1
EADTMH
2
Epidemiology Module - Camp Crisis
2.1
Camp Death Rate
2.1.1
What will affect reported rates?
2.1.2
Surveying a community
3
Epidemiology Module - Is this test useful
4
Epidemiology Module - HIV in Katumba - Measuring Diseases
4.1
Incidence
4.1.1
Cumulative incidence (ncidence Risk)
4.2
Incidence Rate: Incidence/incidence density (person time at risk)
5
Epidemiology Module - Study Design
5.1
Types of studies
5.1.1
Case Report
5.1.2
Cross-sectional studies
5.1.3
Case control
5.1.4
Cohort
5.1.5
RCTs
5.1.6
Evaluating studies
5.1.7
Bias
6
Case of the day - 28/8/18
7
Case of the day - 29/08/2018
8
Epidemiology Module - Academic Writing
8.0.1
I - Intro
8.0.2
M - Methods
8.0.3
R - Results
8.0.4
D - Discussion
8.1
Structure for an essay or report
8.2
Avoiding plagiarism
9
Epidemiology Module - Everything you wanted to know about statistics
9.1
Continuous Data
9.2
Categorical Data
9.3
Summariseing data
9.4
Comparing between groups
9.5
Paired data
9.6
Ratios
9.6.1
Risk Ratios
9.6.2
Odds Ratios
9.7
P value
9.7.1
Confifence intervals
9.8
Sample Size,
10
Fever in Tanzania
10.1
Clinical Problem (in 2002)
10.2
Resources on Causes of Fever GLobally
10.3
Ongoing Research
10.3.1
Bacterial Zoonoses
10.4
Febrile Deaths
11
Basics of Antiretroviral Therapy
11.1
NRTIs
11.2
Protease Inhibitors
11.3
NNRTIs
11.4
Continue Story
11.5
INSTI
11.6
Other ARTs
11.6.1
Entry Inhibitors
11.7
What to avoid
11.8
Aims of treatment
12
Clinical Epi - Outbreak
12.1
Story
12.1.1
What further information may be useful?
12.1.2
How might you prepare to investigate this outbreak
12.2
More Story
12.2.1
What Main categories of disease should you think:
12.3
More story
12.3.1
What modes of transmission should we consider
12.4
More Story
12.4.1
What is the next step in your investigation?
12.4.2
Epidemic Curves
12.5
Summary Of Story so far
12.5.1
What hypotheses would you have for mode of transmission so far?
13
COTD “31/08/2018”
13.1
Case and Questions
13.2
Answers
14
Case of the Day - HIV and Drug Resistance
15
Malaria
15.1
Introduction
15.1.1
What is malaria?
15.1.2
Cases and Death
15.1.3
Geographical
15.1.4
Hot Spots and Hot Pops
15.1.5
Falciparum prevalence
15.1.6
Human Malaria
15.1.7
Life Cycle
15.1.8
Relapse/Recrudescence
15.1.9
Parasite Biomass and resistance terminology
15.2
Clinical Features
15.2.1
Immunity to malaria, Prevelance
15.2.2
Loss of Immunity
15.2.3
Cases
15.2.4
Presenting syndromes in malaria
15.2.5
Treatment
16
Malaria Elimination
16.1
Why is there so much malaria in africa, but not in India or South America?
16.2
Definitions
16.3
Factors important in transmission of malaria?
16.4
What are the most effective tools in elimination?
