Health and Disease

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Health
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 Health & Disease Outline
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⚪ Explain the term health

⚪ Types of disease /disorder: physical,
mental, social, infectious, degenerative,
genetic, deficiency (diet-related)
⚪ Factors that predispose to disease/
disorders
⚪ Global distribution of sickle cell disorder,
diabetes and AIDS
 Objectives
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⚫ Explain the term health

⚫ Define the categories of diseases
⚫ Name and describe common/important diseases
⚫ Comment on factors that predispose to disease
⚫ Causes of common diseases
⚫ Explain the terms incidence and mortality rates
 WHO
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World Health Organization (WHO)

⚫ Specialized agency of the United Nations (193
member states)
⚫ Acts as a coordinating authority on international
public health,
⚫ Headquarters in Geneva, Switzerland.
⚫ Established 7 April 1948
⚫ mission “…the attainment by all peoples of the
highest possible level of health…”
 World Health Day Themes
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⚫ April 7, 2013: Control your blood pressure
⚫ April 7, 2012: Good health adds years to life
⚫ April 7, 2011: Antimicrobial resistance: no action
today, no cure tomorrow
⚫ April 7, 2010: 1000 cities, 1000 lives
⚫ April 6, 2009: Save lives. Make hospitals safe in
emergencies
⚫ April 7, 2008: Protecting health from climate
change
⚫ April 7, 2007: International health security
⚫ April 7, 2006: Working together for health
High/ Raised Blood Pressure
Hypertension
Silent killer, global public health crisis
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• Increases the risk of heart attacks, strokes and kidney failure.
• If left uncontrolled, can also cause blindness, irregularities of the
heartbeat and heart failure. The risk of developing these complications
is higher in the presence of other cardiovascular risk factors such as
diabetes.
• One in three adults worldwide has high blood pressure. The proportion
increases with age, from 1 in 10 people in their 20s and 30s to 5 in 10
people in their 50s
 HBP treatment & WHO goals
Treatment:
⚫ reducing salt intake; eating a balanced diet;
⚫ avoiding harmful use of alcohol; taking regular physical activity;
⚫ maintaining a healthy body weight; and avoiding tobacco use.

Goals of WHD 2013 : Greater awareness, healthy behaviours, improved

detection, and enabling environments; reduce heart attacks and strokes.
⚫ raise awareness of the causes and consequences of high blood
pressure;
⚫ provide information on how to prevent high blood pressure and related
complications;
⚫ encourage adults to check their blood pressure and to follow the advice
of health-care professionals;
⚫ encourage self-care to prevent high blood pressure;
⚫ make blood pressure measurement affordable to all; and
⚫ incite national and local authorities to create enabling environments for
healthy behaviours.
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 World Health Day 2021
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⚫ Theme: “Building a fairer, healthier world”

⚫ The Covid-19 pandemic further highlighted health

inequalities between countries in the world and in
the region of the Americas.

⚫ The populations that suffer most from limited access

to health services also have limited access to quality
education, fewer work opportunities and little
or no access to safe environments, clean water
and air and safe food.
 World Health Day 2021
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⚫ The groups that suffer the most from these

disadvantages are often those that experience
ethnic and gender discrimination.

⚫ These conditions can cause unnecessary

suffering, preventable diseases and
premature death, causing damage to societies
and the economy of the region.
 World Health Day 2021
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⚫ COVID-19 has hit all countries hard, but its impact

has been more severe in communities that
already face significant vulnerability, are more
exposed to disease, are less likely to have access to
quality health services and are more likely to suffer
adverse consequences such as result of the measures
implemented to contain the pandemic.
 Health
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⚫ The condition of being sound in body,

mind, or spirit; especially freedom from
physical disease or pain

⚫ The general condition of the body

⚫ "health is a state of complete physical,

mental and social well-being, and not
merely the absence of disease or infirmity"
 Disease
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A pathological condition
⚪ of a part, organ, or system of an organism
resulting from various causes
⚪ such as infection, genetic defect, or
environmental stress,
characterized by an identifiable group of
signs or symptoms.
 Disease
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⚫ A disease is any abnormal condition of the body or

mind that causes discomfort, dysfunction, or
distress to the person affected or those in contact
with the person.

