MEDICINE,MMCRI-SPOTTERS LIST

DEPARTMENT OF COMMUNITY M
1. ENTOMOLOGY 4. NUTRITION SPOTTERS
1. ANOPHELES EGG 1. PARBOILED RICE
2. ANOPHELES LARVA 2. BENGAL GRAM
3. ANOPHELES ADULT (MALE 3.
BLACK GRAM
ANOPHELES ADULT (FEMALE)
4. CULEX EGG 4.
GREEN GRAM

5. CULEX LARVA 5. BAJRA

6. 6. SOYA BEAN
CULEX ADULT MALE 7. GROUNDNUTS
7. CULEX ADULT
8. AEDES EGG
FEMALE 8.WHEAT
9. AEDESLARVA VEGETABLE
10. AEDES EGYPTIADULT MALE 10. GREEN LEAFY
11, AEDES EGYPTIADULT FEMALE 11. EGG
12. FLEA FEMALE 12. GHEE
13. HEAD LOUSE 13. DATES
14. HARD TICK 14. JAGGERY
15. BED BUG MALE 15. MILK
16. BED BUG FEMALE

2. MCH
1. GROWTH CHART
5. Environment
1. SLOW SAND FILTER
2. MID ARM CIRCUMFERENCE TAPE
2. RAPID SANFILTER
(SHAKIR'S TAPE) 3. SANITARY WELL
3. IRON AND FOLIC ACID TABLETS 4. BERKEFIELD FILTER
4. Oral Rehydration Salt SBORE HOLE LATRINE
5. Vitamin-A solution 6 . HORROCKS APPARATUS
6. MALE CONDOM
7. COPPER-T

-8. ORAL CONTRACEPTIVE PILLS

sn9INFANT WEIGHING SCALE
6.VACCINES
3. MISCELLANEOUS SPOTTERS
1. BCG (BACILLUSCALMETTE
1. BLEACHING POWDER GUERIN)
2. SAVLON POLIOVACCINE
3. EYE GOGGLES
4. INDUSTRIAL SAFETY HELMET
DPT(DIPHTHERIA
5. INDUSTRIAL GLOVES PERTUSSISTETANUS)VACCINE
4. MEASLES
6. GUM BOOTS 5. MEASLES-MUMPS-RUBELLA
6. TETANUS TOXOD
7. HEPATITIS -B
8. PENTAVALENT VACCINE
 MADHA MEDICAL COLLEGE & RESEARCH INSTITUTE
DEPARTMENT OF COMMUNITY MEDICINE
MEASURES OF MORBIDITY & MORTALITY
with the following data of a PHC in 2020; calculate health indicators
Mid Year Population - 35,000
Total deaths due to all causes - 350
Total persons with new sputum positive Tuberculosis cases - 50
Old cases of sputum positive Tuberculosis cases - 25
Deaths due to Tuberculosis 10
Calculate:
a) Crude death rate (2)
b) Prevalence rate of Tuberculosis case (2)
c) Proportionate Mortality rate due to Tuberculosis (2)
d) Case fatality rate of TB (2)
e) Incidence rateof Tuberculosis case(2)

ANSWERS:
a) Crude death rate Total number of death in a year
Mid Year Population (MYP)
350*1000

35,000

10/1000 population.

b) Prevalence rate of Tuberculosis

Number of TB cases in a year 2020 (old+new) *1000
Estimated MYP
50+25*1000
35000
2.1/1000 population.
c) Proportional Mortality rate d/t TB
No. of deaths d/t TB in the year 2020 * 100
Total deaths in the same year
10 *100
350
2.85 %
 2C.o

100
deathsd/tTB*
No. of cases
d) CFR TB
Totalno. of
10/75*100
13.33%

Tuberculosis case
e) Incidence rate of
cases * 1000
= Total no of new
period
Population at risk during that
50/35000*1000

