Integrated Disease Surveillance Project — MCQs
Which of the following is NOT a core component of the WHO's global STI control strategy?
Which disease is most closely associated with intensive international surveillance for global eradication?
In dengue surveillance, indices that are commonly used to monitor Aedes aegypti infestation levels are all, EXCEPT:
According to the ICDS scheme, what is the recommended population range for establishing one Anganwadi centre in rural areas?
Which of the following diseases is primarily monitored under the Integrated Disease Surveillance Program (IDSP)?
A district shows API of 4.2, ABER 11%, and SPR 3.1%. What is the malaria surveillance status?
Many patients with unexplained rash and fever were reported from a village close to the Primary Health Centre (PHC). What is the first step in initiating the investigation of such an epidemic?
STEPwise approach to surveillance for Non-Communicable diseases step 2 is
What is the correct method for collecting water for bacteriological examination during a disease outbreak?
Substantia nigra is connected to which part of the basal ganglia?
Integrated Disease Surveillance Project Indian Medical PG Practice Questions and MCQs
Question 1: Which of the following is NOT a core component of the WHO's global STI control strategy?
- A. Case management
- B. Universal mandatory screening (Correct Answer)
- C. Strategic information systems
- D. Prevention services
Explanation: ***Universal mandatory screening*** - While screening is part of STI control, **universal mandatory screening** for all STIs in the general population is not a core component of the WHO's strategy due to feasibility, cost, and ethical considerations. - The strategy emphasizes **targeted screening** for at-risk populations and opportunistic screening. *Case management* - **Case management**, including accurate diagnosis and effective treatment, is a critical component for managing current infections and preventing further transmission. - This involves syndromic or etiologic approaches to treatment and partner notification. *Strategic information systems* - **Strategic information systems** are essential for monitoring trends, evaluating interventions, and informing policy decisions related to STI control. - This includes surveillance data, program monitoring, and research. *Prevention services* - **Prevention services** are a cornerstone of the WHO's strategy, aiming to reduce the incidence of new infections. - These services encompass health education, condom promotion and distribution, vaccination, and pre-exposure prophylaxis (PrEP).
Question 2: Which disease is most closely associated with intensive international surveillance for global eradication?
- A. Polio (Correct Answer)
- B. Hepatitis
- C. TB
- D. Leprosy
Explanation: **Polio** - **Polio** has been the focus of an intensive global eradication campaign, requiring robust **international surveillance** to track cases, mutations, and vaccine-derived polioviruses. - The **Global Polio Eradication Initiative (GPEI)**, a major international collaboration, relies heavily on coordinated surveillance efforts to ensure no wild poliovirus remains undetected. *Hepatitis* - While **hepatitis** is a significant global health burden, particularly hepatitis B and C, it is not subject to the same level of internationally coordinated, aggressive surveillance aimed at **global eradication** as polio. - Surveillance for hepatitis often focuses on prevalence, incidence, and risk factors at national and regional levels rather than a centralized, real-time eradication tracking system. *TB* - **Tuberculosis (TB)** is a major global health concern, and there are international efforts for control and elimination, but it is not currently targeted for **global eradication** in the same manner as polio. - Surveillance for TB often involves tracking drug-resistant strains and treatment outcomes, but it doesn't involve the immediate, outbreak-focused international alert system seen with diseases like polio or novel pandemics. *Leprosy* - **Leprosy** is a neglected tropical disease, and while there are international efforts for its control and elimination, primarily led by the WHO, it does not involve the same level of intensive, real-time global surveillance for eradication as **polio**. - Surveillance for leprosy is typically focused on case detection, treatment completion, and identifying areas with high endemicity rather than rapid international notification of individual cases for eradication purposes.
Question 3: In dengue surveillance, indices that are commonly used to monitor Aedes aegypti infestation levels are all, EXCEPT:
- A. Street index (Correct Answer)
- B. House index
- C. Breteau index
- D. Pupae index
Explanation: ***Street index*** - The **Street index** is not a standard entomological index used for monitoring *Aedes aegypti* infestation levels or density in dengue surveillance. - Surveillance efforts typically focus on household-level indices to assess mosquito breeding sites. *House index* - The **House index** (HI) measures the percentage of houses infested with *Aedes* larvae and/or pupae. - It provides an indication of the proportion of dwellings in an area that serve as mosquito breeding sites. *Breteau index* - The **Breteau index** (BI) calculates the number of positive containers per 100 houses inspected. - It reflects the density of breeding containers and is considered a more sensitive indicator of mosquito population density than the House index. *Pupae index* - The **Pupae index** (PI) measures the average number of pupae per person or per house. - This index is highly correlated with adult mosquito density and is considered the most accurate indicator of potential dengue transmission risk.
Question 4: According to the ICDS scheme, what is the recommended population range for establishing one Anganwadi centre in rural areas?
