properly covered when the child is not ready avoid
lost of potency.
 Gently open the mouth of the child and introduce two drops of the vaccine
 Hold the mouth of the child until the vaccine has been swallowed by the
child
 Then discard the syringe after use
 Let the mother pet the child incase the child react negatively to the vaccine.

QUESTION 2

(2a) State five hazards associated with immunization programme--------5marks

(2b) Discuss how these hazards can be prevented----------------------------15marks

SUGGESTED ANSWER

(2a) Hazards associated with immunization are;

 TRANSMISSION OF DISEASE:This could arise from the use of improperly

sterilized equipment’s.
 ABSCESS:Formation of abscess at the site of injections.
 INFLAMMATION:The reaction of vascularized living tissue to a local injury
causes accumulation of fluid
 PARALYSIS:Loss of control of the body part (limb) is resulting from damage
to superficial nerve tissues.
37
  FEVER:Hyperpyrexia,rise in body temperature.
 Other include,headaches,malaise and minor reaction such as local
erythema and tenderness of injection sites.Viral vaccines may also give rise
to allergy reactions such as shock.

(2b) These hazards can be prevented through the following;

 Vaccine should be given by qualified health personnel especially the one

collected through injection
 Vaccine should be given at the appropriate site, for instance the one to be
given intramuscula should not be given intraderma.
 Instruction on how to give vaccine should be read and strictly followed.
 Unsterilized needles should not be used for administration of vaccine
 Vaccine that has lost its potency should not be used again.
 Required doses of vaccine should be used and avoid over-dose
 Children should be made comfortable before vaccine is administer into the
host body
 A specific vaccine that will stimulate the preoduction of a specific antibody.
 Incase of allergic reaction after vaccination, this should be reported
immediately
 After vaccination, every waste generated should be disposed sanitarily.

QUESTION 3

3. Distinguish between the following terms

(i) Antigen and Antibody---------------------------------------------------5marks

(ii) Virulence and pathogenicity------------------------------------------5marks

(iii) Endotoxin and Exotoxin-----------------------------------------5marks

(iv) Immunity and immunization-----------------------------------5marks

SUGGESTED ANSWER

38
3(i) ANTIGEN: These are foreign proteineous substance which when introduced
into a foreign species can elicit the production of antibodies. E.g component of
bacterial cell, harmful micro-organism, drugs, vaccine e.t.c

WHILE

ANTIBODY: These are proteinous substance produced by the body as a result of

its reaction to antigen stimulation. Antibodies are proteins that are formed or
found in response to an antigen and react specifically with that antigen. It is also
known as immunoglobulin.

3(ii) VIRULENCE: It is the severity of the damage caused by pathogenic organism.

It is the state of micro-organism to be highly infectious and the degree of damage
imposed upon by the micro-organism.

WHILE

PATTHOGENICITY: It is the ability of pathogen to cause or produce disease

condition in the host after gaining entrance into the host body.

3(iii). ENDOTOXIN: These are toxins produced by microorganism which remain

within the cells wall of the microorganism i.e they are cell pound and they can
only be obtained from the bacteria cells when the cells are broken down by
different forms of chemical extraction. Endotoxin is also known as
Lipopolysaccharides (LPS), Lipoglycans. Endotoxins are large molecules consisting
of a lipid and a polysaccharide composed of 0-antigen, outer core and inner core
joined by a covalent bond, they are found in the outer membrane of Gram-
negative bacteria and elicit strong immune responses in animals.

WHILE

EXOTOXIN: These are toxins that are passed into the surrounding medium of the
micro-organism. The medium can be tissue or circulatory system of the host.
Exotosin is a toxin secreted by bacteria which sometimes cause damage to the
host by destroying cells or disrupting normal cellular metabolism. They are highly

39
potent and can cause damage to the host. Exotoxin may be secreted or similar to
endotoxins or released during lysis of the cell.

Exotoxin may exert their effect locally or produce systemic effects. Well known
exotoxin include; Botulinum toxin produced by Clostridium botulinum,
Corynebacteria diptheriae toxin produced during life-threatening symptoms of
Diptheria, tetanospasmin produced by Clostridium tetani.

The toxic properties of most exotoxins can be inactivated by heat or chemical

treatment to produce a toxoids. These retain their antigenic specificity and can be
used to produce antitoxins and in the case of diptheria and tetanus toxoids are
used as vaccine.

3(iv) IMMUNITY: This is the ability of any living organism to resist infection.
Immunity involves the capability of the body to resist harmful microbes from
entering the body and having sufficient biological defenses to avoid infections,
diseases and other biological invasion.

WHILE

IMMUNIZATION: This is the process of introducing or administering vaccines

either live attenuated or dead vaccine into the body to stimulate immune
response thereby conferring immunity to the recipient by producing pre-
sensitized immune response.

QUESTION 4

(4a) Explain the term specific immunity--------------------------------------5marks

(4b) Describe how serum from animal blood can be use to confer immunity---------
15marks

SUGGESTED ANSWER

40
(4a) SPECIFIC IMMUNITY: It is a form of immunity developed agains a particular
disease. It is also known as adaptive immunity. It is divided into two; Natural
immunity and Artificial immunity,

(A) NATURAL SPECIFIC IMMUNITY: This form of immunity is divided again into
two these are
 NATURAL ACTIVE SPECIFIC IMMUNITY: This occurs when the body is
involved actively in producing antibody and this can be gained in two ways;
a. By actually having the disease: Antibodies are produced in
sufficient number to overcome the pathogens (antigen) during the
course of illness. These antibodies remain in the blood to provide
further protection against the disease and subsequent ones.
b. By having a subclinical infection: In this way the body is exposed
to minute number of pathogens which are not enough to cause
infection but are sufficient to stimulate the production of
antibodies which remain in the blood to provide further
protection
 NATURAL PASSIVE SPECIFIC IMMUNITY: This is the condition in
which antibodies are passed from mother to feotus through the
placental during pregnancy. The immunity conferred is short but
develop fast since antibodies are already made.
(B) ARTIFICIAL SPECIFIC IMMUNITY: This immunity is also divided into two viz;
 ARTIFICIAL ACTIVE SPECIFIC IMMUNITY: This is the immunity
gained from active vaccination. The vaccine used produce mild
infection in the individual, this stimulate the body to produce the
necessary antibodies that will prevent the invasion of stronger
strains of the infectious agent. The process of producing immunity
is slow because the body is actively involved in the production of
antibodies. The immunity so produced has a long lasting effect
and protection e.g BCG vaccine, measles vaccine , oral polio
vaccine e.t.c
 ARTIFICIAL PASSIVE SPECIFIC IMMUNIY: This is an induced
immunity acquired by injection of already made antibodies from

41
 external source such as animal combact the development of
pathogenic organism in the host body e.g anti-rabies, anti-tetanus
serum e.t.c

(4b) How serum from animal can confirm immunity on man include

PREPARATION OF ANTITOXIN (FIRST STAGE)

A guinea pig is used as an example of how easy it is to treat diptheria; 1/15000 th

of a millilitre of toxin is injected as well as 1/100000 th of a millilitre of antitoxin
and the guinea pigs’ life is saved. Next, the toxin is shown being prepared in a lab.
A broth is made, then filtered, sterilized, incubated and then innoculated with
bacillus which is grown in the broth for ten days. The culture is seen after 24
hours and at the end of the ten days.

The culture is transferred to a filter room where antiseptic is added to each

bottle. Then the cultures are filtered and bulked. Preservative is then added and
the liquid is pumped through sterilizing candles. The toxin is then tested on
guinea pigs. If at the correct toxicity, it should kill a guinea pig in five days. The
toxin is then tested for potency.

Next, the toxin is converted into a harmless preparation called toxoid by adding
formalin. Toxoid is a valuable immunizing agent, free of all active toxins.

The antitoxin is closely related with certain proteins of the serum of horses, which
have been injected with toxoid. Horses are kept at the laboratory stables for the
preparation of antitoxin. The horses are shown arriving at the stables and being
examined, for susceptiblity. They are also observed to ensure they are free from
disease. The horses’ blood is tested for any natural immunity. Finally, the horse is
taken to the immunization stables, where the course of immunization begins.

The horse is observed and tested throughout the immunization course. A graph
shows the increase in amount of antitoxin produced by the horse during the
course 24 litres of blood is taken over eight days. After this, the horse is tested
and when fit, another course is repeated. The antitoxin must then be extracted
from the horse blood in as pure a form as possible. First the red blood cells are
42
allowed to setle, next plasma is siphoned off, antiseptic added to the plasma,
which is then bulked. The plasma is dilluted with warm water, then hydrochloric
acid, pepsin and ammunium sulphate are added.This form the antisera which can
now be used to boost immunity in man.

QUESTION 5

5. Write notes on the following;

(i) Universal donor---------------------------------------------------------5marks
(ii) Agglutination---------------------------------------------------------5marks
(iii) Factors that can lead to immunization failure--------------------5marks
(iv.) Immunology----------------------------------------------------------5marks

SUGGESTED ANSWER
5(i) UNIVERSAL DONOR: It is called blood group “0” and this type of blood
group can donate blood to other blood group which include; A, B, AB, and 0.
5(ii) AGGLUTINATION: It is one of the antibody antigen reaction, it is the
clumping that occur with the whole cell e.g bacteria or red blood cells which
result into vissible clump. The clumping is due to binding of antibody molecule
to the antigen and thus immobilizes the microbes and the antigen molecule
and prevent them from spreading through the tissue. It is done routinely in
the laboratory to determine ABO blood grouping.
5(iii) FACTORS THAT CAN LEAD TO IMMUNIZATION FAILURE: This include;
 Lack of adequate funding
 Lack of political will
 Improper planning on the part of health personel
 Poor road network
 Insufficient human resources
 Insufficient equipments and material
 Language barrier
 Lackadascical attitude of the community toward immunization

43
  Lack of adequate information and sensitization of the community

5(d) IMMUNOLOGY: It is the study of immunity and body defence mechanism,

therefore the study of immunity and body defence mechanism help the scientist
to understand the immune race affected by parasitic bacteria and cancer cells.

2016 PAST QUESTION

INTRODUCTION TO IMMUNOLOGY 2016 (EHT213)

QUESTION 1

(1a) Define the term immunology---------------------------------5marks

(1b) Explain Antibody------------------------------------------------5marks

(1c) Discuss the source through which immunity can be achieved, naturally and
artificially-----10marks

SUGGESTED ANSWER

(1a) IMMUNOLOGY: Immunology is a branch of biomedical science that covers

the study of all aspect of immune system in all organisms. It deals with among
other things the physiological functioning of the immune system in a state of both
health and disease.

Immunology cab be defined as the study of procedure used and the mechanism
by which resistance to infection is increased. The study of the diagnostic and
experimental procedure connecting with this problem is usually called serology,
because it involves the use of serum. Knowledge of host defense mechanism is
essential for effective diagnosis, treatment and prevention of infectious disease.

(1b) ANTIBODY: An antibody (Ab) also known as immunoglobulin (Ig) is a Y shape

protein produced by immune system transported by the plasma to identify and
neutralize foreign object such as bacteria and viruses. The antibody recognizes a
unique part of the foreign target know as antigen.Each tip of the Y of an antibody
44
contains a paratope ( a structure which signifies a lock) on an antigen,allowing
this two structures to bind together with precision.Using these binding
mechanisms, an antibody can tag a microbe or an infected cell for attack by other
part of immune system or can neutralized it target directly.The production of the
antibody is the main function of the humoral immune system.Antibodies are
produced by a type of white blood cells called plasma cell.Antibodies can occur in
two physical forms,a soluble form that is secreated fronm the cell, and a
membrane bound form that is attached to the surface of B cell and is referred to
as B cell receptor (BCR).

(1c) Sources through which immunity can be achieved naturally and artificially
include

1. MATERNAL SOURCE: This is immunity obtained through the transplacental

transfer of antibodies from the mother to the feutus or child during
pregnancy and breastfeeding. Immunity obtained here is referred to as
natural passive immunity because it does not last long in the body.
(NATURAL PASSIVE IMMUNITY SOURCE).
2. FOOD(PROTECTECTIVE DIETS) : Since antibodies are made of glycol-protein,
food rich in protein is essential for antibody formulation and other immune
response mechanisms. Also vitamin (e.g vitamin A, D, B complexes, K e.t.c)
and mineral salts e.g ( calcium, phosphorous, manganese e.t.c) have
protective functions and are obtained through the intake of food rich in
them
3. ACTIVE IMMUNIZATION: This is the state of immunity achieved through the
introduction of vaccine. It is a state of resistance developed by an
individual following and effective contacts with the microbial organism or
its products. (ARTIFICIAL ACTIVE IMMUNITY SOURCE)
4. EXPOSURE AND SURVIVAL FROM DISEASE: Having suffered and recovered
from specific disease, the body developed active natural immunity.
Antibodies produced during the course of infection remains in the body
(memory cells) to provide further protection also in the case of having sub-
clinical infections, livelong immunity Is conferred on the host e.g
poliomyelitis, measles. (ACTIVE NATURAL IMMUNITY SOURCE).
45
 5. READY-MADE ANTIBODY PREPARED FROM ANIMAL SOURCE: Antibody
made from animal source can also improve the host immunity and prevent
the development of a particular infection.

QUESTION 2

2. Distinguish between

a. Chemical and mechanical barriers in immunity in the human body

b. Antigen and Antiserum

c. Live vaccine and killed vaccine

SUGGESTED ANSWER

(2a) CHEMICAL BARRIER:These are wide range of substances secreted by body

organs/tissues which can inhibit microbial growth and metabolism. These include
Saliva, hydrochloric acid secreated in the stomach, sebum, tear, and other
secretion with anti-microbial properties such as urine fluid, vaginal fluid e.t.c

WHILE

MECHANICAL BARRIER: It is also known as physical barrier or anatomical barrier,

mechanical barrier provide physical protection against the penetration of harmful
micro-organism into the host body. It provides covering for the host body for
instance the skin, which covers the entire body against the penetration of micro-
organism. Mechanical barrire also provides lining and covering (mucous
membrane) to some of the vital organs such as the Heart, respiratory organs in
the body.

(2b) ANTIGEN: It is defined as any molecule with the ability to stimulate the
production of antibody. It is also known as immunogen or antibody generator.
Examples of antigen are; vaccine, drugs, component of harmful micro-organism.
Antigen is any foreign substance that can provoke or induce immune response in
the host body.

WHILE
46
ANTISERUM: An antiserum is an immunity agent prepared from animal (e.g
horse).It contains readymade antibodies which elicit the development of passive
immunity when injected into human host;e.g ATS

(2c) LIVE VACCINE: These are prepared from living organisms by repeated passing
in the laboratory tissue culture or chick embroy resulting in loss of the capacity of
the organisms to induce full blown disease but retaining their
immunogenicity,hence they are called live attenuated organism. Generally,live
vaccines are more potent immunizing agents than killed vaccines.

WHILE

KILLED VACCINE: These are vaccines prepared by microbes that are subjected to
heat or chemical treatment in the laboratory. They also stimulate active immunity
when injected into the body. Generally,killed vaccines are less efficacious than live
vaccine but are safe immunizing agent.Killed vaccine are used in two or three
primary doses to stimulate antibody production.

QUESTION 3

(3a) Explain the relationship of infection to immunity--------------------5marks

(3b) Explain the following terms epidemic, endemic, pandemic, sporadic and
zoonosis----15marks

SUGGESTED ANSWER

(3a) Firstly, inection is defined as the entry, development and multiplication of an

infectious agent in the host body manifested by the presence of signs and
symptoms. Infection is caused by infectious agent while immunity is the ability of
the host to defend himself or herself against hamful micro-organism responsible
for infection, and this immunity is afforded by lymphocyte (antibody) and
leukocyte (white blood cell). The relationship of infection to immunity could be
explained in this way, firstly, an infection caused by infectious agent must occur

47
before immunity is developed (antibody), because it is the infectious agent after
gaining entrance into the body that call for the production of antibody by the
immune cells. Then antibody after production, is taking by the plasma round the
body to render any foreign bodies harmless. Then after elimination, an immune
memmory is created in the blood to fight against subsequent infections.

(3b) * EPIDEMIC: It is a term used to describe the occurence of cases of disease

clearly in excess of normal expectancy for that population. Epidemic is a term
used to describe sudden and unexpected outbreak of cases of communicable
disease in which large number of the community is affected at the same time and
at the same place. We have point source and non-point source epidemic. Example
is Cholera outbreak.

*. ENDEMIC: This is a term used to describe the constant occurrence of cases of

disease that occurs from time to time without importation from outside
environment. Endemic is divided into the following categories; hyper endemic,
hypo endemic, meso endemic and holo endemic. Examples are malaria fever,
common cold.

*. PANDEMIC: This a term used to describe global outbreak of cases of disease

which spread from one country to another or that spread across the continent.
Examples are HIV/AIDS, Cerebrospinal meningitis, Conjunctivitis, Ebola e.t.c

*. SPORADIC: This is a term used to describe scattered and irregular haphazard

cases of disease in an isolated area. Example is measles

* ZOONOSIS: It is the name given to communicable disease in which the causative

agent can be transferred from infected animan to man and from infected man to
animal. Examples of such diseases are Anthrax caused by bacillus anthracis,
Tuberculosis caused by mycobacterium tuberculosis, Yellow fever caused by
yellow fever virus e.t.c

QUESTION 4

(4a) Explain the term Disease Notification-------------------------------5marks

(4b) Discuss five (5) importance of disease notification--------------15marks

48
SUGGESTED ANSWER

(4a) Disease notification are diseases in which its occurence must immediately
reported to the appropriate health authority for immediate intervention. The
reason why such occurence must be reported immediately is that such disease
spread at a faster rate and kill faster than other occurence, so when such
occurence is reported to appropriate health authority which could be WHO incase
of world wide occurence or federal ministry of health incase of national
occurence or state ministry of health incase of state occurence of local
government health department. Example of such diseases that need to be
reported are Ebola, HIV/AID, Tuberculosis, Cholera, Lassa fever e.t.c

(4b) Importance of disease notification are

(1) Help in providing immediate intervention measure that will eliminate such
occurence from spreading among people in a community.
(2) Help in reducing mortality rate among the people
(3) Help in reducing morbidity rate among the people
(4) Help to reduce medical cost
(5) Help to prevent transboarder spread of infection

QUESTION 5

(5a) Explain the mode of transmission of Lassa fever---------------------5marks

(5b) Enumerate the signs and symptoms of Lassa fever-----------------5marks

(5c) Discuss five (5) control measures of lassal fever------------------10marks

SUGGESTED ANSWER

(5a) Mode of transmission of lassa fever include;

(1) Exposure to the bite of an infected multimammate rat (mastomys

natalensis)
(2) Consumption of contaminated food with the feaces of infected rat
(3) Consumption of contaminated food or water with urine of an infected rat

49
 (4) Person to person transmission through contaminated blood, body fluid e.t.c
(5) Through the use of unsterilized and infected needle.

