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WAPCP Primary study materials
WAPCP Primary study resources

WAPCP Primary: Health Maintenance and Disease Prevention

WAPCP Primary · Work through your exam, one topic at a time.

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Health Maintenance and Disease Prevention

Health Maintenance and Disease Prevention

This domain tests preventive care across the life course in West Africa: immunisation, screening, chemoprophylaxis, and lifestyle counselling. Questions often test the Nigerian/West African immunisation schedule and locally relevant screening.

Core rules and concepts

  • Childhood immunisation (Nigeria EPI): BCG and hepatitis B at birth; OPV0 at birth; pentavalent (DPT-HepB-Hib) at 6, 10, and 14 weeks; measles at 9 and 15 months; yellow fever at 9 months; meningococcal A conjugate at 9 months in the meningitis belt. Vitamin A supplementation at 6-month intervals.
  • Adult immunisation: Tetanus toxoid for pregnant women and wounds; hepatitis B for high-risk groups; influenza and pneumococcal vaccines for older adults and those with chronic disease.
  • Screening: Hypertension from age 18 (or earlier if risk factors); diabetes from age 40 (earlier with obesity, family history); cervical cancer via visual inspection with acetic acid (VIA) or Pap smear from age 25–30; breast cancer via clinical breast examination and mammography where available; prostate cancer only after shared decision-making.
  • Malaria prevention: Insecticide-treated nets; intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine from second trimester; seasonal malaria chemoprevention for children in the Sahel.
  • TB and HIV: Screen contacts of TB patients; offer HIV testing to all TB patients and vice versa.

Worked example

A 45-year-old woman attends a clinic for a routine check-up. She has no symptoms. Reasoning: opportunistic screening should include blood pressure, body mass index, cervical cancer screening (VIA), clinical breast examination, and HIV testing. Diabetes screening is indicated if she has risk factors such as obesity or family history. If she were pregnant, she would need IPTp and tetanus toxoid. Do not order prostate-specific antigen in women; do not screen for prostate cancer in men without discussion.

Traps

  • Using Western screening ages without considering local disease burden (e.g., cervical cancer peaks earlier).
  • Forgetting that HbA1c is unreliable in sickle cell disease.
  • Missing vaccination opportunities at every clinic visit.
  • Assuming all fevers are malaria; always test before treating.