NON-COMMUNICABLE DISEASE PREVENTION − PHILIPPINES: Lung cancer (men and women) was 2.
r (men and women) was 2. SCREENING FOR ELEVATED CHOLESTEROL
− A medical condition that is non-infectious and non-
transmissible.
− termed a “Chronic Disease” due to its long duration
− referred to as a “Lifestyle-related disease” due to
common risk factors such as lifestyle that increase
the likelihood of non-communicable diseases.
− It interferes with the individuals' way of living a
normal life brought cause of non-communicable
diseases.
DIFFERENT DISEASES ATTRIBUTED TO NCDs
1. CARDIOVASCULAR AND CEREBROVASCULAR
DISEASES
− most common cause of NCDs mortality worldwide
which accounts 17.9 mil deaths annually (WHO,
2018).
CARDIOVASCULAR DISEASE
− disease involves the heart or blood vessels (arteries,
capillaries, and veins)
CEREBROVASCULAR DISEASE
− stroke, a group of brain dysfunctions r/t disease of
blood vessels supplying the brain
MOST COMMON CAUSES OF THESE DISEASES:
a. ARTHEROSCLEROSIS
− systolic blood pressure equal or above 140 mm Hg
− diastolic blood pressure equal to 90 mm Hg
b. HYPERTENSION
− disease of the blood vessels characterized by the
deposition of fats and cholesterol within the walls
of the artery (WHO, 2011)
Uncontrolled hypertension and atherosclerosis lead
to heart attack, stroke, kidney damage, and a host of
complications (Stanhope and Lancaster,2010).
Although age and family history are immutable, NCDs
share common risk factors: unhealthy diet, smoking,
sedentary lifestyle, and alcohol consumption.
Moreover, studies reveal that there has been an
observable increase in the consumption of NCD-
implicated food items (Ulep, 2012).
2. CANCER
− most common cause of death worldwide.
− Over 9 million people worldwide die annually due
to cancer (WHO, 2018).
− DEFINITION: malignant neoplasm with group of
various diseases involving unregulated cell growth.
MOST COMMON FORMS
the leading cancer killer followed by liver cancer.
Breast cancer was ranked first among women.
− Substance that cause some cells to undergo genetic
mutations are called CARCINOGENS
→ LIFESTYLE-RELATED FACTORS (causation of cancer):
smoking, unwealthy diet, alcohol drinking, physical
inactivity, and obesity.
3. CHRONIC OBSTRUCTIVE PULMONARY DISEASE
(COPD)
− condition affecting the lungs in which the airways
narrow over time.
− includes bronchitis, chronic asthma, and
emphysema.
− Smoking is a strong risk factor for COPD; 15% of
cigarette smokers develop it
4. DIABETES MELLITUS
− A serious chronic metabolic disease characterized
by high levels of blood sugar due to inability of
pancreas to produce enough insulin or inability of
the body to effectively use the insulin it produces.
− HYPERGLYCEMIA is a common effect of diabetes
(WHO, 2005).
→ SYMPTOMS: increased frequency and amount of
urination, increased thirst, constant hunger, weight
loss, vision changes, and fatigue.
→ COMPLICATIONS associated with diabetes: heart
disease, neuropathies, amputations, and kidney
disease.
− LAB TESTING for diabetes/ prediabetes is
recommended for individuals with any risk factors
− Prevalence among adults in the Philippines in 2015
is 6.2%
− Experts predict this number to increase by 2025
SCREENING—prevention ff diseases attributed to
NCDs
− The identification of an unrecognized disease by the
application of test, examination, or other
procedures that can be applied rapidly to help
identify an individual’s chances of becoming ill.
(WHO, 2011)
1.MONITORING BP (SCREENING FOR HYPERTENSION)
− Blood pressure should be recorded twice daily in
the morning and evening, and for several days
before the diagnosis of hypertension can be made
measurements taken on the 1st day
− consecutive measurements are taken at least a
minute apart and with the person seated.
