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Volume 19, Number 6—June 2013

CME ACTIVITY

Iatrogenic Blood-borne Viral Infections in Refugee Children from War and Transition Zones

Earning CME Credit

To obtain credit, you should first read the journal article. After reading the article, you should be able to answer the following, related, multiple-choice questions. To complete the questions (with a minimum 70% passing score) and earn continuing medical education (CME) credit, please go to www.medscape.org/journal/eid. Credit cannot be obtained for tests completed on paper, although you may use the worksheet below to keep a record of your answers. You must be a registered user on Medscape.org. If you are not registered on Medscape.org, please click on the New Users: Free Registration link on the left hand side of the website to register. Only one answer is correct for each question. Once you successfully answer all post-test questions you will be able to view and/or print your certificate. For questions regarding the content of this activity, contact the accredited provider, CME@medscape.net. For technical assistance, contact CME@webmd.net. American Medical Association’s Physician’s Recognition Award (AMA PRA) credits are accepted in the US as evidence of participation in CME activities. For further information on this award, please refer to http://www.ama-assn.org/ama/pub/category/2922.html. The AMA has determined that physicians not licensed in the US who participate in this CME activity are eligible for AMA PRA Category 1 Credits™. Through agreements that the AMA has made with agencies in some countries, AMA PRA credit may be acceptable as evidence of participation in CME activities. If you are not licensed in the US, please complete the questions online, print the certificate and present it to your national medical association for review.

Article Title:
Iatrogenic Blood-borne Viral Infections in Refugee Children from War and Transition Zones

CME Questions

1. You are a public health consultant to a clinic for refugee children from central Asia, Southeast Asia, and Sub-Saharan Africa. Based on the review by Dr. Goldwater, which of the following statements about observations regarding and factors contributing to iatrogenically transmitted blood-borne virus (BBV) infection is most likely to appear in your report?

A. There is extensive literature documenting and characterizing iatrogenic transmission of BBV infection

B. Several good studies have proven that refugees are at greater risk of BBV infection than others living in conflict zones

C. In iatrogenic cases, vertical transmission of BBV was ruled out by the mothers’ negative serostatus and no history of surrogate breastfeeding or sexual abuse

D. Virus co-infection was not reported in the 4 cases of presumptive iatrogenic BBV infection described by the authors

2. Based on the review by Dr. Goldwater, which of the following statements about the role of contaminated injections and unsafe blood transfusions in contributing to increased prevalence of BBVs in refugee children is most likely correct?

A. According to the World Health Organization (WHO), about 5% of injections given in Sub-Saharan Africa in 2000 were administered unsafely

B. Widespread screening of blood transfusions in developing countries has prevented HCV transmission by this route

C. HIV transmission to babies and children through unscreened blood transfusion has not been reported in Kazakhstan

D. Central Asia’s geographic position along major drug trafficking routes has led to rapidly increasing intravenous drug use and corruption of the blood supply

3. Based on the review by Dr. Goldwater, which of the following statements about other factors contributing to increased prevalence of BBVs among refugee children from central Asia, Southeast Asia, and Sub-Saharan Africa would most likely be correct?

A. Political collapse and civil war do not play a significant role in fostering iatrogenically transmitted BBV infection

B. HIV positivity in children of HIV-negative mothers is not linked to breastfeeding practices

C. Modes of transmission in HIV-infected African children with HIV-uninfected mothers are well documented

D. Wartime rates of rape and sexual violence are much higher than those in peacetime, and prostitution among refugee children also fosters HIV transmission

Activity Evaluation

1. The activity supported the learning objectives.

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2. The material was organized clearly for learning to occur.

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3. The content learned from this activity will impact my practice.

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4. The activity was presented objectively and free of commercial bias.

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