Question: 1. Explain why this is considered to be a case-control study? Include in your answer, who were the cases, and how many were used for the study? Who were the controls, why were they used, and how many were in the study?

2. What were the steps they used to explore the problem? In your assessment, what could some of the potential bias issues be, and how might they control for these?

3. If you discuss the association between exposure and disease for this situation, what conclusions did the investigators draw, and why? Use depth and specificity in your response.

4. What measure do investigators use to determine association for case-control studies? Explain what it may tell you?

5. Did their conclusions change when the researchers investigated the problem in various countries of the Caribbean?

6. What are some policy implications or benefits for having a Survelliance System in place? What are some pertinent qualifications of an effective Survellience System?