− Involves taking a blood sample to determine the
total serum cholesterol, low-density lipoprotein
(LDL) and high-density lipoprotein (HDL).
− Prior to testing the individual should withhold food
or drinks for at least 9-12 hours to ensure accuracy
of results (ACC, 2018).
3. CANCER SCREENING
− involves early detection of warning signals of cancer
developed by the (American Cancer Society).
− WARNING SIGNALS:
• change in bowel or bladder habits
• sore throat that does not heal
• unusual bleeding or discharge
• thickening or lump in breast
• indigestion or difficulty in swallowing
• obvious change in a wart or mole
• nagging cough
• unexplained anemia
• sudden weight loss
RISK FACTORS OF NCDs
1.PHYSICAL INACTIVITY
− key determinant of energy expenditure and is thus
fundamental to energy balance and weight control
2. CIGARETTE SMOKING
− primary risk factor of NCDs
3.UNHEALTHY EATING
− “Obesogenic”
− one of the major risk factors responsible for global
increase of cardiovascular disease, cancer, and
obesity worldwide.
4.EXCESSIVE ALCOHOL INTAKE
− This may lead to metabolic and physiological effects
on all organ system such as gastrointestinal and
cardiovascular disturbances.
− CAUSES: malabsorption, inflammation of the
gastrointestinal tract, liver problems, and cancer
5.EXPOSURE TO VIRUSES
− Viruses play a role in the development of certain
cancers.
− cause cancer Human Papilloma Virus (HPV) that is
linked with cervical and vulvar cancer and capable
of causing cancer are “oncoviruses”.
6.RADIATION
− energy emitted and transferred through matter and
space.
a. UV RADIATION
− adversely affects the genes, and the cell enzymes
causing DNA mutation
b. IONIZING RADIATION
− causes tissue and cell damage by breaking the DNA
molecules
c. SOLAR RADIATION
− primary source of UV radiation
− major cause of skin cancer
PREVENTION OF NCDs
PREVENTION
− requires understanding of the causes of diseases
and the factors that influence how they progress
→ The following are recommended as part of healthy
lifestyle practices:
• Promote healthy diet and nutrition
• Promote physical activities and exercise
• Promote a smoke-free environment and stress
management
PACKAGE OF ESSENTIAL NONCOMMUNICABLE (PEN)
DISEASE INTERVENTION
− PEN is a prioritized set of cost-effective
interventions that can be delivered to an
acceptable quality of care even in resource-poor
settings
− enables early detection and management of
cardiovascular diseases, diabetes, chronic
respiratory disease and cancer to prevent
complications like heart attack and stroke.
MENTAL HEALTH—integral part of every individual
− The WHO defined mental health as “state of social
well-being in which every individual realizes his or
her own potential (self-image), can cope with the
normal stresses of life can work productively and
fruitfully, and is able to make a contribution to her
or his community.”
− DETERMINED BY: socioeconomic factors however
there is evidence that genetics may affect the
mental state of an individual
MENTAL ILLNESS
− any illness experienced by a person that interferes
with his or her thinking, feeling, or social activities
and even daily functioning
− It produces a negative effect on one’s life or the
lives of the family
MENTAL HEALTH PROBLEM
− Does not hamper functioning
− temporarily experienced as a reaction to life
stressors.
