Disease elimination: neonatal tetanus: practice question

A PSM question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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PSM · Disease elimination: neonatal tetanus

Sample item

In one year, district A recorded 4 neonatal tetanus cases among 8,000 live births and district B recorded 5 cases among 4,000 live births. Which statement is correct about elimination of maternal and neonatal tetanus?

ADistrict B has reached the elimination threshold and district A has notBNeither district has reached the elimination thresholdCBoth districts have reached the elimination thresholdDDistrict A has reached the elimination threshold and district B has not

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. District A has reached the elimination threshold and district B has not

Maternal and neonatal tetanus is considered eliminated when there is less than 1 case of neonatal tetanus per 1000 live births in every district. District A has 4 / 8000 = 0.5 per 1000, which is below the threshold. District B has 5 / 4000 = 1.25 per 1000, which is above it.

Option by option

A. District B has reached the elimination threshold and district A has not
The rates are reversed in this option: A is the lower of the two, not B.
B. Neither district has reached the elimination threshold
District A is at 0.5 per 1000, which is under the threshold.
C. Both districts have reached the elimination threshold
District B is at 1.25 per 1000, so it exceeds the threshold.
D. District A has reached the elimination threshold and district B has not (correct)
Correct. A is at 0.5 per 1000 and B is at 1.25 per 1000 against a threshold of under 1.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this PSM question

What is the answer to this PSM question?

The best answer is D, District A has reached the elimination threshold and district B has not. Maternal and neonatal tetanus is considered eliminated when there is less than 1 case of neonatal tetanus per 1000 live births in every district.

Why is "District B has reached the elimination threshold and district A has n…" not the answer?

The rates are reversed in this option: A is the lower of the two, not B.

Why is "Neither district has reached the elimination threshold" not the answer?

District A is at 0.5 per 1000, which is under the threshold.

Why is "Both districts have reached the elimination threshold" not the answer?

District B is at 1.25 per 1000, so it exceeds the threshold.

What concept does this question test?

It tests Disease elimination: neonatal tetanus in PSM. District A has 4 / 8000 = 0.5 per 1000, which is below the threshold. District B has 5 / 4000 = 1.25 per 1000, which is above it.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Disease elimination: neonatal tetanus?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.