prevention & control.ppt

8/14/2019 Prevention & Control.ppt

1/36

Irwin Aras

Community Medicine Dept.

FMUH

Concepts of Disease

Prevention and Control


2/36

(I) Prevention


3/36

The goals of medicine;o to promote health,

o to preserve health,

o to restore health when it is impaired, and

o to minimize suffering and distress.

These goals are embodied in the word"prevention"


4/36

Prevention; Definition and Concept

Actions aimed at eradicating, eliminatingor minimizing the impact of disease and

disability, or if none of these are feasible,

retarding the progress of the disease and

disability.

The concept of prevention is best defined in

the context of levels, traditionally calledprimary, secondary and tertiary

prevention. A fourth level, called primordial

prevention, was later added.


5/36

Determinants of Prevention

Successful prevention depends upon:

a knowledge of causation,

dynamics of transmission,

identification of risk factors and risk groups, availability of prophylactic or early detection and

treatment measures,

an organization for applying these measures to

appropriate persons or groups, and continuous evaluation of and development of

procedures applied


6/36

Preventable Causes of Disease

BEINGS

Biological factors and BehavioralFactors

Environmental factors

Immunologic factors

Nutritional factors

Genetic factors

Services,

Social factors, and

Spiritual

factors


7/36

Natural History of Disease(Gertsman, 2003))


8/36

LeavellsLevels of Prevention

Stage of disease Level of prevention Type of response

Pre-disease Primary Prevention Health promotion and

Specific protection

Latent Disease Secondary prevention Early diagnosis andprompt treatment

Symptomatic Disease Tertiary prevention Disability limitation for

early symptomatic

disease

Rehabilitation for lateSymptomatic disease


9/36

Levels of prevention

Primordial prevention

Primary prevention

Secondary prevention

Tertiary prevention


10/36

Primordial Prevention

consists of actions and measures thatinhibit the emergence of risk factors in

the form of environmental, economic,

social, and behavioral conditions andcultural patterns of living etc.


11/36


It is the prevention of the emergence ordevelopment of risk factors in population

groups in which they have not yet

appeared

For example;

many adult health problems (e.g., obesity,

hypertension) have their early origins inchildhood, because this is the time when

lifestyles are formed (for example, smoking,

eating patterns, physical exercise).


12/36


In primordial prevention, efforts aredirected towards discouraging

children from adopting harmful

lifestyles

The main intervention in primordial

prevention is through individual andmass education


13/36

Primary Prevention

Primary prevention can be defined as; the action taken prior to the onset of disease,

which removes the possibility that the disease

will ever occur. It signifies intervention in the pre-

pathogenesis phase of a disease or healthproblem.

Primary prevention may be accomplishedby measures of Health promotion andSpecific protection


14/36

Primary Prevention

It includes the concept of "positive health;a concept that encourages achievement

and maintenance of "an acceptable level of

health that will enable every individual to

lead a socially and economically productive

life".

Primary prevention may be accomplished; by promote general health and well-being, and

quality of life of people or

by specific protective measures.


15/36

HealthPromotion

Health education

Good standard of nutrition

Attention to personality development

Provision of adequate housing, recreation andagreeable working conditions

Marriage counseling and sex education

Genetics

Periodic selective examinations

SpecificProtection

Use of specific immunizations

Attention to personal hygiene

Use of Environmental sanitation

Protection against occupational hazards Protection from accidents

Use of spesific nutrients

Protection from carcinogens

Avoidance of allergens


16/36

Health promotion

Health promotion is; the process of enabling people to

increase controlover the determinants of

health and thereby improve their health.


17/36

Approaches for Primary Prevention

The WHO has recommended the followingapproaches for the primary prevention of

chronic diseases where the risk factors are

established:

a. Population (mass) strategy

b. High -risk strategy


18/36

Population (mass) strategy

Population strategy" is directed at thewhole population irrespective of individualrisk levels.

For example;

studies have shown that even a smallreduction in the average blood pressure orserum cholesterol of a population would

produce a large reduction in the incidenceof cardiovascular disease

The population approach is directedtowards socio-economic, behavioral and


19/36

High-Risk Strategy

The high -risk strategy aims to bringpreventive care to individuals at

special risk.