− It is less severe and shorter in duration
− may develop into a mental disorders (DOH, 2012)
FOUR FACETS OF MENTAL HEALTH PROBLEMS
1. Defined or direct burden
− burden affecting persons with mental disorders
such as cost of treatment, quality of life, and
disability
2. Undefined or indirect burden
− burden relating to the impact of mental health
problems such as family members or community
who care for the patient
3. Hidden burden
− stigma and violations of human rights to persons
affected with mental health problems
4. Future or health burden
− burden resulting from the aging population or
increasing of social problems such as the
development of complications
CONDITIONS THAT CAN LEAD TO MENTAL ILLNESS
• Stressful life events like death of a loved one,
financial problems, marital conflict, and violence
• Difficult family background
• Brain diseases like mental retardation
• Heredity may be a factor
• Medical problems like kidney and liver failure
RA 11036: MENTAL HEALTH LAW
− act establishing the national mental health policy
for the purpose of enhancing the delivery of
integrated mental health services, promoting and
protecting the rights of persons utilizing psychiatric,
neurologic, and psychosocial health services in the
PH
Specifically, the law calls for the implementation of
the following:
1. Mental health services at the community level for
all LGU’s down to barangay
2. Community resilience and psychosocial well-
being training in all barangays
3. Training and capacity-building programs for local
mental health workers in coordination with
mental health facilities
4. Support services for families and co-workers
5. Dissemination of mental health information and
promotion of mental health awareness
DISABILITY
The WHO (2010) reported that more than 1 billion of
the world’s population had some form of disability
− DEFINITION: general term for impairment, activity
limitations and participations restriction
(International classification of functioning disability
and health, 2010).
− REFERS TO: the negative aspects of the interaction
between individuals with a health condition,
personal, and environmental factors (WHO 2013)
WHO report (2010) nearly 200 million people
experience difficulties in functioning due to aging and
onset of chronic health conditions such as diabetes,
cardiovascular diseases, and mental illness.
RA ACT NO. 7277: Magna carta for Disabled persons
− This law particularly requires a national health
program for PWD’s establishment of medical
rehabilitation centers in provincial hospitals,
integrated and comprehensive program for the
health development of PWD’s that shall make
essential health services for them with an
affordable cost.
7 CATEGORIES OF DISABILITY
1. PSYCHOSOCIAL AND BEHAVIORAL DISABILITIES
2. CHRONIC ILLNESS WITH DISABILITIES
3. LEARNING DISABILITIES
4. MENTAL DISABILITIES
5. VISUAL OR SEEING DISABILITIES
6. ORTHOPEDIC OR MOVING DISABILITIES
7. COMMUNICATION DEFICITS
COMMUNICABLE DISEASES
− illnesses caused by an infectious agent or its toxic
products transmitted directly or indirectly to a
person, animal, intermediary host, or inanimate
environment
CONTAGION—Transmitted by direct physical contact
INFECTIOUS—transmitted indirectly through
contaminated food, body fluids, objects, airborne
inhalation, or through vector organisms that would
require a break in the skin or mucous membranes of
in as individual
EPIDEMIOLOGIC TRIANGLE MODEL
1. AGENT
− organism involved in the development of disease
− must be present for an infection to occur
− include bacteria, viruses, rickettsial agents, fungi,
protozoa, helminths, and arthropods that act as
vectors to agents from their reservoirs to humans
2. HOST
− Although the agent must be present for an infection
to occur, it must be capable of infecting a host.
− Host is any organism that harbors and provides
nutrition for the agent.
− The ability of the host to fight the agent causing the
infection is influenced by many factors such as age,
gender, socioeconomic status, ethnicity, nutritional
and immune status, genetic makeup, hygiene, and
behavior
3. ENVIRONMENT
− refers to the condition in which the agent may exist,
survive, or originate.
− comprises physical, biological, and socioeconomic
components
CHAIN OF INFECTION
− logical sequence of factors that are essential for the
development of their reservoirs to humans.
communicable disease.
− removing any one of the elements prevents the
onset of communicable disease
1. CAUSATIVE AGENT
− an organism capable of producing disease
− The agent interacts with its hosts in several ways
namely:
● Pathogenicity refers to the ability of an agent to
produce disease in those infected with the agent.
● Infectivity refers to the ability of an agent to
infect large numbers of people.
● Virulence refers to the ability to produce disease
in those infected.
● Antigenicity refers to the ability of an agent to
stimulate an immune response.
● Toxigenicity refers to the ability of an agent to
produce toxin that cause infection.
2. RESERVOIR
− environment or object in or on which an organism
survives and multiplies
− Human beings, animals, arthropods, plants, water,
soil, or inanimate objects can be reservoirs of
disease-causing agents
− Some agents may have several reservoirs
3. PORTAL OF EXIT
− path by which an agent leaves its reservoir.