=
1.42 /1000 population

reported
community the no. of measles cases
2. During an epidemic of measles in an urban slum 825 cases, 65 developed complications to
children, Out of these
were S25, out of 1700 under five joint family of 17 persons, there were 7
under-fives.
same village, in a
Which 16 Succumbed. In the cases of measlesoccurred in that family within the
Folowing one primary case, 5 secondary
incubation period. Find out the following
a) Secondary attack rate (2.5)
b)Case Fatality Rate (2.5)
c)How do you investigate the outbreak? (5)
ANSWERS

a) Secondary Attack rate of measles

No. of exposedpersons developing conjunctivitis in the L.P *100
Total No. of exposed persons
5*100
6
83.33%

b) CFR No of deaths d/t conjunctivitis * 100

Total no of measles case
16*100
825
1,9%
 investigation ofan epidemic
) Steps of
of diagnosis
1.Verification epidemic
Confirmation of the existence ofan map & counting population
2. risk - obtaining
3. Defining the population at epidemiological Survey
cases - Medical &
4. Rapidsearch for all Place & Person
5. DataAnalysis - Time,
6. Formulation of Hypothesis
7. Testing of Hypothesis
8.Evaluation of Ecological factors
risk
9.Further investigation of population at
10. Writing the report

tuberculosis on January 1 2021. There were 40 new

there were 200 cases of were cured and 5_others migrated
3. In a population of 10,000 died due to tuberculosis;15
year, 10
cases of tuberculosis during the community in 2021 was 10/000.Calculate the
following:
out. The crude death rate for this

a) Period prevalence for the year 2021.(2) 1ol1o00

b)Point prevalence on December 31 2021.(2)
c) Incidence of tuberculosis in 2021.(2)
d) Case fatality rate.(2)

e) Proportional Mortality rate for tuberculosis.(2)

ANSWERS
a) Period Prevalence of TB for the year 2021
No. of existing TB cases (old+new) during 2021 * 1000
Estimated MYP
200-+40 * 1000
10000

= 24/1000 population

b) Point prevalence of TB on December 31 2021

No. of TB cases existing on the given date * 1000
Estimated MYP
(200+40)-30 * 1000
10000
210 * 1000
 S o l u t i o n :

I n c i d ern c

10000 1.17

c)
21/1000 population.
Incidence of TB (2021)
1000
No. of new TB cases in the year 2021 *
MYP
40 * 1000
10000
4/1000 population.
d) CFR 10 100
240

4.16%

e) Proportional Mortality Rate for TB

10 * 100
100 tnd Total
CDR
10
10/1000
Deatt
10 =
Total deaths
MYP
TotalNo. of deaths = 10*10000/1000
LOxlo|o
= 100 lou0

3. The following data are available for a community,

Mid year population for 2013 1,17,000
Population as on 31 st December, 2013 -1,19,000
Already existing cases of leukemia at the beginning of the year 2013 was 24
New cases of leukemia during the year 2013 was 99
Total deaths due to all causes during the year 2013 was 150
deaths due toleukemia during the year 2013 was 5

Calculate the following:

A. Incidence rate for the year 2013,(2)
B. Period prevalence rate for the year 2013, (2)
C. Point prevalence rate as on 31 December 2013.(2)
D.Crude death rate (2)
E. Case fatality rate (2)
 Solution:
population
Incidence rate of leukemia for the year 2013 = 99 x 1000 = 0.846 new cases/1000
a.
1,17,000
population
Prevalence rate for year 2013 = 24 + 99 x 1000= 1.05 cases /1000
b. Period
1,17,000
1000 =1.03 cases/ 1000 population
c. Point Prevalence rate = 24 + 99 x population
D.Crude death rate =150/1,17000x 1000 = 1.28 / 1000

E.Case fatality rate= 5/123x 100= 4.06%

1,19,000
cases of
population of 2500. During the year 2016, there were 40 new cases and 60 old
o.A village has a disease in 2016. Total deaths due to all causes
during
deaths occurred due to the same
TB. A total of 10
tuberculosis in 2016:
the year 2016 was 25. Calculate for
a. Incidence (2)
b. Prevalence (2)
c. Case fatality rate.(2)
d. Crude death rate (2)
e. proportional mortality rate (2)

Solution:

Total population of village = 2500

New cases = 40
Old cases = 60
Total cases of TB in 2016 = 100
Total deaths due to TB = 10

Incidence = (40/2500)x 1000 = 16 per 1000 population at risk

Prevalence = (100/2500)x 100 = 4%
CFR = (10/100)x 100 = 10%
Crude death rate =25/2500x 1000=10/1000 population
proportional mortality rate = 10/25x 100 =40 / 1000 population

(5-15 years) and 20 adult care

4. A 6 year old child from a boarding school with 600 inmates
and was diagnosed as
takers presented to the School medical officer with maculopapular rashes
complaints. 300 children had
measles. Within one week 9 more children presented with similar
gave previous
received 2 doses of measles vaccine before admission to school and 100 children
history of previous attack.
 Calculate Attack rate of measles (2.5)
secondary attack rate of measles in the boarding.(2.5)
How do you investigate the
outbreak?(5)
Solution: Attack rate = Number of new cases sof measles during specified time interval *100
Total population at risk during the same interval