(5b) The signs and symptoms of Lassa fever include

 Malaise (general weakness of the body)

 Fever (high temperature)
 Difficulty in breathing
 Difficulty in swallowing
 Swollen face
 Shock
 Vomiting and diarrea with bood
 High or low temperature
 Chest pain
 Bleeding from orifices
 Peeling of the body

(5c) The control and preventive measures of lassa fever include;

(1) Ensure that all raw food are stored in rat-proof container
(2) Blood must be properly screened before transfuse to another person
(3) Since there is no vaccine now for the disease, taking of ribavirin will help to
reduce the load of the virus
(4) Early diagnosis will also help to eliminate the virus before it gets to terminal
stage
(5) Rat must be prevented from home by the use of chemical compound or
introduction of predator at home
(6) Environmental sanitation should be strenghtened
(7) Proper waste management should be strictly adhere to
(8) Regular hand washing should be prioritized
(9) Avoid contact with an infected person
(10)Always sterilize needle before using it for another person

50
 2017 PAST QUESTION

INTRODUCTION TO IMMUNOLOGY 2017 (EHT213)

QUESTION 1

1(a) List five (5) immunizable diseases in your country-----------------5marks

1(b) State the vaccines used against the diseases in 1(a) abov-------5marks

1(c) As an Environmental Health Officer, explain the process involved in planning

immunization campaign against any of the diseases mentioned in 1(a)
above-----------------------------------10marks

SUGGESTED ANSWER

1(a) immunizable diseases in my country include;

 Tuberculosis
 Yellow fever
 Poliomyelitis
 Measles
 Diptheria

1(b) Vaccines against the listed diseases in 1(a) above

S/N Diseases Vaccines used

1 Tuberculosis BCG vaccine
2 Yellow fever Yellow fever vaccine
3 Poliomyelitis Polio vaccine
4 Measles Measles vaccine
5 Diptheria DPT vaccine

1(c) Process involved in planning an immunization programme against

Tuberculosis include

51
 (1) Action plan should be drawn which will be immunization against
Tuberculosis
(2) Set your objectives and goals
(3) Visit to the government agaencies fund e.g chairman, governor, and non
governmental agencies for their financial support
(4) Get your resources on ground such as equipment and materials, and
human resources used to implement the programme
(5) Community mobilization and enlightement of the public through mass
media e.g radio, television , news paper.
(6) Advocacy visit to the Obas, Chiefs, religion leaders, opinion leaders,
traditional leader and other influential people in the community and your
intention should be made known to them and choose a particular date with
them for the programme implemntation.
(7) Training of man power that will partake in the campaign and
implementation of the immunization programme.
(8) The use of town criers should be adopted to get community people
informed about the immunization programme and the date and venue.
(9) Implementation of the programme among people in the community such
as children, women of age bearing and pregnant women.
(10)Monitoring and evaluation to know whether success has been achieved or
not
(11)Report writting.

QUESTION 2

(2a) Explain the term complement----------------------------------4marks

(2b) Outline the steps for preparing complement---------------8marks

(2c) Describe the process of complement fixation---------------8marks

SUGGESTED ANSWER

52
(2a)COMPLEMENT: The antibodies formed against microbes can lyse the said
microorganisms, antibodies need the action of some other proteins to lyse the
microbes and such proteins which complement the action of antibodies in lysing
the microorganisms are collectively called as complement. Therefore,
complement is a group of substance occuring in the serum which usually
combines with antibody-antigen complex which give rise to complement fixation.

(2b) Steps for preparing complement include: The best source of complement is
from male guinea pig. Blood can be obtained by cardiac puncture in which case,
the pigs can be used several times. A diet of carrots for guinea pig will increase
the litre of the complement obtained. Collect the blood in clean sterile bottles
and allow clothing. Loosen the clot from the sides of the bottle. Allow to stand for
30mins. Centrifuge and remove the serum, add preservative to the serum and
store in the refrigerator. It is advisable to take the serum off immediately after
taking the blood as complement deteriorates rapidly in an unpreserved state.
Preservation of complement compost of Richardon’s preservation which consist
of Boric acid 0.93g, sodium borate 2.29g e.t.c

(2c) Process of complement fixation: Since complements are group of substances

occuring in the serum which combine with antibody antigen complex so when the
complex is formed, antibody bind to the enemy cells (antigen) and change their
shape exposing their complement binding site, this initiate the binding site of the
complement through the enemy cells surface which lead to lysis or opsonization
of the bacteria. Therefore, the combination of the complement with antibody
antigen complex is known as complement fixation.

QUESTION 3

3. Explain the following terms;

(a) HIV/AIDS-----------------------------------------------------------------5marks

(b) Pentavalent vaccine---------------------------------------------------5marks

(c) Blood group-------------------------------------------------------------5marks

53
(d) Precipitation------------------------------------------------------------5marks

SUGGESTED ANSWER

(3a) HIV/AID: HIV means Human immuno deficiency virus and it is the virus that
enter into human and develop into AIDS. While AIDS stands for Acquired immuno
deficiency syndrome that is collection of different signs and symptoms. HIV is the
virus that is passed from person to person. Over time, HIV destroys an important
kind of the cell in our immune system called CD4 cells or T cell that helps protect
us from infections. When you dont have enough of these CD4 cells, your body
cannot fight off infections the way it normally can. AIDS is the disease caused by
the damage that HIV does to your immune system. You have AIDs when you get
dangerous infections or have a super low number of CD4 cells. AIDs is the most
serious stage of HIV and it leads to dealth over time.

(3b) PENTAVALENT VACCINE: It is 5-in 1 vaccine is a combination vaccine with five

individual vaccines conjugated into one intended to actively protect people from
multiple diseases. Pentavalent vaccine reduces the number of contact with health
personel among the users. It also saves the stress and pain of collecting vaccine
on several body site.

(3c)BLOOD GROUP: It is defined as the method of classifying human blood base

on the presence of antigen on the surface of red blood cells and the most
commonnest blood grouping system is the ABO blood grouping system. The
followings are the type of blood group A, B, O and AB.

(3d) PRECIPITATION: It is one of the antibody antigen reaction, in this reaction

Soluble antigens bind to corresponding antibodies and form precipitates which
may be visible in the serum.

54
 QUESTION 4

(4a) Explain blood transfusion---------------------------------------------5marks

(4b)Describe five (5) possible blood transfusion reactions in an individual-15marks

SUGGESTED ANSWER

(4a) BLOOD TRANSFUSION: Blood transfusion is generally the process of receiving

blood products into one’s circulation intravenously. Transfusions are used for
various medical conditions to replace lost components of the blood. Early
transfusions used whole blood but modern medical practice commonly uses only
components of the blood, such as red blood cells, white blood cells, plasma,
clotting factors, and platelets.

(4b) TRANSFUSION REACTIONS include

(1) ACUTE HEMOLYTIC REACTION: This occurs with transfusion of red blood
cells occurs in about 0.016 percent of transfusions, with about 0.003
percent being fatal. This is due to destruction of donor red blood cells by
performed recipient antibodies. Most often this occurs due to clerical
errors or improper ABO blood typing and cross-matching resulting in a
mismatch in ABO blood type between the donor and the recipient.
Symptoms include fever, chills, chest pain, back pain, hemorrhage,
increased heart rate, shortness of breath and rapid drop in blood pressure.
When suspected, transfusion should be stopped immediately and blood
sent for tests to evaluate for presence of hemolysis.
(2) DELAYED HEMOLYTIC REACTIONS. This occurs more frequently about 0.025
percent of transfusion and are due to the same mechanism as in acute
hemolytic reactions. However, the consequencies are generally mild and a
great proportion of patients may not have symptoms. However, evidence
of hemolysis and falling hemoglobin levels may still occur. Treatment is
generally not needed, but due to the presence of recipient antibodies,
future compatibility may be affected.

55
 (3) FEBRILE NON-HEMOLYTIC REACTIONS: These are the common type of
blood transfusion reaction that occur due to the release of inflammatory
chemical signals released by white blood cells in stored donor blood. This
type of reaction occurs in about 7% of transfusions. Fever is generally short
lived and it is treated with antipyretics and transfusion may be finished as
long as an acute hemolytic reaction is excluded. This is a reason for the
now-widespread use of leukoreduction- the filtration of donor white cells
from red cell product units.
(4) POST TRANSFUSION PURPURA: This is a rare complication that occurs after
transfusion containing platelets that express a surface protein HPA-1a.
Recipient who lack this protein develop sensitization to this protein from
prior transfusions, and develop thrombocytopenia about 7-10 days after
subsequent transfusion. Treatment is with intravenous immunoglobulin,
and recipients should only receive future transfusions with washed cells or
HPA-1a negative cells.
(5) TRANSFUSION-ASSOCIATED ACUTE LUNG INJURY (TRALI): It is an
increasingly recognized adverse event associated with blood transfusion.
Transfusion-associated acute lung injury is a syndrom of acute respiratory
distress, often associated with fever, non-cardiogenic pulmonary edema
and hypotension which may occur as often as 1 in 2000 transfusions.
Symptoms can range from mild to life-threatening, but most patients
recover fully within 96 hours, and the mortality rate from this condition is
less than 10%. Although the cause of TRALI is not clear, it has been
consistently associated with anti-HLA antibodies. Because these types of
antibodies are commonly formed during pregnancy, several transfusion
organizations have decided to use only plasma from men for transfusion.
TRALI is typically associated with plasma components rather than packed
red blood cells, though there is some residual plasma in red blood cell units.

QUESTION 5

(5a) Enumerate five (5) non-specific immunity-------------------------5marks

56
(5b) List five (5) adverse events following vaccination----------------5marks

(5c) Identify five (5) stages of cold chain management--------------5marks

(5d) Explain two (2) of the identified stages in (c) above------------5marks

SUGGESTED ANSWER

(5a) Five non-specific immunity include

 Skin
 Mucous membrane
 Hydrochloric acid
 Tears
 Phagocytes ( granulocyte and agranulocyte)
 Sebum
 Saliva
 Urine

(5b) Five adverse events following vaccination include

 Allergic reaction
 Hyperpyrexia
 Febrile illness
 Abscess
 Disease
 Paralysis

(5c) Stages of cold chain management include

 Production stage
 Transportation from production stage to Airport
 Transportation from Airport to cold chain store ( national,
regional, state, local)
 Monitoring and preservation at cold chain store

57
  Transportation to the final users which may be children, women
and pregnant women

(5d)(1) PRODUCTION STAGE OR MANUFACTURING STAGE: This is the stage where

the vaccines are produced, at this stage every measures must be put in place to
ensure that the potency of the vaccines are not lost but preserved. It is a known
fact that vaccines are gotten from micro-organisms and manipulated in the
laboratory to reduce the pathogenicity but still retain its immunogenicity (ability
to invoke immune response in the host body).

(2) TRANSPORTATION FROM PRODUCTION STAGE TO AIRPORT: This is another

crucial stage in cold chain management, after production the vaccines are
transported to countries where they will be used, therefore, vaccines leave the
production stage to airport and from airport to the central cold chain for regional
distribution.

2018 PAST QUESTION

INTRODUCTION TO IMMUNOLOGY 2018 (EHT213)

58
 QUESTION 1

(1a) Define the term routine immunization--------------------------------5marks

(1b) Explain the strategies for conducting routine immunity-----------------15marks

QUESTION 2

(2) Immunization against vaccine preventable diseases target children under 1

year and women of child bearing age (WCBA). Draw the current immunization
schedule for children under 1 year----20marks

SUGGESTED ANSWER

Administration Guidelines for children <1 year

Vaccine No of Age Minimum Route of Dose Vaccination

doses interval transmission site

BCG 1 At birth ............ Intraderma 0- Upper left

or as 05ml arm
Tuberculosis soon
after
birth as
possible

OPV 4 At birth 4 weeks Oral 2 Mouth

and at drops
6,10
and 14

DPT 3 At 6,10, 4 weeks Intramuscular 0.5ml Outerpart

and 14 of the thigh
weeks
of age
59
 Hepatitis B 1 At birth 4 weeks Intramuscular 0-5ml Outer part
6,and of the thigh
14
weeks

Measles 1 At 9 ................ Subcutaneou 0.5ml Upper left

month s arm

Yellow fever 1 At 9 .................. Subcutaneou 0-5ml Upper right

month s arm

QUESTION 3

(3a) Define hypersensitivity------------------------------------------------3marks

(3b) List five (5) types of hypersensitivity-------------------------------5marks

(3c) Explain any two (2) types of hypersensitivity you have listed in (4b)
above----------------------12marks

SUGGESTED ANSWER

(3a) HYPERSENSITIVITY: Hypersensitivity refers to excessive, abnormal (damaging,

discomfort-producing and sometimes fatal) reactions produced by the normal
immune system. Hypersensitivity reactions require a pre-sensitized (immune)
state of the host. Hypersensitivity reactions can be divided into four types; type 1,
type 11, type 111, type IV, based on the mechanisms involved and time taken for
the reaction. Frequently, a particular clinical condition (disease) may involve more
than one type of reaction.

(3b) Types of hypersensitivity include;

(1) Type 1 or anaphylactic or immediate hypersensitivity

(2) Type 2 or delayed hypersensitivity or cytotoxicity
(3) Type 3 or immune complex
(4) Type 4 or cell mediated hypersensitivity
(5) Type 5
60
 A. (3c) * IMMEDIATE HYPERSENSITIVITY REACTIONS (TYPE 1
HYPERSENSITIVITY)

Type 1 hypersensitivity which is also known as immediate or anaphylactic

hpersensitivity. The reaction may involve skin (Urticaria and eczema), eyes
(conjunctivitis), nasopharynx (rhinitis), brochopulmonary tissues (asthma) and
gastrointestinal tract (gastroenteritis). The reaction may cause a range of
symptoms from minor inconvenience to death. The reaction usually takes 15-30
minutes from the time of exposure to the antigen, although sometimes it may
have a delayed onset (10-12 hours).

Immediate hypersensitivity is mediated by IgE. The primary cellular component in

this hypersensitivity is the mast cell or basophil. The reaction is amplified and or
modified by platelets, neutrophils and eosinophils. A biopsy of the reaction site
demonstrates mainly mast cells and eosinophils.

In this type of reaction, the time taken between contact with an antigen and the
appearance of symptoms of the reaction is short ( within few minutes) the
manifestation of this reaction forms;

 Skin changes, erythema in reactions to common inhalants antigens such as

chemical dusts and pollens
 Arthur reaction: An acute local inflammation which may lead to tissue
damage (cytotoxicity)
 Anaphylactic reactions: This result from over dosage of drugs.

B. . DELAYED HYPERSENSITIVITY REACTION (TYPE 11)

Type 11 hypersensitivity reaction which is also known as cytotoxicity

hypersensitivity and may affect a variety of organs and tissues. The antigens are
normally endogenous, although exogenous chemicals (haptens) which can attach
to cell membranes leading to type 11 hypersensitivity. Drugs induced hemolytic
anemia, granulocytopenia and thrombocytopenia are such examples. The
reaction time is minutes to hours. Type 11 hypersensitivity is primarily mediated

61
by antibodies of the IgM or IgG classes and complement. The associated
symptoms are skin swelling due to contact with an antigen, occuring within
24hours.

QUESTION 4

(4a) Explain the term injection safety------------------------------------5marks

(4b) Enumerate eight (8) principles of injection safety---------------8marks

(4c) Outline seven (7) factors affecting antigen-antibody reaction-----7marks

QUESTION 5

5.. Write notes on the following

(5a) Primary immune response-----------------------------------------5marks

(5b) Immunoglobulin-----------------------------------------------------5marks

(5c) Conjugate vaccine----------------------------------------------------5marks

(5d) Inactivated vaccine--------------------------------------------------5marks

SUGGESTED ANSWER

(5a) PRIMARY IMMUNE RESPONSE: This is the immediate response from the body
as a result of its reaction between an

(5b) IMMUNOGLOBULIN: This is also known as an antibody. It is a Y shape protein

produced by immune system transported by the plasma to identify and neutralize
foreign object such as bacteria and viruses. The antibody recognizes a unique part
of the foreign target known as antigen. Each tip of the Y of an antibody contains a
paratope ( a structure which signifies a lock) on an antigen,allowing this two
structures to bind together with precision. Using these binding mechanisms, an
antibody can tag a microbe or an infected cell for attack by other part of immune
system or can neutralized it target directly.The production of the antibody is the
main function of the humoral immune system.Antibodies are produced by a type
62
of white blood cells called plasma cell. Antibodies can occur in two physical
forms,a soluble form that is secreated from the cell, and a membrane bound form
that is attached to the surface of B cell and is referred to as B cell receptor (BCR).

(5c) CONJUGATE VACCINE: Is a vaccine containing bacterial capsular

polysaccharide joined to a protein to enhance immunogenecity. It is used to
immunize infants and children against ivasive disease caused by Hib bacteria and
that contains the Hib capsular polysaccharide polyribosylribitol phosphate.
Conjugate vaccine is a vaccine fomulated or combined given at the same time to
stimulate different antibody to fight against different diseases in the hos body e.g
DPT vaccine.

(5d) INACTIVATED VACCINE: This is also known as killed vaccine. These are
vaccines prepared by microbes that are subjected to heat or chemical treatment
in the laboratory.

They also stimulate active immunity when injected into the body. Generally,killed
vaccines are less efficacious than live vaccine but are safe immunizing agent.Killed
vaccine are used in two or three primary doses to stimulate antibody production.

2015 WATER SANITATION EHT 208

QUESTION 1

(1a) State five (5) ways by which water from a well is likely to be
contaminated--------5marks

63
(1b) As a Health worker, describe five (5) steps you would take to make stream
water safe for use-----------------------------------------------------------15marks

SUGGESTED ANSWER

(1a) Well water is likely to be contaminated through the following ways;

 When different cups are being used to fetch water from the stored
container
 When the water is accessible to pets e.g goats, dog e.t.c
 When the water is accessible to children
 When the water is exposed to open contaminated air
 When the water is stored in a contaminated bucket

(1b) Steps to make stream water safe for use include;

(1) The first step is to divide the stream water into four section with an
installed sign post that signify the use of each section. The upper part for
drinking purpose, the middle part for domestic purpose and the lower part
for bathing and domestic purpose.
(2) The water environment can be fenced to prevent unauthorized person
from access into the water body. The unauthorized persons are people with
chronic infectious diseases, mad people and animal.
(3) The overgrown weed around the water body should be cleared and
reduced to the bearest level so as to prevent pollutants and contaminants
from getting into the water body.
(4) Containers and buckets used to fetch the water must be cleaned and free
from all agents of pollution and contamination.
(5) The water should be treated with chemical after fetching with available
chemical compound such as chlorine for total destruction of pathogenic
organisms or the water can be boiled before drinking, this is called thermal
treatment.

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 QUESTION 2

2. Explain the importance of water and sanitation in combacting diarrhoea in your

community----------------------20marks

SUGGESTED ANSWER

The importance of water and sanitation in combacting diarrhea in the community

can not be over-emphasized. Firstly let us look at the meaning of diarrhea disease.
Diarrhea is a communicable disease caused by species of bacteria expecially
Eschericia coli manifested by the commonest signs such as frequent stooling,
vomiting, fever e.t.c.

Diarrhea is a disease in which the agent causing it is being contracted from

drinking contaminated water or taking water that contains the agent. Diarrhea is
also a disease associated with poor sanitation in the enviroment such as poor
waste management, presence of overgrown weeds, indiscriminate feaces
disposal, indiscriminate waste water disposal, decomposed food e.t.c

Since water and poor sanitation are the most common media through which one
can easily get this disease from the environment,therefore, attention should be
directed to these above listed media so as to combact the disease from the
community. The importance of water and sanitation in combacting diarrhea
include;

 Proper boiling of water before consumption, this will help to destroy the
bacteria responsible for diarrhea
 Disinfecting of water before use with chemical compound will also help to
prevent diarrhea disease
 Making our well a sanitary ones will also help to prevent diarrhea disease
 Drinking water must be properly stored in a clean container and guide
against contamination
 Drinking water should not be accessible to children and pets to guide
against contamination

65
  Proper washing of drainage system and prevent the presence of stagnant
water will also prevent diarrhea.
 Our food must be thoroughly washed and cooked before eating to destroy
diarrhea disease agent
 Provision of adequate number of sanitary toilet facility to prevent
indiscriminate defeacation.
 The use of human feaces should be discouraged to guide against the spread
of diarrhea disease.
 House keeping, constant washing of used plates should be strictly followed
to prevent diarrhea disease
 Regular hand washing before and after visiting toilets
 Personal hygiene such as cutting of the long nail, avoid coughing while
cooking, head covering while cooking should be strictly adhere to.