− COMMON PORTALS OF EXIT: respiratory,
genitourinary, skin and mucous membranes, and
gastrointestinal tract
4. MODE OF TRANSMISSION
− Path by which agent passes from the portal of exit
in the reservoir to the susceptible host
− CONSIDERED the weakest link
− FOCUS in the prevention and control of infection.
− Different modes of transmission:
• Contact
• Vector
• Vehicle
• Airborne
• Droplet
5. PORTAL OF ENTRY
− path by which an agent invades a susceptible host.
Usually, this path is the same as the portal of exit.
6. SUSCEPTIBLE HOST
− Various factors of the individual that increases their
risk for acquiring the infection
− Biological and personal characteristics of the
individual plays a significant role in determining the
susceptibility of the person to acquire infection
CONTROL, ERADICATION, AND ELIMINATION OF
COMMUNICABLE DISEASES
− ULTIMATE GOAL in the control of communicable
disease is its elimination and eradication so that it is
no longer considered a public health problem
CONTROL refers to activities that reduce morbidity
and mortality of disease at an acceptable
level within a locality
ERADICATION refers to permanent reduction to zero
of the worldwide prevalence of a disease
caused by a specific agent
ELIMINATION is reduction to zero prevalence of a
disease in a single country, continent, or
other limited geographical area
The focus of communicable disease control is to
eliminate the burden of disease and its associated
mortality
 DISEASES TARGETED FOR ELIMINATION
1. MALARIA
− endemic in the country and considered as one of
the “Big Three” communicable diseases aside from
Tuberculosis and HIV/AIDS that has local and global
importance.
− 2018: malaria free provinces increased from 27 to
32 in 2016. But DOH still wasn’t able to achieve the
goal of 40 malaria-free provinces, as there are still 9
remaining that are known to be malaria endemic.
2. FILARIASIS
− goal of the National Filariasis Elimination Program
(NFEP) is to eliminate filariasis as a public health
problem with a prevalence rate of microfilaremia of
less than 1%
3. SCHISTOSOMIASIS
− remained to be endemic in 12 regions in the
country. It has a national prevalence rate of 2.5%
and peaking at 15-49 yrs of age
4. LEPROSY
− Leprosy Program target is to eliminate leprosy as a
public health problem in DOH identified endemic
areas like Eastern Visayas, Ilocos, Zamboanga
Peninsula, Central Visayas, and Northern
Mindanao.
− Challenge: monitoring of the cases due to the
weakness of surveillance
5. RABIES
− the country has been consistently ranked among
the top 10 countries with human rabies death:
− 2010: five areas in the country declared rabies free:
Siquijor, Batanes, Camotes Island, Apo Island, and
Malapascua Island
FUNCTIONS OF PUBLIC HEALTH NURSE IN CONTROL
OF COMMUNICABLE DISEASES
1. Report to local health authorities any known case
of notifiable disease as required by the law RA
11332.
2. Refer any known case of notifiable disease to the
nearest health facility.
3. Initiate health education drive directed towards
prevention of outbreaks in communities.
4. Assist in the diagnosis of potential cases of
communicable disease based on signs and
symptoms.
5. Conduct epidemiologic investigations together
with the public health team during an outbreak.
TUBERCULOSIS ROLES & RESPONSIBILITIES OF NURSE IN NTP &
− one of the oldest and deadly diseases worldwide DOTS STRATEGY
(Enarson, 2000) 1. NURSE ADMINISTRATOR
− Global Tuberculosis Report of 2019 by WHO • Manage the procedures for case-finding activities
reported that an estimated 10 million people with other NTP workers
worldwide had TB in 2018 • Assign and supervise a treatment partner for
− Philippine Statistics Authority show that it already patient who will undergo DOTS
has a 15,689 death rate in the Philippines as of • Supervise rural health midwives to ensure proper