16.5
India vs Africa
16.6
Ross MacDonald Equation
17
Diagnostics
17.1
The ideal test
17.2
Microscopy
17.2.1
The thick film
17.2.2
The thin film
17.2.3
Thick and thin film
17.2.4
Interpreting a film
17.3
Other approaches
17.3.1
Rapid Diagnostic Tests
17.3.2
RDT Problems
17.4
Malaria Control - Entomology, Vector Control, Vaccines
17.5
Life Cycle
17.6
Identification
17.6.1
Eggs
17.6.2
Larvae
17.6.3
Adults
17.7
Behaviour
17.8
Plasmodium falciparum
17.9
Malaria Control through Vector Control
17.9.1
In Tanzania
17.9.2
Vector Control
17.9.3
Larval control
17.9.4
Insecticide Resistance
17.9.5
Conclusion
17.10
Vaccines
17.10.1
Ideal vaccine
17.10.2
Good Enough Vaccine
17.10.3
Difficulty in developing a vaccine
17.10.4
RTS,S
17.10.5
Sporozoite vaccine
17.10.6
Current position
18
Drugs for Non-Severe Falciparum and Malaria Control
18.0.1
Chloroquine
18.0.2
Artemesia Anua: Artemisin Combination Therapies
18.0.3
Drugs for Malaria Control
18.1
COTD “5/9/18”
18.1.1
Presentation
18.1.2
Initial Management
18.1.3
DDx
18.1.4
Sabah
18.1.5
Later Symptoms
18.1.6
Diagnosis
18.1.7
P knowelsi
18.2
Post mortem
18.3
Potential Problem
18.4
Malaria - “Benign”
18.4.1
Forms
18.4.2
Imported P. vivax, ovale, and malariae
18.5
Microscpy
18.5.1
Vivax
18.5.2
Malariae
18.5.3
Treatment of Benign Malaria
18.6
Severe Malaria Prophylaxis
18.6.1
What makes falciparum so fatal?
18.6.2
Cerebral Malaria
18.6.3
Acidosis (Respiratory Distress)
18.6.4
Hypoglycaemia
18.7
Host Genetics
18.7.1
Summary
18.8
Malaria Anaemia
18.8.1
Severe Malaria Anaemia and introduction
18.8.2
Anaemia Demographics
18.8.3
Sub Optimal Malaria Treatment
18.8.4
Definition
18.8.5
Acute Malarial Anaemia
18.8.6
Chronic Malaria Anaemia
18.8.7
Acute On Chronic
18.8.8
Clinical Signs
18.8.9
Management
18.8.10
Iron and the Acute Phase Response:
18.8.11
Malaria in Pregnancy
18.8.12
Summary
18.9
Hyper Reactive Malarial Splenomegaly Syndrome - HMS (Tropical Splenomegaly Syndrome - TSS)
18.9.1
Case Study
18.10
Invasive bacterial disease and malaria
18.10.1
DDx
18.10.2
Epidemiology
18.10.3
Non Typhoidal Salmonella
18.11
Severe Malaria
18.11.1
SEIZURES
18.12
THE COCK UP THEORY OF MALARIA
18.12.1
PREGNANCY
18.13
Cerebral Malaria
18.13.1
Treating Cerebral Malaria
18.13.2
Haemolysis in Artemesinins
18.13.3
Artesunate Resistance
18.13.4
Dirty Laundry - Spot the Cock Ups!
18.13.5
Simple Things that make a huge difference in Severe Malaria in Children in Resource Poor Settings
18.13.6
The Cock Up
18.13.7
SUMMARY
19
Chagas Disease
19.1
Epidemiology
19.2
Life Cycle
19.3
Acute Disease
19.4
Chronic Disease
19.5
Immunology
19.6
Diagnosis
19.7
Management
19.7.1
Drugs
19.8
Prevention
20
Leishmaniasis
20.1
Lifecycle
20.2
Vector
20.3
Leishmania
20.3.1
Cutaneous
20.3.2
Visceral
21
Sleeping Sickness
21.1
Parasite
21.1.1
Life Cycle
21.2
Vector
21.3
Epidemiology
21.3.1
West African
21.3.2
East African
21.4
Clinical Features
21.4.1
Chancre
21.4.2
Haemolymphatic (Stage 1)
21.4.3
Meningoencephalitic (Stage 2)
21.5
Diagnosis
21.6
Treatment
21.7
Prevention and Control
22
Case Presentation
22.1
Biopsy
22.2
Now what?