QUESTION 3

3. Sales of packaged water is fast becoming a thriving business in Africa sub-

region

(3a) Explain the health hazards associated with this trend---------------10marks

(3b) State measures for safeguarding the health of the community with respect to
(3a) above-------------------------------------------------------------------------10marks

(3a) The health hazard associate with this trend include

 Outbreak of water related diseases such as Cholera, Typhoid fever,

Entamoebiasis e.t.c, This is very possible since the business attract alot of
investor, in the long run this might lead to reduction in the used chemical,
because the goal of majority of the investors is to maximise profit without
considering the health of the masses that will consume this water.
 Increase morbidity rate, the rate of sickness will be on hike since this water
will be consume by the low level of the population, and since there is
reduction in chemical used for water treatment, this might lead to disease
condition among the people that consume it.

66
  Indiscriminate disposal of the nylon and this can lead to breeding of
mosquitoes which finally spread plasmodium falciparum the agent causing
malaria fever, packaged water nylon will always retain a small amount of
water after consumption, this small water will provide space for mosquito
to breed.
 Indiscriminate disposal of the nylon can also results into fire outbreak
especially during the dry season which may lead to loss of life and damage
to properties
 Reduction in the asthetic beauty of the environment is also possible due to
indiscriminate discharge of the packaged nylon.

(3b) Measures to safeguiding the health of the community include

 Every packaged water seller must register with the appropriate agencysuch
as NAFDAC before they could be allowed to commence operation
 The facilities and the environment for production must have been
inspected by relevant authority before commencement and certifit fit.
 Regular monitoring and inspection of the facility by EHO, NAFDAC official to
ensure the owner comply with the standard
 The owner must also put measures in place on how to properly and
sanitarily dispose and manage the sarchet resulting from the sale of the
water so that , they will not cause eye sore and other form of hazards in the
community.
 Adequate treated chemicals should be provided for water treatment and
need for laboratory analysis of water after treatment before releasing such
for human consumption.
 Education and sensitization of the masses to only buy registered packaged
water.
 Every unregistered packaged water should be close down, arrested and
prosecuted accordingly by the law.

QUESTION 4

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4. The primary responsible for the provision of potable drinking water in the state
rests with the state government-------------------------------------------20marks

SUGGESTED ANSWER

 It is the responsibility of the government to ensure provision of safe and

adequate water for its citizens
 It is the reponsibility of the government to provide water supply source to
various community such as borehole, sanitary well .
 It is responsibility of the government to provide enough chemical
treatment of water in the water treatment plants.
 Adequate provision of equipment and materias used for provision of safe
water for public consumption
 It is the responsibility of the government to provide adequate personnel
that are knowledgeable in water treaatment aspect so as to ensure
availability of potable water for the public
 Regular payment of salary and other allowances of the personnel working
in water treatment is a also the primary responsibility of the government.
 It is also the primary responsibility of the government that water get to its
citizenry at all times.
 It is also the reponsibility of the that treated water is tested in the
laboratory before releasing for public comsumption.
 Training and retraining of personnel in water treatment plant on the
current techniques and method of treating water and make it available for
public consumption
 It is also the responsibility of the government to set various standards,
policies and laws that will guide water contamination and pollution in the
community.

QUESTION 5

5.. Write notes on the following;

(5a) Turbidity----------------------------------------------------------------5marks

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(5b) Sanitation--------------------------------------------------------------5marks

(5c) Clorination-------------------------------------------------------------5marks

(5d) Aeration----------------------------------------------------------------5marks

SUGGESTED ANSWER

(5a) TURBIDITY: This is the presence of both suspended and colloidal particles in
water which prevent the penetration of light into the water. Turbidity is the state
of unclear water with unsettled particles in water body. Turbidity signifies physical
characteristic of water and it can be measured with turbidity rod. Turbidity is the
cloudiness or haziness of a water caused by suspended solids.

(5b) SANITATION: This refers to all sanitary measures put in place to ensure a
particular substance is free from all agents of pollution and contamination and
making it fit for use. Sanitation when relating to water, it refers to public health
conditions related to clean drinking water and adequate treatment and disposal
of human excreta and sewage. Therefore, sanitation refers to all treatment stages
put in place to safeguard water from contaminants and pollutants and making it
safe for human use.

(5c) CHLORINATION: This is the process of adding chlorine to water so as to

destroy, eradicate, remove and kill the presence of all lives form (e.g bacteria,
virus, protozoan, helminth e.t.c) present in such water and making wholesome
and safe for human consumption.

(5d) AERATION: This is the process of exposing water into open air for oxidation
to take place, so that odour producing substance will be expelled from the water.
Aeration helps to remove physical parameter such as hydrogen sulphide, carbon
dioxide from water. Aeration can be achieved by both natural means and artificial
means with the use of mechanical aerator to supply the needed oxygen to the
water.

69
 2016 WATER SANITATION EHT 208

QUESTION 1

1(a) Define the term potable water-----------------------------------------2marks

1(b) Explain physical, chemical and biological characteristics of water-----18marks

SUGGESTED ANSWER

1(a) POTABLE WATER: It is a form of water that has undergone all water
treatment stages, free from all agents of contamination and pollution and thereby
safe for human consumption. It is also known as wholesome water and it posses
the following features; colouless, odourless, tasteless, sparkling, free from micro-
organisms, free from hazardous chemical.

1(b)(1) PHYSICAL CHARACTERISTIC: These are visible substances presence in water

that may render a particular water unwholesome. Physical parameter in water is
also known as pollutants. Physical characteristics of water include;

 Colour
 Taste
 Odour
 Turbidity
 Temperature

(2) CHEMICAL CHARACTERISTICS: These are presence of both organic and

inorganic chemical substances in water which may render the water
unwholesome for use. Chemical parameter is also known as contaminat.
Examples of inorganic chemical include;

* Aluminium

* Barium

* Chromium

* Cyanide

70
* Magnessium

* Manganese

* Lead

* copper

(3) BIOLOGICAL CHARACTERISTIC: This includes the presence of micro-

organism in water which may lead to disease condition if such water is drunk.
It is also known as contaminant. Biological parameter in water is classified as
follows;

* Total coliform count

* Thermotolerant coliform

* Feacal streptococcus

* Clostridium perfringens

QUESTION 2

2. With the aid of a well labeled diagram, explain hydrological cycle----20marks

SUGGESTED ANSWER

2. Hydrological cycle is the continous circulation of water between the

atmosphere and earth’s surface, it is also knownas water cycle. The energy
required for driving this cycle and thus ensuring a constant supply of fresh
water on land comes directly or indirectly from the sun. When rainwater falls
on the land, solar heat evaporates some quickly from body of water
accumulated on the earth surface back into the atmosphere through
71
EVAPORATION. Water also escapes back into the atmosphere from plants
through TRANSPIRATION.

Moreover the loss of water into the atmosphere from the surface water and
from the plant at the same time is called EVAPOTRANSPIRATION. However,
what is not immediately evaporated, is drunk by animals or absorbed by plants
while some runoff the land surface into the streams, lakes and some sink
through the soil to accumulate as ground water.

Water continues to evaporate from streams, lakes and ocean and from the
bodies of organisms and plants back to the atmosphere, where condensation
occurs and if the capacity of the atmosphere cannot longer hold the water,
then it falls as rain, dew or snow.

The endless cycling of water on earth as rain, back to the atmosphere through
evaporation, traspiration, evapotranspiration and human respiration back to
earth as rain maintain the various aquatic environment and the supply of
water which is required for life on land.

The water cycle carries many chemical nutrients through the ecosystem. It is
an important factor in modifying environmental temperatures. The rainfall
that is necessary for terrestrial and aquatic life is assured by the water.

72
DIAGRAM OF WATER CYCLE

QUESTION 3

(3a) List five (5) reasons for water purification--------------------------5marks

(3b) Explain the conventional methods of municipal water treatment--15marks

SUGGESTED ANSWER

(3a) The reasons for water purification include

 To destroy disease causing organism

73
 To remove faecal matter from water
 To remove dissolved and hazardous chemical fro water
 To remove unpleasant odour from water
 To remove turbidity from water.

(3b) The conventional methods of municipal water treatment include the

following steps

(1) SOURCE: The source of water supply for conventional treatment should
either be from a stream, dam, flowing river, sea, ocean depending on the
population it is to serve
(2) SCREENING: This is the process where suspended large particles are
prevented from entering into the treatment plant from the source and to
bar away aquatic living organisms. This is achieved with the use of wire
mesh (known as bar screen) course and fine bar, each in duplicate and are
placed or erected vertically across the source of water. Screening helps to
remove physical parameter such as stick, leaves, rags, plastic, aquatic lives
e.t.c
(3) AERATION: This is the process of allowing screened water to come in
contact with air for the purpose of oxidation, aeration increases oxidation
thereby absorbing oxygen into the water and expels carbon dioxide.
Aeration removes hydrogen sulphide which causes odour in water. It
oxidizes iron and maganesium present in water. Aeration helps to remove
physical and chemical parameter from water. It can be achieved with the
use of mechanical aerator which helps to supply the needed oxygen into
the water chamber.
(4) COAGULATION/FLOCCULATION STAGE: At this stage, chemical like
aluminium sulphate (AL2SO4) and magnesium carbonate are added into the
already aerated water to flocculate and enable the suspended and
dissolved particles in water to settle down quickly and form floccs. The
coagulants attract the suspended and colloidal particles together to
enhance easy sedimentation. As the water coagulates, the suspended and

74
 insoluble floccs are removed from the water. Coagulation helps to remove
both physical and chemical parameters from the water.
(5) SEDIMENTATION STAGE: After coagulation stage, the coagulated water is
passed into the sedimentation chamber where water particles settle down
naturally at the bottom of the tank as a result of gravitational force. At this
stage, the water is clearer as the suspended solides that are not trapped by
screening and coagulation stage are removed by sedimentation.
(6) FILTERATION STAGE: Water is allowed to flow from the sedimentation to
the filteration chamber where debris in water are filtered up to 85% or
more. Filteration in large water treatment can be done in two ways, either
with the use of slow gravity sand filter or rapid gravity sand filter which is
also known as pressure filter. Filteration can be achieved with the use of
filter bed consists of stone, gravel, sand arranged in layers according to
their sizes. Filteration helps to remove both physical, chemical and
biological parameter from the water.
(7) DISINFECTION STAGE: Here chemical compound is added into the water to
destroy the presence of all form of lives that may be present in water and
make the water free from disease causing agent. When chlorine is used to
achieve disinfection, it is called chlorination. Chlorination also helps to
improve the quality of the water. Chlorine helps to remove biological
parameter inn water.
(8) CHLORINE/PH TESTING: The disinfected water must be tested to confirm
the effectiveness of the treatment. During this process, the acidity and
alkalinity content of the water is checked and balanced with the use of
colour comparator. The PH of a wholesome water ranges between 6.8 and
7.2
(9) STORAGE: After balancing the PH level of the water, the water is pumped
into temporary reservoir and booster station to serve the community and
individual premises in a sequential order.

(10). DISTRIBUTION: Water is distributed directly to the industries, institutions,

estates, public stand taps and to individual premises.

75
 QUESTION 4

(4a) Explain the term sanitary well--------------------------------------5marks

(4b) With the aid of a wll labeled diagram, describe a sanitary well------15marks

SUGGESTED ANSWER

(4a) SANITARY WELL: It is a form of well that is digged to the second

impervious layer of the soil and posses all the sanitary fittings that will reduce
the level of contaminats and pollutants to the bearest level, the sanitary
fittings include tight fitting cover, apron, drain, parapet, internal lining,and a
permanent anchor fetcher.

DIAGRAM OF SANITARY WELL

76
 QUESTION 5

5.. Write notes on the following;

5(i) Water quality standards-------------------------------------------5marks

5(ii) COD-------------------------------------------------------------------5marks

5(iii Chlorination----------------------------------------------------------5marks

5(iv) Water hardness----------------------------------------------------5marks

77
SUGGESTED ANSWER

5(i) WATER QUALITY STANDARDS: It is a term used to describe the chemical,

physical and biological characteristics of water, usually in respect to its suitability
for an intended purpose. These characteristics are controlled or influenced by
substances, which are either dissolved or suspended in water.

5(ii) COD: It is an abbreviation for chemical oxygen demand and it is defined as

the amount of oxygen required by micro-organisms to decompose both organic
and inorganic matter in waste water aided by chemical compound known as
potasium permanganate.

5(iii) CHLORINATION: This is the process whereby chlorine is added into the water
to kill and destroy harmful micro-organisms presence in water. Chlorination helps
to eradicate all forms of lives (disease causing agent) in water.

5(iv) WATER HARDNESS: It is a form of water that cannot readily form lather with
soup as a result of mineral salt presence in such water. The principal minerals
responsible for hardness in water are calcium carbonate, calcium sulphate,
magnesium carbonate and magnesium sulphate.

2017 WATER SANITATION EHT208

QUESTION 1

1(a) Explain the term water sampling---------------------------------5marks

1b) Outline five (5) medical importance of water sampling-------5marks

1(c) Describe the procedure involved in taking water sample from a well--10marks

SUGGESTED

78
1(a) WATER SAMPLING is the process of collecting water sample randomly on
regular basis at various sources for bacteriological examination for the purpose of
determine its quality and safety.

1(b) Medical importance of water sampling include

 To confirm the effectiveness of a water treatment

 To find out the cause of a particular outbreak
 To reduce the spread of water related diseases
 To make available wholesome water for the community
 To promote the health of the masses through drinking potable water

1(c) The procedure involved in taking water sample from a well include

(1) When you get to the point of collection that is at the well, wash your hand
thoroughly with soap and rinse with water
(2) Tie the wire loop or string round the neck of the collection bottle
(3) Sterilize the string and the neck of the bottle with methylated spirit by
using cotton wool
(4) Lower the sterilized bottle and string carefully into the well without
allowing it to touch the side of the well
(5) Fill the bottle to the brim and bring it out carefully without allowing it to
touch either sides of the well
(6) Cover the bottle with the tin foil.
(7) Label the sample and sent to the laboratory for analysis, taking into
cognizance the date, time, and your designation.

QUESTION 2

2(a) State five (5) ways by which stream water could be contaminated-----5marks

2(b) Identify three (3) indicator organisms that indicate water has been
contaminated—3marks

2(c) Describe six (6) ways to protect a stream from pollution----------12marks

79
SUGGESTED ANSWER

2(a) Five ways by which stream water could be contaminated include

 When the stream water is accessible to animal

 Located towards the direction of erosion
 When the stream water is located very close to waste dumping site
 When people fetch the water with different buckets and containers
 When different category of people have access to the water especially
those with chronic infectious diseases.

2(b) Example of indicator organisms include

 Eschericia coli
 Feacal streptococcus
 Clostridium perfringens.

2(c) six ways to protect stream from pollution include

(1) The first step is to divide the stream water into four section with an
installed sign post that signify the use of each section. The upper part for
drinking purpose, the middle part for domestic purpose and the lower part
for bathing and domestic purpose.
(2) The water environment can be fenced to prevent unauthorized person
from access into the water body. The unauthorized persons are people with
chronic infectious diseases, mad people and animal.
(3) The overgrown weed around the water body should be cleared and
reduced to the bearest level so as to prevent pollutants and contaminants
from getting into the water body.
(4) Containers and buckets used to fetch the water must be cleaned and free
from all agents of pollution and contamination.
(5) If there is waste dumping site very close to th water body, this should be
evacuated far from the water body.

80
 (6) The water should be treated after fetching with available chemical
compound such as chlorine for total destruction of pathogenic organisms or
the water can be boiled before drinking, this is called thermal treatment.

QUESTION 3

3(a) Explain water quality under the following parameters;

(i) Physical--------------------------------------------------------------3marks
(ii) Bacteriological------------------------------------------------------4marks
(iii) Chemical-------------------------------------------------------------3marks

3(b) In accordance of world health organization (WHO) list five (5) chemicals and
their maximum permissible limit in drinking water------------------10marks

SUGGESTED ANSWER

3(i) Water quality under physical parameter include

 Tasteless
 Odourless
 Clourless
 Sparkling
 Turbidity free

3(ii) water quality under bacteriological parameter include

 Free from total coliform

 Free from thermotolerant coliform
 Free from streptococcus
 Free from clostridium perfringens

3(iii) Water quality under chemical parameter include

 Free from dissolved chemical responsible for hardness

 Free from organic chemical e.g pesticide, kerosine, detergent

81
  Free from inorganic chemical e.g aluminium, barium, cyanide, chromium,
lead, manganese

3(b)

S/N Chemical Maximum permissible

limit
1 Aluminium 0.2
2 Arsenic 0.01
3 Barium 0.7
4 Cadmium 0.003
5 Chromium 0.05
6 Copper 1
7 Cyanide 0.01
8 Hydrogen 0.05
sulphide
9 Lead 0.01
10 Manganese 0.2

QUESTION 4

4. Discuss five (5) factors militating against the realization of the objectives of
provision of potable water in your country---------------------------------20marks

SUGGESTED ANSWER

(1) LACK OF FUND: Fund plays a major role in achieving the objectives of
provision of potable water, because logistics is needed for planning, and
execution of a set objectives that will lead to achievement of potable water
provision in a particular country. So in the absence of money nothing can b
e achieved.
(2) LACK OF POLITICAL: Lack of governement support is another factor that
militate against the realization of provision of potable water supply in a

82
 country. Any set objectives without government support will be difficult to
achieve.
(3) OVER POPULATION: When a particular country is over populated, it with be
difficult to achieve the objectives of provision of potable water for that
country. The resources available in an over populated country will not be
able to meet the demand of the population and this will become a problem
for that country to achieve its set objectives.
(4) LACK OF PERSONEL OR EXPERTS: This is another factor that militate against
the realization of provision of potable water in a country, any country
devoid of personel or experts, it will be dificult for such country to ahieve
its set objectives.
(5) LACK OF EQUIPMENT: Equipment and materials are essential to achieve the
goal of provision of potable water in any country. Equipments and
materials are needed for execution of any goals or objectives.
(6) TOPOGRAPHY NATURE OF A COUNTRY: The topography of a country also
contribute to factor militating against the realization of provision of potable
water.
(7) CULTURAL CONSIDERATION OF THE PEOPLE: Nigeria is a complex country
with diverse tribes and cultures. The culture of a particular community may
forbid the provision of a potable water in the country, while the other may
allow such.

QUESTION 5

5.. Write notes on the following;

(i) Contaminants------------------------------------------------------5marks

(ii) Coagulation--------------------------------------------------------5marks

(iii). Filtration-----------------------------------------------------------5marks

(iv). Disinfection--------------------------------------------------------5marks

83
SUGGESTED

5(i) CONTAMINANTS: These are pathogenic organisms and toxic chemical present
in a medium (water, air and land) which cause dieases condition or other disorder
when ingested by man or when it comes in contact with man.

5(ii) COAGULATION: This is the process whereby aluminium sulphate (coagulant)

is added into water to help facilitates the quick settling of suspended and colloidal
particles at the bottom of the tank. It is achieved with the use of coagulant
followed by stirring of water with mechanical stirrer for a few hours and
thereafter, the particles are attracted by the chemical and aids its settling down at
the bottom of the tank.

5(iii) FILTRATION: This is the process whereby water is allowed to pass through a
filter medium so as to remove pollutants and contaminants from the water. In a
conventional water treatment, filtration is achieved with the use of filter bed such
as stones, gravel, sand. But home treatment of water, it is achieved with the use
of funnel, white clean cloth and a keg

5(iv) DISINFECTION: This is the process of addind chemical compound into water
so as to destroy the presence of all form of lives present in such water and
thereby making such water free from agents of contamination. Example of
chemical used include chlorine, ozone, chloride of lime e.t.c

2018 WATER SANITATION EHT208

QUESTION 1

1. (a) Define the term Rain water harvesting-----------------------5marks

(b) State five (5) advantages of rain water harvesting---------5marks
(c) Explain five (5) factors that can influence the quality of rain water in an
industrial community-------------------------------------------------5marks
SUGGESTED ANSWER

84
 1(a) Rain water harvesting is the process of collecting rain water through direct
collection or collection through eave of gutter in a bucket or a constructed tank or
reservoir for immediate and future use. It is commonly practiced in the southern
part of the country such as Edo state, Deltal state. It is also common in an arear
where ground water is not accessible or feasible.

