DISEASES OF PUBLIC HEALTH IMPORTANCE

STUDENT ID:
STUDENT NAME:
You have been appointed to the ministry of health as a consultant on communicable and
non-communicable diseases
1. a) Draft a letter to the permanent secretary ministry of health highlighting the
approaches/interventions you will use to help government in curbing down the high
prevalence of Hepatitis B in the Karamojong Region (8 Marks)

AMPEIRE DERRICK
CONSULTANT COMMUNICABLE & NON-COMMUNICABLE DISEASES
+256 786562387
Ampairederrick@gmail.com
March 23, 2022

To The permanent secretary,

M Plot 6, Lourdel Road, Nakasero
P.O Box 7272,
Kampala Uganda.
Phone: Tel: +256 417 712260

Dear Madam,
RE: INTERVENTIONS TO HELP GOVERNMENT CURB HEPATITIS B IN THE
KARAMOJONG REGION
Greetings madam, my name is Ampeire Derrick, the recently appointed consultant on
communicable and non-communicable diseases. I am here writing this letter today to discuss
with you the approaches and interventions that can be used by the government to curb down the
high prevalence of hepatitis B in the Karamojong region.
Hepatitis B is an infectious disease caused by the hepatitis B virus (HBV) that affects the liver; it
is a type of viral hepatitis that can cause both acute and chronic infection. The virus is
transmitted by exposure to infectious blood or body fluids. In areas where the disease is
common, Infection around the time of birth or from contact with other people's blood during
childhood is the most frequent method by which hepatitis B is acquired.
According to a study carried out in 2004, the infection is highly endemic in Uganda with a
national prevalence estimate of 10%. The in-country distribution of the virus however varies
from region to region. The highest prevalence is found in the Northern part of the country, with
karamojong region having a high prevalence of 25%, thus the need to come up with strategies
and approaches to curb it. Listed below are some of the approaches and strategies that the
Government can use to curb the high prevalence of the of the HBV;
 Prevention of mother-to-child transmission (MTCT). To ensure this, there should be
mandatory antenatal hepatitis B surface antigen screening: Initiation of tenofovir 300 mg
daily at 28–32 weeks of pregnancy if hepatitis B virus (HBV) DNA concentration is
higher than 200 000 IU/mL to further reduce risk of perinatal transmission.
 Baby treated with HBV birth-dose vaccine within 24 hr. of birth. Babies should be given
the HBV dose vaccine within the first 24 hours of birth. This will reduce on the baby’s
risks of getting the virus.
 Ensure full coverage of universal hepatitis B vaccination. The government should launch
campaigns that will be aimed at vaccinating the entire population against the virus. This
will help reduce on the prevalence and also the rate of infection.
 Identify high-risk groups, especially family members, household contacts, and sexual
contacts for HBsAg screening, HBV vaccination. Groups like the elderly, expectant
mothers, newly born children should be screened and vaccinated in order to reduce on the
risks of transmission.
 Ensure that health-care workers are screened and vaccinated against HBV. Since health
workers are a first point of contact with the patients, they should be screened and
vaccinated against HBV so that to reduce on the risk of the getting the virus and also
spreading the virus to the other population.
 Establish pathways of linkage to care for individuals who are HBV mono-infected. The
Government should come up with a care system for the people with the virus so that they
do not feel left out and also improve their immunity through better feeding.
 Use of affordable prequalified point-of-care testing for HBV serology and HBV DNA
concentration quantification to upscale identification of individuals infected with HBV.
 The government should put in place sensitization programs that will help the
communities learn more about the hepatitis virus, how it’s transmitted and how you can
prevent it. This will help create awareness about the disease and also motivate the
community towards better health.
With all these strategies put in place, I believe that the high hepatitis B prevalence will be curbed
and the numbers will reduce hence improving the health of our community. I will be waiting to
hear from you soon.
Yours sincerely,