=5%
=10/600-(300+100)*100
=10/200*100
Secondary
Num of
Attack rate =
exXposed persons developing measles within
Total population at risk during theincubation period from primary case* 100
same interval
=9/=4.5%600-(300+100)*100
=9/200*100

Steps of
1.
Verificinvestigation
ation of
of an
epidemic
2.
Confirmation diagnosis
of the
3. Defining the existence of an epidemic
4. Rapid search population at risk -
for all cases - obtaining map &counting population
5. Data
Analysis - Time, PlaceMedical
&
&
epidemiological Survey
6.
Formulation of Person
7. Testing Hypothesis
of Hypothesis
8.
Evaluation of Ecological factors
9. Further
10. Writinginvestigation
of population at risk
the report

MCH AND
1. The
FERTILITY INDICATORS
following data were obtained from
(i) Mid-year Population zone-10 of Chennai corporation records.
(ii) No. of live births 10000
(iii) No. of fetal deaths (>28 5000
(iv) No. of deaths within 7 daysweeks gestation) 200
of birth 200
(v) No. of deaths between 8"
day -28
(vi) No. of deaths below l year of days 100
age500
 1.Crude Birth Rate (2)
Calculate 2.Perinatal Mortality rate (2)
3. Early neonatal mortality rate
4. Late nconatal mortality rate (2)
5. Infant mortality rate
(2)
(2)
ANSWERS

1.Crude Birth Rate= No of Live births which

0ccurred among the
Mid-Year Population of the same year population given yearxi000
in a

=5000x1000
10000
Goo
-6:Stivehirths/1000 population
2. Perinatal Mortality
rate=Still birth + early neonatal deaths x 1000
Total live births
200+200 x1000
5000
80/1000 live birth

3.Early neonatal mortality rate= No of

deaths of children less than 7days of
birthx1000
Total number of live births of the
same year
200 x1000
5000
40/1000 Live births

4. Late neonatal mortality rate= No of Death of Children between 8 davs &28 days of age in
given yearx1000 a

Total number of Livebirths of the

same year

100 x1000
5000
 20/1000LB
given
lessthan 1 year ofage in a Yearx\00%
Rate= No of Death of children
5. Infant Mortality of the same year
of Live births
Total number
500 x 1000

5000
100/1000 LB

that year 2300 live births, 1100deaths of

population during the vear 2020 had
Z. A town of 1lakh deaths.in which 75 had acute diarrhoeal disease,
deaths, 138 infant
al age groups, 5maternal
out of which 13 cases died

Calculate 1.Crude birth rate (2)

2. Crude Death Rate (2)
3. Maternal Mortality rate (2)
4. Infant Mortality rate (2)
5. Noof deaths due to ADD (2)

1. CBR = Total No. of births during that year x1000

Estimated MYP
2300 x1000
100000
23/1000 population

2. CDR 1100 x_1000

100000

11/1000 population
3. MMR Total no. of maternal deaths x 1000
Total LB
5x 10000
2300
21.7/ 100000 LB

4. IMR 138 x 1000

2300
 E No of 60 / 1000LB
deaths due to ADD=No of
yearxl00 deaths due to ADD among the
No of cases due to ADD population in a giyen
among
- 15x\3
the population in a given
year
I3
100
=995-deaths due to-Abp 7 3 doats dus 10 DD

3. The following data relate to a town for the year 2020

Midyear population
No. of live births 100000
2400
No. of deaths
1040
Ofthose who died 600
were
delivery, 2 between 43 and women, out of which 8 died
56" day following between the 1 and 42nd day
delivery. delivery. The rest of the deaths were followingto
No. of foetal deaths > 1000 unrelated
gm.) 40
No. of deaths under 1 week
40
No. of deaths in first 4 weeks 120
No. of infant deaths
160
Calculate the following
1.Crude death rate
(2)
2.Maternal Mortality rate
(2)
3. Post-neonatal Mortality rate
(2)
4. Infant Mortality rate
(2)
5. Early Neonatal death
(2)
ANSWERS
1. CDR 1040 x 1000
100000
10.4/1000population
2. MMR Total no of female deaths d/tcomplication of pregnancy,
Child birth or 42 days of delivery in a given year xl0000
Total LB
8 x 100000
2400
3.33 / 1000 LB
 000
ofbirthx 1
year
rate daystol
mortality 28
neonatal Deathsfrom TotalLB
3. Post
160-120x1000
24001000population
16.6/

