5th Lecture - Prevention & Control of Diseases - 12 Dec 2015
5th Lecture - Prevention & Control of Diseases - 12 Dec 2015
5th Lecture - Prevention & Control of Diseases - 12 Dec 2015
OF DISEASES
Pre-Pathogenesis phase
Disease
Process
Pathogenesis phase
Death
Chronic
Host
Disability/defe
ct
illness
Tissue/physi
o change
multiplicatio
n
Entry
Environment
Mode of
intervention
Primary
preventi
on
Health
Specific
Promotio Protectio
n
n
Immunity/
resistance
Recovery
Interaction--- Host
raction
Early path Early
lesions
Level of
preventi
on
Sign/symptom
s
Secondary
prevention
ED&T
Advance
disease
Convalescence
Tertiary prevention
Disability
Limitatio
n
Rehabilitation
RISK FACTORS
Exact agent of disease can not be identified e.g. CHD,
RISK FACTORS
Identifiable prior to event/disease
Combination of risk factors may have additive or
RISK FACTORS
Modifiable smoking, hypertension, raised cholesterol
OR
Collective malaria risk areas, pollution, poor water supply
Risk factors as well as degree of risk are determined by
epidemiological studies
Importance pre-symptomatic screening for diseases
RISK GROUPS
Risk/target groups identified as per certain criteria,
Physical env
Socio-cultural situation
prevalence
To reduce duration of disease
To reduce severity & complications
To reduce mortality
To reduce further spread and transmission
To reduce financial burden
PRE-REQUISITES FOR
PREVENTION AND
CONTROL
Knowledge of
Natural h/o disease
Aetiology/ causation
Dynamics of transmission
Availability of prophylactic/early detection tools
and treatment
Organisational infrastructure
Continuous monitoring and evaluation
SOME IMP
TERMINOLOGIES
Diseases control
Diseases
elimination
Diseases
Eradication
DISEASE CONTROL
Containment of disease to a level where it
DISEASE ELIMINATION
Intermediate goal between control and
eradication
Interruption of transmission and elimination of
disease from a large geographic area/region
Regional elimination is precursor for
eradication
E.g. Measles, Diphtheria, Polio
DISEASE ERADICATION
Termination of all transmission of infection by
extermination of agent
Absolute process to uproot
Used for cessation of infection/disease from globe
SMALLPOX is only disease to have been eradicated
from world
Polio, Measles and Guineaworm
disease(Dracunculiasis)
are considered amenable for eradication
DISEASE ERADICATION
Every disease has its own epidemiological
DISEASE ERADICATION
Control measures aim to reduce morbidity from
disease
Once morbidity is reduced substantially, residual
DISEASE
PREVENTION
Prevention
Promote
health
Preserve
health
Restore
health
LEVELS OF
PREVENTION
Primordial
Primary
Secondary
Tertiary
PRIMORDIAL
PREVENTION
New concept, especially applicable for chronic
Diseases
Prevention of emergence/development of risk
factors/unhealthy lifestyles in populations
where these have not yet occurred/appeared
discouraging to adopt harmful lifestyles
smoking, eating patterns, lack of physical
exercise
By individual / mass education
PRIMARY PREVENTION
Action before onset of disease ( Pre-
pathogenic phase)
Removing possibility of occurrence of disease
By Health promotion and Specific
protection , as also Health Education
Not only for prevention of occurrence of
disease but also includes concept of Positive
Health
Also for chronic Diseases - elimination/
modification of risk factors
PRIMARY PREVENTION
Approaches
1.
Population/Mass strategy
E.g.
Directed
PRIMARY PREVENTION
2. High-risk strategy
Detection
PRIMARY PREVENTION
Safe, low cost, high returns
E.g. Rise in std of living(Primary Prevention)
SECONDARY
PREVENTION
To halt progress of disease at its early stage and prevent
and screening)
Aims to search for un-recognised illness and early
TERTIARY PREVENTION
Late pathogenesis stage
Aim to limit/ reduce further impairment
MODES OF INTERVENTION
Health Promotion
Specific protection
Early diagnosis and treatment
Disability limitation
Rehabilitation
HEALTH PROMOTION
Enabling people to have increased control to
HEALTH PROMOTION
1. Health Education
Most cost effective
Inform about diseases their causation and
prevention
Aimed at general public, priority groups, indls,
community leaders, decision makers
2. Environmental modifications
E.g. Safe water, sanitary latrines, control of
pests/rodents, better housing etc
HEALTH PROMOTION
3. Nutritional interventions
Nutrition education, food fortification, nutritional
supplementation, nutritional programmes
4. Lifestyle and behavioural changes
Requires individual and community responsibility
for health
Role of treatment providers as educators
Health education is imp for changing opinions,
habits and behaviour
SPECIFIC PROTECTION
Immunization
Chemoprophylaxis
Occupational hazards and accidents
Environmental control
carcinogens/ allergens/pollution
Safety and quality of food & drugs
Nutrition - Iodised salt for goiter
- Iron & folic acid
- Mid day meal
- Vit A for
Nightblindness
Genetic counselling
DISABILITY LIMITATION
Late pathogenesis phase to halt progression of
Impairment
e.g.
May
e.g.
DISABILITY LIMITATION
2. Disability
Restriction/inability to do certain activities/functions
DISABILITY LIMITATION
Accident
medical
Loss of foot
--- Disease
--- Impairment
Largely
----- Handicap
Largely
DISABILITY
LIMITATION
TREATMENT:
Medical
Surgical
REHABILITATION
Combined and coordinated use of
REHABILITATION
Medical - restoration of
REHABILITATION MEDICINE
New speciality
Includes disciplines of Physiotherapy,
waste
ou
Y
k
n
a
Th