⚪ Sometimes the term is used broadly to include

injuries, disabilities, syndromes, symptoms,
deviant behaviors, and atypical variations of
structure and function.
 Classification of diseases 1
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1. Cancers

2. Infections

3. Organ system diseases

⚪ Pulmonary - Asthma, emphysema
⚪ Urogenital - Prostatism, impotency, chronic renal failure
⚪ Gastrointestinal – pacreatitist , cirrhosis, ulcer
⚪ Endocrine - diabetes
⚪ Musculoskeletal – rheumatoid arthritis, lupus, osteoporosis
⚪ Cardiovascular – angina, congestive heart failure, atrial fibrillation
⚪ Nervous – multiple sclerosis, epilepsy, blindness
 Classification of diseases 2
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1. Infectious diseases
⚪ Parasitic
⚪ Bacterial
⚪ Viral
⚪ Fungal
2. Environmental diseases
⚪ Nutritional
⚪ Diseases due to unfavourable environmental
factors
3. Other diseases
⚪ Tumors
⚪ Genetic disorders
⚪ Mental disorders
 Classification of diseases 3
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1. Intrinsic 2. Extrinsic
⚪ Hereditary ⚪ Exogenous
⚪ Glandular microbes enter from
outside
⚪ Dietary
infectious diseases
⚪ Cancer
⚪ Endogenous
⚪ Stress-related latent microbes in
⚪ Autoimmune body causes disease of
compromised
immune system
 Classification of Disease 4
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1. Acute
⚪ begins abruptly, has severe symptoms but last only a
short time.
⚪ pneumonia, influenza, typhoid fever, meningitis,
smallpox, measles, scarlet fever

2. Chronic
⚪ develop slowly, last long periods of time, and often
never cured. Some cause few problems; some cause
only episodic problems or have symptoms that can
be controlled with medication; others may severely
limit life.
⚪ E.g. diabetes, congestive heart failure, asthma,
hypertension, chronic kidney disease, depression,
irritable bowel syndrome, arthritis, emphysema,
and multiple sclerosis, cancer.
 Causes of diseases (# of diseases)
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⚫ Arthropod-Borne (34) Infectious diseases –
⚫ Biological Weapons (11) approximately 201 diseases
⚫ Chemical & Nuclear Weapons (6) are caused by
⚫ Childhood Infections (19)
⚫ bacteria (47),
⚫ Community-Acquired (27)
⚫ Foodborne--Fluke (4) ⚫ fungi (8),
⚫ Foodborne--Intestinal Nematode (5) ⚫ helminths (26),
⚫ Foodborne--Intoxication (9) ⚫ protozoa (11),
⚫ Foodborne--Tapeworm (3)
⚫ toxins (22),
⚫ Foodborne--Tissue Nematode (5)
⚫ Gastroenteritis, Inflammatory (7) ⚫ viruses (44)
⚫ Gastroenteritis, Noninflammatory (6) ⚫ chemicals (21),
⚫ Occupational (19) ⚫ other agents (3), and
⚫ Sapronoses (14) ⚫ immune disorders (3).
⚫ Sexually-Transmitted (7)
⚫ Zoonoses (25)
http://www.outbreakid.com/categories.htm
 Methods of disease transmission
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Direct
disease-causing microbe
moves directly from one
host to the next
⚫ hands
⚫ teeth/ ingestion
⚫ droplets (inhaled) from
sneezing, coughing
⚫ sexual contact
⚫ animal bites/scratches
Indirect
disease-causing microbe
contacts an intermediate
object before the it
contacts the second host
to cause disease.
⚫ fomites (non-living
objects - door handles,
toilet seats, needles,
eating utensils)
⚫ animal products
⚫ water/ food/ air/ soil
 Methods of disease transmission
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⚫ Vectors
(Arthropods esp. insects) mosquitoes, cockroaches lice
fleas ticks

⚪ biological - the microorganism actually

grows and reproduces in the arthropod
host
⚪ mechanical - the microorganism is
transported on the body of the arthropod
host.
 Epidemiology
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⚫ Epidemiology
⚫ term “epidemiology” is derived from the Greek word
that means frequency.

⚫ study of the causes, distribution, and control

of disease in populations.
⚫ serves as the foundation and logic of interventions
made in the interest of public health and preventive
medicine
 Epidemiology
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⚫ Frequency of a disease is the total number of

existing cases in a given population.
⚫ Prevalence = total no. of new cases/ total number
of persons in population x 100

⚫ Incidence of a disease is the number of new

cases during a particular time; incidence rate
is also referred to as morbidity.
⚫ Incidence = number of new cases/ number of
healthy persons
 Epidemic & Endemic Diseases
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⚫ Epidemic: a disease that appears as new cases

in a given human population, during a given
period, at a rate that substantially exceeds
what is expected, based on recent experience
⚪ An epidemic may be restricted to one locale (outbreak), more general
(epidemic) or even global (pandemic).
⚪ Incidence rate - the # of new cases in the population during a specified
period of time