Ampeire Derrick
b) With relevant examples where possible, explain any 4 classification of infectious
disease (8 Marks)
An infectious disease is one caused by an agent, often a type of microorganism that impairs a
person’s health. In many cases, infectious disease can be spread from person to person, either
directly (e.g., via skin contact) or indirectly (e.g., via contaminated food or water). Infectious
diseases can be classified into the following categories;
Bacterial Infections
Bacteria are everywhere. They’re on our phone and computer screens, they’re involved in
making yogurt and cheeses, and they help us digest our food. While we encounter millions of
these cells every day, there are some types of bacteria that are harmful. Some examples of
bacterial infections are: bacterial meningitis, otitis media, pneumonia, tuberculosis, gastritis,
food poisoning etc.
They usually fall under one of three distinct shapes:
 Spherical: These are known as cocci.
 Rod-shaped: These have the name bacilli.
 Spiral: Coiled bacteria are known as spirilla. If the coil of a spirillum is particularly
tight, scientists call it a spirochete.
Viral infections
Viral infections occur due to infection with a virus. Viruses contain a small piece of genetic
code, and a coat of protein and lipid (fat) molecules protects them.
Viruses invade a host and attach themselves to a cell. As they enter the cell, they release their
genetic material. This material forces the cell to replicate the virus, and the virus multiplies.
When the cell dies, it releases new viruses, which infect new cells. Viral infections include:
 the common cold, which mainly occurs due to rhinovirus, coronavirus, and adenovirus
 encephalitis and meningitis
 warts and skin infections
 COVID-19, a respiratory disease that develops after a novel coronavirus infection that is
currently causing a global pandemic
Fungal Infections
Fungi are typically found on dead or rotten matter (plant and animal) and exist as one of two
types of cells: yeast cells or mold cells. Commonly occurring fungal infections include many
skin diseases, such as ringworm and athlete's foot, pneumocystis pneumonia, blast mycosis
among others.
Parasitic infection
Protozoa are a type of parasite that thrive on moisture and frequently spread disease via water.
Some protozoa cause intestinal infections, resulting in diarrhea, nausea, and stomach upset.
In healthy people, parasites cause mild illness, but those with severely weakened immune
systems can develop serious infections that can spread to major organs. The majority of parasitic
infections affect countries in the tropics and subtropics. Prevalent parasitic infections include
malaria, Chagas disease, and toxocariasis.
c) What are some potential prevention and control strategies you can employ to avoid
the disease emergence and re emergencies? (8 Marks)
Below are some of the strategies that can help in the prevention and control of disease
emergencies and re-emergencies;
Wash your hands.
This is especially important before and after preparing food, before eating, and after using the
toilet. And try not to touch your eyes, nose or mouth with your hands, as that's a common way
germs enter the body.
Get vaccinated.
Vaccination can drastically reduce your chances of contracting many diseases. Make sure to keep
up to date on your recommended vaccinations, as well as the ones of the young ones.
Stay home when ill.
If possible, don't go to work if you are vomiting, have diarrhea or have a fever. Don't send your
child to school if he or she has these signs. This helps reduce on the rate of spread of certain
diseases such as flue.
Prepare food safely.
Keep counters and other kitchen surfaces clean when preparing meals. Cook foods to the proper
temperature and maintain a clean cooking environment. For meats, please cook till tender.
Practice safe sex.
Always use condoms if you or your partner has a history of sexually transmitted infections or
high-risk behavior. This will help reduce on the infection rate for the other person.
Don't share personal items.
Use your own toothbrush, comb and razor. Avoid sharing drinking glasses or dining utensils.
Disinfect rooms that may have high concentrations of bacteria, such as the kitchen and bathroom.
d) Illustrate the different forms of cardiovascular diseases clearly stating (8 Marks)
Below are some of the forms of cardio vascular diseases;
Coronary heart disease
Coronary heart disease occurs when the flow of oxygen-rich blood to the heart muscle is blocked
or reduced. This puts an increased strain on the heart, and can lead to:
 angina – chest pain caused by restricted blood flow to the heart muscle
 heart attacks – where the blood flow to the heart muscle is suddenly blocked
 heart failure – where the heart is unable to pump blood around the body properly
Strokes and TIAs
A stroke is where the blood supply to part of the brain is cut off, which can cause brain damage
and possibly death.
A transient ischemic attack (also called a TIA or "mini-stroke") is similar, but the blood flow to
the brain is only temporarily disrupted.
The main symptoms of a stroke or TIA are;
 Face – the face may have drooped on one side, the person may be unable to smile, or
their mouth or eye may have dropped.
 Arms – the person may not be able to lift both arms and keep them there because of arm
weakness or numbness in one arm.
 Speech – their speech may be slurred or garbled, or they may not be able to talk at all.

