Role of community pharmacist in national programs (Malaria, TB) MCQs With Answer

Introduction:

This quiz collection is designed for M.Pharm students preparing for Hospital & Community Pharmacy (MPP 103T) and focuses on the community pharmacist’s role in national programmes for Malaria and Tuberculosis. It covers practical responsibilities such as diagnosis support, appropriate dispensing, adherence counselling, pharmacovigilance, referral pathways, and logistics within national frameworks (e.g., NVBDCP for malaria and NTEP for TB). Questions integrate clinical, programmatic and regulatory aspects to deepen understanding of how community pharmacists contribute to case detection, treatment completion, prevention, and public health reporting. Use these MCQs to test knowledge required for effective participation in national disease control efforts and patient-centered care.

Q1. Which of the following is a primary responsibility of a community pharmacist under the National Tuberculosis Elimination Programme (NTEP)?

• Initiate full anti-TB chemotherapy without programme registration
• Collect sputum samples or refer suspected TB patients to designated diagnostic centres
• Administer injectable TB drugs at the pharmacy
• Perform chest X-rays at the pharmacy

Correct Answer: Collect sputum samples or refer suspected TB patients to designated diagnostic centres

Q2. Before dispensing antimalarial therapy for suspected uncomplicated falciparum malaria, community pharmacists should:

• Dispense artemisinin monotherapy immediately
• Advise testing with microscopy or a malaria rapid diagnostic test (RDT) prior to treatment
• Always prescribe primaquine as a single agent
• Refer all febrile patients for hospital admission

Correct Answer: Advise testing with microscopy or a malaria rapid diagnostic test (RDT) prior to treatment

Q3. Which antitubercular drug interaction is most important for pharmacists to counsel about when dispensing rifampicin?

• Rifampicin inhibits CYP3A4 leading to increased warfarin levels
• Rifampicin induces CYP enzymes causing reduced efficacy of oral contraceptives and some anticoagulants
• Rifampicin has no clinically significant drug interactions
• Rifampicin increases serum digoxin levels substantially

Correct Answer: Rifampicin induces CYP enzymes causing reduced efficacy of oral contraceptives and some anticoagulants

Q4. Under malaria control programmes, which regimen is recommended as first-line therapy for confirmed Plasmodium falciparum infection in most endemic settings?

• Quinine monotherapy for seven days
• Artemisinin-based combination therapy (ACT)
• Chloroquine single dose
• Primaquine alone

Correct Answer: Artemisinin-based combination therapy (ACT)

Q5. What is a key role of community pharmacists in improving treatment adherence for TB patients enrolled in NTEP?

• Replacing DOTS entirely with pharmacy dispensing
• Providing counseling, refill reminders, and liaising with TB health workers for directly observed treatment support
• Offering shorter regimens without informing the programme
• Giving take-home multi-dose injectable therapy

Correct Answer: Providing counseling, refill reminders, and liaising with TB health workers for directly observed treatment support

Q6. Which of the following best describes the pharmacist’s responsibility regarding anti-malarial stock management under national programmes?

• Maintain adequate supplies, follow FIFO, and report stock levels and expiries to programme authorities
• Order only on patient demand without record-keeping
• Store all antimalarials in a freezer to extend shelf life
• Mix different antimalarial brands to create a combined formulation

Correct Answer: Maintain adequate supplies, follow FIFO, and report stock levels and expiries to programme authorities

Q7. Which statement about primaquine use in malaria is correct and important for community pharmacists to counsel?

• Primaquine is safe for all patients and requires no G6PD testing
• Primaquine is used as a single dose gametocytocide for falciparum and as a 14-day radical cure for vivax; G6PD testing should be considered before radical cure
• Primaquine cures drug-resistant falciparum on its own
• Primaquine should be given to children under 1 month at full adult doses

Correct Answer: Primaquine is used as a single dose gametocytocide for falciparum and as a 14-day radical cure for vivax; G6PD testing should be considered before radical cure

Q8. In the context of TB control, what is the pharmacist’s role in pharmacovigilance?

• Ignore adverse effects as long as treatment continues
• Identify, counsel on, document and report suspected adverse drug reactions to the programme’s pharmacovigilance system
• Advise patients to stop treatment without informing programme staff if side effects occur
• Prescribe add-on medications without program coordination

Correct Answer: Identify, counsel on, document and report suspected adverse drug reactions to the programme’s pharmacovigilance system

Q9. Which legal/ethical responsibility applies to community pharmacists when dispensing anti-TB medicines under NTEP?

• Dispense anti-TB drugs without documentation to maintain patient privacy
• Ensure treatment is recorded in programme registers and preserve confidentiality while reporting required data
• Refuse all TB patients from the pharmacy
• Share patient details publicly to promote community awareness

Correct Answer: Ensure treatment is recorded in programme registers and preserve confidentiality while reporting required data

Q10. Which infection control practice is essential in pharmacies to prevent transmission when handling suspected TB patients?