⚫ Endemic: disease that occurs at a constant but

relatively high rate in a population (common)
 WHO top 10 causes of death
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World Deaths in millions % of deaths

Ischaemic heart disease 7.25 12.8%

Stroke and other cerebrovascular disease 6.15 10.8%

Lower respiratory infections 3.46 6.1%

Chronic obstructive pulmonary disease 3.28 5.8%

Diarrhoeal diseases 2.46 4.3%

HIV/AIDS 1.78 3.1%

Trachea, bronchus, lung cancers 1.39 2.4%

Tuberculosis 1.34 2.4%

Diabetes mellitus 1.26 2.2%
Road traffic accidents 1.21 2.1%
Influence:
Height and Weight, Medical History, Diet, Smoking History, (alcohol and drug abuse history),
Physical Activity, Family History
Poverty level, Nutritional status, Access to clean water and environment, Access to health care
 WHO top 10 causes of death
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Low-income countries Middle-income countries High-income countries

Lower respiratory infections Ischaemic heart disease Ischaemic heart disease

Diarrhoeal diseases Stroke and other cerebrovascular disease Stroke and other cerebrovascular disease

HIV/AIDS Chronic obstructive pulmonary disease Trachea, bronchus, lung cancers

Ischaemic heart disease Lower respiratory infections Alzheimer and other dementias

Malaria Diarrhoeal diseases Lower respiratory infections

Stroke and other cerebrovascular disease HIV/AIDS Chronic obstructive pulmonary disease

Tuberculosis Road traffic accidents Colon and rectum cancers

Prematurity and low birth weight Tuberculosis Diabetes mellitus

Birth asphyxia and birth trauma Diabetes mellitus Hypertensive heart disease

Neonatal infections Hypertensive heart disease Breast cancer

 World Health Emphasis
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⚫ SARS, Malaria, AIDS, Polio, Tuberculosis,
⚫ Hypretension, Diabetes, Cancers
⚫ Reduce smoking
⚫ Healthy eating

2012 outbreaks of disease (WHO)

⚫ Avian Influenza–
⚪ Egypt, Indonesia, China, Bangladesh, Vietnam, Cambodia
⚪ pandemic influenza H1N1 2009 over 17483 deaths.

⚫ Yellow Fever in Cameron & Ghana

Jamaica: Malaria 2007; H1N1 2009; Dengue; Leptospi
 Pandemic influenza H1N1
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⚫ Symptoms flu-like: malaise, fever, cough, headache, muscle

and joint pain, sore throat and runny nose, and sometimes
vomiting and diarrhoea.
⚫ Most people experience mild illness and recover fully without
treatment.
⚫ Transmitted: person to person via exposure to infected
droplets expelled by coughing or sneezing that can be
inhaled, or that can contaminate hands or surfaces.
⚫ Prevention: cover mouth and nose when coughing or
sneezing, stay home when unwell, clean hands regularly.
⚫ Deaths underreported: confirmed 17483 (march 28,
2010)
World Diseases H1N1
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COVID-19
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Malaria
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 AIDS
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⚫ Acquired Immune Deficiency Syndrome

⚫ Cause: human immunodeficiency virus (retrovirus)
⚫ Collection of symptoms and infections resulting from
the specific damage to the immune system (CD4+ T
cells, dendritic cells and macrophages) .
⚫ Transmitted via body fluids (blood, semen, vaginal
fluid, preseminal fluid, and breast milk).
 AIDS
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⚫ Stage I: HIV disease is asymptomatic and not

categorized as AIDS
⚫ Stage II: includes minor mucocutaneous
manifestations and recurrent upper respiratory tract
infections
⚫ Stage III: includes unexplained chronic diarrhea for
longer than a month, severe bacterial infections and
pulmonary tuberculosis
⚫ Stage IV: includes toxoplasmosis (protozoa) of the
brain, candidiasis (fungi) of the esophagus, trachea,
bronchi or lungs and Kaposi's sarcoma (skin, mouth
tumor) etc; these diseases are indicators of AIDS.
 HIV/AIDS in Jamaica (USAID)
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HIV and AIDS Estimates 2.9 million (mid-2010)

Total Population*

Estimated Population Living with HIV/AIDS ** 27,000 [19,000–36,000] (2007)

Adult HIV Prevalence** 1.6% [1.1–2.1%] (2007)

Sex Workers: 9% (2006)

MSM: 32% (2008)