- A. 700-1000 (Urban)
- B. 1000-1500 (Urban high density)
- C. 300-800 (Hilly/Tribal areas)
- D. 400-800 (Rural) (Correct Answer)
Explanation: ***400-800 (Rural)*** - The **Integrated Child Development Services (ICDS)** scheme recommends one Anganwadi centre for a population of **400-800** in **rural areas**. - This is the **standard population norm** as per ICDS guidelines for establishing Anganwadi centres in typical rural settings. - This ensures adequate coverage and accessibility of ICDS services (nutrition, immunization, health check-ups, and preschool education) for mothers and children. *700-1000 (Urban)* - This population range (**700-1000**) is the standard norm for **urban areas**, not rural areas. - Urban areas have higher population density, hence a slightly larger population range is used per Anganwadi centre. - The question specifically asks about **rural areas**, making this option incorrect. *300-800 (Hilly/Tribal areas)* - This range (**300-800**) is designated for **hilly, difficult terrain, or specific tribal areas** where geographical challenges and scattered populations require lower population norms. - While this includes rural characteristics, it represents **special category areas**, not standard rural areas as asked in the question. *1000-1500 (Urban high density)* - A population target of **1000-1500** would be too high even for standard urban norms and doesn't align with official ICDS guidelines. - This is not applicable to **rural areas** as specified in the question.
Question 5: Which of the following diseases is primarily monitored under the Integrated Disease Surveillance Program (IDSP)?
- A. Tuberculosis
- B. HIV
- C. Malaria (Correct Answer)
- D. Diabetes
Explanation: ***Malaria*** - Malaria is a significant public health concern with high incidence and mortality, making its surveillance crucial for **disease control and elimination efforts**. - The IDSP aims for early detection and rapid response to **outbreaks of communicable diseases**, including vector-borne diseases like malaria. *Tuberculosis* - While a major public health issue, **tuberculosis (TB)** is primarily monitored under the **National Tuberculosis Elimination Programme (NTEP)**, which has a dedicated and extensive surveillance system. - The NTEP focuses on active case finding, treatment, and prevention of TB through a specific, robust framework separate from the IDSP's general surveillance. *HIV* - **HIV/AIDS** surveillance is conducted under the **National AIDS Control Organisation (NACO)**, which has a specialized program for monitoring prevalence, incidence, and risk behaviors. - NACO's surveillance includes sentinel surveillance among specific populations and programmatic data collection, distinct from the IDSP's generalized infectious disease monitoring. *Diabetes* - **Diabetes** is a **non-communicable disease** and is not primarily monitored under the IDSP, which focuses on infectious disease outbreaks. - Surveillance for non-communicable diseases like diabetes typically falls under programs dedicated to non-communicable disease prevention and control, focusing on prevalence and risk factors.
Question 6: A district shows API of 4.2, ABER 11%, and SPR 3.1%. What is the malaria surveillance status?
- A. Poor surveillance
- B. Cannot be determined
- C. Adequate surveillance (Correct Answer)
- D. Optimal surveillance
Explanation: ***Adequate surveillance*** - An **ABER of 11%** meets the WHO minimum threshold of **≥10%** for adequate malaria surveillance, indicating that blood examination is occurring at an acceptable level. - An **API of 4.2** per 1000 population indicates moderate malaria transmission with reasonable case detection. - An **SPR of 3.1%** is within the acceptable range (1-5%), suggesting balanced testing practices—not excessively high (which would indicate poor case detection) or extremely low (though lower would be better). - Together, these metrics indicate a **functioning surveillance system** that meets basic adequacy criteria but has room for optimization. *Poor surveillance* - This would be characterized by **ABER <10%** (indicating inadequate blood examination coverage), very **high SPR >10%** (suggesting only highly symptomatic cases are tested), or extremely low reporting rates. - The given values (API 4.2, ABER 11%, SPR 3.1%) do not align with poor surveillance indicators. *Cannot be determined* - The three epidemiological indicators provided (API, ABER, SPR) are **standard WHO metrics** specifically designed to assess malaria surveillance effectiveness. - These metrics provide **sufficient information** to make a determination about surveillance status. *Optimal surveillance* - Optimal surveillance would require **ABER ≥20-50%** (much higher blood examination coverage), **SPR <2%** (indicating highly sensitive early case detection), and comprehensive reporting systems. - While the current ABER of 11% is adequate, it is just above the minimum threshold and would need substantial improvement to reach optimal levels.
Question 7: Many patients with unexplained rash and fever were reported from a village close to the Primary Health Centre (PHC). What is the first step in initiating the investigation of such an epidemic?