1(b) Advantages of water harvesting include

 It makes water available for future use

 It prevents water shortage diseases caused as a result of lack of water for
personal hygiene
 It prevents water wastage
 It makes water available for immediate use
 It makes water available for other uses e.g construction,wetting of the
ground, irrigation on the farm land

1(c) The factors that can influence the quality of rain water include

 When storage of rain water is close to the defective septic thank, this will
definitely influence the qaulity of the rain water in an industrial
environment. Defective septic tank is a potential source of contamination in
a community.
 When the rain water is being stored in a contaminated tank, this will greatly
influence the quality of the water in an industrial environment.
 When the rain water is accessible to animal, this will also affect the quality
of the rain water in an industrial environment,
 When the water is collected through a contaminated roof or eave gutter,
this will affect the quality of rain water in such environment.

QUESTION 2
2. Discuss four (2) sources of ground water pollution/contamination in your
country----------------------------------------------------------------20marks
SUGGESTED ANSWER

85
 (1) WASTE DUMPING SITE: Waste dumping site is a potential source of
ground water polution and contamination especially where the soil is
very porous. During decomposition of organic waste, there is tendency
for liquid waste emanated from the decomposition to percolate through
the soil and cause ground water pollution and contamination. Therefore,
to avoid ground water pollution and contamination, dumping site should
be located far from the the community.
(2) LEAKAGE AND DEFECTIVE SEPTIC THANK: This is another source of
ground water pollution and contamination, especially for any source of
water located to this leaking and defective septic tank. This might lead
to sudden outbreak of cases of communicable disease in such
community.
(3) WHEN THE SOURCE OF THE GROUND WATER IS EXPOSED DIRECTLY TO
EROSION: For instance if a well lack parapet, this might expose the well
directly to incoming erosion which might lead to pollution and
contamination and render such water unwholesome for human use.
Therefore every well should be provided with parapet to prevent
erosion from entring into the well.
(4) USING CONTAMINATED BUCKET OR FETCHER TO FETCH WATER FROM
THE WELL: This might also render a well water (underground)
contaminated and polluted. To avoid contamination and pollution
through fetcher, a permanent fetcher must be stationed on the well. We
must guide against the use of differents fetchers.

QUESTION 3
3. Poor water distribution can affect the quality and quantity of water in a
community
(a) Highlight six (6) factors responsible for poor water distribution----6marks
(b) Explain four (4) qualities of a good water distribution line----------8marks
(c) List six (6) materials used in water distribution-----------------------6marks

86
 SUGGESTED ANSWER

3(a) Factors responsible for poor water distribution include

 Topography of the area

 Faulty pipe or transfer station
 Vandalization of water distribution line
 When the distribution line is not properly laid
 Shortage of water from the source
 Poor funding by the governement

3(b) Qualities of good water distribution line include

 Durability: Good water distribution line should be durable and must be able
to stand the test of time
 Affordability: It must be cheap and available at at all time.
 Carrying capacity: water distribution line must have a very high carrying
capacity to be able to supply the needed water to a community.
 Good gradient: water distribution line must be of a good gradient so as
ensure free flow of water without interruption.

3(c) Material used in water distribution include

 Water van
 Pipe of different sizes
 Metallic pipe of different size
 Hose
 Different water reservoir
 Different buckets

QUESTION 4
4. Describe two (2) methods of chemical examination of water in the
laboratory
SUGGESTED ANSWER

87
 TITRIMETRIC METHOD:Titrimetric analysis is a method of analysi in which a
solution of the substance being determined is treated with a solution of a
suitable reagent of exactly known concentration. The reagent is added to
the substance until the amount of substance to be determined. The
equipment used in this analysis are
(1) Karl-Fischer titrator: A classical method in analytical chemistry that uses
volumetric to determine trace amounts of water in a sample. The Karl
Fischer titration is based on an iodine/iodine reaction. The endpoint of
titration is reached when all the water is consumed. The process uses an
organic base [B], sulphur dioxide,iodine and an alcohol.The original Karl
Fischer method used pyridine or imidazole as organic base and
methanol or ethanol as alcohol
(2) Auto titrator: The basic of titration is the following : A solution- a so
called titrant or standard –is added to sample to be analyzed. Auto
titrator model ‘’Mayura Auto Titrator HP77’’ consists basically of an
electric burette,a sensor whose signal is amplified with a preamplifier
and a computer.During a titration the titrator measures the signal of
the sensor and uses this information to control the addition of the
titrant with the electric burette. Once the endpoint is reached, the
computer calculates the volume of titrant added and converts this value
to a result based on formulas. The formulas needed for this calculation
can be programmed and depend on type of analysis.
 COLOURIMETRIC METHOD: This is a technique that used to evaluate an
unknown color in reference to known colors. In a colorimetric chemical test
the intensity of the color from the reaction must be proportional to the
concentration of the substance being tested. Colorimeter can be used to
photoelectrically measure the amount of colored light absorbed by a
colored sample in reference to colorless sample. Therefore, colorimetric
analysis is a method of determining the concentration of a chemical
element or compound in a solution with the aid of colour reagent. It is
applicable to both organic compound and inorganic compounds.
Colourimeter is used to test for water quality by screening for chemicals
such as chlorine, fluoride, cyanide, dissolved oxygen, iron, molybdenum,
88
 zinc and hydrazine. Colorimetric method adopted the Beer-Lambert law for
its application. Beer-lambert law states that the concentration of a dissolve
substance or solute is proportional to the amount of light that it absorbs.

QUESTION 5
5. Write notes on the following;
(a) Leachate--------------------------------------------------------------5marks
(b) Residual chlorine----------------------------------------------------5marks
(c) Service reservoir--------------------------------------------------5marks
(d) Ph of water---------------------------------------------------------5marks

SUGGESTED ANSWER

5(a) LEACHATE: This is a liquid waste resulting from decomposition of

organic waste in a dumping site which percolates through the soil to cause
ground water contamination and pollution. Leachate brings out foul odour
and contains harmful micro-organism with alot of chemical compound.

5(b) RESIDUAL CHLORINE: It is a form of chlorine with residual effect

against subsequent pathogenic organism that might come in contact with a
treated water. The essence of residual chlorine is to continue working until
the treated water gets to individual table. When a water is treated without
a residual chlorine and such water is released for distribution, there might
be recontamination along the water distribution line due to faulty pipe or
leaking pipe and this might result into sudden outbreak of cases of
communicable disease among those who consume the water. But when a
chlorine with residual effect is used, this will continue killing harmful micro-
organism, till the water get to the consumer’s table.

5(c) SERVICE RESERVOIR: A service reservoir is a water storage container

that holds clean water after it has been treated in a water plant, and before
it is piped to the end users. These containers are covered and are designed
to keep the water safe from contamination. Their main purpose is to
provide a buffer within the water supply system so that water supplies can
89
be maintained across periods of varying demand. Service reservoirs
typically need to be situated at a sufficient height to maintain enough
pressure in the downstream pipe network to provide a good flow to the
area being supplied and to enable the water to be raised up to the top of
buildings.

5(d) Ph OF WATER: This is the acidity or alkalinity of water. The P H of a pure

water is 7. Water with a P H lower than 7 is considered acidic and with a P H
greater than 7 is considered basic. The normal range for P H in surface water
system is 6.5 to 8.5 and the PH range for groundwater system is between 6
to 8.5.

2015 PAST QUESTION

EHT 210-PUBLIC HEALTH LAWS AND ETHICS

QUESTION 1

1(a) Define the term injunction-----------------------------------2marks

1(b) List and explain two (2) types of injunction----------------8marks

1(c) Enumerate ten (10) nuisances that can be abated summarily--10 marks
90
 SUGGESTED ANSWER

1(a) INJUNCTION: Injunctions are order of the court commanding or

preventing parties to court actions to do or refrain from doing a
certain things. Injunction may be restriction or mandatory.

1(b)* Ex-parte or Interim Injunction: Ex-parte injunction is an

interim injunction issued after the court has heard from only the
moving party and subsists until the court has heard the other
party. In other word, it is an interim order to restrain a respondent
or defendant who is not in court pending the time he will be put on
notice to defend himself. An Ex-parte order means that the order is
made without the other side being put on notice. It is an order
made in very special circumstances.

 Interlocutory Injunction: This is a temporary injunction

issued before or during trial to prevent an irreparable injury
from occurring before the court has chance to decide the case.
The injunction is issued only after the defendant received
notice and an opportunity to be heard. And this operates until
the final judgment.

1(c) Nuisances that can be abated summarily include;

*Presence of overgrown weed

*Indiscriminate discharge of waste water

*Indiscriminate defeacation around the premises

91
*Rearing of animal within the premises

*Offensive trade such smoking of fish

* Evidence of cooking in the passge

* presence of stagnant water around the premise

* Presence of tall tree considered to be hazardous and dangerous to

man

* Presence of dangerous excavation withing the premises

*Unswept floor full of dirts.

QUESTION 2

2. State the functions of the following in our legal system

(a) Attorney General of a state---------------------------------5marks

(b) Chief judge of a state-------------------------------------5marks

(c) Solicitor General of a state--------------------------5marks

(d) Chief justice of the federation------------------------5marks

SUGGESTED ANSWER

(a) ATTORNEY GENERAL OF A STATE: An Attorney general of a

state government is appointed by the state governor. This is
done on political grounds but the person must be a seasoned
legal practitioner not below the level of a senior advocate. He

92
 normally holds the office of the attorney general and state
commissioner for justice, he performs the statutory duties as
entrenched in the constitution.
(b)CHIEF JUDGE OF A STATE: The honourable chief judge of a
state is the head of all the courts in a state judiciary. He is
therefore directly in control of all staff including the chief
registrar of the state. The chief judge shall perform both
administrative and adjudicating duties. He shall therefore
continue to sit over both civil and criminal matters apart from
the other duties bestowed on him by his officer as a chief
judge. He shall normally preside in high court No.1 at the
headquarters of the state judiciary. As head of a state
judiciary, he shall assign both civil and criminal cases to
himself and to all other judges sitting at the headquarters.
One of the important duties of the chief judge is to see to the
welfare of judges, magistrates and all the staff collectively to
encourage them to put in their best and to ensure industrial
harmony.
(c) SOLICITOR GENERAL OF A STATE: Solicitor general is a
principal law officer employed in the service of the state
government to advise the state government on legal matters.
He is a seasoned legal practitoner that also stand in to defend
the actions and legal activities of the state government as well
as empowered to prosecute all libel cases, misdeeds, or
blackmail of person or group of persons made against the

93
 government. It is also known as permanent secretary in the
state ministry of justice.
(d)CHIEF JUSTICE OF THE FEDERATION: The honourable chief
justice of the federation is the head of all the courts in the
federal judiciary. He is therefore directly in control of all staff
including the chief registrar of the Federation. The chief justice
shall perform both administrative and adjudicating duties. He
shall therefore continue to sit over both civil and criminal
matters apart from the other duties bestowed on him by his
officer as a chief justice. He shall normally preside in supreme
court. As head of the federal judiciary, he shall assign both
civil and criminal cases to himself and to all other judge. One
of the important duties of the chief justice is to see to the
welfare of justces, and all the staff collectively to encourage
them to put in their best and to ensure industrial harmony.

QUESTION 3

3(a) State five (5) features of an abatement notice--------------5marks

3(b) Prepare an Abatement notice intended to be served on the

author of a nuisance of a dilapidated walls and overgrown weeds at
the rear of the premises on the land landlord Mr. Musa john of 6
kings road, suleja, Niger state.-----------------------------------15marks

SUGGESTED ANSWER

3(a) The features of an abatement notice include

94
  Name of the author of the nuisance which could be the
landlord or occupiers
 Address of the landlord or occupiers
 Nuisances detected in that premises and their effects on man’s
health
 What is expected of the landlord or occupiers where the
nuisances have been detected to do as regard the detected
nuisances
 Date of the inspection which include day, month and year.
 Name and signature of the officer serving the notice
 Name and signature of witness
 Method of serving the abatement notice.
 Date when the abatement notice was served
 Signature of the receiver of the abatement notice

3(b) NOTICE TO ABATE NUISANCE

TO---------------------------------------------------------------------------------------------

95
OF-------------------------------------------------------------------------------------------

You are hereby required to abate within--------------------------------------days

A nuisance at-----------------------------------consisting of --------------------------

--------------------------------------------------------------------------------------------

-------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------
And for that
purpose---------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------And to prevent
re-occurence of the nuisance DATED this-------------day
of---------------------------------------------------2019--------------------
at------------------------

----------------------------------------

Director Of Environmental services

-------------------------------------------------------------------------------------------------

I hereby certify that a copy of the above was served by me on the-------------Day

Of-------------------2019-------------at-------------by being (state how serve)---------

In the presence
of-----------------------------------------------------------------------------------------------
------ --------------------------------------Sgnature
Environmental health officer.

96
 QUESTION 4

4. (a) Explain the term Appeal-------------------------5marks

(b) State the process of appointment of the Attorney General of a

state---10marks.

(c) List the hierarchy of courts in your country----------5marks

SUGGESTED ANSWER

4(a) APPEAL: Is the act or resorting to a superior court to review the

decision of an inferior court or administrative agency. This arises
when the judgment delivered by the lower court does not satisfy the
aggrieved party, the person can appeal seeking new judgment from
the higher court which is superior to the formal court where the
judgment is first pronounced.

4(b) The process of appointmnet of Attorney general include

 The position is based on policatical ground

 The person must be a seasoned legal practitioner
 Not below the level of senior advocate
 The person must be a lawyer and barrister with more than 15
years experince
 The person must be recommended by Bar Association of
Nigeria
 The person must not have any record of criminal cases

4(c) The hierarchy of court in Nigeria include;

97
  FROM HIGHEST TO LOWEST
(1)Supreme court
(2)Court of Appeal
(3)High courts (both state and federal high court)
(4)Area court
(5)Magistrate court
(6)Customary court
 FROM LOWEST TO THE HIGHEST
(1)Customary court
(2)Magistrate court
(3)Area court
(4)High court
(5)Court of Appeal
(6)Supreme court

QUESTION 5

5.. Write notes on the following;

5(a) Criminal procedure-----------------------------5marks

5(b) Criminal code-----------------------------------5marks

5(c) Penal code---------------------------------------5marks

5(d) Nuisance order-----------------------------------5marks

SUGGESTED ANSWER

98
5(a) CRIMINAL PROCEDURE: Criminal procedure is the rules
hoverning the mechanisms under which crimes are investigated,
prosecuted, adjudicated and punished. It includes the protection of
accused person constitutional rights.

5(b) CRIMINAL CODE: These are bulk of applicable rules of criminal

law in the Southern parts of the country. Criminal code can be
traceable to the English Common law and criminal code is based on
the Queensland, Code of Australia.

5(c) PENAL CODE: Penal codes are bulk of the applicable rules of
criminal law in the Northern parts of the country and this can be
traceable to the English Common law. Penal code was an offspring
of the Indian penal code with some reflections of Islamic culture.

5(d) NUISANCE ORDER: Nuisance order is a court order which may

be a closing order or abatement order or prohibition order or
combination of such order issued on the owner of a premises or
agent in charge of the premises to prohibit, the occurrence of a
particular nuisance or to close down a premises and prevent it from
usage or to prevent the reoccurrence of a particular nuisance. It is
given after a sanitation case has been decided in the court.

EHT 210-PUBLIC HEALTH LAWS AND ETHICS 2016.

QUESTION 1

1(a) Define the term law and public health law -----------------------------10marks

99
1(b) Enumerate the principal branches of law in your country-----------5marks

1(c) Explain four (4) functions of law in the society-----------------------5marks

SUGGESTED ANSWER

1(a)LAW: Law can be defined as a set of rules that regulates the

relationship between the members of a given society and a breach of
which attracts sanctions. Law can also be defined as a rule or
system of rules established by authority. It can also be defined as
the rules and regulations made by authorities which is binding on
the target subjects. Laws can also be defined as major means by
which institutions that provide public services such as
environmental service, health care services, education or other
ancillary social amenities and benefits are established, regulated,
structured and conduct of their affairs monitored.

1. PUBLIC HEALTH LAW: Public Health Law can be defined as the

law that forbids persons to engage in activities that may
endangered the health of others and specifies government
agencies to carry out certain programmes to advance public
health. In other word Public health law may be said to include
environmental health law which is concerned with the regulation
of the conduct of public and private institutions and individual
to ensure the maintenance of a wholesome environment,
prevention of disease and promotion of health to ensure a
healthy individual, community and nation.
1(b) The principal branches of law in your country include;

* Criminal Law

* Civil law

100
* Environmental Law

* Administrative Law

* International Law

* Constitutional Law

* Company Law

* Medical Law

* Insurance Law

* Property Law

* Family Law

* Press Law

1(c) Functions of law in the society include;

(1)Law is the foundation of all socio-economy relationship and

regulation, and anything or action that is inconsistent with the law
is regarded as illegal

(2).Law regulates the major organs and institution of Government.

For instance, the relationship between the three arms of
government that is the executive, the legislature and the judiciary
are regulated on the basis of the law

101
(3)Laws help to keep individuals, communities, states and nations
at peace. This is because the basic function of law is to ensure
peaceful co-existence and security of all.

(4) Laws also protect the freedom of individuals. For example,

nobody can be detained unlawfully without committing any offence
and in most cases, it has to be at the instance of a court of
competent jurisdiction.

(5) Laws also guarantee us the freedom of speech, association,

religion and movement. It equally makes special provisions for how
individual can enforce his right whenever it is infringed or breached

QUESTION 2

2. Explain the process of a bill becoming law in a presidential

system of government in your country----------------------20marks
SUGGESTED ANSWER

The process of a bill becoming law in a presidential system of

government in your country include;

Firstly, law making process commence with the formulation of

a Bill. Then what is a bill?

 BILL: A bill is the draft of a proposed law presented to the

legislature for debate and approval. It is only when bills are
initiated, deliberated upon and enacted into law by the
parliament and signed by the president that they become laws.
Types of bills include;
102
 (1)PRIVATE BILL: This is a draft of proposed law tha applies to
a particular class of persons or area. Such draft caters for
the interest of a particular group or a particular area.
(2)PRIVATE MEMBER’S BILL: This is a bill introduced by a
parliamentarian which may have effect on the general
public e.g a bill to introduce social security for the
unemployed in the country.
(3)AN APPROPRIATE OR MONEY BILLS: This relates to public
funds and may be presented to both houses by the
executive or may emanate from either house, if it is federal.
(4)A GOVERNMENT BILLS: This is a bill which the executive
submits to either or both houses for passage into law.
 VARIOUS STAGES OF PASSING A BILL INTO LAW
i. FIRST READING: This is when the draft of a bill is
presented to the clerk of the House by a member of the
Executive or a member of the parliament depending on
the type of the bill . Members of the parliment will be
notified about the presence of such bill by the clerk who
will read out the title. The bill is printed into leaflets for
members to study before the second reading. At this
point and opposition to the bill is registered.
ii. SECOND READING: This is a stage in which the person
that brought the bill will give reasons to justify the need
for the proposed legislation. Members of the parliament
will then debate or argue for or against the bill whether it
should be read a second time. If the majority are in

103
 favour, it will move to the next stage and if not, the bill
will be killed here.
iii. THE COMMITTEE STAGE: The bill is referred to
committee which can be committee for the whole house
or standing committee depending on the importance of
the bill. Standing committee is made up of four or five
members. At this stage, the committee will consider the
bill section by section for detailed discussion,
amendment and report.
iv. THE REPORT STAGE: At this stage the committee reports
back to the whole House, all their findings and the
amendments made to the bill. Any member may still
move for amendment at this stage.
v. THIRD READING: A thorough look would be taken on the
bill to correct certain errors or to improve on the actual
drafting of the bill. A final vote is taken to pass or reject
the bill. This process will be repeated in the upper House.
Any amendment suggested by the upper house will
require both Houses jointly setting up a committee to
iron things out.
vi. ASSENT: The bill is then presented to the president for
his assent. This is the final stage of law making . After
the president assent (approve or sign) the bill becomes
law.
vii. VETO: When the president in respect of a bill passed by
the National Assembly witholds his assent after 30 days

104
 of presentation of the bill to him, the respective houses
may pass it by two-thirds majority. The bill shall become
law and the assent of the president shall not be required.