22.3
As a clinician
22.4
Case Presentation
22.4.1
DDX
22.4.2
Treatment
22.4.3
Then what happened?
23
Tissue Nematodes: Filariasis
23.1
Lymphatic Filiarisis
23.2
Life Cycle
23.3
Epidemiology
23.4
Vector
23.5
Presentation
23.5.1
Acute Adenolymphangitis
23.5.2
Chronic
23.5.3
Asymptomatic Microfiliariasis
23.5.4
Tropical Pulmonary Eosinophilia
23.6
Pathology
23.7
Diagnosis
23.7.1
POCUS Scrotum
23.8
Treatment
23.8.1
DEC Alternatives
23.8.2
Procedural
23.8.3
Supportive care
23.9
Prevention
23.10
External Source
24
Guinea Worm - Dracunculiasis
25
Loa Loa
25.1
Life Cycle
25.2
Vector
25.3
Epidemiology
25.4
Pathophysiology
25.5
Clinical PRrestntation
25.5.1
Calabar Swelling
25.5.2
Eye worm
25.5.3
Systemic Symptoms
25.6
Diagnosis
25.6.1
Lab
25.6.2
Treatment
25.6.3
Public Health - Onchocerciasis Control
25.6.4
DEC in onchocerciasis
26
Mansonella perstans
27
Onchocerciasis - “River Blindness”
27.1
Epidemiology
27.2
Life Cycle
27.3
Clinical Features
27.3.1
Presentation
27.3.2
Skin
27.3.3
Nodules
27.3.4
Lymphatics
27.3.5
Eye
27.3.6
Nodding Syndrome
27.4
Diagnosis
27.4.1
Skin Snip/Punch Biopsy
27.4.2
Nodule Excision
27.4.3
Eye Disease
27.4.4
Bloods
27.4.5
Microscopy
27.4.6
DEC Patch test
27.5
Treatment
27.5.1
Ivermectin
27.5.2
Doxycycline
27.6
Prevention
27.7
Summary
28
Cestodes
28.1
Life Cycle
29
Fish Tapeworm
29.1
Presentation
29.2
Diagnosis
29.3
Treatment
30
Beef Tapeworm - Taenia saginata
30.1
Requirements
30.2
Clinical Features
30.3
Diagnosis
30.4
Treat
31
Pig Tapeworm - Taenia solium
31.1
One Life Cycle
31.2
Another life cycle
31.3
Presentation
31.4
Diagnosis
31.5
Treat
32
Echinococcus
32.1
e. granulosis
32.1.1
Epi
32.1.2
Pathogenesis
32.1.3
Pathology
32.1.4
Clinical Features
32.1.5
Diagnosis
32.1.6
Treat
32.1.7
Prevention
32.2
multilocularis
32.2.1
Clinical Features
32.2.2
Diagnosis
32.2.3
Treat
32.2.4
Prevent
32.3
polycystic
33
COTD - 20/09/18 - Jo Jarvis
33.1
COTD One
33.1.1
DDx
33.1.2
Thin Film
33.1.3
Clinical Features
33.2
COTD 2
33.2.1
Diagnosis
33.2.2
Treatment
33.3
Investigation confusion
34
GI Nematodes
34.1
Pinworm
34.2
Lifecycle
34.3
Epidemioogy
34.4
Clinical Infection
34.5
Path
34.6
Diagnosis
34.7
Treat
34.7.1
Break Cycle
35
Whip Worm
35.1
Life Cycle
35.2
Epidemiology
35.3
Clinical Features
35.4
Immune Response
35.5
Diagnose
35.6
Treat
36
Giant Round Worm
36.1
Life Cycle
36.2
Epi
36.3
Clinical Features
36.3.1
Complications
36.4
Diagnosis
36.5
Treat
36.6
Blah
37
Human Hookworms
37.1
Life Cycle
37.2
Epi
37.3
Presentation
37.3.1
Skin Penetration
37.3.2
Lung Migration
37.3.3
GI Infections
37.4
Diagnosis
37.5
Treat
37.5.1
Vaccine?