Percentage of HIV-Infected People in Need 43% (2007)

of Treatment Who Receive ART

GLOBAL estimate: # of persons (adults and children) living with AIDS (2009)
33 300 000 [31 400 000 – 35 300 000]
 http://www.avert.org/caribbean.htm
Caribbean: Living with HIV/AIDS 2011 statistics
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Living with HIV/AIDS Deaths due to
AIDS per year
ARV coverage
Country Adult (15-49) (most recent
All people %
estimate)
prevalence %
Bahamas 6,500 2.8 <500 40
Barbados 1,400 0.9 <100 no data
Belize 4,600 2.3 no data 62
Cuba 14,100 0.2 <200 >95
Dominican
44,000 0.7 1,700 80
Republic
Guyana 6,200 1.1 <500 82
Haiti 120,000 1.8 5,800 58
Jamaica 30,000 1.8 1,600 60
Suriname 3,400 1 <500 53
Trinidad and
13,000 1.5 <1,000 no data
Tobago
 Malaria
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⚫ Each year, malaria attacks about 400 million people,

two to three million of whom succumb to the illness

⚫ Female Anopheles sp. mosquitoes (60 species can act

as vectors)
Malaria
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⚫ Domain: Eukaryota
Kingdom Protoctista
Phylum: Apicomplexa
Class: Aconoidasida
Order: Haemosporida
Family: Plasmodiidae
⚫ Genus Plasmodium

⚫ Plasmodium falciparum
⚫ Plasmodium vivax
⚫ Plasmodium ovale
⚫ Plasmodium malariae
 Sickle cell disease
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⚫ Transmission: inherited (genetic)

⚪ Valine substituted for glutamic acid in the haemoglobin
sequence.
⚫ Deoxygenated RBC loose discoid shape and get
sickle shaped
⚫ Symptoms/ Signs: Reduced blood supply, anaemia,
jaundice, gall stones, fatigue, breathlessness, rapid
heartbeat, delayed growth, susceptibility to
infections, skin ulcers, vision problems, blocked
blood vessels (acute chest syndrome, pain, stroke,
organ damage)
 Sickle cell disease
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⚫ Sickle cell trait is the genetic condition

selected for in regions of endemic malaria
⚫ Distribution of malaria (yellow) and sickle cell (red)
 Sickle cell / malaria
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⚫ People with normal haemoglobin
[AA] are susceptible to death from
malaria.
⚫ People with sickle cell trait [AS] Sickle cell
who have one gene for Hb A and disease is a
one gene for Hb S, have a greater necessary
consequence of
chance of surviving malaria the existence of
(mechanism unknown) and do not the trait
have suffer adverse consequences condition
from the Hb S gene. because of the
⚫ People with sickle cell disease [SS] genetics of
reproduction.
are susceptible to death from the
complications of sickle cell disease. http://sickle.bwh.harvard.edu/malaria_sickle.html
 schistosomiasis
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⚫ 200 million people worldwide

⚫ Caribbean: Antigua, Dominican Republic, Guadeloupe,
Martinique, Montserrat, Saint Lucia
⚫ Cause: Phylum Platyhelmithes: Schistosoma mansoni, S.
haematobium, and S. japonicum
⚫ Transmission: contact with contaminated water. Eggs
urinated or defecated in water infect snails. The stage that
leaves the snail can infest humans
⚫ Symptoms due to immune reaction to the worms: rash or
itchy skin. Fever, chills, cough, and muscle aches. If eggs enter
brain - seizures, paralysis, or spinal cord inflammation. Liver,
lung intestine damage.
 Tuberculosis
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⚫ 1/3 world population has the bacterium (not all

infections become the disease)
⚫ 2011: 8.7 million people fell ill with TB and 1.4
million died from TB.
⚫ Cause: mycobacterium Mycobacterium tuberculosis
or M. bovis.
⚫ Symptoms: bloody cough, fever, chills, pallor, weight
loss, appetite loss
⚫ Transmission: aerosol from cough etc.
 Tuberculosis
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World TB incidence. Data from WHO, 2006.

Cases per 100,000;
Red = >300, orange = 200-300; yellow = 100-200; green 50-100 and grey <50.
Jamaican data
9: Estimated Prevalence (per 100,000 population, incl HIV-positive) (2004)
1: TB mortality (per 100,000, population, incl HIV-positive) (2004)
10:% of adult (15-49) TB cases HIV-positive (2004)
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 Diabetes
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⚫ Jamaica point prevalence 17.9% in the 15-and-over
age-group.

⚫ Type I: Body fails to produce insulin

⚫ Type II: Body produces insulin but does not use it
properly (most common)
⚫ Gestational: Body is not able to make and use all the
insulin it needs for pregnancy