Page 70 Principles of Epidemiology
INSTRUCTION: Answer all questions in the same booklet for section A, Section B should be
answered in the provided answer sheets and any form of malpractice will lead to conciliation of the
examine
SECTION A
Please select the most correct answer on the following questions:
1. In the definition of epidemiology, the terms “distribution” and “determinants” taken
together refer to:
A. Frequency, pattern, and causes of health events
B. Dissemination of information to those who need to know
C. Knowledge, attitudes, and practices related to health
D. Public health services and resources
2. Descriptive epidemiology includes all EXCEPT:
A. What
B. Who
C. When
D. Where
E. Why
5. The time course of a disease outbreak is usually displayed as a:
A. Secular trend
B. Seasonal trend
C. Epidemic curve
D. Endemic curve
3. When analyzing data by age the categories should be:
A. The same for all diseases
B. <1 year, 1 to 4 years, 5 to 9 years, 10 to 14 years, 15 to 19 years, and 20 years for
Communicable diseases, but not necessarily for chronic diseases
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C. Appropriate for each condition and narrow enough to detect any age-related patterns
present in the data
D. 5-year age groups for all diseases unless the data suggest the need for narrower categories
to find a pattern or aberrancy
4. Because socioeconomic status is difficult to quantify, we commonly use all of the
following substitute measures EXCEPT:
A. Educational achievement
B. Family income
C. Occupation
D. Social standing
5. The Framingham study, in which a group of residents have been followed since the
1950’s to identify occurrence and risk factors for heart disease, is an example of which
type(s) of study? (Circle ALL that apply.)
A. Experimental
B. Observational
C. Cohort
D. Case-control
E. Clinical trial
6. The Cancer and Steroid Hormone (CASH) study, in which women with breast cancer and a
comparable group of women without breast cancer were asked about their prior use of oral
contraceptives (“the Pill”), is an example of which type of study? (Circle ALL that apply.)
A. Experimental
B. Observational
C. Cohort
D. Case-control
E. Clinical trial
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7. The primary difference between an experimental and observational study is:
A. The investigator is “blinded” (prevented from knowing the subjects’ true exposure status
until the end of the study) in an experimental study but not in an observational study
B. The investigator controls the subject’s exposure in an experimental study but not in an
observational study
C. The investigator controls the subject’s outcome in an experimental study but not in an
observational study
D. Experimental studies are conducted with animals; observational studies are conducted
with humans
8. The functions of public health surveillance include which of the following?
A. Collection of health data
B. Analysis of health data
C. Interpretation of health data
D. Dissemination of health data
E. Disease control actions developed from the collection, analysis, and interpretation of
health data
9. Direct transmission includes which of the following modes of transmission?
A. Droplet spread
B. Vehicleborne transmission
C. Vectorborne transmission
D. Airborne transmission
14. An epidemic curve which follows the classic log-normal pattern of sharp rise and
more gradual decline is most consistent with which manner of spread?
A. Continuous source
B. Intermittent source
C. Point source
D. Propagated
E. Mixed
11.Public health surveillance requires the cooperation of people that are responsible
for which of the following? (Circle ALL that apply.)
A. Providing disease reports
B. Processing disease reports
C. Using the information from disease reports for clinical use
D. Applying the information from disease reports to public health planning and action
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12.The primary difference between a surveillance system and a survey
is:
A. A surveillance system is population-based
B. A surveillance system is ongoing
C. A surveillance system cannot assure confidentiality
D. A survey is generally cheaper
13. Public health officials have recently taken action to overcome a common limitation of
the notifiable disease reporting system. This limitation is:
A. Underreporting
B. Lack of representativeness of reported cases
C. Lack of timeliness
D. Inconsistency of case definitions
14. A health department sometimes adds a disease to the notifiable disease list even if
no effective control measures are available. This action is justifiable if:
A. The health department is well staffed and can handle the addition without
compromising its other activities
B. The disease is on the notifiable disease list of a neighboring state with a similar
population
C. The disease is new, and surveillance reports may shed light on its epidemiology
D. The incidence of the disease has been steadily increasing
15.The minimum number of human cases necessary for a health department action such
as an investigation or control activities is:
A. One
B. Two times the expected number
C. Variable, depending on the disease, but at least two cases
D. Variable, depending on the disease, but could be one or zero
E. Variable, depending on public concern and political pressure
16.One week, CDC received by electronic telecommunication several times more case
reports of a disease in one county than had been reported in the preceding 2 weeks. No
increase was reported in neighboring counties. Possible explanations for this increase
include:
A. Epidemic
B. Duplicate reports
C. Batch reporting
D. Increase in the county’s population
E. New physician in the county
17.The primary difference between surveillance systems for communicable diseases and
most surveillance systems for chronic diseases occurs as part of which activity?
A.Data collection
B. Data analysis
C. Data interpretation
D. Data dissemination
E. Link to programs
18. In a recent survey, investigators found that the prevalence of Disease A was higher
than the prevalence of Disease B. The incidence and seasonal pattern of both diseases are
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similar. Explanations consistent with this observation include:
A. Patients recover more quickly from Disease A than from Disease B
B. Patients recover more quickly from Disease B than from Disease A
C. Patients die quickly from Disease A but not from Disease B
D. Patients die quickly from Disease B but not from Disease A
19. A recent train derailment exposed residents of a community to a chemical hazard.
Many residents became ill; some died. To calculate the probability or risk of illness,
which denominator would you use?
A. The size of the population at risk at the beginning of the period
B. The size of the population at risk at the midpoint of the period
C. The size of the population at risk at the end of the period
D. The average size of the population at risk during the period
20. During the second week of February, 87 persons in a small community (population
460) attended a social event which included a meal prepared by several of the participants.
Within 3 days, 39 of the participants became ill with a condition diagnosed as
salmonellosis. The attack rate among participants was:
A. 0.45/100
B. 8.5/100
C. 18.9/100
D. 44.8/100
E. Cannot be calculated from the information given
SECTION B
18. A disease outbreak has been reported in Entebbe town. Five patients with a dry cough,
fever, sore throat, hoarse voice and lack of smell with a history of having recently
returned from travel abroad, and they have reported to health units around Entebbe
town in the last
2 days. Three of the patients were having difficulty in breathing and needed to be given
oxygen at Entebbe Grade B hospital.
a) Discuss three steps in your immediate plan to investigate the disease outbreak.
b) What study design is appropriate at this moment?
c) What further investigations are you likely to carry out?
Page 70 Principles of Epidemiology
19. Two students, a masters and PhD, were designing studies as part of their degree
programs. The master’s student wanted to find out whether young girls exposed to
contraceptives were at less risk of having unwanted pregnancies and abortions. The
PhD student wanted to assess the effect of long term contraceptives use on the risk of
ovarian cancer.
a) Discuss with examples, three types of study designs the masters student could use for
the study.
b) Discuss with examples, two study designs the PhD student could use to test
his/her hypothesis (s).
20.Uganda reported an outbreak of COVID-19 in March
2020. Several interventions have been implemented to stop the spread of the
disease. These include lockdowns, hand washing and wearing masks. Other
interventions have been implemented at the level of health facilities to improve
treatment of COVID-19 patients.
a) What study design would you implement to assess the level knowledge of the
population on COVID-19 prevention? And why?
b) What study design would you implement to study perceptions, opinions
and behavioural practices towards COVID-19 prevention?
c) Asindu has developed a vaccine against COVID-19, what study design would
you implement to evaluate the efficacy of the vaccine?
END