38
Dog Hookworm
38.1
Treat
39
Strongyloides
39.1
Clinical Presentation
39.2
Diagnosis
39.3
Dx Hyperinfection
39.4
Treat
40
Amoebic Infections
40.1
Entameba histolyctica
40.1.1
Epi
40.1.2
Transmission
40.1.3
Entamoeba
40.1.4
Intestinal Ameobiasis*
40.1.5
Extraintestinal Amebiasis
41
COTD
41.1
COTD One
41.2
COTD 2
41.3
Cotd 3
41.3.1
DDx
41.4
Investigation
41.4.1
CT
41.4.2
Day 4
42
Giardia
42.1
Giardiasis - Acute Diarrhoea
42.2
Epi
42.3
Clinically
42.4
Presentation
42.5
Test
42.6
Treat
43
Cryptosporidium
43.1
Epi
43.2
Path
43.3
Disease
43.4
Diagnose
43.5
Treat
44
Hermaphroditic Flukes
44.1
Paragonimus
44.1.1
Life Cycle
44.1.2
Epi
44.1.3
Clinical
44.1.4
Diagnosis
44.1.5
Treat
44.2
Fascioliasis
44.2.1
COTD
44.2.2
Disease
44.2.3
Diagnosis
44.2.4
Treatment
44.3
Oriental Liver Fluke / Clonorchis sinensis
45
Schistosomiasis
45.0.1
Life Cycle
45.0.2
Epi
45.0.3
Pathogenesis
45.0.4
Clinical features
45.0.5
Diagnosis
45.0.6
Treatment
45.0.7
Neruoschistosomiasis
45.0.8
Prevent/Control
46
Worms Maggots and Fleas
46.1
Treat cutaneous larva migrans:
46.2
Cutaneous myiasis…
46.2.1
Treat
46.3
Fleas
47
Clinical Cases
47.1
Case One: Measles
47.1.1
Examination:
47.1.2
Investigations:
47.1.3
Management:
47.1.4
Why is mortality higher in SSA than in Europe?
47.2
Case Two: Hand Foot Syndrome of Sickle Cell Disease
47.2.1
Investigations
47.2.2
Risks
47.2.3
Management
47.3
Case 3 - Yaws
47.3.1
Investigations:
47.3.2
Treponema Pallidum
47.3.3
Management
48
Neurological Disorders
48.1
The Big 5
48.1.1
Epilepsy
48.1.2
Infections
48.1.3
Blah
49
Rabies
49.1
Intro
49.2
Epidemiology
49.3
Vector
49.4
Dogs
49.4.1
Bats
49.5
Virus
49.6
Clinical Forms
49.6.1
Starting Symptoms
49.7
DDx
49.8
Diagnosis
49.9
Manage
49.9.1
PEP
50
Stroke in Africa
50.1
Epidemiology
50.2
Clinical Features
50.3
Pathology
50.4
Risk Factors
50.5
Management
50.6
Mortality
50.7
Quality of Life
50.8
Perceived Cause of Stroke
50.9
Tetanospasmin
50.10
Clinical Features/Course
50.10.1
Classical Presentations
50.10.2
Atypical Presentations
50.11
Epidemiology
50.11.1
Complications
50.11.2
sECONDARY INFECTIONS
50.12
Diagnosis
50.13
DDX
50.14
Management
50.14.1
Plus
51
Sexually Transmitted Infections
51.1
Why do you have rates of STIS higher in SSA than Europe
51.2
