Global Health Initiatives — MCQs
Which of the following is NOT a core component of the WHO's global STI control strategy?
At what age is the first dose of Measles vaccination given under the Universal Immunization Programme (UIP)?
Not under millennium development goals?
Which of the following statements is incorrect regarding the strategic plan for malaria control 2012-2017?
Which vaccine is given at birth to provide protection against tuberculosis as per the National Immunization Schedule in India?
The Roll Back Malaria programme focused mainly on
Which of the following procedures is not typically covered by the National Programme for Control of Blindness (NPCB) for reimbursement of surgery done by a non-governmental organization (NGO) eye hospital?
With regard to the Goals, Milestones and Targets for the Global Technical Strategy for Malaria (2016-2030), consider the following statements: 1. Compared to 2015, the target is to reduce the malaria mortality rates globally by at least 90% by year 2030 2. Compared to 2015, the target is to reduce malaria case incidence by 90% by year 2030 3. Eliminate malaria from at least 35 countries, where malaria was transmitted in 2015, by year 2030 Which of the above statements hold true?
Due to a measles outbreak in a community, a medical officer decided to immunize a child aged seven months with measles vaccine. When should the next measles vaccine be administered?
Which of the following statements about HPV vaccination is true?
Global Health Initiatives 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: At what age is the first dose of Measles vaccination given under the Universal Immunization Programme (UIP)?
- A. 10 weeks
- B. 9 months (Correct Answer)
- C. 14 weeks
- D. 6 months
Explanation: ***9 months*** - The first dose of the **Measles-Rubella (MR) vaccine** is given at **9 months of age** as per India's Universal Immunization Programme (UIP). - This timing is chosen because **maternal antibodies** against measles, which can interfere with vaccine effectiveness, generally wane by this age. - A second dose is given at **16-24 months** to ensure adequate protection (Note: Some countries use MMR vaccine which includes mumps component as well). *10 weeks* - This age is associated with the administration of other routine vaccinations like **Pentavalent vaccine (DPT-HepB-Hib)** and **OPV/IPV**, not measles. - Administering the measles vaccine too early, when **maternal antibodies** are still high, leads to suboptimal immune response. *14 weeks* - This is when the **third dose of Pentavalent vaccine and OPV/IPV** are given as part of the routine immunization schedule. - This age is not the standard recommendation for initial measles vaccination. *6 months* - While specific high-risk situations (e.g., outbreaks or travel to endemic areas) might warrant an additional measles vaccine dose at 6 months, it is **not the routine recommended age** for the first dose. - At 6 months, there may still be sufficient **maternal antibodies** to interfere with vaccine efficacy, leading to poorer immune response compared to vaccination at 9 months. - If given at 6 months during outbreaks, the child still receives routine doses at 9 months and 16-24 months.
Question 3: Not under millennium development goals?
- A. Eradication of extreme poverty
- B. Global partnership for development
- C. Reduction of cardiovascular health hazards (Correct Answer)
- D. Sustainability of the environment
Explanation: ***Reduction of cardiovascular health hazards*** - The **Millennium Development Goals (MDGs)** focused on broader health issues like poverty, hunger, maternal and child health, and infectious diseases, rather than specific non-communicable diseases. - While improving health was a core tenet, specific targets for reducing **cardiovascular disease** burdens were not explicitly listed as one of the eight MDGs. *Eradication of extreme poverty* - This was the **first and overarching goal** of the MDGs, aiming to halve the proportion of people living on less than $1.25 a day by 2015. - It included targets related to **employment** and **hunger reduction**. *Global partnership for development* - This was the **eighth and final goal** of the MDGs, emphasizing international cooperation to achieve the other goals. - It focused on issues such as **aid, debt relief**, and **access to technology**. *Sustainability of the environment* - This was one of the **seven major MDGs (Goal 7)**, aiming to integrate principles of sustainable development into country policies and programs. - It included targets related to **reducing biodiversity loss** and increasing access to safe drinking water.
Question 4: Which of the following statements is incorrect regarding the strategic plan for malaria control 2012-2017?