QUESTION 3

3. Nigerian public health laws are good for the achievement of good
public health, inspite of the above our health is deteriorating
daily. State and explain ten (10) urgent steps that can be taken
to remedy this urgly trend.
SUGGESTED ANSWER

3.The steps taking include;

(1) ADEQUATE FUNDING OR BUDGETING: There must be

adequate budgeting in the area of public health so as to achieve the
goals and objectives of improving public health.

(2) ADEQUATE HEALTH POLICIES: This is another way by which

we can improve the health of the masses, there should be adequate
health policies by the national assembly and ensure that the health
policies and implemented.

(3) GOVERNMENT COMMITTMENT: Government at all levels must

show commitment towards achieving the goals and objectives of
public health laws. A situation whereby public health laws and
policies are lacking government support, this will in turn affect the
health of masses.

105
(4) ADEQUATE RESOURCES: Resources must be made available in
achieving the the goals and objectives of public health laws and
policies so as to improve the health of masses.

(5) AVAILABILITY OF HEALTH PERSONEL: There must be

adequate personel available that will enforce public health laws to
ensure compliance with the law. One thing is for a law to be made
another thing is for the law to be enforced for compliance.
Government should employ adequate Environmental Health Officers
that will enforce public health law.

(6) END BRIBERY AND CORRUPTION: Bribery and corruption

among the public health enforcers should be stopped. Monitoring
team can be set up to investigate and sanction any health officer
indudging in this despondent act. Without putting an end to
corrupting among health officers, it will be difficult to achieve the
goals and objectives of public health

(7) PROVISION OF REWARD AND, INCENTIVES: The health officers

should be motivated so as to put in their best in the course of
discharging their responsiblity. This will also help to prevent
corruption on the part of health officers. Government at all levels
should endeavored to motivate their employee with incentives,
rewards e.t.c.

(8) TRAINING AND RETRAINING OF HEALTH PERSONNEL: This

will also help to achieve the goals and objectives of public health
health, every persone concerned right from the formulation of

106
health policies till implementation of the policies should be sponsor
for training as regard the areas so as to keep themselves updated
about current information.

(9) COMMUNITY SENSITIZATION AND AWARENESS: The

community that serves as the receiving end for the law should be
adequately sensitized about their roles and responsiblities toward
compliance with the laws. This will help in achieving the goals of
public health law as soon as possible and this in turn improve our
health as a whole.

(10) INVOLVEMENT OF STAKEHOLDERS: Involvement of

stakeholders and non-governmental organization in health policy
making and implementation will also help to achieve the goals and
objectives of public health law and improve the health of the
masses.

QUESTION 4

4(a) Explain the term appeal---------------------------5marks

4(b) Explain four grounds on which an aggrieved sanitary

offender---10marks

4(c) List the content of a charge sheet----------------5marks

SUGGESTED ANSWER

4(a) APPEAL: Is the act or resorting to a superior court to review the

decision of an inferior court or administrative agency. This arises

107
when the judgment delivered by the lower court does not satisfy the
aggrieved party, the person can appeal seeking new judgment from
the higher court which is superior to the formal court where the
judgment is first pronounced.

4(b) Grounds on which an aggrieved sanitary offender may appeal

include;

 When the sanitary offended was not pleased with the

judgement delivered in the court, the sanitary offender may
appeal the judgement in the higher court for better decision
 When the sanitary offender did not commit the offences he
was formally acused of and yet he was not vindicated in the
court of law
 When the sanitary offender knew that the court where the his
case was handled has no competent jurisdiction to handle
such case
 When the sanitary offender supply the court with enough
evidences that he did not commit the offences he was formally
accused of and yet he was not favoured
 When the sanitary offender was not granted hearing
permission in the court.

4(c) The contents of the charge sheet include;

 Name of the sanitary offender

 Address of the sanitary offender

108
  Offences committed by the sanitary offender (nuisances
detected and the effects)
 Date when the offences were committed.

QUESTION 5

5.. Write notes on the following;

5(a) Nuisance order---------------------------------------5marks

5(b) Adoptive Bye-law-----------------------------------5marks

5(c) State laws--------------------------------------------5marks

5(d) Legal officers-----------------------------------------5marks

SUGGESTED ANSWER

5(a) NUISANCE ORDER: NUISANCE ORDER: Nuisance order is a

court order which may be a closing order or abatement order or
prohibition order or combination of such order issued on the owner
of a premises or agent in charge of the premises to prohibit, the
occurrence of a particular nuisance or to close down a premises
and prevent it from usage or to prevent the reoccurrence of a
particular nuisance. It is given after a sanitation case has been
decided in the court.

109
5(b) ADOPTIVE BYE-LAW: Means any bye-law that is in force for
determination of any legal issue at that point in time in a particular
place and on same specific matters.

5(c) STATE LAWS: These are laws made by the state house of
assemble at the state level under civilian regim or administration
for the conduct of the masses. These laws must be passed by the
state house of assembly and assented to by the Governor.

5(d) LEGAL OFFICER: He is a public officer employed to administer

or advise in legal matter. Legal officer is a lawyer and a barrister
who advise the on legal issue or defend the public in the law court.

2017 PUBLIC HEALTH LAWS AND ETHICS EHT210

QUESTION 1

1. Discuss the procedure for summary abatement of structural

nuisance—20marks
SUGGESTED ANSWER
The procedure for summary abatement of structural nuisance
include
(i) Inspection will be conducted by a qualified and licensed
environmental health officer at a premises
(ii) Detection of nuisances especially structural nuisances

110
(iii) After being satisfied with the detected nuisances in such
area, then he issued an abatement notice to the defuater
or the author of the nuisances
(iv) Then, he came for verification whether the requisition of
the abatement notice has been complied with.
(v) Then if health officer confirm defauter’s non-compliance
with terms of abatement notice
(vi) He issues court summons, which he will prepare and
subsequently serve on the defauter.
(vii) He will prepare a charge sheet based on the allegations or
nuisances which have been stated in the abatement
notice and summons.
(viii) He will have to file the charge sheet in the court and a
date is fixed for hearing of the case
(ix) Court sits and parties (the prosecutor and his witness
and defaulter or accuse) will appear in the court.
(x) On the day of trial, the accused is called out and the
charge is read to him as contained in the charge sheet.
(xi) The accused may plead guity or not guity.
(xii) The prosecutor will present its case and calls witnesses
to give in support of its case
(xiii) After the prosecution must have closed his case the
defence (accused) will present his case
(xiv) Parties may address the court
(xv) The court will deliver its judgement

111
 (xvi) If the accused is found guilty he is punished. The
punishement may be in terms of imprisonment,
abatement order, prohibition order of closing .
2. (a) State two(2) cases that can be heard in the following courts;
(i) Customary court-----------------------------2marks
(ii) Magistrate court---------------------------2marks
(iii) High court----------------------------------2marks

(b) Outline the steps involved in the civil procedure---14marks

SUGGESTED ANSWER

2(ai) The cases that can be heard in customary court include

 Land cases under customary law

 Cases relating to matrimonial causes and custody of children
under customary law
 Inheritance of property according to custom
 Succession.
2(aii) The cases that can be heard in magistrate court include
 Environmental sanitation matters or cases
 Stealing cases
 Landlord and tenant matters
2(aiii) The cases that can be heard in high court include;
 Robbery cases
 Murder cases
 Rape cases

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(2b) Steps involved in a civil proceedure include

 A plaintiff will a case agiant a defendant in the court of

competent jurisdiction
 The a court summon will be sent to the defendant that a
particular case has been instituted against him or her ,
therefore, he or she needs to appear in court to defend himself
or herself.
 The plaintiff will prepare a charge sheet based on the
allegation levelled against the defendant.
 The court sits and the parties (the plaintiff and the defendant)
 The charges or complaints is read to the defendant
 Then the defendant will explain his own side of the matters
 So also the plaintiff will equally explain his own side of the
matter
 Then the magistrate will address the two parties invloved and
redress the issue
 Though the wrongdoer is not punished at the end of the day,
but he or she will be made to rstitute the wrong he has done.

113
 QUESTION 3
3. (a) List five (5) judicial officers in a legal system----------5marks
(b) Explain two (2) functions each for the five (5) judicial
officers listed in 3(a) above--------------------------10marks
(c) Differentiate between examination in chief and cross
examination—5marks
SUGGESTED ANSWER
3(a) Judicial officers in a legal system include;
(1)The chief judge
(2)Judge
(3)The chief registrar
(4)Magistrate
(5)Court bailiff
(6)Court registrar
(7)Court clerk
3(b) THE CHIEF JUDGE AND ITS FUNCTIONS;
 The honourable chief judge is the head of all the courts in a
state judiciary. He is therefore directly in control of all staff
including the chief registrar of the high court of justice of a
state.
 The chief judge performs both administrative and adjudicating
duties. He shall therefore continue to sit over both civil and
criminal matters apart from the other duties bestowed on him
by his office as a chief judge.

114
 As the head of a state judiciary, he shall assign both civil and
criminal cases to himself and to all other judges sitting at the
headquarters.
 The chief judge also see to the welfare of judges, magistrates
and all the staff collectively to encourage them to put in their
best and to ensure industrial harmony.

THE JUDGE AND ITS FUNCTIONS;

 A judge of the high court is a public official appointed to
decide all matters between persons, or between government or
authority in actions and proceedings relating the
determination of any question as to civil rights and
obligations.
 Every judge whether at the state or federal high court shall
therefore sit and adjudicate over both criminal and civil cases
brought before him in accordance with the rule of law,and
rules of the court and proper procedure.
 A judge of high court shall hear determine all appeals from the
decisions, rulings and judgements of magistrate courts in civil
and criminal causes and matters given in the exercise of the
original jurisdiction of the said courts as well as cases started
by magistrate.

THE CHIEF REGISTRAR AND ITS FUNCTION

 The chief registrar is the accounting officer of the judiciary

whether at the state high court, federal high court, National

115
 industria court of Nigeria, Court of appeal or supreme court.
The chief registraris the head of administration.
 He performs only administrative duties even though he might
have been a magistrate before his appointment as a chief
registrar.
 He is responsible for all policies formulation and its execution.
 He is responsible for discipline of all judiciary staff under him.
The chief registrar is under the control of the head of court
that is the chief judge of a state.

THE MAGISTRATE AND ITS FUNCTIONS;

 A magistrate is a public officer with specific delegated
executive or judicial powers. Usually, he is an officer who
conducts preliminary hearings or has limited power to try
minor criminal or civil cases.
 The magistrate also has power to issue summon and warrants
for the purpose of compelling the attendance of accused or
persons as witness before the court.
 Power to take oath of solemn affirmation and declarations

THE COURT BAILIFF AND ITS FUNCTIONS

 He is a court officer who maintains order during court

proceedings.
 He is also a sheriff’s officer who serves all court processes on
litigants from the write of summons to motion on notice,

116
 statement of claim and statement of defence and orders of
injunction (interim or interlocutory).
 He also performs execution of orders, rulings and judgements
arising from civil or criminal proceedings.
 In the case of order to force open the door of a room or
buiding, the bailiff must be present to take the inventory of all
the property found in the room or building in the presence of a
police officer

THE COURT REGISTRAR AND ITS FUNCTIONS;

 This is the officer directly in charge of all staff attached to each
of the courts like the court clerk, the bailiff, court orderly e.t.c.
 He oversees the day to day running of each court.
 He shall sit in court with the judge or magistrate and shall
attend to every need of the presiding officer and the lawyers.
 He shall ensure that all fines and fees paid are receipted for by
the cashier or himself.

COURT CLERK AND ITS FUNCTIONS

 The court clerk is directly under the court registrar. He shall

make all necessary arrangement for court sitting and sits in
court with the magistrate or judge.
 He shall at the directive or instruction of the court registrar
prepare court orders, rulings and record of proceedings.
 He shall also take custody of record books and exhibits.

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3(c) EXAMINATION-IN-CHIEF: This is the examination of a witness
by the party who calls him. The purpose of examination-in-chief is
to elicit information from a witness which is favourable to the party
who called him to give evidence. It takes the form of responses to a
series of successive questions leading to a complete story line in the
end to strengthened the case.

WHILE

CROSS EXAMINATION: This is the examination of a witness by a

party other than the party who calls him. The purpose of cross
examination is firstly to establish and advance your own case and
secondly to attack the other side’s case. The objective of cross
examination is to destroy or damage material parts of the
examination-in-chief so as to weaken it and thereby reduce its
weight. And also to descredit the witness by showing that his
evidence is unworthy of beleif by reason of bias, interest or his lack
of honesty or lack of knowledge of the evnts to which he testified

QUESTION 4

4. (a) The Ethical code of practice of Enviromnetal is meant to

play a major role in the promotion of public health in your
country.
Explain five (5) of this roles--------------------------10marks
(b) Explain five (5) importance of the health policy in your
country—10marks
SUGGESTED ANSWER

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 4(a) The major roles played by ethical code of practice of
Environmental health include;
 To provide an equitable and practicable platform for the
implementation of the provisions of the public health laws,
edicts and policies across Nigeria as a whole.
 It helps to engender the observance of the public health laws
and other related laws pertinent to environmentall health.
 It helps to have a uniform frame work and machinery for
administering the operation and resources of the profession.
 It helps to maintain uniformity of documentation at all levels
of operations be it federal, state or local government council
for posterity
 It helps to facilitate reproduce ability of excellent operations in
the profession and create plat form for improvement

4(b) The importance of health policy iclude;

 It serves as the guidelines for the implementation of
environmental health services in the country.
 Prevention of spread of communicable diseases through
execution of health policy.
 Improvement of the health of masses through execution of
health policy
 Empower the environmental health officers to carry out their
job without interruption.
 It helps in the prevention and precervation of the health of the
total population through the activities of house to house

119
 inspection, industrial inspection, abattoir inspection and
prosecution of sanitary offenders in the court of the law.
QUESTION 5
5. Write notes on the following trms
(a) Adoptive bye-law---------------------------5marks
(b)Penal code-----------------------------------5marks
(c) Solicitor general------------------------------5marks
(d)Presiding magistrate------------------------5marks
SUGGESTED ANSWER

5(a) ADOPTIVE BYE-LAW: Means any bye-law that is in force for

determination of any legal issue at that point in time in a particular
place and on same specific matters.

5(b) PENAL CODE: Penal code contains the bulk of applicable rules
applies to the Northern states of Nigeria. The penal code was an
offspring of the indian penal code with some reflections of islamic
culture. For instances section 387 of the penal code punishes
adultery while section 403 punishes a moslem for drinking alcohol.

5(c) SOLICITOR GENERAL: The solicitor general is also the

permanent secretary of the ministry of justice. He is the accounting
officer of the ministry of justice in a state and at the federal level.
He is a solicitor and barrister and a career officer. He is next to the
political appointee who is head of the ministry. The director of
public prosecutions and director of civil litigations are directly
under the control and supervision of the solicitor general. The
solicitor general subject to his convenience may still appear in court
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for the prosecution and defence of important cases involving the
state government.

5(d) PRESIDING MAGISTRATE: It is the magistrate the is currently

deciding a case whether criminal or civil cases in the court of law.
Presiding magistrate is the magistrate stationed to a particular
magistrate court in a district for the purpose of determining both
criminal and civil case under his jurisdiction at a particular time.

2018 PUBLIC HEALTH LAW EHT 210

QUESTION 1

1. (a) Explain the expression of sources of --5marks

(b) List five (5) principal sources of law-------5marks
(c) Explain the five (5) listed sources in (b) above---10marks
SUGGESTED ANSWER
1(a) SOURCES OF LAW: This mean the origin of a particular
laws used in the country. Sources of law serve as the
fundamental basis where a country derived it law applicable in
that country.
1(b) The sources of law include
 The constitution
 Legislation
 English law
 Customary law

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 Islamic law
 Judicial precedents )case law)
 International obligations and treaties
 Text books written by eminent jurists.
1(c) Explaination of the sources of law include;
a. THE CONSTITUTION: In Nigeria, the constitution refers to
the document containing the substance of the law of the
country. In its loose and abstract sense, it may mean the
system of laws, customs and conventions which defines the
composition and powers of organs of the state and regulates
the relations of various state organs to one another and to
the private citizen. The constitution of the federal republic
of Nigeria is superior to all other laws of the land and it
regulates the judicial, executive and legislative organs of
governance. The current constitution is the 1999
constitution and it came into operation on May 29, 1999.
b. LEGISLATION: The constitution of the federal republic of
Nigeria 1999 regulates the distribution of legislative
business between the national assembly (senate and the
house of representatives) which has power to make laws for
the federation and the house of Assembly of each state of
the federation. The current legislation in force at the federal
level is largely contained in the laws of the federation of
Nigeria 1990 (LFN). Laws made after the 1990 law revision
exercise of the federal laws of the federal republic of Nigeria.
Federal laws under the military known as Decree and the

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 state laws known as Edicts, form the bulk of the primary
legislation.
c. ENGLISH LAW: There are two sets of Englis law which apply
to Nigeria. They are;
 The received English law comprising the common law, the
doctrines of equity, statutes of general application in force in
England on January 1, 1900 and statutes and subdiary
legislation on specified matter
 English law (statutes) made Octomber 1, 1960 and extending
to Nigeria which are not yet repealed.
d. JUDICIAL PRECEDENTS (CASE LAW): Judicial precedents
or case law as a source of law is where judges are bound to
follow rules of law established in previous court decisions
on matter on all similar matter/cases. Judicial precedent is
created by the decision of the court on any issue in respect
of which there has been no precedent. The supreme court is
the highest court of the land and the final court of appeal.
The court of appeal (original known as the federal court of
appeal) was established in 1976 as a national penultimate
court to entertain appeals from the High courts, which are
the trial court of general jurisdiction.
e. INTERNATIONAL OBLIGATIONS AND TREATIES: Nigeria as
a member of United Nations, ECOWAS, African union (AU)
and other international bodies sometimes enters into
obligations and treaties which may be of interest and which
may promote unity and other benefits internally and

123
 domestically. Once these obligations and treaties are
entered and acceded to by the federal Government of
Nigeria, they become part of our sources of laws once such
treaties are ratified or passed into our municipal law.

QUESTION 2
2. State the jurisdiction of the following courts;
(a) Supreme---------------------------5marks
(b)Court of Appeal-----------------------5marks
(c) Federal High court--------------------5marks
(d)Industrial court-------------------------5marks
SUGGESTED ANSWER

2(a) SUPREME COURT: As the name implies, this is the apex

court in the hierarchy of courts in Nigeria and situated in the
federal Capital territory, Abuja. The chief justice of the federation
heads the judiciary of Nigeria and presides over the court. The
jurisdiction the court includes;

 The court has limited but exclusive original jurisdiction in any

dispute between the federation and a state if and in so far as
that dispute involves any question ( whether of law or fact) on
which the existence of a legal right depends.
 In respect of appeals, the supreme court is the final port of
call. It appeallate jurisdiction determines appeals from the
court of Appeal and this is also to the exclusion of any other
court.