000
160 x 1
4. IMR 2400
66.6/1000population birthx1000
daysof
children lessthan 7
deathssof
neonatal death =No of year
5. Early births ofthe same
live
Totalnumberof
=40x1000

2400
16.6/1000 population

of women in reproduc
Kundrathur PHCis 38,000. The age distribution
4.The Midyear population of
age and live births are given below:
No. of Women No, of live births
Age Group 455
15-24 3500
3700 315
25-34
2900 210
hydsborweg
35-44
10100 980

Calculate: 1.CBR (2)

2. Age Specific Fertility Rate (ASFR) (4)
3. Total Fertility Rate and comment (TFR)(4)ANSWERS

1. Crude BR Total No. of births during that year x1000

Estimated MYP

= 980/38000*1000

= 25.78 /1000 population

 2. ASFR
No. of LB in one particular age group *1000
MDY female population in that age group
ASFR (15-24 yrs) 455* 1000
3500
130
ASFR (25-34 yrs) 315 * 1000

90 85.\
ASFR (35-44) = 210 * 1000
15-19

581a.41
3. TFR
5xASFR
Chulolren a wmn l
1000
5x 270 aveg
hove
ho

yChe wene to
1000
1.35 Rur seprduthie yeon
TFR - 1.35 children /woman through her
mortality is well below the replacement fertilityreproductive
level of 2.1
period assuming current fertility and no

SMid-year population of a city in 2018 was 60,000. The following vital

year.y events occurred in same
Given data
Total number of live births
Total number of deaths 15000
Total number of still births (Late fetal deaths) 6000
60
Total number of deaths of children within 7 days
Total number of deaths of children within 28 daysafter birth 180
after birth 320
Total number of deaths of children within 1 year of
age 600
Total number of maternal deaths due to
puerperal causes 40
Calculate the following:
1. Crude Birth Rate (CBR)(1)
2. Crude Death Rate (CDR)(1)
3. Peri-natal Mortality rate (PMR) (1)
4. Neonatal Mortality rate (NMR)(2)
5. Maternal Mortality rate (MMR) (2)
 Soluti

(IMR)2)
rate
Mortality X/00D
Infant rate(1)
6. neonatalmortality 15000x1000 16,000
7.Post

ANSWERS
1.CBR 600000

6000x1000
2. CDR 600000
6o+18D
240x1000 15,o00
3. PMR
15000
21.3100DL6
16/1000LB
X1000e
320
Q00 15,000
180+ 330x
4. NMR
1kÍ00
50015000
33.3-1000LB

5. PNMR 100/150 I5,000

6.6 1000LB

6. MMR 40x 1000

15000
400
15000
26.67/ 100000 LB

7. IMR 600x1000
15000
40 / 1000 LB

a midyear population of 13,00,000:

6. Following data is available for the year 2015 for a district with
No. of women No. of Live Births
Age Group(years)
15-19 36, 300 1, 500
20-24 35, 100 8, 900
25-29 32, 870 7, 600
30- 34 25, 310 2, 400
35-39 22,520 1, 200
40- 44 43, 460 1, 110
45 - 49 39, 740 570
2, 35, 300 23, 280
 Rate, (2)
1. Calculate Crude Birth
Rate(3)
2. General Fertility
3. Total Fertility Rate(3)
4. Comment on your result.(2) MYF6emalepopub
Solution:
1. Crude Birth Rate =23, 280 x 1000
13, 00, 000
= 17.90 live births / 1000 population tòsam

2. GFR = 23, 280 x1000

2, 35, 300 reproductive age group
=98.93 live births / 1000 women in

3. ASFR= No. of live births in a particular age group x1000

Mid- year female population of same age group
Births
Age Group Age Specific Fertility Rates for Live group 15 - 19 yrs
15 - 19 41. 32 live births/ 1000 women in age
yrs
20-24 253. 56 live births/ 1000 women in age group 20 - 24
29 yrs
25 -29 231. 21 live births/ 1000 women in age group 25-
30-34 94. 82 1live births/ 1000women in age group 30 -34 yrs
35-39 53. 29 live births/ 1000 women in age group 35 -39 yrs
40 44 25. 54 live births/ 1000 women in age group 40 44 yrs
45 49 14. 34 live births/ 1000 women in age group 45 49 yrs
Total 714.08 live births/ 1000 women in reproductive age group

TFR =714. 08 x5
3570. 4
1000

=3.57

4. Comment: TFR = 3.57 children / woman through her reproductive period assuming current fertility and n
mortality. Thenational health goal and population policy (2000) require CBR at 21 per thousand, TFR at 2childre
per woman through her reproductive period assuming current fertility and no mortality. CBR is satisfactory br
TFR is high.

