Communicable Diseases 1.Kmtc-1
Communicable Diseases 1.Kmtc-1
Communicable Diseases 1.Kmtc-1
LOICE
BScN
Reservoir
Direct Indirect
transmission transmission
Vehicle-borne
Direct contact •Vector-borne:
Droplet infection •Mechanical propagative
Cyclo-prop.
Contact with soil •Air-borne
biological Cyclo-develop.
Unclean hands
Trans-placental (vertical) and fingers
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Susceptible host
• Host capable of acquiring a disease
• An infectious agent seeks a susceptible host aiming “successful
parasitism”.
• Four stages are required for successful parasitism:
1. Portal of entry
2. Site of election inside the body
3. Portal of exit
4. Survival in external environment
1.MALARIA
SYMPTOMS SIGNS
Fever and chills High temperatur
General malaise
Rigors:sudden feeling of cold
Joint pains
accompanied by rise in
Backache
temperature
Nausea
Splenomegaly
Vommiting and diarrhoea
Headache Jaundice
dizziness Convulsions
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anemia
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Stages of malarial fever
A typical attack of fever has 3 stages : cold, hot and sweating.
1. The cold stage : temperature rises and patient shivers: last 1-
2hrs.In this stage .the infected red blood cells burst releasing
merozoites and many ring forms are seen in blood smear.
2. The hot stage: The temperature is high, the skin is dry and hot,
there is severe headache and often nausea and vomiting :last 3-4
hrs
• Once contracted, the yellow fever virus incubates in the body for 3
to 6 days.
• The most common Symptoms are fever, muscle pain with
prominent backache, headache, loss of appetite, and nausea or
vomiting. In most cases, symptoms disappear after 3 to 4 days.
• A small percentage of patients, however, enter a second, more toxic
phase within 24 hours of recovering from initial symptoms
1.Socioeconomic conditions
Poverty increases the risk for leishmaniasis. Poor housing and
domestic sanitary conditions (such as a lack of waste management or
open sewerage) may increase sandfly breeding and resting sites, as
well as their access to humans. Sandflies are attracted to crowded
housing as these provide a good source of blood-meals. Human
behaviour, such as sleeping outside or on the ground, may increase
risk. The use of insecticide-treated bednets reduces risk.
2.Malnutrition
Diets lacking protein-energy, iron, vitamin A and zinc increase the risk
that an infection will progress to kala-azar.
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cont
3.Population mobility
Epidemics of both cutaneous and visceral leishmaniasis are often
associated with migration and the movement of non-immune people
into areas with existing transmission cycles. Occupational exposure as
well as widespread deforestation remain important factors. For
example, people settling in areas that used to be forests may be moving
near sandflies’ habitat. This can lead to a rapid increase in cases.
4.Environmental changes
Environmental changes that can affect the incidence of leishmaniasis
include urbanization, domestication of the transmission cycle and the
incursion of agricultural farms and settlements into forested areas
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cont
5.Climate change
Leishmaniasis is climate-sensitive, and strongly affected by changes
in rainfall, temperature and humidity.
• changes in temperature, rainfall and humidity can have strong
effects on vectors and reservoir hosts by altering their distribution
and influencing their survival and population sizes;
INTRODUCTION
• cysts-passers who are usually asymptomatic are responsible for the spread of
amoebic dysentery
• Therefore in order to prevent and control this disease, you need to do the
following:
• Advise people to boil drinking water (chlorination does not kill the cysts)
• Search for and treat carriers among
food handlers
• Commence a campaign for more latrines in an area with endemic amoebiasis
• Conduct community campaigns about good personal hygiene practices, such
as regular hand washing
• The bacillus anthracis forms spores when exposed to the air. The
spores can survive for years in the soil even under harsh weather
conditions.
• The spores enter the animals orally (through the mouth or
ingestion).
• The body of a sick or dead animal contains millions of anthrax
bacilli. These bacilli are shed through animal urine, droppings,
saliva milk and blood.
• If any of these body fluids are touched or the meat of an infected
animal eaten, a person becomes infected with anthrax.
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Clinical features
• The clinical features depend on the route of entry of the anthrax
bacillus.
• Skin or cutaneous anthrax presents with a malignant pustule with
a black necrotic centre. The wound is usually painless and has
swollen edges. Skin anthrax has low mortality.
• Respiratory tract anthrax on the other hand has a high mortality
rate and presents with severe respiratory distress and shock.
• Digestive tract anthrax is characterised by fever, sepsis, watery
diarrhoea and vomiting
• Ensure that all meat offered for sale is inspected and educate the
community on proper disposal of all infected animals.
• The carcasses must be burnt or buried two meters deep in the
ground in calcium oxide powder (quick lime).
• Other measures include annual vaccination of cows at risk, proper
disinfection of hides and skins, and vaccination of members of the
community who are at risk of getting anthrax.
• Hookworm eggs are embryonated by the time they are passed out
with faeces.
• when the faeces stand for a long time before examination the free
larvae can be found.