Case Report - HIV plus STI’s
52
STI Syndromes
52.1
Urethral Discharge in Men/Causes of Urethritis in Men
52.2
Lower Abdominal Pain in Women/Cervical Discharge/Pelvic Inflammatory Disease
52.3
Vaginal Discharge
52.4
Syndromic Approach Advantage
52.5
Syndromic Approach Disadvantages
52.6
Genital Ulcers
52.6.1
Genital Herpes
52.6.2
Syphilis
52.6.3
Chancroid
52.6.4
LGV
52.6.5
Donovanosis (granuloma inguinale)
52.6.6
Treatment
53
Syphilis
53.1
Congenital Syphilis
54
STI Control Programmes
55
Case Of The Day
55.1
Investigations
56
Global Eye Health
56.1
Measuring visual acuity
56.2
Magnitude of Global Disease Burden
56.3
Causes
56.3.1
Cataract
56.3.2
Refractive Error
56.3.3
Glaucoma
56.3.4
ARMD
56.3.5
Corneal Opacity
56.3.6
Diabetic Retinopathy
57
Trachoma
57.1
Clinical Progression
57.2
Control
57.3
Bug: Chlamydia trachomatis
57.4
Transmission
57.5
Infection and Disease
57.6
Strategy for Dealing With Trachoma: SAFE
57.6.1
Surgery
57.6.2
Antibiotics
57.6.3
Face Washing and Environmental Improvements
58
Diagnosis and Management for Primary Eye Care
58.1
Acute Red Eye
58.2
Acute Red Eye With Trauma
58.3
Cannot See
59
Causes of Fever in Africa
59.1
Invasive Bacterial Disease In African Children
59.1.1
Risk Factors For Invasive Bacterial Infections in African Children
59.2
Empiric Treatment with Abx in kids with Severe Malaria
59.3
HIV Positive Patients with Severe Sepsis
59.4
Leptospirosis
59.5
Meingococcal Meningitis
60
Arboviruses
60.1
Dengue
60.1.1
Definitions
60.1.2
Virus
60.1.3
Illness
60.1.4
Platelets
60.1.5
Severe
60.1.6
Capillary Leakage
60.1.7
Diagnosis
60.1.8
Treatment
60.1.9
Vaccine?
60.1.10
Vector Control
60.2
Chikungunya
60.3
Zika
60.3.1
Diagnosis
60.3.2
WHO
60.4
Yellow Fever
61
SouthEast Asian Infectious Diseases
61.1
Meliodosis
61.1.1
RF’s
61.1.2
CF’s
61.1.3
Bug
61.1.4
Tests
61.1.5
Treatment
61.2
Japenese Encephalitis
61.2.1
CF’s
61.2.2
Tests
61.2.3
Treat
61.2.4
Vaccine
61.3
Scrub Typhus
61.3.1
Clinical Features
61.3.2
Investigations
61.3.3
Treatment
61.4
Talaromyces/Penicilliosis
61.4.1
Clinical Features
61.4.2
Treat
62
Neglected Tropical Diseases
63
VHF
63.1
VHF in Travellers
63.2
Clinical Features
63.3
Marburg
63.3.1
Pathophysiology
63.3.2
Diagnosis and Treatment
63.4
Lassa
63.4.1
Prophylaxis?
