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SECOND YEAR JANUARY SEMESTER EXAMINATIONS

FOR THE DEGREE OF BACHELOR OF COMMUNITY HEALTH

COURSE: BIOSTATISTICS AND EPIDEMIOLOGY

DATE: April 2011

TIME: 3 hours

________________________________________________________________________

INSTRUCTIONS:

This exam has two parts; 1 and 2

Answer questions according to the instructions in each part.

Answer each part in a different answer booklet.

Answer any four questions.

Do not write anything on the question paper

Mobile phones are not allowed in the Examination room

________________________________________________________________________

SECTION A: Answer all questions

1.

i.

ii.

iii.

2.

i.

ii.

iii.

(4 Marks)

(b) The sugar levels in the blood of a sample taken at Mukono Health Centre, are

normally distributed with mean 12 and standard deviation 2.5, find the probability that

the levels are

Below 7

(5 Marks)

Between 8 and 10

(8 Marks)

The value of the sugar level at which 25.78% of the patients fall

(8 Marks)

(3 Marks)

A study carried by Mukono University examined national attitudes about

tranquilizers. The study of 14 people revealed that approximately 0.7 believe that

tranquilizers do not really cure anything they just cover up the real trouble.

Find the probability that

Exactly five people believe that they do not cure but just cover up real trouble

(6 Marks)

At least five people believe that they do not cure but just cover up real trouble

(6 Marks)

Between 10 and 14 people believe that they do not cure but just cover up real trouble

(10 Marks)

3.

The following scores represent the final examination grade for an elementary

Mathematics course

24

13

28

15

25

29

15

46

9

10

17

22

23

17

16

32

11

12

18

20

13

27

18

22

20

14

26

14

19

19

40

31

17

21

23

26

18

24

21

27

a) Construct a frequency distribution. (10 Marks)

b) Calculate

i.

The mean

(2 Marks)

ii.

Mode

(5 Marks)

iii. Median

(5 Marks)

Comment on the results in i, ii, and iii

(3 Marks)

4.

Class

51-60

61-70

71-80

81-90

91-100

101-110

111- 120

I.

II.

III.

I.

II.

III.

5.

23

80

52

41

60

34

Frequency

3

7

10

12

7

3

2

a) What is the

modal class (2 Marks)

median class (2 Marks)

class interval (2 Marks)

b) Find

Variance (15 Marks)

Standard deviation (2 Marks)

Comment on the results in a and b above (2 Marks)

The following represent the number of patients that came to the Health centre for 60

(sixty days)

60

79

32

57

74

52

70

82

36

77

81

95

41

65

92

85

55

76

10

64

75

78

25

80

98

81

67

71

83

54

64

72

88

62

74

43

78

89

76

84

48

84

90

15

79

67

17

82

69

74

63

80

85

61

i.

Set up a frequency distribution

ii.

Set up a relative frequency distribution

iii. Set up a cumulative frequency distribution

iv.

Set up a relative cumulative frequency distribution

(5 Marks)

(5 Marks)

(5 Marks)

(5 Marks)

(5 Marks)

SECTION A: Multiple Choice Questions (Select one correct Option)

SECTION B: Essay Questions (Attempt one question only)

SECTION A: Compulsory

(Circle one correct Option)

1. Epidemiology is often defined as:a) An observational science that links factors with heath related states

b) The use of analytical techniques to study the distribution and determinants of disease

c) The study of the application of interventions in the control of disease

d) The action oriented scientific study of the distribution and determinants of disease

2. The Epidemiological Approach is often viewed as a two step approach. It involves:a) Determining disease associated factors and testing associations to infer causality

b) Measuring disease occurrence and testing associations to infer causality

c) Observation of health related phenomena and describing the unusual patterns there from

d) Determining causality and designing appropriately treated interventions

3. Herd immunity is the resistance of an entire population conferred by the fact that a critical

proportion of the population is protected. The probability of a susceptible person meeting a

diseased person is negligible. The above situation will only hold if the following assumption

is true:

a).That 95% of the population is vaccinated and immunized

b).That the disease agent is restricted to one single host in which the disease occurs

c).That transmission is indirect, with an extra-human reservoir

d).That the population is organized in structured communities with minimal mixing

4. The following are uses of Epidemiology, except:a). Identifying aetiological agents an high risk groups

b). Identifying natural history of a disease

c). Identifying the intervention that are efficacious

d). Isolating biological agents implicated in disease aetiology

5. A rate is characterized by all the following except

a). It is a proportion that includes a specification of time

b). It refers to instantaneous change in one quantity per unit change in another

c). Maternal mortality ratio is a classic example

d). The numerator is always part of the denominator

a). Reliability

d) All the above

b). Correlation

e) None of the above

c). Validity

7. Acceptable measures to describe the number of people who become sick after eating at the

same restaurant on the same night are: Circle the most correct measure:

a). Period prevalence

b). Mortality index

c). Attack rate

d). Point prevalence ratio

e). Crude death rate

8. The population at risk may refer to any of the following except:

a). A population which is susceptible to developing the disease of interest

b). Part of a population which is susceptible to developing the disease of interest

c). Its accurate measurement can be affected by selective undercounting of population groups

in a census

d). The denominator used in calculating the maternal mortality rate

Use the following information to answer questions 9 12. Dr. Kisitu is the DDHS of Wakiso

District. An outbreak of Cholera occurred in Wakiso District in the month of November

2004. Dr. Kisitu found that 15 of the 20 households with cases did not have a latrine while 22

of the 30 controls in the study had a latrine in the home.

9. What type of study design did Dr. Kisitu employ?

a) Cohort

b) Cross-sectional

c) Case control

d) Clinical Trial

e) None of the above

10. What is the Odds Ratio for the association between cholera and absence of a latrine?

a) 0.12

b) 1.5

c) 8.25

d) 0.67

11. Is the absence of a latrine, the cause of cholera?

a) Yes

b) No

12. If 6 of the 20 cases died, what is the case fatality rate?

a) 60%

b) 42.9%

c) 30%

d) 100%

13. In a case-control study of ovarian cancer, there were 235 cases and 451 controls. 40 cases

and 118 controls reported that they had used oral contraceptives. The estimated risk (Odds

ratio) of ovarian cancer associated with the use of contraceptives is:

4

a) 0.58

b) 0.65

c) 1.73

d) 1.54

e) 0.69

Questions 14 and 15 are based on the following statement:

Factor A, B and C each individually cause a certain disease without the other factors, but only

when followed by exposure to factor X. Exposure to factor X alone is not followed by disease

but the disease never occurs in the absence of exposure to factor X.

14. Factor X is:

a) A necessary and sufficient cause

b) A necessary but not sufficient cause

c) A sufficient but not necessary cause

d) Neither necessary nor sufficient

15. Factor A is:

a) A necessary and sufficient cause

b) A necessary but not sufficient cause

c) A sufficient but not necessary cause

d) Neither necessary nor sufficient

e) None of the above.

SECTION B:

Question 1: Based on the Epidemiological triad of disease causation, briefly explain why

malaria is a common infection/disease in Uganda

(10 marks).

Question 2: In a population of 1000 people, 400 are alcoholics and out of these alcoholics,

150 developed liver cirrhosis. The rest of the population were teetotalers and out of these,

only 40 developed liver cirrhosis

(10 marks)

a) Summarize this information in a tabular form

b) Calculate the relative risk of developing liver cirrhosis

c) Calculate the attributable risk percent

d) From your above findings, what is your conclusion?

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