- A. 50% reduction in mortality by 2017
- B. Objective is API < 1 per 10,000 (Correct Answer)
- C. Complete treatment to 100% of patients
- D. Annual incidence < 1 per 1000 by 2017
Explanation: ***Objective is API < 1 per 10,000*** - The correct objective for the **Annual Parasite Incidence (API)** in the 2012-2017 strategic plan for malaria control was to reduce it to **less than 1 per 1,000 population**, not 1 per 10,000, making this statement incorrect. - This metric measures the number of new malaria cases per 1,000 people per year. *50% reduction in mortality by 2017* - A key objective of the **National Framework for Malaria Elimination in India** (which this strategic plan aimed to contribute to) was indeed to achieve a significant reduction in malaria-related mortality. - Specifically, aiming for a **50% reduction in mortality** by 2017 was a stated goal to lessen the disease burden. *Annual incidence < 1 per 1000 by 2017* - One of the primary goals of the **Malaria Control Strategic Plan 2012-2017** was to reduce the annual parasite incidence (API) to **less than 1 per 1,000 population** in all endemic areas. - This target focused on decreasing the occurrence of new malaria cases. *Complete treatment to 100% of patients* - A core component of malaria control strategies emphasizes ensuring that **all confirmed malaria cases** receive complete and effective treatment. - Achieving **100% complete treatment adherence** is crucial to prevent drug resistance and eliminate the parasite reservoir.
Question 5: Which vaccine is given at birth to provide protection against tuberculosis as per the National Immunization Schedule in India?
- A. Measles
- B. BCG (Correct Answer)
- C. OPV
- D. Hepatitis B
Explanation: ***Correct: BCG*** - The **BCG vaccine** (Bacille Calmette-Guérin) is the only vaccine given at birth specifically to protect against **tuberculosis** - It is administered at birth or as early as possible as part of the **National Immunization Schedule** - BCG is particularly important in India due to the high burden of tuberculosis *Incorrect: Measles* - The **measles vaccine** is given at **9 months of age**, not at birth - Early administration is less effective due to the presence of **maternal antibodies** that can interfere with vaccine response *Incorrect: OPV* - While **OPV zero dose (OPV0)** is also given at birth for early polio protection, it protects against **poliomyelitis**, not tuberculosis - OPV is followed by subsequent doses at 6, 10, and 14 weeks *Incorrect: Hepatitis B* - **Hepatitis B birth dose** is also given within 24 hours of birth to prevent **vertical transmission** - However, it protects against **Hepatitis B virus infection**, not tuberculosis
Question 6: The Roll Back Malaria programme focused mainly on
- A. IEC campaigns for community awareness
- B. Insecticide treated bed nets (Correct Answer)
- C. Development of larvivorous fishes for eradication of larvae.
- D. Presumptive treatment of malaria case
Explanation: ***Insecticide treated bed nets*** - The **Roll Back Malaria (RBM)** program, launched in 1998, focused significantly on key interventions including the promotion and distribution of **insecticide-treated nets (ITNs)**. - ITNs are highly effective in **preventing mosquito bites**, thus reducing malaria transmission, especially in vulnerable populations. *IEC campaigns for community awareness* - While **Information, Education, and Communication (IEC)** campaigns are crucial for health programs, they were a supportive component rather than the primary focus of RBM's core intervention strategy. - RBM emphasized **tangible interventions** with direct impact on disease transmission. *Development of larvivorous fishes for eradication of larvae* - The use of **larvivorous fish** is a form of biological control, which is typically part of **integrated vector management** but not the central pillar of RBM's strategy. - RBM prioritized interventions with **broad, immediate impact** across larger populations. *Presumptive treatment of malaria case* - **Presumptive treatment** (treating based on symptoms without laboratory confirmation) was an important aspect of early malaria control but not the main strategic thrust of the RBM initiative. - RBM's primary focus was on **prevention and rapid diagnosis/treatment** using effective antimalarials, and vector control strategies.
Question 7: Which of the following procedures is not typically covered by the National Programme for Control of Blindness (NPCB) for reimbursement of surgery done by a non-governmental organization (NGO) eye hospital?
- A. Cataract surgery
- B. Pan retinal photocoagulation for diabetic retinopathy
- C. Syringing and probing of the nasolacrimal duct (Correct Answer)
- D. Trabeculectomy surgery
Explanation: ***Syringing and probing of the nasolacrimal duct*** - While important for lacrimal drainage issues, procedures like **syringing and probing** are generally considered minor and less vision-restoring compared to the major surgeries targeted by the **NPCB**. - The **NPCB** focuses on interventions for leading causes of blindness, primarily **cataract** and other significant vision-threatening conditions, which this procedure typically isn't. *Cataract surgery* - **Cataract surgery** is a cornerstone of the **NPCB's** efforts, as cataracts are the leading cause of reversible blindness. - Reimbursement for **cataract surgery** is a primary objective to improve access and reduce the burden of blindness. *Pan retinal photocoagulation for diabetic retinopathy* - **Diabetic retinopathy** is a major cause of preventable blindness, and **pan retinal photocoagulation (PRP)** is a key intervention to preserve vision. - The **NPCB** includes procedures for **diabetic retinopathy** management due to its significant public health impact. *Trabeculectomy surgery* - **Trabeculectomy** is a surgical procedure for **glaucoma**, which is another significant cause of irreversible blindness. - The **NPCB** includes interventions for **glaucoma** given its severe vision-threatening nature and the need for surgical management in many cases.
