REPUBLIC OF CAMEROON

REPUBLIC DU CAMEROUN
Peace-Work-Fatherland
Paix-Travail-Patrie
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MINISTERE DE
MINISTERE DE
L’ENSIGNEMENT SUPERIEUR
L’ENSIGNEMENT SUPERIEUR
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NATIONAL COMMISSION FOR THE ORGANISATION OF THE
COMMISSION NATIONALE d’ORGANISATION DES EXAMENS
HIGHER NATIONAL DIPLOMA (HND) EXAM
DU HND
NATIONAUX

HIGHER NATIONAL DIPLOMA (HND) EXAM

JUNE-JULY 2021 SESSION Examination Date……..………………….

OPTION NURSING

SPECIALTIES NURSING

COURSE TITLE PUBLIC HEALTH

COURSE CODE NUS15

TYPE OF EXAMINATION WRITTEN

CREDIT VALUE 6

DURATION: 3 HOURS

GENERAL INSTRUCTIONS

You are reminded of the necessity of orderly presentation of your material and good English

Where calculations are required, clearly show your working and be chronological in your answer

SPECIFIC INSTRUCTION

THE MARKS ALL SUM UP TO 100

The different Public Health subjects: epidermiology, communication for behavioural change/HIS,
the economics of health, school and occupational health and infectious and parasitic disease are
represented in this paper in the mentioned percentages.

The questions are structured into MCQs, Short Answers and Essay

ATTEMPT ALL QUESTIONS

SECTIONA: MULTIPLE CHOICE QUESTIONS (25 MARKS)

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1. Which of the following is not a measure of frequency in epidemiology?

(A) Risk

(B) Agent

(C) Prevalence

(D) Incidence

2. Morbidity in epidemiology refers to all of the following, except_________

(A) Number of sick persons suffering from an illness at a point in time.

(B) Total number of sick persons

(C) New number of sick persons with a particular disease

(D) Degree of illness in a person with a particular disease

3. The environment in which a disease happens may be all of the following

except____________

(A) School

(B) Hospital

(C) Community

(D) None of the above

4. Which of the following is Not an aspect of descriptive epidemiology?

(A) Collection of date

(B) Collation of data

(C) Drawing of tables and charts

(D) Verifying assumptions

5. A case definition may have all of the following elements before confirmation except_______

(A) Person

(B) Time

(C) Place

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 (D) Laboratory diagnosis

6. A very important element in a case definition is____________

(A) Laboratory diagnosis

(B) Person

(C) Clinical feature

(D) Site of infection

7. Distribution of health – related states of events focuses on_______________

(A) Frequency and pattern

(B) Determinations

(C) Risk factors

(D) Health events

8. The hallmark of analytic epidemiology is____________

(A) Comparison group

(B) Experimentation

(C) Observation

(D) Analysis

9. Epidemiology is linked to other fields like statistics, laboratory science, etc.

because_____________

(A) It draws an knowledge from those fields

(B) It depends on a comprehensive approach by all personnel

(C) It depends only skills from those fields

(D) It is a holistic discipline

10. Which of the following is NOT a source of vital statistics?

(A) Fertility statistics

(B) Vital record linkage

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 (C) Marriage and divorce

(D) Incidence rate

11. Which of the following data are not routinely recorded?

(A) Morbidity

(B) Mortality

(C) Disease – case registry

(D) Health insurance

12. Which of the following are jointly known as methods in epidemiology?

(A) Vital statistics sources

(B) Vital record – linkage statistics

(C) Measures of morbidity and vital

(D) Risk rate.

13. Incidencerate refers to______________

(A) The risk of a person coming down with an infection

(B) The probability that a person may fall sick

(C) The number of people who fall sick

(D) The degree at which a disease occurs

14. In epidemiology, the_______________is very important when describing a disease

prevalence

(A) Denominator

(B) Frequency

(C) Ratio

(D) Rate

15. Which of the following is the underlying meaning of attack rate?

(A) The number of people who are exposed to an agent

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 (B) The number of agents or proportion of agent that may attack a population

(C) Proportion of persons exposed to an agent and develop the disease

(D) The number of infections microbes that may come in contact with people

16. Primary health care is an important component of public health because it involves all of the

following except_______________

(A) Community participation

(B) Intersectoral collaboration

(C) Essential primary and public health functions

(D) Family health support

17. What kind of statistic is the blood pressure (BP) of a person?

(A) Numerical continuous

(B) Discrete continuous

(C) Numerical

(D) Categorical

18. A table that shows the relationship between exposure and outcome is?

(A) A contingency table

(B) A tabulation

(C) A cross tabulation

(D) None of the above

19. An epidemiologist may focus on all of the following, except___________

(A) Counting cases

(B) Developing case definition

(C) Identifying risks

(D) Making drug prescription

20. Which of the following aspects is very sensitive during surveillance?

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 (A) Timely dissemination of information

(B) Collation of data

(C) Analysis of data

(D) Interpretation of data

21. Public health focuses on all of the following except_____________

(A) Health promotion and protection

(B) Illness and injury prevention

(C) Modification of behaviour

(D) Diagnosis and treatment

22. How is public health different from clinical medicine?

(A) Public health is concerned only with community diagnosis.