124
 2(b) COURT OF APPEAL: This is next in the hierarchy of
courts in Nigeria and its decisions and binding on all other
lower courts. It is essentially a court of appeallate jurisdiction.
It is composed of the president of the court of Appeal and
other justices of the court of Appeal not being less than forty-
nine. The jurisdiction of the court include;
 The court has original and exclusive jurisdiction over
questions as to whether a person has been validly elected to
the office of president or vice president of the federation or
whether the term of office of such person has ceased or
whether the office has become vacant.
 It also has appeallate jurisdiction to hears appeal from
decisions of the High courts of the states and the federal
Capital Territory, Federal high court, the Sharia courts of
appeal of the states or of the federal capital territory,
customary court of appeal of the states or of the federal capital
territory as well as from decisions of a court martial or other
tribunals as specified by an Act of the National Assembly.
2(c) FEDERAL HIGH COURT: There is a federal court for the
country. This court was formally known as the Federal
Revenue Court. The 1979 constitution adopted it and changed
its name to Federal High court. It was further confirmed under
section 249 of the 1999 constitution. A federal high court
comprises of a chief judge and such number of judges as the
National Assembly may prescribe. The jurisdiction of the court
include;

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 The court has limited but exclusive jurisdiction in cilvil and
criminal causes or matters as set out in the constitution under
section 251
 The federal high court also exercises jurisdiction and powers
in respect of treason, treasonable felony and allied offences as
well as criminal causes and matters in respect of which
jurisdiction is conferred in section 251 (3).
2(d) INDUSTRIAL COURT: The main purpose of establishing
industrial court is to allow industrial harmony between
workers and the employers. The jurisdiction of indusrial court
include;
 Attend to cases relagting to employee and employer
 Cases relating to the deprivement of employee rights, benefits
and compensation

QUESTION 3
3. (a) Differentiate the functions of the solicitor General from that
of Attorney general------------------------------10marks
(b) Explain the role of the Environmental Health Officer and
the ministry of justice in the prosecution of an environmental
health offender-----10marks
SUGGESTED ANSWER
3(a) THE FUNCTIONS OF SOLICITOR GENERAL INCLUDE;
 Solicitor general whic is also known as the permanent
secretary in the ministry of justice at his own convenient still

126
 appear in court for the prosecution and defence of important
cases involving the state government.
 He supervises the activities of Director of public prosecution
and Director of civil ligation under him and the works of other
surbodinated under him.
 He also performs administrative duties.
WHILE

THE FUNCTIONS OF ATTORNEY GENERAL INCLUDE;

 The Attorney general which is also known as commissioner for

justice at the state level or minister of justice at the federal
level, He institute proceedings before any court
 To take over and continue the prosecution of any case
 And to discontinue at any stage before judgement is delivered
any criminal proceedings whether instituted by any other
authority or person.

3(b) THE ROLES OF EHO AND MINISTRY OF JUSTICE IN THE

PROSECUTION OF ENVIRONMENTAL HEALTH OFFENDER
INCLUDE
 Inspection of premises as saddled by the public health law.
 Detection of nuisances
 Issuance of abatement notice in case of structural nuisances
 Verification whether the notice has been complied with by the
author of the nuisance or not

127
 On non-compliance with the abatement notice, this leads to
formal trial in the court of law with competent jurisdiction
 Prosecution of the sanitary offenders in the court of law by
ministry of justice or the environmental health officers
 Environmental health officers also present themselves as
witness in the court of law during trial of sanitary offenders.
 Issuance of court orders to rectify the detected nuisance for
which abatement notice has been ealier served.

QUESTION 4
4. (a) Explain the term special courts-----------------5marks
(b) Describe five (5) special courts---------------15marks
SUGGESTED ANSWER
4(a) SPECIAL COURTS: These are courts other than the
regular courts like the customary court, magistrate court, high
court, sharia court, court of appeal e.t.c. These courts are
established to perform special judicial functions. In most
cases, they handle their assignments expeditiously which may
be too difficult to achieve in the regular courts which must
adhere strictly to the rules and procedures of court which may
be waived in the special court.
4(b) Special court include;
 JUVENILE COURT: Juvenile courts are special courts
established for the trial of young offenders and for the welfare
of the young. The courts are established by the Children and
young persons law. The enactment defines the term young

128
 person as a person who has attained the age of 14 years but
has not attained the age of 17 years. A child means a person
who is under 14 years. Juvenile court is constituted by a
magistrate sitting with other members appointed by an
appropriate authority. The court is not open to the public and
the identity of the offenders is not to be published without the
leave of court. A child shall not be ordered to be imprisoned
and a young person also shall not be ordered to be imprisoned
if he can be suitably dealt with in any other way whether by
probation, fine, corporal punishment, commital to an
approved institution.
 COURT OF MARTIAL?MILITARY COURTS: These are military
courts in the country. Normally, only members of the Armed
forces such as The Nigerian Army, the Nigerian Navy and the
Nigerian Air force are subjected to the jurisdiction of military
courts.
 TRIBUNALS: Many bodies not designated courts under the law
yet perform judicial or quasi-judicial functions. They are
usually designated tribunals by the law establishing them. A
tribunal performing judicial or quasi judicial functions may be
regarded as a court having special jurisdiction. A body
performing such functions may be called a tribunal rather
than a court by the legislature merely because the legislature
requires the body to consist of experts in a particular area of
the law or deal speedily with certain aspects of the law or
adopt a procedures different from the usual court procedures

129
 of for any two or more of those reasons. Tribunals include
Robbery and Firearms Tribunal for the trial of the armed
robbery suspects, Rent Tribunals for the trial of recovery of
premises and Election Tribunals which shall hear and
determine election petitions.
 ENVIRONMENTAL SANITATION MOBILE COURT: Mobile court
is established for the protection and enforcement of the
environmental laws and regulations. The court is usually
presided over by a legal practitioner who is a magistrate. It is a
court that carries out on the spot trial and sentence of persons
contravening any provision of the law in respect of which the
court is established. The only difference between this court
and any other court is that while the other courts have a
particular place of sitting, but environmental sanitation mobile
court moves from one place to the other to try cases pertaining
to sanitation offences at its chosen spot summarily. The
mobile court can immediately after trying cases in a particular
area move to another area and again try any environmental
sanitation cases available.
 REVENUE COURT: A revenue court is a court that has and
exercises jurisdiction in civil and criminal causes relating to
actions for recovery of any penalty, rates, taxes, contributions,
levies, obligation, claim, expenses or other like demands which
are recovery by virtue of any enactmen for the time being in
force. Trial of any of the aforementioned matters can be
conducted in a magistrate’s court or the High court.

130
 QUESTION 5
5. Write notes on the follwing;
(a) Milk Shop-------------------------------------5marks
(b)Applicable Bye-law--------------------------------5marks
(c) Competent council-------------------------------5marks
(d)Civil procedures---------------------------------5marks
SUGGESTED ANSWER

5(a) MILK SHOP: Is a place where milks other than imported

preserved milks is supplied or in which milks other than such
imported milks is kept for sale.

5(b) APPLICABLE BYE-LAW: It means any bye-law that is in

force for determination of any legal issue at that point in time in a
particular place and on same specific matters.

5(c) COMPETENT COUNCIL: Means a local government council

upon which the functions of a council under the health law are
conferred by instrument made under the local government law.

5(d) CIVIL PROCEDURE: It is a body of law or rules enacted by

the legislature or courts governing the methods and practices used
in civil litigation.

131
 2015 PRINCIPLES AND PRACTICE OF FIRST AID EHT207

QUESTION 1

1. (a) Define the term First Aid-----------------------------------------------------3marks

(b) Identify eight (8) qualities of a first aider-------------------------4marks
(c) Enumerate six (6) contents of a first Aid Box and suggest the most
appropriate location of the box in a factory--------------------------3marks
(d) Describe the handling and transportation of an unconscious person to
the hospital--------------------------------------------------------------10marks
SUGGESTED ANSWER
1(a) FIRST AID: It is the immediate assistance given to a victim of
emergency either minor or major prio to the arrival of a doctor or before
such person is being taking to the hospital for further treatment. First aid is
being administered by a trained person known as first aider to resuscitate,
revive and safe life, and also prevent injury from getting worst.
1(b) The qualities of a first aider include;
 Ability to act quickly, quietly and methodically
 First aider must be well trained and be regularly examined at least every
three years to ensure good professionalism thus he should possess
academic and professional qualification.
 The first aider must be knowledgeable in the field of human anatomy and
physiology
 First aider must maintain calmness while administering first aid service
 Ability to communicate in a simple english language
 Ability to give correct information to Doctor on arrival
 Ability to maintain confidentiality as regards every secret he knew about
the victim
 Constant word of assurance to the victim that he or she will make it no
matter the gravity of the emergency.

1(c) The contents of the first aid box include;

132
 Absorbent balls
 Antiseptic centrimide cream
 Bandage of various size and forms( conform bandage, compressed
bandage, Triangular bandage, elastic bandage, cloth bandage)
 Hydrogen peroxide
 Eyes washed solution
 Eyes shield
 Gauge pads
 Splinter forcept
 Splint padding
 First aid pocket guide
 Tongue depression
 Instant cold pack
 Biro and book
 Cotton wool
 Disposable gloove

1(d) The handling and transportation of unconscious person to the hospital

include

 Never move the person unless there is immediate danger to life or if skilled
help is not readily available
 Remove clothing from the casualty
 Control by standers for ventilation
 It is better to leave the casualty undisturbed, send for help and provide
first aid on the spot.
 If breathing stop appply artificial resuscitation mechanism
 The method of transport depends on
(1) The nature and the cause of the unconsciousness
(2) The number of helpers
(3) Facility’s build
(4) Distance to be covered.
(5) Route to be travelled

133
 Never attempt to give any thing to the casualty
 Arrange for ambulance to move the casualty to the hospital for better
treatment.

QUESTION 2
2. (ai) Define the term emergengy as it applies to first Aid 2marks
(aii) State the characteristics of emergencies--------------------------------3marks
(bi) Enumerate ten (10) emergencies--------------------------------5marks
(bii) Describe drowing as an emergency----------------------------5marks
(c.) Identify vital signs that determine an emergency---------------5marks

SUGGESTED ANSWER
(2ai) Emergency is an occurence that is detrimental to human health and
the environment which need urgent or immediate attention to preserve
life, properties and the environment. Examples Traffic road accident,
drowning, outbreak of disease, e.t.c
(2aii) The characteristic of emergency include
 Life threatening
 Sudden onset
 Loss of properties

(2bi) examples of emergency include

 Snake bite
 Shock
 Drowning
 Fainting
 Burns
 Insect sting
 Bleeding
 Fracture
 Outbreak of disease
 Landslide

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 Earth quake
 Bee sting

(2bii) Drowning is one of the medical emergency caused when a victim become
submerged in water as a result of inability of the victim to swim and this cause
water to enter into the lungs of the victim or causing the throat to go into
spasm so constricting the air passage Drowning is the major source of
accidental dealth and can be a result of cold, fatigue, injury, disorientation,
intoxication.

(2c) The vital signs that determine an emergency include

 Bleeding
 Fainting
 Shock
 Unconsciousness
 Hypotension

QUESTION 3

3. Differentiate between medical and environmental emergencies, under the

following
(a) Definition-------------------------------------------------------------5marks
(b) Types-------------------------------------------------------------------5marks
(c) Assessment------------------------------------------------------------5marks
(d) Management-------------------------------------------------------5marks

SUGGESTED ANSWER

(3a) MEDICAL EMERGENCY: It is a form emergency or occurence that is

detrimental to human health or form of emergency that leads to injury, or
disability, or disaese conditions or loss of life.

WHILE

135
 ENVIRONMENTAL EMERGENCY: Is a form of emergency that cause
destruction to the environmental media such as water, land and air e.g
Earth quake. Environmental emergency leads to destruction of properties
and alter the natural composition of the environment.

(3b) TYPES OF EMERGENCY INCLUDE

S/N MEDICAL EMERGENCY ENVIRONMENTAL EMERGENCY

1 SNAKE BITE LANSLIDE
2 DROWNING FOREST FIRE
3 OUTBREAK OF DISEASE EARTH QUAKE
4 BURNS PSUNAMI
5 SCALD VOLCANIC ERUPTION

(3b) ASSESSMENT OF MEDICAL EMERGENCY INCLUDE

 Protect the casualty from danger

 Beware of your limitation
 Access each casualty to determine treatment priorities and threat those
with life threatening conditions first.

ASSESSMENT OF ENVIRONMENTAL EMERGENCY INCLUDE

 Observe what has happened quickly and calmly
 Look for dangers to yourself
 Never put yourself at risk
(3d) MANAGEMENT OF BOTH MEDICAL AND ENVIRONMENTAL
EMERGENCY INCLUDE
 Remove the casualty from the source of the danger
 Control bystanders
 Allow for fresh air
 Treat for shock
 If breathing stop start artificial resuscitation as soon as possible
 Reassure the patients and his relative
 Transfer the victims to the hospital for further treatment

136
 Ensure that the environment is rehabilitated back to normal
 Evacuate damaged properties from the environment

QUESTION 4

4. Resulting from a fall from a 3-storey building, a person sustains fracture of

the spine. As a First Aider, explain the management of the injured person
until the arrival of an ambulance
SUGGESTED ANSWER
The management include
 Remove clothing from the casualty
 Control bystanders for ventilation
 Treat difficulty in breathing, bleeding and unconsciousness incase
 Treat all fractures in the position in which the casualty is found, unless
there is immediate danger to life.
 Immobilize and support the fractured part (spine) using bandages or
splints. This should be done on both sides of fracture.
 Raise the injured part after immobilising it to minimize discomfort and
swelling rolled up blankets can be used.
 Treat for shock immediately
 Carefully and gently apply traction to the end of the bone and straighten it
as far as the casualty will feel little pains
 Transport the victim in a car to the hospital for further treatment.

QUESTION 5

5. Write notes on the following;

(a) Wound------------------------------------------------------5marks
(b) Dressing------------------------------------------------5marks
(c) Syncope--------------------------------------------------5marks
(d) Poisoning--------------------------------------------------5marks

137
SUGGESTED ANSWER

(5a) WOUND: A wound is an abnormal break in the skin or other tissues which
allow blood to escape. External wounds are complicated by the fact that the
germs can enter the tissues and cause infection. Type of wound include incised
wound, lacerated wound, contused wound, puncture wound, abrasions e.t.c

(5b) DRESSING:Dressing is the process of applying protective covering to the

wound to prevent bleeding, prevent infection, absorb any discharge, avoid further
injury and assist in healing. Types of dressing are adhesive dressing, non-adhesive
dressing, Gauze dressing, improvised dressing e.t.c.

(5c) SYNCOPE: Syncope is also known as fainting and is defined as a brief loss of
unconsciousness that is caused by a temporary reduction of blood flow to the
brain. A Fainting may be cause by reaction to pain, or emotional upset or prolong
standing.

(5d) POISONING: Poisoning is the intake of poison ( that is harmful substances and
when sufficient doses are taken may kill a person). Poison may be consumed
accidentally or for suicidal purpose or intentionally for killing enemies.

2016 PRINCIPLE AND PRACTICE OF FIRST AID EHT207

QUESTION 1

1 (a) State five (5) golden rules of first aid---------------------------5marks

(b) List three goals of first aid-----------------------------------------3marks

(c) Outline four (4) principles of first aid-----------------------------8marks

(d) List four (4) emergency situation requiring first Aid----------4marks

SUGGESTED ANSWER

(1a) The golden rule of first Aid include

138
 Do first thing first, quickly, quietly and without panic.
 Reassure the casualty and his relatives sympathetically.
 Look for the following; (a) Is there any failure of or hospital as breathing if
yes start artificial respiration (b) Is there any failure of circulation? If yes
start external cardiac massage, (c) Is there severe bleeding? If yes stop
bleeding by pressing on the pressure points.
 Avoid handling the casualty unnecessarily
 Arrange for the safe removal of the casualty to the care of a doctor as soon
as possible

(1b) The goals of first Aid include;

 To preserve life
 To prevent further injury and deterioration of the condition
 To make the victim as comfortable as possible to conserve strenght.

(1c) The principle of First Aid include

 Assess the situation

(a) Observe what has happened quickly and calmly
(b) Look for dangers to yourself and to the casualty
(c) Never put yourelf at risk
 Make the area safe by ;
(a) Protect the casualty from danger
(b) Be awareto determine treatment of your limitation
 Assess all casualties and give emergency first aid by;
(a) Assess each casualty to determine treatment priorities and treat those
with life threatening conditions first
 Get help as prompt as possible by
(a) Quickly ensure that any necessary specialist help has been summoned
and is on it’s way.

(1d) Emergency situation requiring first aid include

 Snake bite

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  Poisoning
 Insect sting
 Outbreak of disease
 Drowninig

QUESTION 2

2. (a) Explain the term indirect pressure----------------------------------4marks

(b) List eight (8) pressure points in the human body-------------------8marks

(c) Highly steps you would take to arrest bleeding in the lower li------8marks

SUGGESTED

(2a) INDIRECT PRESSURE: It is a process or method being applied by the first aider
to control haemorrhage or excessive bleeding at various pressure points, in
between the heart and the wound. At a pressure point, an important artery is
compressed against an underlying bone as to cut blood supply there in. Indirect
pressure is applied during dressing and should not exceed 15minutes.

(2b) PRESSURE POINTS IN HUMAN BODY INCLUDE

 Facial pressure point

 Temporal pressure point
 Crotic pressure point
 Brachial pressure point
 Radial pressure point
 Auxillary pressure point
 Dorsalic pressure point
 Subclavia pressure point
 Femoral pressure
 Occipital pressure point

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(2c) STEPS TO TAKE TO ARREST BLEEDING OF THE LOWER LIMB INCLUDE

 Place the victim in such a position that he or she will be least affected by
the loss of blood
 Lie the victim down and elevate the legs in a semi-flexed position. This will
prevent aggravation of spinal injury or breathing impairment
 Control the bleeding
 Maintain the air way
 Prevent the loss of body heat putting blankets under and over the victim
 Victim should be kept at rest, as movement will increase heart action which
causes the blood to flow faster and perhaps interfere with clot formation or
dislodge a clot already formed.

QUESTION 3

3.. Explain the first aid management of the following conditions

(a) Convulsion-----------------------------------------------------------5marks

(b) Scald-----------------------------------------------------------------------5marks

(c) Bee sting------------------------------------------------------------------5marks

(d) Sprain------------------------------------------------------------------------5marks

SUGGESTED ANSWER

(3a) CONVULSION: The management include

 Place the victim in a comfortable position and allow fresh air

 Then a spoon filled witha salt may be inserted into the patient mouth to
separate the upper from lower teeth
 Treat for shock immediately
 Commence artificial respiration until the patient is restored
 Then send to hospital for treatment.

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 QUESTION 4

4 (a) Explain Artificial resuscitation--------------------------------------------5marks

(b.) Describe the proceedure involved in the following methods of artificial

resuscitation-5marks

(i) Mouth to mouth resuscitation-------------------------------------5marks

(ii) Holger Nelson’s resuscitation----------------------------------------5marks

(c.) List five (5) conditions that may lead to the application of measures in (b) (i
and ii) above ---5marks

SUGGESTED ANSWER

(4a) ARTIFICIAL RESUSCITATION: It is the method used to make a casaulty whose

natural breathing has stopped or seized to make it start breathing again. Or it can
also mean a temporary taking over of respiration from an unconscious casualty
until normal breathing is restored independently.

(4bi) THE PROCEDURE FOR MOUTH TO MOUTH RESUSCITATION INCLUDE

 Open mouth wide and take a deep breath

 Pinch the casualty nostril together with your fingers
 Seal your lips round his mouth
 Blow air into his lungs until they are filled
 Remove your mouth
 Watch the chest movement
 The repeat the whole process until the casualty can breath again.