August 18, 2023. implementation of DOTS
PREVENTION AND CONTROL • Maintain and update the NTP register
1. BCG vaccination of newborn infants provides 50% • Conduct training of the health workers in
protection against any TB disease coordination with the Municipal Health Office
2. Health education (MHO)
3. Environmental sanitation • Prepare and submit the Quarterly Reports to
4. Early diagnosis and treatment Provincial Health Office (PHO). Analyze data
5. Respiratory isolation together with MHO for future planning activity.
CAUSATIVE AGENT 2. NURSE AS HEALTH EDUCATOR
• Mycobacterium tuberculosis − Patient education is very important in the intensive
• M. africanum from humans phase of treatment
• occasionally by M. bovis from cattle, or M. canettii − vital to a successful outcome that patient education
MODE OF TRANSMISSION will be an ongoing process throughout the duration
− Airborne droplet: coughing, sneezing, and spitting of the treatment period (WHO, 2003)
− close contacts especially household members could 3. NURSE AS CASE MANAGER AND COORDINATOR
be infected with TB. − Managing services for the individually diagnosed or
INCUBATION: 4—6 weeks suspected of having TB from initiation to
completion of treatment and a change in the
SIGNS AND SYMPTOMS
diagnosis or death.
Fever: low grade late afternoon
4. NURSE AS COMMUNITY ORGANIZER (CO)
loss of appetite
easy fatigability • Generate data on the incidence of TB in the locality.
night sweats • Conduct home visitation to patients and treatment
dry cough partners.
later productive with hemoptysis • Meet the health workers and other key leaders.
chest pain • Determine resources for the treatment regimen.
LABORATORY/DIAGNOSTIC EXAM • Build the team.
• Direct sputum smear microscopy (DSSM) • Conduct networking and establish linkages LGU and
• Xpert MTB/RIF NGOs.
• TB Skin Test (TST) 5. NURSE AS TREATMENT PARTNERS
• Chest X-ray − continue to use the nursing process as a systematic
MANAGEMENT approach in providing individualized care to patient
− TB is curable; but requires adherence to drug intake 6. NURSE AS TB ADVOCATE
for the prescribed duration (Pratt, 2005) • Shares experiences and accomplishments in terms
− This comprises a combination of antibiotics, which of cure and referral to TB network.
need to be taken together to prevent the • Disseminates right information on TB through
development of drug resistance available information, education, and
communication camping materials.
• Serves as moral support to TB patients and fellow
advocates.
• Conducts health education activities on how TB is
acquired.
• Promotes the DOTS services of TB partners
including the private sector.
• Advocates DOTS as a strategy for curing TB.
LEPROSY
CAUSATIVE AGENT
− Mycobacterium leprae
− Hansen’s bacillus
MODE OF TRANSMISSION
− Prolonged skin contact
− Droplet infection
INCUBATION PERIOD: 5 months – 5 yrs
LAB/DIAGNOSTIC TEST: Skin slit test
PATIENT CLASSIFICTION OF LEPROSY
• PAUCIBACILLARY (PB): (-) Skin slit test or five or less
lesions
• MLTICIBACILLARY (MB): (+) Skin slit test and more
than five lesions
SIGNS AND SYMPTOMS
Early signs - reddish or white change in skin color, loss
of sensation on the skin lesion, decrease/ loss of
sweating and hair growth over the lesion, thickened
and/or painful nerves, muscle weakness, pain or
redness of the eye, nasal obstruction/bleeding, ulcers
that do not heal
Late signs - loss of eyebrow (madarosis), inability to
close eyelids (lagopthalmos), clawing of fingers and
toes, contractures, sinking of the nose bridge,
enlargement of the breast in males (gynecomastia),
chronic ulcers.
TREATMENT
Multidrug therapy (MDT)
− involves the use of two or more drugs. (ex.
Rifampicin, clofazimine, and dapsone)
− main purpose of MDT is to kill all viable organisms
in a relatively short period of time rendering the
patient noninfectious.