(B) Public health is concerned with clinical treatment.

(C) Public health is concerned with medical diagnosis.

(D) Public health is concerned with both the community and clinical medicine.

23. The main role of public health officers is to____________

(A) Understand health related states or vents and disseminate the information.

(B) Understand health related states or events and prevent illnesses.

(C) Understand health related states or events and apply the knowledge to control health

problems.

(D) Understand health related states or events and deliver the information to those who

need to know

24. What are the factors that must be fulfilled for a disease condition to occur?

(A) There must be a susceptible host and a conducive environment for the agent.

(B) There must be an infectious agent and a host.

(C) There must be a favourable environment for the agent to develop

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 (D) The absence or presence of the agent, a susceptible and a conducive environment for

the agent to thrive

25. _________ ensures effective community participation.

(A) District Chief of Service

(B) Local authorities

(C) Dialogue structures

(D) Committees

SECTION B: SHORT ANWERS (25 MARKS)

INSTRUCTION: BE CLEAR AND CONCISE

1) What is “cold chain”? (2marks)

2) How sensitive are vaccines to heat and cold? (3 marks)

3) Define the following terms

a. Infectious disease (2 mks)

b. Epidemiological triangle (2 mks)

c. Sporadic disease (2 mks)

4) How can we define “Health for All (HFA)”? (2 mks)

5) How can we define “health system”? (2 marks)

6) What is the difference between health system and health care service?( 4 marks)

7) List the components of the health system in Cameroon (3 mks)

8) Name three acts of health quackery (3 marks)

SECTION C: LONG ESSAY (50 MARKS)

INSTRUCTION: AVOID DIRTY WORK

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1. Write short notes on:

a) Immunization (5 marks)

b) Intersectoral collaboration ( 5marks)

2. What are the basic principles of primary health care? Give the advantage of each?

(10mks)

3. Enumerate the safe work practices to prevent injury and accidents and classify the main

injuries encountered in the hospitality industry. (10 mks)

4. Outline the causes for population explosion in Cameroon in terms of demography (5mks)

5. Outline five (5) ways in which prevalence of a disease can be increased and five (5) ways

in which prevalence of a disease can be decreased (10mks)

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 MARKING GUIDE PUBLIC HEALTH

PART A: MULTIPLE CHOICE QUESTIONS (30 MARKS)

1. B 10. D 19. D

2. B 11. A 20. A

3. D 12. C 21. D

4. D 13. A 22. D

5. D 14. A 23. C

6. A 15. C 24. D

7. A 16. D 25. C

8. A 17. A

9. A 18. A

PART B: SHORT ANSWRS (25 MARKS)

1) The ‘cold chain’ is the system of transporting and storing vaccines within the safe temperature

range of +2°C to +8°C.The cold chain begins from the time the vaccine is manufactured, continues

through to the state or territory vaccine distribution centres and ends when the vaccine is

administered.

2)Vaccines are delicate biological substances that can become less effective or destroyed if they are

either:

• frozen

• allowed to get too warm, or

• exposed to direct sunlight or UV light, including fluorescent light.

When vaccines are repeatedly exposed to temperatures outside the +2°C to+8°C range, the loss of

potency is cumulative and cannot be reversed. If we don’t protect our vaccines they won’t protect

our community

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3)a)Infectious disease: this is an abnormal condition or discomfort affecting human being organism

cause bacteria; fungi; parasite and viruses; it can be transmitted directly (person to person) or

indirectly (transmission through fomite or inanimate objects)

b) Epidemiological triangle: It is a model put in place by health personnel to find the causes of

disease. It help to discover the agent, host and factors related to the environment that affect the

health of individuals or community in order to set up appropriate preventives measures or curative

methods.

c) Sporadic disease: this is abnormal condition related disease which occurs occasionally in a

given area; such as Typhoid fever.

4)Health for all (HFA) is a social goal and can be defined as: a stage of health development whereby

everyone has access to quality health care or will practice self-care protected by financial security so

that no individual or family experiences catastrophic expenditure that may bring about

impoverishment.

5) A health system consists of all organizations, people and actions whose primary intent is to

promote, restore or maintain health. This includes efforts to influence the determinants of health as

well as more direct health improving activities. A health system is therefore more than the pyramid

of publicly owned facilities that deliver personal health services. It includes, for example, a mother

caring for a sick child at home; private providers; behaviour change programmes; vector-control

campaigns; health insurance etc…

6)Health systems are much broader than health services. Health services refer to medical and public

health services provided by both the government (the health sector) and the private sector. They

cover modern and traditional medicine as well as services provided by the community.

The main objective of PHC is to provide a continuum of preventive, promotive, curative and

rehabilitative care and not just medical care alone. The PHC approach aims at people centred care

that offers universal coverage, social equity and financial protection. A health system which is based

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on PHC is one that aims to provide cost-effective, comprehensive, equitable and quality care to the

entire population including the poor, the vulnerable and the marginalized. All measures taken to

achieve this constitute health system strengthening based on the PHC approach.