This requires detection of individuals

at high risk by the optimum use of

clinical methods.


20/36

Secondary Prevention

It is defined as;action which hal ts the prog ress of a diseaseat its incipient stage and preventscomplications.

The specific interventions are: early diagnosis (e.g. screening tests, and case

finding programs.) and adequate treatment.

Attempts to; arrest the disease process, restore health by seeking out unrecognized disease

and treating it before irreversible pathologicalchanges take place, and

reverse communicability of infectious diseases.


21/36

Early Diagnosis and Prompt

Treatment WHO Expert Committee in 1973 defined

early detection of health disorders as;

the detection of disturbances ofhomoeostatic and compensatory

mechanism while biochemical,morphological and functional changes arestill reversible.

The earlier the disease is diagnosed andtreated, the better it is for prognosis of thecase and in the prevention of theoccurrence of other secondary cases.


22/36

Tertiary Prevention

It is used when the disease process hasadvanced beyond its early stages.

It is defined as;

all the measures available to reduce orlimit impairments and disabilities, and to

promote the patients adjustment to

irremediable conditions.

Intervention that should be accomplished inthe stage of tertiary prevention are

disability limitation, and rehabilitation.


23/36

Disability Limitation

disease

impairment

disability

handicap


24/36

Impairment

Impairment is;

any loss or abnormality of

psychological, physiological or

anatomical structure or function.


25/36

Disability

Disability is;

any restriction or lack of ability to

perform an activity in the manner or

within the range considered normal forthe human being.


26/36

Handicap

Handicap is;

a disadvantage for a given individual,

resulting from an impairment or

disability, that limits or prevents thefulfillment of a role in the community

that is normal (depending on age, sex,

and social and cultural factors) for thatindividual.


27/36

Rehabilitation is;

the combined and coordinated use of

medical, social, educational, and

vocational measures for training andretraining the individual to the highest

possible level of functional ability.

Rehabilitation


28/36

(II) Control


29/36

Control

The term disease control describes ongoingoperations aimed at reducing:

The incidence of disease

The duration of disease and consequently the

risk of transmission

The effects of infection, including both the

physical and psychosocial complications

The financial burden to the community.


30/36

Control Activities

Focus on primary prevention or

secondary prevention, but most

programs combine both.

Control Elimination Eradication


31/36

Disease Elimination

Between control and eradication, anintermediate goal has been described,called "regional elimination

The term "elimination" is used to describeinterruption of transmission of disease;

as for example, elimination of measles, polio anddiphtheria from large geographic regions or

areas

Regional elimination is now seen as animportant precursor of eradication


32/36

Disease Eradication

Eradication literally means to "tear out by roots".

It is the process of Termination of allt ransm iss ion o f infect ion by exterm inat ion o f

the infect ious agent through survei l lance andcontainment.

Eradication is an absolute process, an "all or

none" phenomenon, restricted to termination of aninfection from the whole world. It implies thatdisease will no longer occur in a population.

To-date, only one disease has been eradicated,

that is smallpox.


33/36

Monitoring

Defined as;"the performance and analysis of routinemeasurements aimed to detectingchanges in the environment or health

status of population" (Thus we havemonitoring of air pollution, water quality,growth and nutritional status, etc).


34/36

Surveillance

surveillance means to watch over with greatattention, authority and often with

suspicion.

Defined as;

"the continuous scrutiny (inspection) of

the factors that determine the occurrence

and distribution of disease and otherconditions of ill-health"


35/36

References

Salama, R. Concept of prevention & control.Lecture Presiding.

PhD. Community Medicine Suez Canal

University Egypt.

Gerstman, BB (2003). Epidemiology keptsimple.

Yarnell, J (2007). Epidemiology and prevention.

Gordis, L (2009). Epidemiology.Bustan, MN (1997). Epidemiologi penyakit tidak

menular.

Noor, NN (1997). Epidemiologi penyakit menular.


36/36

Terima Kasih

Thank you

Asante

GraciasGrazie

Dyanavad

SpaciboMerci, Danke

Naishitz

Arigato

Shohkrahn

Gnxe

Multu^mesc

Hvala

Ngiyabonga

Cmo*nKamsa hamnida

Syukron

prevention & control.ppt

Documents