Question 8: With regard to the Goals, Milestones and Targets for the Global Technical Strategy for Malaria (2016-2030), consider the following statements: 1. Compared to 2015, the target is to reduce the malaria mortality rates globally by at least 90% by year 2030 2. Compared to 2015, the target is to reduce malaria case incidence by 90% by year 2030 3. Eliminate malaria from at least 35 countries, where malaria was transmitted in 2015, by year 2030 Which of the above statements hold true?
- A. 1 and 3 only
- B. 1 and 2 only
- C. 2 and 3 only
- D. 1, 2 and 3 (Correct Answer)
Explanation: ***1, 2 and 3*** - All three statements accurately reflect the **core targets** set by the Global Technical Strategy for Malaria (2016-2030). - These ambitious goals aim to achieve significant reductions in malaria burden and eventual eradication in many regions. *1 and 3 only* - This option is incorrect because it omits statement 2, which is a verified goal for **reducing malaria case incidence**. - All three statements are indeed part of the strategy's published objectives. *1 and 2 only* - This option is incorrect as it excludes statement 3 regarding the **elimination of malaria** from at least 35 countries. - The strategy encompasses all three stated objectives for global malaria control. *2 and 3 only* - This option is incorrect because it fails to include statement 1, which specifies the target for **reducing malaria mortality rates**. - The strategy explicitly addresses all three aspects: mortality, incidence, and country-level elimination.
Question 9: Due to a measles outbreak in a community, a medical officer decided to immunize a child aged seven months with measles vaccine. When should the next measles vaccine be administered?
- A. Not required
- B. When the child completes nine months of age (Correct Answer)
- C. When the child completes fifteen months of age
- D. After four weeks
Explanation: ***When the child completes nine months of age*** - A measles vaccine given at **seven months during an outbreak** is considered a **zero-dose** or **early dose** and does NOT replace the routine immunization schedule. - According to the **Indian National Immunization Schedule**, the routine first dose of measles vaccine (MR vaccine) is given at **9 months of age**, regardless of whether an earlier outbreak dose was administered. - Vaccines given before 9 months have **reduced efficacy** due to interference from maternal antibodies, making the 9-month dose essential for adequate seroconversion. - After the 9-month dose, a second dose is given at **16-24 months** as per routine schedule. *When the child completes fifteen months of age* - While 15-18 months is appropriate timing for the **second dose** of measles vaccine in the routine schedule, it is not the immediate next dose after a 7-month outbreak vaccination. - The child still requires the **routine 9-month dose first**, followed by the second dose at 16-24 months. - Skipping the 9-month dose and going directly to 15 months would leave a prolonged gap without adequate protection. *Not required* - This is **incorrect** because early doses given before 9 months are considered zero-doses and do not provide reliable long-term immunity. - The routine schedule **must still be followed** to ensure proper immunization, starting with the 9-month dose. *After four weeks* - A four-week interval after the 7-month dose is **too short** and not recommended in immunization guidelines. - There is **no indication** for such an early repeat dose; the child should wait until the routine 9-month schedule for the next dose.
Question 10: Which of the following statements about HPV vaccination is true?
- A. It is given to women aged 20-40 years.
- B. The primary dose consists of 2 doses.
- C. It has an efficacy greater than 70% for cervical cancer. (Correct Answer)
- D. There are two types available in the market.
Explanation: ***It has an efficacy greater than 70% for cervical cancer.*** - HPV vaccines are highly effective in preventing **HPV infections**, which are the primary cause of cervical cancer. Studies show they have an efficacy of **over 70%** (and often much higher for certain strains) in preventing cervical precancers and cancers. - The vaccine works by inducing an immune response to the **HPV L1 capsid protein**, which prevents the virus from infecting cells. *It is given to women aged 20-40 years.* - The primary target group for HPV vaccination is **adolescents**, typically aged 9-14 years, before potential exposure to the virus. - While catch-up vaccination may be recommended for young adults up to age 26, routine vaccination in women aged 20-40 years is **less common and less effective** due to likely prior exposure. *The primary dose consists of 2 doses.* - For individuals initiating vaccination before their 15th birthday, the primary dose schedule consists of **2 doses**. - For individuals 15 years and older, a **3-dose schedule** is typically recommended. *There are two types available in the market.* - Currently, there are **three types** of HPV vaccines available globally: bivalent (targeting HPV 16, 18), quadrivalent (targeting HPV 6, 11, 16, 18), and **nonavalent (targeting HPV 6, 11, 16, 18, 31, 33, 45, 52, 58)**. - The specific types available in a particular market may vary, but globally, there are more than two.
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