Community Health II: Main Exam, 20 July 2023

Mount Kenya University · Department of Community Health, Epidemiology and Biostatistics · Diploma in Health Records and Information Technology · DPH2201

Community Health II past exam 2022-2023 from Mount Kenya University, includes model answers for all questions.

Instructions: ANSWER ALL QUESTIONS IN SECTION (A) AND TWO IN SECTION (B)

ANSWER ALL QUESTIONS IN SECTION (A) AND TWO IN SECTION (B)

SECTION A (40 marks)

1. Define the following terms;

  1. a) Herd immunity
    Model answer
    • Herd immunity: The indirect protection of susceptible individuals that occurs when a sufficient proportion of a population is immune to an infectious disease, reducing the likelihood of transmission.
  2. b) Disease
    Model answer
    • Disease: A deviation from normal physiological function caused by pathogenic agents, environmental factors, or genetic abnormalities, resulting in characteristic signs and symptoms.
  3. c) Primary health care
    Model answer
    • Primary health care: A comprehensive approach to health that provides essential health services, promotes health education, and addresses the social determinants of health at the community level, emphasizing accessibility, affordability, and community participation.

2. Explain the infection prevention and control principles (ipc).

Model answer
  • Standard precautions: Treat all patients as potentially infectious; use gloves, masks, eye protection, and gowns as needed.
  • Hand hygiene: Perform hand washing or alcohol‑based hand rub before and after patient contact.
  • Safe injection practices: Use sterile equipment, avoid needle recapping, and dispose of sharps in puncture‑proof containers.
  • Environmental cleaning: Regularly disinfect surfaces and equipment according to risk level.
  • Respiratory hygiene/cough etiquette: Provide tissues, masks, and proper disposal for patients with coughs.
  • Isolation precautions: Apply contact, droplet, or airborne precautions based on the pathogen’s mode of transmission.
  • Waste management: Segregate, treat, and dispose of biomedical waste safely.
  • Staff training and monitoring: Educate health‑care workers on IPC policies and audit compliance.

3. Describe the ozone depletion process and anticipated consequences.

Model answer
  • Ozone depletion process:
  • Chlorofluorocarbons (CFCs) and halons released into the atmosphere rise to the stratosphere.
  • UV radiation breaks down CFC molecules, releasing chlorine atoms.
  • Chlorine catalytically destroys ozone (O₃) → O₂ + Cl·, repeating the cycle.
  • Anticipated consequences:
  • Increased ultraviolet‑B (UV‑B) radiation reaching the Earth’s surface.
  • Higher incidence of skin cancer, cataracts, and immune‑system suppression in humans.
  • Damage to marine phytoplankton and terrestrial plant DNA, affecting ecosystems.
  • Reduced crop yields and altered agricultural productivity.
  • Accelerated climate‑change feedbacks due to changes in atmospheric chemistry.

4. Elaborate on any three events following immunization.

Model answer
  • Local reactions: Pain, redness, swelling, or induration at the injection site, usually resolving within a few days.
  • Systemic reactions: Low‑grade fever, malaise, headache, or muscle aches occurring 24–48 hours post‑vaccination.
  • Rare adverse events: Allergic reactions ranging from urticaria to anaphylaxis, requiring immediate medical attention.

5. Describe three reasons for studying community health.

Model answer
  • Health promotion: Understanding community health enables design of programs that encourage healthy behaviours and prevent disease.
  • Resource allocation: Data on community health guides efficient distribution of limited health resources and budgeting.
  • Policy development: Evidence from community health studies informs national and local health policies and legislation.

6. Name four challenges faced during implementation of community health program

Model answer
  • Limited funding: Insufficient financial resources restrict program scope and sustainability.
  • Human resource shortages: Lack of trained health workers hampers service delivery.
  • Cultural barriers: Traditional beliefs and practices may resist modern health interventions.
  • Inadequate infrastructure: Poor transport, water, and sanitation facilities limit program reach.
  • More answers:
  • Weak health information systems, political instability, and low community participation.

7. Explain any three types of vaccines used in Kenya with relevant examples.

Model answer
  • Live‑attenuated vaccines – contain weakened pathogens that replicate without causing disease; e.g., Measles‑Mumps‑Rubella (MMR) vaccine.
  • Inactivated (killed) vaccines – use pathogen that has been killed; e.g., Inactivated Polio Vaccine (IPV) used in Kenya’s routine schedule.
  • Subunit/Conjugate vaccines – include only parts of the pathogen (protein, polysaccharide) to stimulate immunity; e.g., Haemophilus influenzae type b (Hib) conjugate vaccine.

SECTION B (30 marks)

8. Discuss on the steps applied when investigating disease outbreak.

Model answer
  • Verify the case definition – confirm that cases meet a standard clinical and/or laboratory definition.
  • Establish a line list – record each case’s person, place, time, and exposure details.
  • Descriptive epidemiology – analyse data by time (epidemic curve), place (mapping), and person (age, sex, occupation).
  • Formulate hypotheses – generate possible sources or modes of transmission based on patterns.
  • Conduct analytical studies – case‑control or cohort studies to test hypotheses.
  • Implement control measures – isolate cases, vaccinate, improve sanitation, etc., based on findings.
  • Communicate findings – report to health authorities, media, and community.
  • Monitor and evaluate – continue surveillance to ensure outbreak is contained.

9. Discuss any five determinants of health.

Model answer
  • Socio‑economic status – income, education and occupation affect access to health services and healthy living conditions.
  • Physical environment – housing quality, water, sanitation and pollution influence disease risk.
  • Behavioural factors – diet, tobacco use, alcohol consumption and physical activity shape health outcomes.
  • Genetic/biological factors – inherited traits and age determine susceptibility to certain conditions.
  • Health services – availability, affordability and quality of medical care impact health status.

10. Discuss any five principles of primary health care.

Model answer
  • Equitable access – health services should be universally reachable regardless of income, location or ethnicity.
  • Community participation – communities must be involved in planning, implementing and evaluating health actions.
  • Intersectoral collaboration – health outcomes depend on coordinated action across education, agriculture, water, etc.
  • Appropriate technology – use of affordable, culturally acceptable and sustainable technologies.
  • Health promotion and disease prevention – focus on preventive measures rather than curative care alone.

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