Peripheral arterial disease

Peripheral arterial disease occurs when there's a blockage in the arteries to the limbs, usually the
legs. This can cause:
 dull or cramping leg pain, which is worse when walking and gets better with rest
 hair loss on the legs and feet
 numbness or weakness in the legs
 persistent ulcers (open sores) on the feet and legs
Aortic disease
Aortic diseases are a group of conditions affecting the aorta. This is the largest blood vessel in
the body, which carries blood from the heart to the rest of the body.
One of most common aortic diseases is an aortic aneurysm, where the aorta becomes weakened
and bulges outwards. This doesn't usually have any symptoms, but there's a chance it could burst
and cause life-threatening bleeding.
i) The risk factors
The main risk factors for cardiovascular (CVD) diseases are outlined below;
High blood pressure
High blood pressure (hypertension) is one of the most important risk factors for CVD. If your
blood pressure is too high, it can damage your blood vessels.
Smoking
Smoking and other tobacco use is also a significant risk factor for CVD. The harmful substances
in tobacco can damage and narrow your blood vessels.
High cholesterol
Cholesterol is a fatty substance found in the blood. If you have high cholesterol, it can cause
your blood vessels to narrow and increase your risk of developing a blood clot.
Diabetes
Diabetes is a lifelong condition that causes your blood sugar level to become too high.
High blood sugar levels can damage the blood vessels, making them more likely to become
narrowed.
Many people with type 2 diabetes are also overweight or obese, which is also a risk factor for
CVD.
Inactivity
If you don't exercise regularly, it's more likely that you'll have high blood pressure, high
cholesterol levels and be overweight. All of these are risk factors for CVD. Exercising regularly
will help keep your heart healthy. When combined with a healthy diet, exercise can also help you
maintain a healthy weight.
Being overweight or obese
Being overweight or obese increases your risk of developing diabetes and high blood pressure,
both of which are risk factors for CVD.
Other factors that affect your risk of developing CVD include:
 age – CVD is most common in people over 50 and your risk of developing it increases as
you get older
 gender – men are more likely to develop CVD at an earlier age than women
 diet – an unhealthy diet can lead to high cholesterol and high blood pressure
 alcohol – excessive alcohol consumption can also increase your cholesterol and blood
pressure levels, and contribute to weight gain
ii) Prevention and control
A healthy lifestyle can lower your risk of cardiovascular diseases. If you already have CVD,
staying as healthy as possible can reduce the chances of it getting worse.
Ways you can reduce your CVD risk are outlined below.
Stop smoking
If you smoke, you should try to give up as soon as possible. Stopping smoking will help reduce
on the risk of getting a CVD.
Have a balanced diet
A healthy, balanced diet is recommended for a healthy heart. A balanced diet includes:
 low levels of saturated fat, try to include healthier sources of fat, such as oily fish, nuts
and seeds, and olive oil, low levels of salt, low levels of sugar, plenty of fibre and
wholegrain foods, plenty of fruit and vegetables.
Exercise regularly
Adults are advised to do at least 150 minutes of moderate activity a week, such as cycling or
brisk walking. If you find it difficult to do this, start at a level you feel comfortable with and
gradually increase the duration and intensity of your activity as your fitness improves.
Maintain a healthy weight
If you're overweight or obese, a combination of regular exercise and a healthy diet can help you
lose weight.
Cut down on alcohol
If you drink alcohol, try not to exceed the recommended limit of 14 alcohol units a week for men
and women.
Medication
If you have a particularly high risk of developing CVD, you can visit the nearby hospital to help
make recommendations on taking medication to reduce your risk.
Medications that may be recommended include statins to lower blood cholesterol levels, low-
dose aspirin to prevent blood clots, and tablets to reduce blood pressure.
e) Why is it important to study communicable and non-communicable diseases? (8
Marks)
Below are some of the importance of studying communicable and non-communicable diseases;
Builds knowledge skills and attitude towards health
Someone gets the opportunity to learn about what a communicable and non-communicable
disease is, its causes, risk factors and what they can lead to. One may be able to identify the signs
and symptoms and thereby knowing the disease that they may be suffering from.
It helps motivate people to improve their health
Encourages a person to make healthy choices. They are instructed to avoid unhealthy habits. One
know all the unhealthy behavior and what such behavior can lead to, so they tend to avoid such
behavior in order to live a health life.
It has a positive effect on the finances of the economy
It helps boost the community’s economy by reducing on healthcare spending and lost
productivity due to preventable illness. Since some one knows the causes and the risk factors that
may lead to a particular disease, one can follow the right procedures to avoid getting the disease
thus cutting the costs of healthcare spending.
Public health centers and hospitals will not be too crowded. There won’t be scarcity of free
medicines. Additionally, people will have the ability to work, which is a big help to the
economy.
Total 40 Marks