Epidemiology and principles of evidence-based medicine

THE CALENDAR-THEMATIC PLAN OF LECTURES ON EPIDEMIOLOGY
V COURSE, 2024/2025 ACADEMIC YEARS

The credit-modular system involves the study of general, special epidemiology, structured into meaningful modules as logically completed parts of the curriculum. The grade for the module is defined as the sum of the assessments of the daily survey of theoretical and practical training and computer testing on the topics that are provided for by the module (including sections of independent work).

The training provides for the requirement of 100% attendance at lectures and practical classes.

When learning the materials of the module, the student is awarded a maximum of 6 points for each practical lesson (the grade is given in the traditional 4-point grading system). The maximum number of points that a student can receive in practical classes during the academic year is 896. The following points are awarded for the defense of work on retrospective epidemiological analysis: “5” – 8 points, “4” – 6 points, “3” – 5 points, ” 2″ – 0 points. Protection of the epidemiological map: “5” – 12 points, “4” – 10 points, “3” – 8 points, “2” – 0 points. For meaningful module control 1, a student can receive a maximum of 18 points, the minimum required point is 11. The maximum number of points for the student’s current educational activity is 120. The student is admitted to the final module control under the condition that the requirements of the educational program are met and if for the current educational activity he scored no less than 72 points. The final module control is carried out according to the schedule at the end of the cycle. The grade for the final module control is given in the traditional 4-point grading system with further conversion into points, while the grade “5” corresponds to 80 points, “4” – 64 points, “3” – 48 points, “2” – 0 points. The final module control is credited to the student if he scored at least 48 out of 80 points.

Assessment:

91% – 100% – 91.5-100.5 points – “5” (according to the ECT A scale)

76% – 90% – 76.5-91.0 points – “4” (on the ECT BC scale)

60% – 75% – 60.0-76.0 points – “3” (according to the ECT DE scale)

59 points and less – “2” (on the ECT FX scale, F).

The system provides additional incentives:

– participation in the Olympiad in epidemiology: for 1 prize + 18 points, for 2 – 16 points, 3 – 14 points to the final mark.

Final certification in the course of epidemiology is carried out by adding points obtained in practical classes for control and coursework and additional ones.

Notes.

Regulations on the 1st round of the Olympiad in epidemiology. Olympiad structure:

– average score for practical and final lessons – maximum score 5;

– computer testing (50 questions) – maximum score 5;

– solving situational tasks “STEP 2” (two tasks) – maximum score 10,

– practical skills – maximum score 5.

The maximum number of points that a student can get in the first round of the Olympiad is 25.

List of questions for self-training:

1. Subject and tasks of epidemiology. The main stages of the development of epidemiology (D. Samoilovich, D.K. Zabolotny, L.V. Gromashevskyi, V.D. Belyakov).
2. Epidemic process and its components. Sections of teaching about the epidemic process. Driving forces of the epidemic process.
3. Peculiarities of the epidemic process in anthroponoses and zoonoses. The concept of sapronosis.
4. Quantitative and qualitative manifestations of the epidemic process.
5. Anti-epidemic measures in centers of infectious diseases.
6. Center of infectious disease. Directions for conducting an epidemiological survey of the center? What determines the boundaries of the center of an infectious disease? Give examples.
7. The purpose and tasks of the epidemiological examination of the cell. How are infectious patients detected and reported?
8. Source and reservoir of pathogens of infectious diseases. A sick person and a carrier and their epidemiological significance. Categories of carriers of infectious disease agents.
9. Measures for decontamination of patients and carriers as sources of pathogens of infectious diseases.
10. Epidemiological importance of animals (rodents, domestic animals, etc.).
11. The concept of deratization, types and methods.
12. Definition of the transmission mechanism, its links. Factors and ways of transmission of pathogens of infectious diseases. Types of mechanisms of transmission of pathogens of human infectious diseases.
13. Epidemiological importance of arthropods (mosquitoes, flies, ticks, lice, fleas, etc.) as carriers of pathogens of infectious diseases.
14. Types and methods of disinsection. Definition of disinfection, its types and methods. Disinfection quality control.
15. Sterilization and its stages, quality control.
16. Calendar of preventive vaccinations of Ukraine. Legal aspects of vaccine prophylaxis. Basic regulatory documents in the field of epidemiology.
17. Epidemiological research method, its structure. Epidemiological, social and economic significance of infectious diseases.
18. Levels of evidence in medicine. Analysis of the territorial distribution of morbidity.
19. Manifestations of the epidemic process in the annual dynamics of morbidity and the causes that determine them. Manifestations of the epidemic process in the long-term dynamics of morbidity and the causes that determine them.
20. Structure and level of morbidity of the population by collectives, groups and nosological forms. Concepts of territory, groups, time and risk factors.
21. The importance of the social factor in the development of the epidemic process. The importance of the natural factor in the development of epidemic diarrhea.
22. The purpose and features of the organization of screening examinations of the population.
23. Planning of anti-epidemic and preventive measures.
24. Epidemiological classification of infectious diseases. • Epidemiological features of the group of intestinal infections.
25. Epidemiological features of the group of respiratory tract infections.
26. Epidemiological features of the group of blood infections.
27. Epidemiological features of the group of external covers.
28. Epidemiology and prevention of nosocomial infections
29. Epidemiology and prevention of hospital infections.
30. Preventive and anti-epidemic measures for the most common diseases.
31. Peculiarities of the epidemic process during an emergency situation.
32. Definition and tasks of bacteriological intelligence. Rules for the selection of materials for the indication of bacteriological weapons.

