Self-Assessment Questions (SAQs) for Study Session 33

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering the questions below. One question also tests some of the Learning Outcomes of Study Session 32. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 33.1 (tests Learning Outcomes 33.1, 31.2, 31.3 and 33.4)

Which of the following statements is false? In each case, state why it is incorrect.

A  Typhoid fever is transmitted mainly indirectly by contaminated food or water.

B  The characteristic manifestations of cholera include bloody diarrhoea.

C  Shigellosis is transmitted mainly by direct person-to-person contact.

D  Diarrhoeal diseases can lead to severe dehydration and shock.

E  Viruses are the commonest cause of diarrhoea in children.

F  Typhoid fever is a common cause of diarrhoea in adults.

Answer

A is true. Typhoid fever is transmitted mainly indirectly, via contaminated food or water.

B is false. The characteristic manifestations of cholera are voluminous rice-water diarrhoea and vomiting – but not bloody diarrhoea.

C is true. Shigellosis is transmitted mainly by direct person-to-person contact.

D is true. Diarrhoeal diseases can lead to severe dehydration and shock.

E is true. Viruses are the commonest cause of diarrhoea in children.

F is false. Typhoid fever usually presents with constipation rather than diarrhoea in adults. The main symptom is continuous high fever.

SAQ 33.2 (tests Learning Outcomes 31.1, 33.4 and 33.5)

If you see an adult patient with bloody diarrhoea, what actions should you take:

  • a.To treat the patient?
  • b.To prevent the disease from spreading?

Answer

  • a.In an adult patient with bloody diarrhoea, you should start immediate rehydration with ORS, and refer him/her to a higher health facility for laboratory diagnosis of the causative infectious agent and specific treatment.
  • b.You should report the suspected case to the woreda Health Office and request assistance in preventing an epidemic. Ask the patient’s family members and neighbours about the presence of other individuals with a similar illness, and advise all contacts of the patient to apply thorough hygiene measures, including handwashing with soap and water. Make sure they control the spread of the infectious agents by boiling or disinfecting clothes, bedding or utensils used by the patient; these articles must not be washed in water sources used for bathing or drinking.

SAQ 33.3 (tests Learning Outcomes 33.2, 33.3 and 33.4)

Complete the missing details from Table 33.3 below.

Table 33.3  Incubation periods and most affected age-groups for common bacterial and viral faeco-oral diseases.

DiseaseIncubation periodAge group for most cases
Cholera
Shigellosis
Rotavirus infection
Typhoid fever

Answer

The completed version of Table 33.3 appears below.

Table 33.3  Incubation periods and most affected age-groups for common bacterial and viral faeco-oral diseases

DiseaseIncubation periodAge group for most cases
Cholera 2 hours to 5 daysAll ages can be affected
Shigellosis1 to 3 days2 to 3 years
Rotavirus infection2 to 3 daysUnder 5 years
Typhoid fever1 to 2 weeksOver 5 years

SAQ 33.4 (tests Learning Outcomes 33.1, 33.2, 33.2, 33.4 and 33.5)

  • a.Rotaviruses are endemic in all developing countries and the major cause of diarrhoeal diseases in young children. What does endemic mean?
  • b.How are bacterial and viral diarrhoeal diseases transmitted?
  • c.A nine-month-old baby has had three episodes of watery diarrhoea in the last three days. The mother says the child is still partly breastfed, and is eating and drinking normally. It does not appear to be dehydrated. What actions should you take and what should you advise the mother?

Answer

  • a.Endemic means that rotaviruses and the diarrhoeal diseases they cause are ‘always present’ in the country at an approximately steady rate.
  • b.Bacterial and viral diarrhoeal diseases are transmitted directly by hands contaminated with faeces that make contact with the mouth, and indirectly in contaminated food, water, soil and utensils (e.g. bottles used to feed milk to infants), and by flies that have crawled over faeces.
  • c.The mother tells you that the infant is still breastfeeding, eating and drinking normally. As long as it is not dehydrated, there is no need to give ORS immediately. But the mother should be advised to go on breastfeeding as much as the child will drink, and feed other nourishing food and drinks with a very clean cup and spoon. She should wash her hands frequently and thoroughly with soap, particularly after changing the infant’s nappy (diaper) or cleaning its bottom. Tell her she must bring the child back to see you immediately, or take it to the nearest health centre or hospital, if its diarrhoea persists or gets worse.

Summary of Study Session 33