• Perform sputum induction in a crowded waiting room
• Use proper ventilation, provide masks, and refer for testing rather than performing aerosol-generating procedures on site
• Require all staff to touch patient belongings
• Ignore cough hygiene advice

Correct Answer: Use proper ventilation, provide masks, and refer for testing rather than performing aerosol-generating procedures on site

Q11. When a community pharmacist encounters a patient with recurrent malaria despite treatment, the most appropriate action is to:

• Double the dose of the dispensed antimalarial without testing
• Refer for parasitological confirmation, assess adherence, and notify the programme about possible treatment failure
• Switch to chloroquine regardless of species
• Provide antibiotics for presumed bacterial infection

Correct Answer: Refer for parasitological confirmation, assess adherence, and notify the programme about possible treatment failure

Q12. Which of the following is a correct statement about DOTS strategy that pharmacists should support?

• DOTS requires direct observation of treatment only for the first week
• DOTS combines supervised drug intake, regular follow-up, reliable drug supply, and proper record-keeping to ensure completion
• DOTS means patients self-report adherence at monthly intervals only
• DOTS is obsolete and should not be followed

Correct Answer: DOTS combines supervised drug intake, regular follow-up, reliable drug supply, and proper record-keeping to ensure completion

Q13. Which reporting duty is expected of community pharmacists working with national malaria programmes?

• No reporting is required; pharmacists only dispense medications
• Report confirmed malaria cases, RDT usage and stock-outs as per programme guidelines
• Report only severe malaria deaths and ignore uncomplicated cases
• Report patient income details to the programme

Correct Answer: Report confirmed malaria cases, RDT usage and stock-outs as per programme guidelines

Q14. For drug-sensitive pulmonary TB, which treatment schedule should a pharmacist recognize as standard first-line therapy to advise patients correctly?

• 6 months total: 2 months of HRZE followed by 4 months of HR (2HRZE/4HR)
• 3 months of isoniazid monotherapy
• 12 months of streptomycin injections only
• Single-dose rifampicin therapy

Correct Answer: 6 months total: 2 months of HRZE followed by 4 months of HR (2HRZE/4HR)

Q15. Which practice helps prevent development of antimalarial drug resistance and is advocated by community pharmacists?

• Encouraging use of monotherapy with artemisinin derivatives
• Ensuring confirmed diagnosis and using full-dose artemisinin-based combination therapy (ACT) as per guidelines
• Reducing dose to make treatment last longer
• Using antibiotics alone for malaria treatment

Correct Answer: Ensuring confirmed diagnosis and using full-dose artemisinin-based combination therapy (ACT) as per guidelines

Q16. Which aspect of patient counselling is especially important for TB medication tolerance?

• Telling patients that side effects never occur
• Informing patients about common side effects (e.g., hepatotoxicity, peripheral neuropathy), advising reporting, and suggesting measures (e.g., pyridoxine for isoniazid)**
• Advising abrupt cessation if any mild symptom occurs
• Suggesting herbal alternatives without consulting programme staff

Correct Answer: Informing patients about common side effects (e.g., hepatotoxicity, peripheral neuropathy), advising reporting, and suggesting measures (e.g., pyridoxine for isoniazid)**

Q17. Which statement correctly describes the pharmacist’s role in community awareness for malaria prevention?

• Community pharmacists should avoid discussing prevention to prevent causing alarm
• Pharmacists should educate on vector control, bed net use, early testing for fever, and adherence to treatment
• Pharmacists should recommend self-medication with leftover antimalarials
• Pharmacists should advise ignoring peak mosquito hours as prevention

Correct Answer: Pharmacists should educate on vector control, bed net use, early testing for fever, and adherence to treatment

Q18. Which of the following is a correct action when a pharmacist receives a TB patient’s lost-to-follow-up case who demands anti-TB drugs?

• Dispense full course immediately without linking to programme records
• Coordinate with NTEP staff to re-link the patient into care, document treatment history, and ensure supervised restart as per guidelines
• Refuse any assistance
• Provide antibiotics instead of anti-TB drugs

Correct Answer: Coordinate with NTEP staff to re-link the patient into care, document treatment history, and ensure supervised restart as per guidelines

Q19. Which cold-chain related statement is accurate for anti-TB and most antimalarial medicines in community pharmacy settings?

• All anti-TB and antimalarial medicines require storage in a vaccine-like cold chain
• Most are stable at normal controlled room temperature; pharmacists must avoid extreme heat and moisture and follow manufacturer storage instructions
• They must be frozen to maintain potency
• Storage conditions are irrelevant for these drugs

Correct Answer: Most are stable at normal controlled room temperature; pharmacists must avoid extreme heat and moisture and follow manufacturer storage instructions

Q20. Which of the following best reflects the community pharmacist’s contribution to program monitoring and evaluation for TB and malaria?

• Refusing to participate in any surveys or reporting
• Providing timely case and commodity reports, participating in audits, and sharing adverse event and adherence data with programme managers
• Reporting only positive outcomes and withholding stock-out information
• Altering patient records to meet programme targets

Correct Answer: Providing timely case and commodity reports, participating in audits, and sharing adverse event and adherence data with programme managers

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