63.5
Crimean Congo Haemorrhagic Fever
63.6
Ribavirin
63.7
Case 4
63.7.1
Cryptococcoma
63.8
Case 13
63.9
Case 8
63.10
Case 25
63.11
Case 7
63.12
Case 15
63.13
Case 57
63.14
Case 36
63.15
Case 6
63.16
Case 10
63.17
Case 61
63.18
Case 49
63.19
Case 51
63.20
Case 55
64
HIV Associated TB
64.1
Why is it hard to diagnose HIV and TB
64.2
Different Tests
64.3
Diagnostic Algorithm For HIV Positive Patients
65
Emergency Care
66
Neurology
67
Mental Health
67.1
Uganda Mental Disorders
68
Cardiology
68.1
CVD
68.1.1
Risk Factors
68.2
HTN
68.3
Rheumatic Heart Disease
68.4
CAD
69
Paliative Care
70
Renal Medicine
71
Ebola
72
Ebola
72.1
Strategy To Stop Ebola Transmission
72.1.1
Case Management
72.1.2
Case Finding
72.1.3
Safe Burial
72.1.4
Social Mobilisation
72.2
Virology & Diagnostics
72.2.1
Principles of Diagnostics
72.2.2
Testing Options
72.3
Community Engagement
72.3.1
Techniques
72.4
Knowledge Attitudes Practice (KAP) Survey
72.4.1
DRC Problems
72.5
Organisation at the Ebola Treatment Centre and Screening
72.5.1
Zones
72.5.2
Screening Area
72.6
PPE
72.6.1
Common Mistakes
72.7
Buddy System And Supervision
72.7.1
Inside ETU
72.7.2
Glove Hygeine
72.7.3
Putting on PPE
72.8
EVD Survivors
72.8.1
Ebola Complications
72.8.2
WHO Guidelines
72.8.3
Infection Prevention and Control in survivors
73
Care for the newborn baby
73.1
Preterm/low birth weight babies
73.2
Low Birth Weight
73.3
Preterm VS SGA
73.4
Estimating gestational age
73.5
Challenges for preterm care
73.6
Example Neonatal Units
73.7
Care of the newborn
73.8
CRITICAL ILLNESS
73.9
Management
73.9.1
Resp Distress
73.9.2
Antenatal Steroids
73.9.3
Hypoglycaemia
73.9.4
Feeding
73.9.5
IV Fluids
73.10
Jaundice
74
Malnutrition and CHAIN
74.1
Aetiology
74.2
Diagnostics
74.2.1
WHO Growth Reference Standards
74.3
Treatment Aims
74.4
Childhood Acute Illness and Nutrition Network
74.4.1
What’s the problem causing chronic ill health in kids in LMIC?
75
The Acutely Unwell Malnourished Child
75.1
Oedema
75.2
10 Steps of Management
75.2.1
Hypoglycaemia
75.2.2
Temperature
75.2.3
Dehydration
75.2.4
Electrolytes
75.2.5
Infection
75.2.6
Micronutrients
75.2.7
Feeding and Catch Up Growth
75.2.8
Sensory and emotional Support
75.2.9
Preparing for Follow Up/Recovery
75.2.10
HIV
75.3
Babies under 6 months
75.4
Deaths and community opinion
76
Community Management
77
Anaemia and Obstetric Haemorrhage
77.1
Anaemia
77.1.1
Causes
77.2
Haemorrhage
77.2.1
Causes
77.2.2
C Sections
77.2.3
Prevent haemorrhage
77.2.4
Detecting haemorrhage
77.2.5
Stopping Bleeding
77.2.6
Replacing Blood
78
Blood Transfusion
79
Hypertensive Disorders in Pregnancy
79.1
Preeclampsia
79.1.1
Management
79.1.2
Complications
79.1.3
Challenges
80
Paediatric HIV
80.1
Eliminating Mother To Child Transmission
81
Clinical Presentation and Management of HIV in Children
81.1
Diagnosing
81.2
Treating
81.2.1
Treatment Failure
81.3
Adolescents
82
Diarrhoea in Kids
83
FEAST
84
Febrile Children in the Tropics
85
Pneumonia in Children
86
Tuberculosis in Children
87
Sepsis in Pregnancy
88
Child Neurology in East Africa
89
Neonatal Encephalopathy
90
Obstructed Labour
90.1
Recognition, Managment, Prevention, and Consequences of Obstructed Labour
91
Paediatric Neurodisability
92
Revision Session
92.1
Bex and Fatima
92.2
Labour and Ed
92.3
Fever, Seizures, Coma - Bill Jane Shunmay
92.4
Newborn Health - Cally Al
92.5
Obstetric Care
92.6
Sick Kids
EADTMH
71
Ebola
Colin Brown