(4bii) THE PROCEDURE FOR HOLGER NELSON’ RESUSCITATION INCLUDE

 In this method casualty’s face is down, forehead resting on the back of

overlapped hands.
 The first aider kneels on both knees at the casualty’s side in a position just
below his hip joint. Then he places his hands on the loins of the casualty,

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 one on each side of the backbone with wrist almost touching and thumbs
apart.
 Now first aider has to lean slowly forward without bending the elbow and
knee. First aider’s shoulder will come vertically above the hands
 Allow the weight to be communicated to the loin of the patient
 Now first aider will release the pressure and by doing so abdominal organs
will fall back, diaphragm will drop and will induce inspiration
 Then two phases of movements will take five seconds i.e twelve times a
minute
 Artificial respiration is to be continued until natural breathing is restored
unless a doctor decides that further efforts are of no use.

(4c) The condition that could lead to application of both mouth to mouth and
Holger Nelson’ resuscitation include

 Unconsciousness
 Drowning
 Convulsion
 Gasping
 Asphyxia

QUESTION 5

5.. Write notes on the following

(a) Stomach poison----------------------------------------------------5marks

(b) Haemoptysis---------------------------------------------------------5marks

(c) Arterial bleeding----------------------------------------------------5marks

(d) Pressure point------------------------------------------------------5marks

SUGGESTED ANSWER

(5a) STOMACH POISON:

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(5b) HAEMOPTYSIS: This is the condition in which a person coughs up of blood.
This may be caused by infections e.g Tuberculosis, it may also be caused by
accidents which may make the blood to come out from the respiratory tract but
usually the lung.

(5c) ARTERIAL BLEEDING: This is the bleeding from the artery, which is richly
oxygenated blood, bright and red, under pressure from the heart. A severed main
artery may jet blood several feet high and rapidly reduce the volume of circulating
blood.

(5c) PRESSURE POINT: It is a point on the skin that is extremely sensitive to

pressure because of the presence of pressure sensing organs. It could also be
defined as any of several points on the body above an artery that when firmly
pressed will control bleeding from the artery at a point farther away from the
heart.

2017-PRINCIPLE AND PRACTICE OF FIRST AID EHT207

QUESTION 1

1. (a) Define the word fainting---------------------------------------2marks

(b) List six causes of fainting-------------------------------------6marks
(c) Describe the first Aid management of fainting------------12marks

SUGGESTED ANSWER

(1a) FAINTING: It is a brief loss of consciousness that is caused by a temporary

reduction of blood flow to the brain. Fainting may be a reaction to a pain or fright
or emotional upset exhaustion or lack of food, or prolong standing.

(1b) Causes of fainting include

 Prolong standing

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  Stress
 Obstruction of food
 Accident
 Ingestion of foreign material e.g carbon monoxide
 Falling object on the head

(1c) FIRST AID MANAGEMENT INCLUDE

 Lay the casualty down, raise and support her legs

 Remove tight clothing from the casualty
 Control bystanders
 Ensure plenty of fresh air
 Remove any obstruction to breathing that could restrict chest movement
 Incase of unconsciousness open the air way, check breathing and pulse and
be ready to resuscitate
 Reassure as the casualty recovers
 Treat for shock
 Transport the casualty to hospital for better care

QUESTION 2

2. (a) Define the term emergency-------------------------------------2marks

(b) List six (6) emergencies that can require the attention of a First Aider-----
6marks
(c) State two factor a first Aider must consider during environmental
emergencies---2marks
(d) State five (5) urgent steps that must be taken in an emergency

SUGGESTED ANSWER

(2a) EMMERGENCY: Emergency is an occurence that is detrimental to human

health and the environment which need urgent or immediate attention to
preserve life, properties and the environment. Examples Traffic road accident,
drowning, outbreak of disease, e.t.c

(2b) Six (6) emergencies that can require the attention of a first aider include
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  Accident
 Snake bite
 Drowing
 Fainting
 Fracture
 Haemoptysis

(2c) Factors to be considered by the first aider during environmental emergencies

include

 Safety of the people involved

 Safety of properties
 Safety of the environment

(2d) Five urgent steps that must be taken in an emergency include

 Remove the casualty from the source of the emergency so as to reduce the
number of mortality and morbidity rate
 Imidiate treatment of the casualties from emergency should also be
paramount.
 Another urgent step is the safety of the properties of the victims involved in
the and people around where such occurence happened
 Another urgent step is that the first aider must also consider his own safety
during emergency so to avoid multiple casualties on the ground
 The safety of the environment is another step the first aider should be
taken
 To find out the cause of the emergency is another step that must be taken
by the first aider

QUESTION 3
3. (a) Define the term Stroke------------------------------------------2marks

(b)State the signs and symptoms of stroke-----------------------6marks

(c) Describe the First Aid management of Stroke-----------------12marks

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SUGGESTED ANSWER

(3a) STROKE: Stroke is a condition in which the blood supply to the part of brain is
suddenly and seriously impaired by the blood clot. It may be caused by high blood
pressure and other circulation disorder.

(3b) The signs and symptoms of stroke include

 A sudden or severe headache

 A confused emotional and mental state
 Unconsciousness
 Weakness of limb
 Paralysis
 High blood pressure

(3c) The first Aid management of Stroke include;

 Open the air ways, check breathing and pulse

 Monitor the record breathing, pulse level every 10mins
 Loose any clothing that might impede or obstruct breath
 Lay casualty down with head and shoulders slightly raised and supported
 Make provision for adequate ventilation
 Do not give any stimulant to the casualty
 Depending on the condition, transfer to the hospital for better care.

QUESTION 4
4. (a) Define the term wound-------------------------------------------2marks
(b) state three types of wound------------------------------------3marks
(c) Explain six (6) steps of wound management--------------15marks
SUGGESTED ANSWER
(4a) WOUND: A wound is an abnormal break in the skin or other tissue
which allows blood to escape. External wounds are complicated by the fact
that the germs can enter the tissue and cuase infection.
(4b) Types of wound include;
 Incised wound
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 Contused wound puncture wound
 Penetratiing wound
 Lacerated wound abrasions
 Perforating wound
(4c) Steps of wound management include
 Control ant bleeding by carefully squeezing the edge of the wound together
 Place the casualty in half sitting position with the knees bent up to prevent
the wound gaping and reduce strain on the injured area. Support shoulder
and knees
 Apply a dressing to the wound and secure with a bandage or adehesive
strapping.
 If the casualty becomes unconscious but is breathing normally support the
abdomen and place the casualty in recovery position
 If breathing and heart stop, begin resuscitation immediately
 Treat shock
 Look for evidence of internal bleeding
 If vomiting occurs support the abdomen by pressing gently on the cloth of
dressing to prevent protrusion of the intestine.
 Shift the casualty to hospital immediately.

QUESTION 5

5. (a) Explain the term Asphyxia----------------------------------------3marks

(b) Enumerate five conditions that may lead to Asphyxia--------5marks
(c) List five (5) signs of an Asphyxiated person--------------------2marks
(d) Outline the first Aid management of Asphyxiated casualty---10marks
SUGGESTED ANSWER
(5a) ASPHYXIA: Is a condition in which the lungs do not get sufficient supply
of air for breathing. If this continues for some minutes breathing and heart
action stop and dealth occurs.
(5c) Conditions that may lead to Asphyxia includes
 Food going down wrong way that is into the air passage
 Water getting into air passage that is drowning

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 Irritant gases like coal gas, motor exhaust fumes, smoke, sewer gas in deep
unused wells getting into air passage
 Vomit or foreign body like artificial teeth in air passage
 Tongue falling back in unconscious patient
(5d) Signs and symptoms of an Asphyxiated person include
 Difficulty in breathing
 Noisy breathing
 Veins of the neck becomes swollen
 Face, lips, fingers, nails and toes turn blue
 Pulse rate get faster and feeble
 Confusion
 Unconsciousness
 Froth may appear at mouth and nostrils.

(5d) the first aid management of asphyxiated casualty include

(1) Remove the cause of asphyxia and open the air way
(2) Remove tight clothing from the casualty
(3) Control bystanders
(4) Allow fresh air
(5) If the casualty is not breathing begin artificial ventilation or mouth-to-
mouth respiration immediately
(6) When breathing and pulse return, place the casualty in recovery position
(7) Check breathing rate, pulse and levels of consciousness at ten minutes
interval
(8) Send casualty to hospital.

2018 PRINCIPLE OF FIRST AID AND PRACTICE EHT207

QUESTION 1

149
1. (a) Define the term first aid-------------------------------------------5marks
(b) State five (5) purposes of first aid-----------------------------5marks
(c) Itemize ten (10) qualities if First Aider----------------------10marks
SUGGESTED ANSWER
(1a) FIRST AID: It is the immediate assistance given to a victim of
emergency either minor or major prio to the arrival of a doctor or before
such person is being taking to the hospital for further treatment. First aid is
being administered by a trained person known as first aider to resuscitate,
revive and safe life, and also prevent injury from getting worst.

(1b) The purposes of first aid include;

 To preserve life
 To prevent further injury and deterioration of the condition
 To make the victim as comfortable as possible to conserve strenght.
 To make information available for doctors
 To promote quick recovery.

(1c) Qualities of a First Aid include;

 Ability to act quickly, quietly and methodically

 First aider must be well trained and be regularly examined at least every
three years to ensure good professionalism thus he should possess
academic and professional qualification.
 The first aider must be knowledgeable in the field of human anatomy and
physiology
 First aider must maintain calmness while administering first aid service
 Ability to communicate in a simple english language
 Ability to give correct information to Doctor on arrival
 Ability to maintain confidentiality as regards every secret he knew about
the victim
 Constant word of assurance to the victim that he or she will make it no
matter the gravity of the emergency.
 Ability to protect himself or herself from harm or infection

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 Arrange the casualty’s removal to hospital, into the care of a doctor.

QUESTION 2
2. Distinguishe between the following;
(a) i. Strains and Sprains------------------------------------------------------5marks
ii. Burns and Scalds---------------------------------------------------------5marks
(b) Explain the principles of paying the PRICE and avoiding the HARM for
the first seventy-two (72) hours after injury-------------------10marks
SUGGESTED ANSWER
(2ai) STRAINS: Means stretching of muscles in the body beyond the
normal expansion. It affects the tendons
WHILE
SPRAINS: This occurs when there is an injury to the ligament of the
joints in the body. It brings about tearing of the ligament.

(2aii) BURNS: These are caused by dry sources of heat or contact with
strong alkali and acid. It is also the destruction of the body tissues by dry
heat and it may be caused by fire, hot or molten metal, elctricity and
lightening, corrosive chemicals e.g strong acid like Nitric acid, sulphuric
acid and strong alkali like sodium hydroxide
WHILE
SCALDS: These are injury caused by moist heat such like boiling
water, stream, hot oil, hot tar, and hot liquid.

QUESTION 3
3. (a) Explain the term unconsciousness----------------------------5marks

(b)List five (5) causes of unconsciousness----------------------5marks

(c) Describe the first aid management of an unconscious victim------10marks

SUGGESTED ANSWER

151
 (3a) UNCONSCIOUSNESS: It is the state when a victim become unaware of
his or her environment caused as result of temporary loss of blood to the
brain.

(3b) The causes of unconsciousness include

 Bad news
 Gun shot
 Chronic disease
 Accident
 Drowning
(3c) First Aid management of unconsciousness include
 Remove tight clothing around the neck, chest, and waist from the victim
 Control bystanders
 Maintain the airway open
 Remove any denature or detached teeth and clear the casualty’s mouth of
any vomit or blood
 If breathing stop, start artificial ventilation immediately.
 Examine the patient for head injury or other causes of unconsciousness
 Put the patient in a lateral position
 Manage serious wound and fracture
 If there is spinal injury do not move the patient
 Check pulse, breathing and level of responsiveness
 If he recovers consciousness, reassure him and do not give anything by
mouth
 And do not leave him unattended to.

QUESTION 4
4. (a) State eight (8) signs and symptoms of snake bite-------------8marks

(b)List two (2) examples each of poisonous and non-poisonous sanke---

4marks

(c) Describe the First Aid management of snake bite------12marks

152
SUGGESTED ANSWER

(4a) The signs and symptoms of snake bite include

 Pain and numbness at the site of bite

 Drowsiness
 Burning pain at the site
 Swelling
 Dimness of vision
 Difficulty in breathing and speech
 Area become bluish purple after bite in 12 hours
 Dribbling of saliva
 Paralysis
 Convulsion
 Coma.

(4b) Examples of poisonous sanke inclued

 Tiger snake
 Horned viper
 Black mamba
 Green mamba
 Death adder
 King cobra
Examples of non-poisonous snake include
 Rat snake
 Boas
 Garter snake
 bullsnakes

(4c) The first aid management of snake bite include

(1) Lay the victim down, give him complete rest

(2) Calm and reassure
(3) Do not make him to walk

153
 (4) Apply a tourniquet immediately around a single boned portion of the limb
between the bite and the heart and it should be loosened for a few seconds
at a regular interval of about ten minutes
(5) Immobilize the affected limband gently wash the wound with normal saline

(6) Ice park can be applied on the wound

(7) Excision of the bitten area

(8) Sucking the poison from the site is controversial practice

(9) Treat shock

(10) Resuscitation if there is difficulty in breathing

(11) Shift the patient to the hospital immediately

(12) Take the killed snake, if available for identification. This will help the
doctor for proper management

QUESTION 5

5. Write notes on the following;

(a) Syncope-----------------------------------------------------------5marks
(b) Poisoning--------------------------------------------------------5marks
(c) Drowning------------------------------------------------------5marks
(d) Haemorrhage-------------------------------------------------5marks

SUGGESTED ANSWER

154
(5a) SYNCOPE: Syncope is also known as fainting and is defined as a brief loss of
unconsciousness that is caused by a temporary reduction of blood flow to the
brain. A Fainting may be cause by reaction to pain, or emotional upset or prolong
standing.

(5b) POISONING: Poisoning is the intake of poison ( that is harmful substances and
when sufficient doses are taken may kill a person). Poison may be consumed
accidentally or for suicidal purpose or intentionally for killing enemies.

(5c) DROWNING: Drowning is one of the medical emergency caused when a

victim become submerged in water as a result of inability of the victim to swim
and this cause water to enter into the lungs of the victim or causing the throat to
go into spasm so constricting the air passage Drowning is the major source of
accidental dealth and can be a result of cold, fatigue, injury, disorientation,
intoxication.

(5d) HAEMORRHAGE: This is also known as bleeding and is the process of loosing
blood from the body, it could be internal or external. Haemorrhage could be
caused by accident, chronic disease condition, falling of object on a person. Type
of bleeding include arterial bleeding, venous bleeding, capillary bleeding e.t.

2015 PRIMARY HEALTH CARE DELIVERY SYSTEM EHT 211

155
 QUESTION 1

1. (a) Describe the levels of health services available in your country----6marks

(b) Enumerate the seven (7) features of the primary health care as
enshrined in the Alma-Ata declaration-----------------------------14marks
SUGGESTED ANSWER
(1a) Levels of health services in Nigeria include
 THE PRIMARY HEALTH CARE LEVEL OR TIER: This is the first point of entry
for individuals and communities and the health care system is the
responsibility of the local government. It takes care of common health
problems and involves health centres and clinics and appropriate
personnel. It refers cass to sescondary or tertiary.
 SECONDARY HEALTH CARE: This level accepts referral from the primary
health care and is managed by the state government. It uses appropriate
personnel and involves general hospitals and specialist hospital. It refers
cases to tertiary.
 THE TERTIARY HEALTH CARE: This provides highly specialized medical care
by advanced diagnostic service . it refers cases to secondary and primaryn
levels. It uses appropriate personnel and includes teaching hospital,
orthopedic hospital, psychiatric hospital. It is the responsiblity of the
federal government.
(1b) Features of the primary health care as enshrined in the Alma-Ata
declaration, this includes
 Essential service
 Base on practical
 Social acceptable method
 Universally acessible
 Affordable
 First point of contact
 Self reliance
 Self determination

156
 QUESTION 2

2. To ensure proper implementation of primary health care activities there is

need for period evaluation
(a) Define evaluation as applied in primary health care ----------------5marks
(b) Explain the levels of evaluation in primary health care and the
importance of each

SUGGESTED ANSWER

(2a) EVALUATION: This is assessment of a health services or project to

know whether the stated objectives and goals of such project or service
has been achived or not. Evaluation can be done the a project is being
executed, or even during the process of executing the project or after a
project has been completed. Evaluation is a process which attempts to
determineas systematically as possible the relevance, effectiveness and
impact of activities in the light of their objectives.
(2b) Levels of Evaluation include;
 PLANNING EVALUATION: This is performed prior to development of a given
exhibit of program of project. The focus is on concepts and how the
average visitor will interprete them. Exhibit or project designers must
determine what concepts are above the level of comprehension for their
audience, how best to present the information and what subjects are of
actual interest to the intended audience. The importance of planning
evaluation is that, it has ability to eliminate working on a project that has
little demand or will be too difficult for the target audience to comprehend.
It is also useful for future exhibit development projects and should be
considered part of the exhibit design research process.
 FORMATIVE EVALUATION: This take place during the actual development of
an exhibit. Exhibit developers can take a prototype of the exhibit and test it
with target audiences to see if they are going in the correct direction.
Formative evaluations are usually not formal, but are indispensable to the

157
 exhibit creation process as they act as essential checks to the intended
success of the exhibit.
 SUMMATIVE EVALUATION: This is the most common and formal of the
evaluation types, particular because it is often required from those funding
the exhibit. A summative evaluation is performed after an exhibit has been
installed for the general public and is often done by outside evaluators to
assure a high level of objectivity. Visitors are timed during their various
activities with the exhibit, usability tests are performed as well as affective
tests to see how the visitor enjoyed the exhibit and possibly what they
learned.

QUESTION 3
3. (a) Explain the term service integration in primary health care--------5marks
(b) Describe the services that need to be integrated for effective primary
health care delivery

SUGGESTED ANSWER

(3a) SERVICE INTEGRATION: This refers to interprofessional health care

services, it is an approach characterized by a high degree of
collaboration and communication among health professionals to
implement health services for the benefit of the masses. Integrated
service gives room for sharing of information among health team
members related to patient care and the establishment of a
comprehensive treatment plan to address the biological, psychological
and social needs of the patient. Services integration is the combination
of different health services by different health providers for better
health care delivery.
(3b) The services that need to be integrated includes
 Family planning can be integrated with HIV care at the same facility
 Maternal, newborn can be integrated with child health care at the same
facility

158
  Child immunization can be integrated with postabortion care services at the
same facility or through a community based program so as to benefit
clients, providers and programs.
(c) Discuss the following principles of primary health care
i. Equity-------------------------------------------------------------------5marks
ii. Appropriate technology---------------------------------------------5marks
iii. Affordability----------------------------------------------------------5marks
iv. Intersectoral collaboration-------------------------------------------5marks

SUGGESTED ANSWER

(4i) EQUITY: This is to ensure that health resources and services are evenly
distributed among the people of a country. Therefore, in the spirit of social justice
and equity, federal government is determined to set in motion, the process that
will ensure that every nigerian obtain the health services she or he needs, when
and where it is needed, at a cost the country can afford.

(4ii) APPRROPRIATE TECHNOLOGY: This involves the use of simple equipment,

methods, techniques to execute or implement primary health care services.
Therefore, primary health care require the development, adaptation and
application of simple equipment, technique and methods that people can afford
and use to solve health problem. Appropriate technology is a fashionable way of
doing things in low cost, effective way that local people can manage and control
which leads to self-reliance.

(4iii) AFFORDABILITY: Primary health should be delivered at the lowest possible

cost, that is the service should be cheap and affordable to all the people in the
community whether rural or urban.