Approximate list of questions for an oral interview (practical skills):

1. The procedure for conducting an epidemiological survey of a center of viral hepatitis
2. Plan of anti-epidemic measures to eliminate the outbreak of viral hepatitis A in the home outbreak
3. Plan of anti-epidemic measures to eliminate the outbreak of viral hepatitis A in a children’s preschool
4. Methods of epidemiological examination of the source of infection
5. Procedure for collecting epidemiological anamnesis
6. Measures when detecting a patient (suspected) of a quarantine infection at an outpatient appointment
7. Measures when detecting a patient (suspected) of a quarantine infection on a vehicle
8. Procedure for notification of detection of a patient (suspected) of a quarantine infection
9. Emergency prevention in the center of the plague
10. Disinfection of feces of a typhoid patient
11. Disinfection quality control methods
12. Preparation of 10% basic solution of perchloric lime
13. Composition and types of anti-plague suit
14. Methods of quality control of pre-sterilization treatment of medical instruments
15. Procedure for quality control of chamber disinfection.

The method of carrying out a differentiated assessment in the discipline “epidemiology and principles of evidence-based medicine”, 5th year

After the end of classroom classes provided by the curriculum, a differential assessment is conducted, to which students who do not have academic debt and have scored at least 72 points for the current performance (current performance 72-120 points) are admitted.

Current control is carried out at each practical session in accordance with the specific goals of the topic and contains standardized forms of control of theoretical training and control of professional skills. Current control includes assessment of the level of knowledge (testing conducted online (with independent preparation), oral or written express survey, test control using test tasks), assessment of the main stage of practical training (solving typical situational tasks of an increased level of complexity), assessment of the final level knowledge in class (solving situational problems of the III level of complexity, interpreting the results of laboratory and other methods of examination of the patient).

The form of the final modular control of the academic discipline includes control of theoretical training (using standardized and test tasks) and control of professional skills (using situational tasks of level III) in accordance with the program.

Structure:

1 Test computer control – maximum score 10 points.

2 Practical skills (oral interview) – 30 points

3 Written work – situational task and answer to theoretical questions – 40 points.

Example of written work.

1 A 32-year-old female patient turned to the district therapist on the 5th day of illness with complaints of a severe headache, general weakness, lack of appetite, insomnia, an increase in body temperature from 37.50 C on the first day of the illness with a gradual increase to 39.00 C on the day of seeking medical help. Objectively: significant pallor of the skin, no rash. The tongue is covered with a grayish-white plaque, there are teeth marks on the lateral surfaces, which are free from plaque. Pulse 78 per minute, blood pressure 110/60 mm Hg. Art. The abdomen is moderately swollen, painless. The liver protrudes 1.5-2 cm from under the edge of the costal arch. Padalka’s symptom is positive. There were no bowel movements for two days. The preliminary diagnosis is typhoid fever.

1 a. Specify the duration of the epicenter. Describe the primary anti-epidemic measures for the patient.

1 b. Plan anti-epidemic measures for contact persons.

1 c. Method, method and means of disinfection.

2. Specify the scheme of immunization against diphtheria. Name the immunobiological drugs.

3. Meningococcal infection. Epidemiological features (source of pathogens, factors and ways of transmission, manifestations of the epidemic process, conditions for admission of convalescents to children’s institutions).

Practical skills (oral interview) – 30 points.

1. Describe the procedure for carrying out an epidemiological survey of a center of viral hepatitis A.

2. How emergency prevention is carried out in a cholera outbreak

Standards of answers to the questions

1a The patient must be hospitalized and transported by ambulance. The emergency message is sent by the doctor who registered the case of the disease. The duration of the existence of the epidemic center is 21 days from the moment the patient is hospitalized and the final disinfection is carried out.

1b Persons who communicated with the patient are identified in the cell. They specify the presence of symptoms of the disease and the date of their occurrence, the fact of consumption of food and water, which can be considered as potential transmission factors. Medical observation of contact persons for 21 days, starting from the day of patient isolation and final disinfection, with mandatory thermometry once every 3 days. A one-time bacteriological (feces, urine) and serological (blood with the help of RPGA) examination is carried out for persons who communicated with the patient in the cell at their place of residence. “Food workers” and persons equated to them are suspended from work until negative results of bacteriological tests are obtained. People suffering from diseases of the liver and biliary tract additionally undergo a one-time bacteriological examination of the duodenal contents.

1c In the unit after hospitalization, final disinfection is carried out. Physical and chemical disinfection methods are used. Dishes, linen, personal hygiene items of the patient are disinfected by boiling in a 2% soda solution for 15 minutes. The room where the patient was was washed with a 0.1% solution of Dexactin.

2. Vaccination against diphtheria is carried out at 2 (first vaccination) – 4 (second vaccination) – 6 (third vaccination) – 18 months (fourth vaccination). For vaccination, a vaccine with both whole-cell pertussis component (AKD) and acellular (AaKDP) is used. Revaccination against diphtheria and tetanus at the age of 6 is carried out with diphtheria-tetanus toxoid (ATP), the next one at 16 years is with diphtheria-tetanus toxoid with a reduced antigen content (ADP-M). Subsequent revaccinations are carried out every 10 years of ADP-M.

3. Meningococcal infection – the source of the pathogen: patients with meningococcal nasopharyngitis or the generalized form and meningococcal carriers; factors and ways of transmission – air and aerosol ways (infection occurs with prolonged and close contact during talking, sneezing, coughing); registered in all age groups, but children under 5 make up 70% of all patients; morbidity levels increase in the winter-spring period (sporadic morbidity and outbreaks); a convalescent girl is admitted to children’s institutions after a one-time control bacteriological examination of mucus from the nasopharynx, taken 5 days after discharge from the hospital.

Recommended literature for self-training in the discipline “epidemiology and principles of evidence-based medicine”, 5th year

Download syllabus