7) They are

- a public sector – a private sector - a traditional sector

The acts are: - Using “Congo’’ fifty to cure pain

Believing AIDS is witchcraft

Using urine to treat snake bite

PART C: LONG ESSAY (30 MARKS)

1)

a. Immunization : it is the act of injecting a killed microbe (vaccine) into the body that

stimulate the immune system which is the natural defense system of the body to fight against

the microorganism causing the disease; when the vaccine is injected into the body the

immune system is stimulate which in turn release antibodies to fight against the

microorganism. 5mks

b. Intersectoral collaboration: This is the coordination of health activities with other sectors;

such sectors include Education, Finance, Agriculture, Information etc. There should be a

working relationship these bodies and the health ministry. 5mks

2) What are the basic principles of primary health care? Give the advantage of each?

These include:

- Community participation ( 2 mks)

- Intersectoral collaboration (2mks)

- Integration of health care programmes (2mks)

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 - Equity (2mks)

- Self-reliance (2mks)

 Community participation

Is the whole mark of primary health care, without which it will not succeed. Community

participation is a process by which individuals and family assume responsibility for their own health

and those of the community and develop the capacity to contribute to their/and the community

development. Participation can be in the area of identification of needs or during implementation.

The community needs to participate at village, ward, district or local government level. Participation

is easier at the ward or village level because the issue of heterogeneity is eliminated.

Advantages of Community Participation

-It addresses the felt health needs of the -It ensures sustainability

people -It ensures cost sharing

-It ensures social responsibility among the -It ensures enhancement of knowledge

community -It encourages intersectoral collaboration

 Intersectoral Collaboration

This is the coordination of health activities with other sectors; such sectors include Education,

Finance, Agriculture, Information etc. There should be a working relationship these bodies and the

health ministry.

Advantages

-Overall human development

-It ensures economic development

-It ensures affordability

 Integration of Health Services

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This is defined as coordination of various primary health care components into a whole programme

and made available at all times including referrals.

Advantages

-It ensures efficient use of all resources and removes areas of wastage.

-It ensures sustainability of programme

-It ensures bye pass phenomenon

-It reduces opportunity cost

-It grantees clients confidentiality

 Equity

The health care resources available in a given community should not be in the handle of a few. And

resources should be accessible and affordable to all. Addressing the issue of equity in Nigeria. It is

divided in 3 components:

Decentralization of health of services into federal state-local government-ward levels.

The essential drug services and the national drug formulae making drugs available at all levels and at

low cost.

National health insurance scheme-where people contribute to the health services of those who don’t

have or cannot afford.

 Self-Reliance

This involves the use of technological methods and scientifically sound and maintain by the

community .It can be in terms of human resources, money or materials. Human resources in Nigeria-

medical officer of health, community health officer, nurses midwives, community health extension

work, community health Aid etc

Money-Is to ensure that there is financial backing.

Material- can be in form of physical facilities, drugs or other biological.

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Advantages of self-reliance

-Affordability -Acceptability

-Sustainability -Authenticity

Accept one point and an advantage for each one, 2 marks each x 5 =10marks.

3) Safe work practices to prevent injury and accidents are: 6mks

- Using the prescribed Personal Protective Equipment

- Using safe manual-handling techniques

- Using knives and equipment safely

- Handling hot surfaces safely

- Safe handling of chemicals

- Clearing hazards from your work area

- Paying attention to safety signs

The main injuries encountered in the hospitality industry. 4mks

-Lifting heavy or awkward objects such as drums, bags and cartons

-Prolonged activities such standing in one place

-Repetitive work such as bench work and stove work

-Slips and falls on wet, oily or uneven floors

4. Outline of causes for population explosion in Cameroon (5mks)

The causes for population explosion in Cameroon are:

a. Marginal reduction in birth rate as against a steep decline in death rates

b. High Infant mortality and child mortality leads couples to have larger families to ensure survival

of a few

c. Preference for a male child leads to a number of children being born in the quest for a male child

d. Need of more hands to work in the farms to conserve resources within the families

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e. Young age at marriage

f. Early onset of procreation

5. Outline five (5) ways in which prevalence of a disease can be increased and five (5) ways in

which prevalence of a disease can be decreased (10mks)

How prevalence of a disease can be increase 5mks

The prevalence of a disease can increase in the following conditions:

– The duration of the disease is very long (i.e. chronic conditions)

– The level of incidence i.e. the higher the incidence, the larger is the prevalence.

– Improved methods of diagnosis that lead to detection of larger number of cases than before.

– Availability of effective treatment, which prolongs life such that the individual lives longer while

still suffering from the disease.

– A sudden migration of cases into an area where the disease was not very common earlier.

How prevalence of a disease can be decrease 5mks

– A very short duration of the disease (applicable to the acute disease conditions).

– A very low incidence of disease

– Lack of proper diagnostic equipment or skills for the detection of disease.

– Diseases with a high mortality such that very few individuals survive

– Out migration of diseased individuals

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