7. In a village with a population 5000, the following events occur in 2019.

Total no. of live births is 135.
b. Total number of deaths is 60.
c. Number of infant deaths is 15.
d. Number of maternal deaths is 2
e. Early neonatal death 7
 2N.e o nmat
oarlt a l r

yearx1000

Calculate all possible rates

1, CBR (2)
2.CDR (2)
3. MMR (2)
4. IMR (2)
5. END (2)

Solutions:
per 1000 MYP
CrudeBirthRate = [135/5000]x 1000 = 27 births 1000MYP 1481 deaths per 1
CrudeDeathRate = [60/5000]x 1000= 12 deaths per deaths per 1000 live births or
14.8 maternal
Maternal Mortality Rate =[2/135]x 11000 =
lakh live births births
Mortality Rate = [15/1351x 1000 = 111 infant deaths per 1000 live
Infant live births
51.8 perl000
Early neonatal Death= (7/135]x1000=

following statistics are available for the year 2011

town with a population
8.In 1.a Live birth- 8000 of 200000 the
2. Total Death - 2400
3. Maternl death- 10
4. Infant death - 480
5. Still birth- 20
6. Death<28 days -240
7. Death <7days -160
Calculate:
(a) Infant mortality rate(2)
(b) Neo natal mortality rate (2)
(c) Early neo-natal mortality rate (2)
(d) Post neo-natal mortality rate(2)
(e) still birth rate(2)

1. Infant mortality rate(IMR)-No of death of children less than 1year of age in a given wearx
Total number of live births

-480x1000
8000
-60 per thousand live births
2. Neonatal mortality rate= No of death of children between 28 days &1
year of age in a oiven
yearxl000

Total number of live births of same year

-240x1000
8000
=30 per thousand live births.
3. Early -neonatal mortality rate-No of deaths of
yearx1000 children less than 7 days of age in a given
Total number of live births

160x1000
8000

=20 per thousand live births

4. Post-neonatal mortality rate=No of death of
given yearx1000 children between 28 days &1 year of age in

Total number of live births of same year

= 480-240 x 1000

8000

-30 per thousand live births

5. Still birth rate= Foetal death weighing over

1000 gram at birthx1000
Total livet still birth weighing over 1000 gram
-20x1000
-20DO0
8000 +20
-2.49 per 1000 live births
 E a r l y - n e o n

x 1 0 0 0

PHC.Population-1, 00,000.
obtained from a
2. The following data are
o Live births -6000
o Death below 7 days - 300
o Neo-natal deaths - 350
o Infant's deaths -400
o Maternal Death- 30

1.Calculate- Maternal mortality ratio(2)

2. Infant mortality rate (2)
3. Neonatal mortality rate (2)
4. Early neonatal mortality rate(2)
5. Post neonatal mortality rate(2)
I. MIMR=Total no of female deaths due to complications of pregnancy Childbirth or within 42
days of delivery from puerperal causes? in an area during the given year X1000
Total Number of live births

=30 x1000
6000

=5 per thousand live births.

2. (IMRF Infant mortality

yearx1000
rate(IMR)=No of death of children less than 1 year of age in a given

Total number of live birth

-400x 1000
6000
= 66.6 per thousand live births.
3. Neonatal mortality rate= No of death of children
yearx1000 between 28 days &1 year of age in a given

Total number of live births of

same year

=350x100
6000

-58.3 per thousand live births.

 4. Early-n eonatal mortality rate-No of deaths of children less than 7 days of age in a given
Learx1000 Total number of live births

=300x1000

6000

=50per thousand live births

5. Post-neonatal mortality rate-No of death of children between 28 days &1 year of ace in a
given yearx1000
Total number of live births of same year
= 400-350x1000

6000

= 50/6000x1000

=8.33 per thousand live births

9.The statistics of a town is given below

Midyear population -20,000

Live birth 400
Death - 180.
Still birth 40
Early Neo- natal death -10,
Late Ne0- natal death -8
Post Neo- natal death - 12,
Maternal death -2

From the data calculate

1. Maternal mortality ratio (2)

2. Infant mortality rate(2)
3. Neonatal mortality rate (2)
4. Early neonatal mortality rate(2)
5. Post neonatal mortality rate(2)