HLTC07 article points for exam.docx

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Trinity College Courses
Barakat- Haddad

Global Prevalence of Diabetes  The number of people with diabetes is expected to double between 2000 and 2030.  number of people with diabetes will more than double as a consequence of population aging and urbanization Global Aging : The challenge of Success  ―older people‖ and ―older population‖ refer to people age 65 or older  Oldest old = 80 years or older  Industrialized nations have the highest percentage of older people in the world today  60% of the world‘s older population now live in less developed countries  Population aging is defined as the percentage of a given population age 65 or older  World ‗oldest‘ major country is Italy  Italy, then japan, then Greece (oldest population)  Demographics indices of aging:  Aging index: # of people age 65 or older per 100 children under age 15  Median age: 32 years old (developed countries)  Social support ratios:  Elderly support ratios: the # of people age 65 or older per 100 people ages 20 to 64 in a given population  At very old ages, the rate of increase in mortality tends to slow  significant growth of the population age 100 or older, thanks to improvements in nutrition, health and healthcare  decline in the number of babies = more people at older ages  Populations with high fertility tend to have low proportions of older people (What does having more babies have to do with old people?...Are they going to die faster?)  The heterogeneity hypothesis: deceleration in old age mortality is a result of frailer older people dying at younger ages  survivial of the fittest  Aging has proceeded more gradually in Western nations  African people: HIV/AIDS; rapidly growing number of widows and the role that polygyny may play in their well-being  Epidemiological transition: a broad set of changes that include a shift from high to low fertility, study expansion of life expectancy at birth  3 stages: Age of pestilence and Famine, Age of receding Pandemics, Age of Degenerative and Man-made Diseases; 4 stgeE: hybrid: social and geography affects health  Immigration of working adults, retire people travelling to other countries; retired people come back to home countries  Demographic transition: population shifted form high to low mortality, thanks to better health and nutrition  Human survival curve: depicts people‘s chance of surviving another year as they age  86% of people born today will survive to age 60  Compression of morbidity: Fries' hypothesis is that the burden of lifetime illness may be compressed into a shorter period before the time of death, if the age of onset of the first chronic infirmity can be postponed  Gender and Aging: Men have higher death rates than women at all ages  Married people enjoy healthier and longer lives Global capacity for emerging infectious disease detection  highlight the need for improvements in global outbreak surveillance  Globalization: international travel and trade  A major advancement has been the formation of GOARN in 2000: operational network through which human and technical resources from institutions and networks in global epidemic surveillance are pooled  some of the longest delays in outbreak discovery and public communication occurred in Africa.  continued need for development of public health infrastructure in Africa  challenging to concretely define endemic disease, or to determine when isolated clusters of illness constituted outbreaks. PANDEMIC INFLUENZA PREPAREDNESS AND RESPONSE Recommended actions before, during and after a pandemic: 1. planning and coordination
 2. situation monitoring and assessment 3. reducing the spread of disease
 4. continuity of health care provision 5. communications. [P.S.R.C.C.] Phase 1: no viruses Phase 2: animal influenza virus circulating among animals is known to have caused infection in humans Phase 3: small clusters of disease in people; so small that it can‘t be called an outbreak Phase 4 : verified human-to-human transmission of an animal or human-animal influenza virus able to cause ―community-level outbreaks‖ Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region Phase 6: the pandemic phase. A community level outbreak like in phase 5, plus a different country in a second WHO region post-peak: signifies that pandemic activity appears to be decreasing; uncertain if a second wave will occur post-pandemic: influenza disease activity will have returned to levels normally seen for seasonal influenza. • genetic reassortment: a process in which genes from animal and human influenza viruses mix together to create a human-animal influenza reassortant virus; • genetic mutation: a process in which genes in an animal influenza virus change allowing the virus to infect humans and transmit easily among them. • avian influenza A virus of subtype H5N1 comes from poultry infection • Whole-of-society pandemic readiness’ explores the roles of each of these groups in greater detail Avian and pandemic influenza: An overview  Influenza is the one virus that causes the greatest number of vaccine-preventable deaths worldwide every year  Two is the number of antiviral drug classes that are approved for use in preventing/treating influenza  This is the number of conditions necessary for pandemic influenza to occur: (1) a novel virus, (2) the ability to cause illness and (3) transmissibility from human-to- human.  Number 153: This represents the number of human deaths due to avian influenza in the last 3 years  the current pandemic vaccines require two doses. Global Epidemiology of Tuberculosis  Tuberculosis is the leading cause of death from a curable infectious disease  Tuberculosis is primarily a disease of men.  China, Bangaldesh, Pakistan, India , Indonesia  Old, indigenous people get TB  There is no specific, sensitive, inexpensive, and rapid method of diagnosis of the disease. WHO‘s new Stop TB Strategy  nearly 20 million patients have been cured of tuberculosis, through DOTS  DOTS alone is not sufficient to achieve the 2015 tuberculosis-related Millennium Development Goals (MDG)-> reduce it to 50%  First : pursue quality DOTS expansion and enhancement.  Second : TB/HIV, MDR-TB, and other special challenges need to be addressed.  Third : contribute to health system strengthening.  Fourth, is to engage all care providers. [E.M.H.E]  By 20
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