(4iv) INTERSECTORAL COLLABORATION: The implementation of primary health

care should be supported by other sectors. These sectors can also serve as entry
points for the development and implementation of primary health care. PHC
require the collaboration of health and other related sectors for its success. PHC
involves in addition to the health sector, all related sectors and aspect of national

159
and community development in particular agriculture, education, housing, public
works, and other sectors and demands the coordinated efforts off all the sectors.

(d) Write notes on the following

(a) Team work approach---------------------------------------------------5marks
(b) Advocacy---------------------------------------------------------------5marks
(c) Comprehensive services----------------------------------------------------5marks
(d) Community based approach-------------------------------------------------5marks
SUGGESTED ANSWER

(5a) TEAM WORK APPROACH:This can be defined as an approach by the number

of people of an activity or set of interrelated activities undertaken in order to
achieve common objectives. This is the strategy adopted when a group of people
work together to give health care to individual and familiy in the community.
Team work approach is the method adopted by different health personnel to find
a solution to a health problem of an individual, group of people or the community
at large.

(5b) ADVOCACY: It is an activity by an individual or group that aims to influence

decisions within political, economic and social systems and institution. The
essence of advocacy is to influence the decision makers to provide health facility
for the use of people. To advocate means to champion a cause for the purpose
positive decision making, it can come inform of lobbying the authority to provide
a basic health facility of service that will better the life of the masses.

(5c) COMPREHENSIVE SERVICES: This is the provision of integrated

preventive,curative, rebilitative and promotive service to people in the
community. Comprehensive service is a service that is robust which entails both
preventive, curative, rehabilitative and promotive at the same time so as to
improve, promote and prolong the life the community.

(5d) COMMUNITY BASED APPROACH: This involves the use of community based
health workers to mobilize the community and provide preventive and curative
health services. The community based health workers carry out community
mobilization, community diagnosis, situational analysis and advocacy to find

160
solution to problems in the community. Community based approach involves the
provision of basic health service at the village level including promotive,
preventive, curative and rehabilitive services to meet with the basic health need
of the people in the community.

2016 PRIMARY HEALTH CARE DELIVERY SYSTEM EHT 211

QUESTION 1

1. (a) Define Primary Health Care according to Alma-Ata declaration----5marks

(b) State ten components of primary health care--------------------10marks
(c) List five factors that may influence health--------------------5marks
SUGGESTED ANSWER
(1a) Primary Health Care is defined according to Alma-Ata declaration as an
essential health care based on practical, scientifically sound and socially
acceptable methods and technology made universally accessible to
individual and families in the community, through their full participation
and at a cost that the community and country can afford to maintain at
every stage of their developement in the spirit of sel-reliance and self
determination.
(1b) The components of primary health care include
 Education concerning prevailing health problems and the methods of
preventing and controlling
 Promotion of adequate food supply and proper nutrition
 Provision of adequate supply of water and basic sanitation
 Maternal and child health including family planning
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 Immunization against major infectious diseases
 Prevention and control of locally endemic diseases e.g malaria
 Appropriate treatment of common illness and injuries
 Provision of essential drugs
 Mental health
 Cared of the aged
 Prevention of road traffic and occupational accident
 Dental health.
(1c) Factors that influence health
 Cultural factors such as female genital mutilation, use of cow dung for the
drssing of the unbilical cord, making people to drink cow urine during
convulsion.
 Socio-economic factor such as life style, poverty level, unemployment, low
income e.t.c.
 Environmental factor such as air pollution, poor waste management, poor
housing e.t.c.
 Personal factor such as smoking, alcohol, health awareness
 Mechanical factor such as pointed machine, sharp edge machine .

QUESTION 2
2. (a) Enumerate the five primary health care development committee-5marks
(b) Explain any three of them listed above-----------------------15marks
SUGGESTED ANSWER
(2a) Five primary health care development committee include
 Ward Health Development committee (WHDC)
 Village health development committee (VHDC)
 Primary health care development committee (PHCDC)
 Health facility development committee (HFDC)
 National health development committee (NHDC)

(2b)* WARD HEALTH DEVELOPMENT COMMITTEE: It is an initiative of

National primary health care development agency which is designed to

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 strengthen local communities to advocate for them in terms of knowledge
dissemination of health information with cognizance of socio-cultural
context in which health actions are being taken.
** VILLAGE HEALTH DEVELOPMENT COMMITTEE: Village health
development committee will facilitate in addressing the health needs of the
entire village with the help of health providers and health institutions.
Village health committee will play an important role in planning and
monitoring of the health care services through community monitoring
mechanism.
** HEALTH FACILITY COMMITTEE:Health facility governing committee
were first introduced in 1999 within health facilities of all levels of the
health system alongside the introduction of the community health fund.
Community health fund is a voluntary scheme for rural populations,
providing primary and in some cases , secondary care in public facilities.
The main role of the facility include; develop the plans and budget of the
facility, mobilize the community to contribute to the community health
facility and ensuring the availability of drugs and equipment.

QUESTION 3
3. (a) Explain five challenging facing primary health care implementation-------
10marks
(b) Explain five remedies to the challenge-------------------------10marks
SUGGESTED ANSWER
(3a) Challenges facing primary health care implementation include
 SHORTAGE OF FUND: Since fund plays a major role in the implementation
of primary health care, therefore, shortage of fund will be an hindering
factor towards a successful implementation.
 INADEQUATE MATERIAL AND EQUIPMENT: The material and equipment are
what we used to execute the service of primary health care, where these
are material and equipment are not sufficient or not available, this will
definitely affect the implementation of primary health.
 INADEQUATE COMMUNITY PARTICIPATION: Community participation is a
major determinant of successful implementation of primary health care
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 service, where there is no adequate community participation especially
during immunization programme, it will be very difficult to achieve success.
 LACK OF INFORMATION: Lack or inadequate information is another factor
that hinders the successful implementation of primary health care in the
country. Information on who to do it, where to do it, and when to do it.
 LACK OF TOTAL COMMITTMENT OR LACK OF POLITICAL: Change in
governement with different personality with different ideas may also affect
the successful implementation of primary health care in the country. Lack
of governement support may hinder the implementation of primary health
care.

(3b) The remedies to te stated problems include

 PROVISION OF ADEQUATE FUND OR ADEQUATE BUDGET : Provision of

adequate fund will facilitate successful implementation of primary health
care
 AVAILABILITY OF ADEQUATE TRAINED PERSONNEL: Availanility of trained
personnel that will do the job will also facilitate prompt implementation of
primary health care
 GOVERNMENT SUPPORT OR POLITICAL WILL: Government support for
primary health care service will facilitate quick implementation of the
service
 PROVISION OF ADEQUATE MATERIAL AND EQUIPMENT:Availability of
adequate equipment and material will also help in the prompt
implementation of primary health care service
 COMMUNITY MOBILIZATION AND PARTICIPATION: The people of the
community where the primary health service is to be implemented should
be mobilized to partake in the execution of the service.

QUESTION 4
4. Polio eradication faces a lot of challenges. Discuss five ways on how to use
primary health care strategies to eradicate it in your country--------20marks

SUGGESTED ANSWER

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 THROUGH COMMUNITY PARTICIPATION: ALL the community members
should be involved in the fight against polio in the country and the
responsibility of community member should be told on how to prevent
polio through community hygiene and individual hygiene. Community
members must also be involved during immunization of polio, because
community member serve as the mouth piece to their people towards
immunization compliance. Opinion leaders, chiefs, Obas, religion leaders
and traditional leaders in the community should also be informed during
immunization against polio eradication.
 INTERSECTORAL COLLABORATION: This is the involvement of other
agencies whose functions are health related in the community. For
instance, the ministry of health has an important role in stimulating and
coordinating action for health with other socio economic sectors concerned
with state and community development. Therefore, involving other sectors
in conjunction to ministry of health will help to facilitate measures that lead
to eradicate polio in the country
 HEALTH EDUCATION AND SENSITIZATION OF THE MASSES: Constant
sensitization program on polio eradication should be a priority through
radio, television news paper and other socio media should be enhanced.
People should be informed on the preventive measures and control
measures to be taking to eradicate polio. People must be adequately
sensitized on the precautions against polio.
 PROMPT NOTIFICATION OF THE DISEASE: Any occurence of polio must be
reported immediately to the appropriate health authhority so that quick
intervention measures will be instituted against the disease and this will
ensure prompt eradication of such disease in the country. The appropriate
health authority could be local governemnt health department or state
ministry of health or federal ministry of health.
 AFFORDABILTY: Both the curative and preventive drugs against polio must
be affordable to the common man to buy. This will make the poor people to
buy the drugs and use, thereby assisting in eradication of the disease.

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 5. Write notes on the following
(a) Common sources of health care delivery----------------------5marks
(b) Referral services----------------------------------------------------5marks
(c) Health planning-------------------------------------------------------------5marks
(d) Outreach health services----------------------------------------------------5marks

SUGGESTED ANSWER

(5a) COMMON SOURCES OF HEALTH CARE DELIVERY: This means the origin of
health care delivery and the source include the specialized health personnel,
health facilities e.t.c

(5b) REFERRAL SERVICES: Referral is a process by which a health care provider

transfer the responsibility of the patient’s management temporarily or
permanently to another health care provider or professional. In primary health
care referral is usually from the lowest level of care to highest (i.e health post to
BHC to PHC to CHC to Hospital) excepts in emergency when a patient can be
referred directly to any facility for immediate attention without going through the
hierarch.

(5c) HEALTH PLANNING: This is an orderly process of defining community health

problems, identifying unmet needs and surveying the resources to meet them,
establishing priority goals that are realistic and feasible and projecting
administrative action to accomplish the purpose of the proposed programme.

(5d) OUTREACH HEALTH SERVICES: They provide health services that make it
possible to stay in your home longer, and receive the support and care you need.
Therefore, outreach health services is used to describe any type of health service
that mobilize health workers to provide services to the population or to other
health workers away from the location where they usually work and live.

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 2018 PRIMARY HEALTH CARE DELIVERY SYSTEM EHT 211

QUESTION 1

1. (a) Define primary health care according to Alma-Ata declaration-----5marks

(b) Describe the level of health care services available in your country—
15marks

SUGGESTED ANSWER
(1a) Primary Health Care is defined according to Alma-Ata declaration as an
essential health care based on practical, scientifically sound and socially
acceptable methods and technology made universally accessible to
individual and families in the community, through their full participation
and at a cost that the community and country can afford to maintain at
every stage of their developement in the spirit of sel-reliance and self
determination.

(1b)The level of health care services in Nigeria include

 THE PRIMARY HEALTH CARE LEVEL OR TIER: This is the first point of entry
for individuals and communities and the health care system is the
responsibility of the local government. It takes care of common health
problems and involves health centres and clinics and appropriate
personnel. It refers cass to sescondary or tertiary.
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 SECONDARY HEALTH CARE: This level accepts referral from the primary
health care and is managed by the state government. It uses appropriate
personnel and involves general hospitals and specialist hospital. It refers
cases to tertiary.
 THE TERTIARY HEALTH CARE: This provides highly specialized medical care
by advanced diagnostic service . it refers cases to secondary and primaryn
levels. It uses appropriate personnel and includes teaching hospital,
orthopedic hospital, psychiatric hospital. It is the responsiblity of the
federal government.

QUESTION 2
2. (a) Enumerate five principle of primary health care-------------------5marks
(b) Explain three of the principles above---------------------------15marks
SUGGESTED ANSWER
(2a) The priciple of primary health care include
 Principle of community participation
 Principle of intersectoral approach
 Principle of appropriate technology
 Principle of sel reliance
 Principle of essential service
 Principle of integrated service
 Principle of prevention
 Principle of affordability
 Principle of political will
 Principle of equitoral distribution

(2b) ** PRINCIPLE OF COMMUNITY PARTICIPATION: Community participation

is the process by which individuas and families assume responsibility for their
own health and welfare and for those of the community and develop the
capacity to contribute to their own health and the community’s development.
They come to know their situation better and are motivated to solve their
common problem.

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 ** PRINCIPLE OF INTERSECTORAL COLLABORATION: (Multi-sectoral
collaboration). Primary health care requires the support of other sectors; these
sectors can also serve as entry points for the development and
implementation of PHC. PHC requires the collaboration of health and other
related sectors sectors for its success. PHC involves in addition to the health
sector, all related sectors and aspect of national and community development
in particular, agriculture, education, housing, public works and other sectors
and demands for coordination efforts of all the sectors.

** PRINCIPLE OF APPROPRIATE TECHNOLOGY: Primary health care requires

the development, adaptation and application of simple equipment technique
and methods that people can afford and use to solve health problem.
Appropriate technology is a fashionable way of doing things in low cost,
effective way that local people can manage and control which leads to self
reliance.

QUESTION 3
3. (a) Define lassa fever and its epidemiology-----------------------10marks
(b) State five PHC strategies to eradicate the infection in your country----
10marks

SUGGESTED ANSWER

(3a) LASSA FEVER: Lassa fever or lassa hemorrhagic fever is an acute viral
hemorrhagic fever caused by Lassa virus and that occurs in West Africa. The
illness was discovered in 1969 when two missionary Nurses died in Nigeria.
The virus was named after a town in Nigeria where the first cases occurred.
The virus, a member of the virus family “Arenaviridae”, is a single-stranded RNA
virus and zoonotic, or animal borne.
It result in 3000,000 to 500,000 cases annually and causes about 5,000
deaths each year. It is an asymptomatic infectious disease. The outbreak of theses
disease has been observed in Nigeria, Liberia, Sierraleone, Guinea and Central
Africa republic. The primary animal host of the Lassa virus is the NATAL. It is
usually acquired from infected rats; the causative agent is Lassa virus.

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  MODE OF TRANSMISSION INCLUDE:

The virus is probably transmitted by contact with feaces or urine of animals

assessing, it can also be contacted through touching, playing with or cutting up a
rat’s dead body. It can also be contacted through the following;
(1) By close contact with infected body fluid including blood, urine, vomit

(2)Through sexual intercourse with an infected person

(3)In the laboratory

(4) Eating of contaminated food or water with infected urine and feaces of
infected rat.

* SIGNS AND SYMPTOMS INCLUDE;

1. Nausea
2. Vomiting
3. Stomach ache
4. Weight loss
5. Back pain
6. Swollen face
7. Rash
8. Bleeding
9. Muscle pain
10.Diarrhea
11.Cough
12.Chest pain
13.Fever and shivering
14.Headache
15.Sore throat
16.Malaise
17.Meningitis unilateral
18.Seizures
19.Blood pressure change
20.Loss of appetite

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 INCUBATION PERIOD INCLUDE;
 The incubation period of Lassa fever ranges from 7-21 days. The clinical
disease begins as a flu like illness characterized be fever, general weakness
and malaise, which may be accompanied by cough, sore throat and severe
headache.
 The symptoms typically appear in 10 days after infection. The virus is
excreted in urine for 3-9 weeks and in semen for three months.
 After the incubation period of 7-21 days an acute illness with multi
organ involvement develops. Non-specific symptoms will appear examples
are fever, facial swelling, muscle fatigue, conjunctivitis and mucosal
bleeding e.t.c.

(3b) STRATEGIES TO ERADICATE LASSA FEVER INCLUDE;

 Mass sensitization about the occurence of lassa fever and measures to take to
prevent it, people should be informed on proper food storage in a tight fitting
containers to prevent rad access
 Environmental sanitation is another measure to eradicate lassa fever, this
include proper waste management, housing sanitation, regular washing of
drains and cutting down of over grown weeds around the premises.
 Provision of safe water supplies and food hygiene: Our water should be
treated before drinking so as to make it potable and safe for consumption.
Our food must be thoroughly cooked before eating.
 Control of Rat: Rats should be controlled in our premises so as to prevent
the spread of lassa fever in our country. The following method should be
adopted to control rats in our premises, mechanical control method, physical
control method, chemical control method and biological control.
 quarantination and isolation: Quarantination is the ristriction or limitation
of the movement of suspected cases of a particular diseases prior to the
incubation period of such diseases while isolation is the separation of
infected person from non infected person so as to commence treatment as
erly as possible on the infected ones. These strategies will help to prevent
the spread of such diseases and also help to control the occurence.

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 QUESTION 4

4. (a) Enumerate four factors that will contribute to and sustain high
immunization coverage------------------------------------------10marks
(b) identify ten basics roles of PHC in your country health system---10marks
SUGGESTED ANSWER
(4a) The factors that will contribute to and sustain high immunization
coverage include
(5) Advocacy
(6) Community mobilization and sensitization
(7) Effective supervision and monitoring
(8) Intersectoral collaboration
(9) Evaluation tools
(10) Formation of committee at various levels

(4b) The roles of primary health care include

(1) Baseline survey, whereby the major health problems of the community are
identified (community diagnosis)
(2) Situation analysis aimed at determining the ability of health services to
respond to the problems, taking into consideration the existing health
resources such as facilities, manpower e.t.c in the area and the presence of
certain basic infrastructure that affect health e.g roads, electricity, water
supply school e.t.c
(3) Zoning of local government area in district and assigning health team to
each zone or district or ward
(4) Registration of house hold i.e house hold numbering and placement of
home based record in each house
(5) Community mobilization which include formation of village and district
health committee.
(6) Training include retraining of existing health workers
(7) Upgrading of existing health facilities to perform comprehensive primary
health care function

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(8) Monitoring and evaluation at home clinics , community and local
governement levels of the various activities.
(9) Promotion of public health through treatment of common illness and injury
(10) Prolonging life through provision of curative, preventive,
rehabilitative and promotive health services.

QUESTION 5
5. In the last few years your country has been ravaged by epidemic diseases
(a) List any five of such diseases-----------------------------------5marks
(b) As a primary care worker, explain five methods you will adopt to control
the spread of the diseases---------------------------------------15marks

SUGGESTED ANSWER

(5a) the diseses are;

Lassa fever

 Tuberculosis
 Fever
 Choleral
 Yellow fever
 Measles

(5b) Method to adopt in order to eradicate the listed diseases include

 PROMPT NOTIFICATION OF THEIR OCCURENCE TO THE APPROPRIATE

HEALTH AUTHORITY: Any occurence of listed above diseases should be
reported immediately to the appropriate health authhority so that quick
intervention measures will be instituted against the diseases and this will
ensure prompt eradication of such diseases in the country. This will also
reduce the spread of such diseases and limit the level of damage it might
cause among the people. The appropriate health authority could be local
governemnt health department or state ministry of health or federal
ministry of health.

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 QUARANTINATION AND ISOLATION: Quarantination is the ristriction or
limitation of the movement of suspected cases of a particular diseases prior
to the incubation period of such diseases while isolation is the separation of
infected person from non infected person so as to commence treatment as
erly as possible on the infected ones. These strategies will help to prevent
the spread of such diseases and also help to control the occurence.
 EARLY DIAGNOSIS: Eraly diagnosi of a particular occurence will help to
tackle the disease before the disease agent establish itself fully in the body
and this will help to eradicate it at the source before transmitted to other
person. The moment a person start seeing some signs and symptoms, early
diagnosis should be made to find out the cause of the disease as soon as
possible.
 IMMUNIZATION SERVICES: Immunization is the process of innoculating or
introducing a vaccine either live attenuated of dead vaccine into the host to
trigger the production of specific antibody which fight against a specific
disease. Immunization will help the target population to boost immunity
against a particular disease that is vaccine preventable such as
Tuberculosis, measles, yellow fever. All our children, women of age bearing
and pregnant women can be immunized ahead of any disease occurence in
the country.
 IMMIGRATION AND EMMIGRATION CHECK: This should be done at various
boarders such as air, sea and land. People leaving the country should be
checked and vaccinated before leaving to prevent borader transmission of
disease and also those that are coming from another country into our own
country should be scrutinized at the boarders and ensure that they are free
from disease agent before allowed to enter into the country.

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