• When an infected person passes faeces in the soil, the larvae bury
themselves in the moist damp soil.
• The larvae are called rhabditiform and only become infective after
five days, when they change into the sheathed filariform stage.
• This disease occurs when a person ingests pork infected with the
taenia solium larvae.
• Whereas in the beef tapeworm the embryo attaches itself to the
wall of the small bowel and grows into an adult worm, the pork
tapeworm behaves differently.
• The embryo penetrates the intestinal wall of the human as it does
the pig, and it is carried to organs like striated muscle or the
brain. This can cause serious problems such as epilepsy and death
• The whoop starts 1 to 2 weeks after the cold symptoms and lasts
6weeks to 3months
• Thick, clear, sticky mucous may be coughed up at the end of the
coughing spasm
• Coughing spasms are more
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TRAINING at night
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Stage 3 (Convalescent stage ):
• Gradual disappearance of symptoms occurring over 2 to 4 weeks,
however, coughing spells can last for weeks or months
• Cough may become louder and may sound like it is getting worse
as the person is getting better
1.Community Health
• is the science and art of promoting health and preventing disease through
organised community participation
• Represent information called vital stastics
2.Incidence
• number of new cases of a disease or condition occurring over any specified
time
no. of new cases in a specified period
Incidence rate = ---------------------- x 1000
population at risk during the period
• This is a measure of the number of women who die as a result of child bearing in a given
year per 100,000 live births i.e.
• During this period of exploration, you also sound out the reactions
of members of the community.
• This can be done by talking to people informally in market places
and eating places.
• This way, you will easily find their opinions or problems in the
community and their likely solutions.
• Also by talking to them you can gather information regarding
possible resistance to the survey and how to approach different
members of the community
To answer this question you will need to specify the tasks that need
to be done and then identify who will do them and how long it will
take them
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CONT
• Consider the following factors:
1. Time to travel to the study area
2. Time to locate the groups
3. Time and number of times each group will be visited. Allow time for
following up defaulters
4. Calculate the number of interviews that can be completed in a day
5. Calculate the number of days that will be needed to complete the whole
sample
6. Calculate the time needed for other parts of the study for example five
days for preparation and
pre-testing and twenty days for actual work
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CONT
• How do we select and train the official interviewers?
Ideally, the interviewers should come from the community so that
they are well known to its members.
• School teachers, school children, health centre staff, village elders
and young educated people are some of the people who can help you
to survey your area and fill in the questionnaires.
• However, if your interviewers are not from that community, then you
will need to introduce them to the community leaders and if possible
to the community members in a public meeting.
• Once the survey begins, they should wear identification badges and
introduce themselves
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The people you select for training as interviewers should have the following qualities:
1) Be literate and well known to the community
2) Have the ability to display the right attitudes and opinions
3) Be able to explain the questionnaire effectively to the community
4) Be able to use the tools presented in
your package
5) Be able to establish good rapport with individuals, families or groups they will
meet
6) Be good listeners and sensitive towards other
people's feelings
7) Be able to relate well to the community members
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CONT
• You should impress on the interviewers the value of working well
with all sections of the community.
• If one of your tools addresses a specific group like the youths, you
should select an interviewer of the same age or sex who can identify
with the group. This helps to elicit the salient points from their
responses.
• Whenever possible, select people who speak the language of the study
group.
• The people who are selected as interviewers have different
educational backgrounds from yours and may interpret questions
and answers differently.
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CONT
• When training interviewers you need to explain the
following:
1. The purpose of the survey
2. The method to record the various expressions used by
people to answer particular questions
3. The procedure they should follow to get cooperation
from the people being surveyed
closed-ended
• An open-ended question is a type of question that allows the
respondent to provide their own answer. It encourages the
respondent to think and describe a situation in their own words.
The respondent is not given any answers to select from. The
answer given is best recorded in the respondent’s own words
• The data you obtain from the field is known as ’raw data’.
• In this state, it does not give much information and is therefore
difficult to interpret. That is why it needs further work known as
data analysis.
• Data analysis is the separation and categorisation of numerical
data into groups in order to understand its meaning
Number of
Age in years Tally Percentage
patients
0-4 IIIII IIIII 10 33
5-9 IIIII II 7 23
10-14 IIII 4 14
15-19 III 3 10
20-24 III 3 10
25-29 III 3 10
Total 30 COLLEGE
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Coding and Entering Data
• Once you sort and code your data you are now ready to
analyse it. There are two types of analysis that are carried
out on data.
Qualitative analysis
Quantitative analysis
• Qualitative analysis is usually applied on data which can
be counted but can not be measured, such as, colour .
• Once you have grouped your data, there are many ways
of presenting it
a) Tabular presentation
b) Graphical presentation
• This covers the various tables that are used to present data, for
example, frequency distribution table.
This section seeks to explain why the survey was undertaken and
which questions it was designed to answer.
• It is started by defining what community diagnosis is.
• Explain why the survey was undertaken
• Finally you describe the geographical position of the place you
carried out the survey