1. The multifaceted intervention for asthma control implemented in Salvador, Brazil, prioritised the establishment
of reference centres for severe asthma. Which of the following statements is correct, in relation to this public
health intervention? |
A greater impact on the prevention of asthma hospitalisations would be achieved if priority was given to mild-to-moderate
asthma in primary healthcare.
The marked decline in hospitalisations achieved after the intervention implemented suggests that the majority of admissions
in this urban environment were among subjects with severe asthma.
The intervention implemented resulted in a marked and significant decline in the numerous preventable deaths due to asthma
in the entire city.
In low-resource settings, an intervention for control of severe asthma using medications listed as essential by the World
Health Organization is sufficient for public health purposes and may be cost effective.
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2. Which of the following conclusions is true? |
It is extremely difficult to control asthma in any country due to poor adherence to inhaled corticosteroids.
The most important aspect of the intervention implemented to control severe asthma was the expertise of specialists in reference
centres.
Smoking tobacco was an important barrier to asthma control in this low-income setting.
Even in a low-income setting, one may obtain sufficient adherence to control severe asthma.
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3. Considering the possible sources of bias, which of the following may be correctly supposed? |
It is not possible that such a marked and rapid reduction in admissions due to asthma in a city with 2.8 million inhabitants
is
related to an intervention focused on fewer than 2,000 subjects.
A reduction in the availability of hospital beds in Salvador and Recife over the years has probably contributed to the decline
in hospitalisations in both cities.
An increase in the availability of hospital beds in Salvador over the years favours the possibility that the reduction in
hospitalisations is a consequence of the intervention.
The most likely reason for the decline in asthma hospitalisation rates in Brazil is the improved coverage of primary
healthcare and accessibility to essential medications such as inhaled corticosteroids.
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4. Considering Brazil to be a middle-income country with remarkable heterogeneity of wealth and a significant
proportion of low-resource settings, which of the following is true? |
A similar programme is unlikely to be successful in low-income countries.
This programme cannot be maintained in the long term because it is funded by a research project.
It is unlikely that a similar programme will fail in a middle-income country, regardless
of the support of the public health system, because generic inhaled corticosteroids are affordable.
The sustainability of the
programme evaluated depends on the continuous support of the public health system.
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