- A. Defining the population at risk
- B. Confirm existence of epidemic (Correct Answer)
- C. Rapid search for all cases
- D. Verification of diagnosis
Explanation: ***Confirm existence of epidemic*** - The initial and crucial step in any epidemiological investigation is to **verify if a true epidemic exists**, which involves comparing current disease incidence with expected levels. - This step helps to differentiate between a real outbreak and a normal fluctuation in disease occurrence or an artifact of increased reporting. *Defining the population at risk* - While important, identifying the **population at risk** comes after confirming an epidemic and is essential for calculating attack rates and understanding disease spread. - This step helps in understanding who might be exposed or susceptible, allowing for targeted interventions. *Rapid search for all cases* - A **rapid search for all cases** is a critical component of case finding once an epidemic has been confirmed and a case definition established. - This step helps in understanding the magnitude of the outbreak and identifying patterns of transmission. *Verification of diagnosis* - **Verification of diagnosis** is crucial for ensuring that reported cases meet the established case definition and to exclude other conditions. - This process helps to ensure the accuracy of data collected during the investigation and precedes further epidemiological analysis.
Question 8: STEPwise approach to surveillance for Non-Communicable diseases step 2 is
- A. Biochemical Measurement
- B. Behavioral measurement
- C. Physical measurement (Correct Answer)
- D. Emotional Assessment
Explanation: ***Physical measurement*** - The **STEPwise approach** to NCD surveillance involves three steps, with Step 2 specifically focusing on **physical measurements**. - This step includes measurements like **blood pressure**, BMI, weight, height, and waist circumference, which provide crucial data on NCD risk factors. *Biochemical Measurement* - This is typically **Step 3** in the WHO STEPwise approach, focusing on biological measurements from blood or urine samples. - Examples include **blood glucose**, cholesterol levels, and other biomarkers. *Behavioral measurement* - This corresponds to **Step 1** of the WHO STEPwise approach, which involves self-reported data on lifestyle factors. - It covers aspects like **diet**, physical activity, and tobacco/alcohol consumption. *Emotional Assessment* - While emotional and mental health are relevant to overall well-being, **emotional assessment** is not a standard, distinct step in the core WHO STEPwise approach for NCD surveillance. - The STEPs focus on behavioral, physical, and biochemical indicators of NCD risk.
Question 9: What is the correct method for collecting water for bacteriological examination during a disease outbreak?
- A. Collect water from already leaking taps
- B. Collect water from a tap after letting it flow for at least 1 minute to ensure freshness (Correct Answer)
- C. Collect from a gentle stream of water to avoid splashing
- D. Before collecting, let water flow for at least 1 minute
Explanation: ***Correct: Collect water from a tap after letting it flow for at least 1 minute to ensure freshness*** - This is the **standard protocol** for bacteriological water sampling as per WHO and APHA guidelines - Flushing for **at least 1 minute** removes stagnant water from pipes and tap fixtures that may contain biofilms or non-representative bacterial contamination - This ensures the sample represents the **actual water supply** rather than water sitting in pipes - The complete statement includes both the flushing step AND the collection, making it a **complete procedure** *Incorrect: Collect water from already leaking taps* - Leaking taps contain **stagnant water** with biofilm accumulation that is not representative of the main water supply - Continuous dripping allows **external contamination** from air and surrounding surfaces - Does not follow standard water sampling protocols *Incorrect: Collect from a gentle stream of water to avoid splashing* - While avoiding splashing is important to prevent external contamination, this option **omits the critical flushing step** - Without prior flushing, the sample may contain bacteria from **stagnant water in pipes** rather than the actual supply - Incomplete methodology *Incorrect: Before collecting, let water flow for at least 1 minute* - While this describes the flushing step correctly, it is **incomplete as a method** - It states "before collecting" but doesn't describe the actual collection process - The question asks for the "correct method" which should include the complete procedure, not just a preparatory step
Question 10: Substantia nigra is connected to which part of the basal ganglia?
- A. Thalamus
- B. Pallidum
- C. Striatum (Correct Answer)
- D. Subthalamic nucleus
Explanation: ***Striatum*** - The **substantia nigra pars compacta (SNc)** provides **dopaminergic input** to the striatum via the **nigrostriatal pathway**, which is crucial for motor control [1]. - This connection establishes the direct and indirect pathways of the basal ganglia, modulating **movement initiation** and **inhibition** [1]. *Thalamus* - The thalamus acts as a **relay station** for information leaving the basal ganglia, but it is not directly connected to the substantia nigra as a primary input or output structure within the basal ganglia circuitry [1]. - The basal ganglia influence the thalamus, which then projects to the **motor cortex**, but the direct connection from substantia nigra is to the striatum. *Pallidum* - The **pallidum (globus pallidus)** receives input from the striatum and projects to the thalamus, but it is not directly connected to the substantia nigra as the **primary recipient** of nigral efferents [1]. - While it's part of the basal ganglia, the substantia nigra's main direct projection is to the **striatum**. *Subthalamic nucleus* - The **subthalamic nucleus (STN)** is an excitatory component of the basal ganglia that receives input from the cortex and projects to the globus pallidus. - While there are some indirect connections, the STN is not the primary target of the **nigrostriatal dopaminergic projections** from the substantia nigra [1].
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