Lecture 19 Ethical Principles in Epidemiologic Research

Question 1

Belmont Report Purpose

Answer 1

Primary purpose is to protect subjects and participants in clinical trials and research studies

Question 2

Belmont Report Principle 2
Beneficence

Answer 2

Beneficence:
This means do no harm. Maximize all potential benefits and to minimize all potential harms. A type of obligation to cover acts of kindness or charity.

Question 3

Belmont Report Principle 1
Respect for Persons

Answer 3

Respect for Persons:
This requires that we acknowledge people’s autonomy and to protect those with diminished autonomy.

Question 4

Belmont Report Principle 3
Justice

Answer 4

Justice: Benefits and burdens are fairly distributed among the population. There is an equitable selection of study participants. Avoidance of selecting vulnerable populations. Those that are involved in research as participants should be able to benefit from the research.

Question 5

Belmont Report

Answer 5

R
B
J

Question 6

Syphilis

Answer 6

STD or congenital transmission (mother to child) about 3, 755 children cases

Caused by Treponema pallidum spirochete bacterium

Reportable disease

Question 7

Syphilis is cured by penicillin

Answer 7

True

Question 8

Syphilis increases HIV transmission

Answer 8

True

Question 9

Syphilis is spread by direct contact with person who has syphilitic lesion

Answer 9

True

Question 10

Syphilis is less common than chlamydia and gonorrhea

Answer 10

True, syphilis cases are 207, 255
Chlamydia is 1,649,716
Gonorrhea is 648, 056

Question 11

1/3 of cases are in the early stage

Answer 11

True (59,016) which is during the most infectious period

Question 12

Chancre

Answer 12

Highest infectious period
Primary stage of disease that lasts 2-6 weeks.
Sores appear on parts of the body.

Question 13

Rash and Other Symptoms

Answer 13

High infection period
Secondary stage of disease
Rash appears with flu symptoms

Question 14

Tertiary Late Syphilis

Answer 14

No longer contagious, bacteria will attack liver, brain, bone, heart.
Can lead to heart disease, paralysis, organ damage, necrosis, dementia, blindness, and death 10-30 years later.

Question 15

Congenital Syphilis

Answer 15

Neglected public health problem that results in stillbirths, premature and low birth weight, deformities at birth, mental deficits, and skin lesions.

Question 16

Transmission of syphilis from mother to child

Answer 16

1. Untreated syphilis can pass through Mother’s bloodstream to child
2. Bacterium can be transmitted to baby in birth canal or placenta.
3. Preventable by early screening and treatment at least 30 days before delivery.
4. Can be passed to child during breastfeeding if there are sores on the breast.

Question 17

Syphilis was at an all time high in the 1940s-1950s

Answer 17

True, then it went on a downhill trend significantly.

Question 18

Primary and secondary syphilis is more prominent among males

Answer 18

True with the most reported cases by age 70.5

Question 19

Primary and secondary syphilis is on the rise among women aged 15-44 as of 2022

Answer 19

True

Question 20

Race/Ethnicities negatively impacted by syphilis

Answer 20

Black and African Americans are most severely impacted by syphilis (18, 696) cases.

Question 21

Syphilis: Levels of Prevention

Answer 21

Primary: Educate people to use condoms and avoid risky sex
Secondary: Screen to find people with early disease and treat infected people; use surveillance systems to identify high risk groups.

Question 22

Tertiary

Answer 22

Treat people with established syphilis to avoid complications.

Question 23

Herpes

Answer 23

STD transmitted via two types of viruses.
1. Herpes Simplex Type 1
2. Herpes Simplex Type 2

Question 24

Herpes Simplex Type 1

Answer 24

Commonly causes cold sores
Can also cause genital herpes

Question 25

Herpes Simplex Type 2

Answer 25

Usual cause of genital herpes Can also infect the mouth

Question 26

Genital Herpes

Answer 26

STD 572,000 new cases / year 11.9% of persons aged 14-49 years have HSV-2 and 12.1% when adjusted for age. Prevalence of genital herpes is always higher because of the increasing number of genital infections caused by HSV-1.

Question 27

Spread of Herpes

Answer 27

1. Oral, vaginal, or anal sex/contact 2. Contact with fluids from a herpes sore can cause infection 3. Infection also possible without presence of visible sores.

Question 28

Symptoms of Herpes

Answer 28

No symptoms or very mild symptoms Includes sores around the genitals, rectum, mouth Can be accompanied with flu0like symptoms Repeat outbreaks are common No cure only medicines to help alleviate the symptoms.

Question 29

There are more prevalent cases of HSV-2 than incident cases

Answer 29

True

Question 30

HSV-1 and HSV-2

Answer 30

Can causes blindness, encephalitis, and aseptic meningitis (inflammation of the linings of the brain)

Question 31

HIV and Herpes

Answer 31

2-4 fold increased risk of acquiring HIV, if exposed to that infection when genital herpes is present. The herpes sores which can lead to open wounds allow for an an increase risk of HIV transmission.

Question 32

Herpes and Infant Health

Answer 32

Passed from mother to child resulting in neonatal herpes. C-section can prevent HSV transmission to infant. Antiviral medication at 36 weeks gestation through delivery can reduce the risk of a recurrent outbreak.

Question 33

Risk Factors

Answer 33

1. Having female genitalia 2. Compromised immune system 3. Unprotected sex with multiple partners

Question 34

Risk Factors for Herpes Recurrent Outbreaks

Answer 34

1. Emotional Stress 2. Fatigue 3. Other Infections 4. Physical injury/irritation of the genital area

Question 35

USPSTF Recommends against screening for herpes in asymptomatic pregnant women and adolescents and adults.

Answer 35

True because there are high rates of false-positive screening tests resulting in anxiety.