Which region is indicated by a star?  _______

6. Many of the determinants of health are known to contribute to disease causation, however previous influenza pandemics including the ongoing covid-19 pandemic are said to exacerbate social inequalities 6.1 Explain how the following health determinants affect covid-19 outcomes  6.1.1 Behavior     (2) 6.1.2 Biological    (2) 6.1.3 Age             (2)   6.2 Explain  how the following social inequalities  have been exacerbated by the covid-19 pandemic in your country 6.2.1 Food security    (2) 6.2.2 Access to healthcare    (2) 6.2.3 Education         (2)    

3.10 In RCTs  participants in the control arm can also be  offered the intervention at the start of the trial

3.4 Temporality can be ascertained in cross sectional studies

Question 5.The following is an abstract from a hypothetical report on malaria from Statssa, 2020. According to this report, there were an estimated 360,000 cases of malaria in 2020 of which 60% were new cases. The bulk of the new cases are said to have come from the three provinces of South Africa where malaria is endemic, namely; Mpumalanga (MP), KwaZulu Natal (KZN) and Limpopo (L). These provinces are reported to have contributed 25%; 20% and 20% to the new case load respectively. Please study the table below and answer the questions that follow.     Mpumalanga (MP) KwaZulu-Natal (KZN) Limpopo (L) Mid- year population 8, 000 000 11,000000 9, 000 000 Number of deaths 6,000 4,500 6,500               5.1 Calculate malaria  incidence rates per 100,000 population for the three (3) provinces    (10) 5.2 Calculate the  measure of  the severity  of malaria for each of  the three (3) provinces   (3)

1.10 Which of the following statements is NOT characteristic of a prospective cohort study?

Question 4.The following scenario relates to one of the food items that were under investigation following a suspected food poisoning outbreak that had occurred following for a birthday celebration by 250 patrons at a local restaurant. About 150 of these individuals were reported to have experienced severe stomach cramps, a few hours after consuming the food, and of these 80% had listed beef stew as one of the food items they had consumed. Only 15% of those that did not fall ill, had consumed the beef stew.  4.1 State with a reason, the appropriate study design (3) 4.2 Calculate the  appropriate measure of association  (8)  4.3 Interpret the results  (2)

3.6 In  foodborne outbreak investigations,  controls can be selected from hospitalized individuals   provided they  live in the same community as the cases

3.7 Informed consent can be sought  at any stage  in a  clinical trial

8. In an efficacy study, a clinical study was conducted on a new drug that was believed to lower blood pressure levels among participants with uncontrolled high blood pressure (HBP) in one of the villages in the Eastern Cape. Local health care workers (HCWs), were hired to recruit potential participants who were offered incentives in the form of food parcels and amounts of R1, 000. Upon sponsor initiated audit, it was found that an informed consent (IC) had been sought from the participants, with risks and benefits clearly stated, however, the IC form was written in English. There was no documentation of the drug approval by the Drug Regulating Authority. Preliminary data analysis also revealed that nearly two-thirds of the participants were over the age of 60 years and had a primary level of education. Furthermore, the Induna of the village had been awarded an amount of R5, 000 for approval.   Please explain how the following ethical principles were not upheld. Where possible provide two points for each ethical principle. 8.1 Informed consent (2) 8.2.  Autonomy (2) 8.3. Anonymity and confidentiality (2) 8.4. Non-maleficence (2)