PREVENTION AND CONTROL
• BCG vaccination
• Avoidance of prolonged skin to skin contact with
active untreated case
• Good personal hygiene
• Adequate nutrition
• Health education
VECTOR-BORNED DISEASES
DENGUE
− public health problem in the PH
− disease once associated with the rainy season has
begun to change its pattern in the country.
CAUSATIVE AGENT: Dengue Virus (DEN)
MODE OF TRANSMISSION: Bite of mosquito
INCUBATION: 3-14 days, commonly 5-7 days
SUSCEPTIBLE
• All individuals regardless of age, gender, or
geographic location are at risk.
• children between 0-9 years are commonly affected
based on age distribution.
• epidemic is frequent in populated areas with poor
environmental conditions conducive for vector
breeding.
LABORATORY/DIAGNOSTIC EXAMINATION:
• Tourniquet test or Rumpel-Leads test
• Capillary Refill Test or Nail Blanch Test
• Platelet Count and Hematocrit Count
• Hemagglutination-inhibition (HI) test
• Dengue NS1 Kit
DENGUE CLASSIFICATION
− Due to the wide different clinical presentations and
unpredictable clinical evolution and outcome, a
new model for classifying dengue has been
developed by WHO expert consensus group.
− It is practical to use and aids the clinician in deciding
as to where and how intensively the patient should
be observed and treated.
PHASES OF ILLNESS
1. FEBRILE PHASE
Lasts 2 to 7 days-high-grade fever, facial flushing, skin
erythema, generalized body ache, myalgia, arthralgia,
and headache.
2. CRITICAL PHASE
Lasts 24 to 48 hours-when the temperature drops and
remains below 37.5-38 degrees Celsius or less usually
on day 3-7 of illness, an increase in capillary
permeability with increasing hematocrit levels may
occur.
3. RECOVERY PHASE
Usually takes place in the following 48-72 hours
general well-being improves, appetite returns,
gastrointestinal symptoms subsides, hemodynamic
status becomes stable.
TREATMENT
− Management for Dengue is symptomatic and
supportive Follow-up is also important for proper
observation and monitoring of patients
− All suspected cases of Dengue should be referred to
a health facility immediately for proper
management and to Prevent complications.
1. Give paracetamol every 4-6 hours. If the patient
still has a high fever, do a tepid sponge bath.
2. Encourage oral intake of oral rehydration solution
(ORS), fruit juice and other fluids containing
electrolytes and sugar to replace losses from fever
and vomiting.
3. Advise the patient to avoid dark colored foods
that can mask bleeding. Diet should be low fat,
low fiber, non-irritating, non-carbonated.
4. Ensure strict bed rest and protect patients from
trauma to reduce the risk of bleeding.
5. Do not give intramuscular injections to avoid
hematoma
6. Instruct the care-givers that the patient should be
brought to hospital immediately if there will be a
problem.
7. For nose bleeding (epistaxis), maintain an
elevated position and apply ice compress to
promote vasoconstriction.
8. Blood transfusion should be given as soon as
severe bleeding is suspected or recognized.
9. In cases of shock, place the client in a dorsal
recumbent position to promote circulation.
10. Monitor laboratory results such as platelet and
hematocrit count accordingly.
4 STRATEGIES FOR PREVENTION
1. Search and destroy breeding places of mosquito
2. Seek early consultation and immediate treatment
3. Self-protection measures
4. Say yes to fogging only during outbreaks
MALARIA
CAUSATIVE AGENT
• Plasmodium falciparum
• vivax, ovale
• malariae (Protozoa)
MODE OF TRANSMISSION
VECTOR—female Anopheles mosquito
SIGNS AND SYMPTOMS
Recurrent fever preceded by chills and profuse
sweating, malaise, anemia
INCUBATION PERIOD: 7 days or longer
LABORATORY/DIAGNOSITIC EXAMINATION
1. History of having been in a malaria-endemic area:
Palawan and Mindoro
2. Blood smear
TREATMENTS
1. Chloroquine phosphate 250 mg-all species except P.
malariae
2. Sulfadoxine 50 mg-For resistant P. falciparum
3. Primaquine —For relapse P. vivax and P. ovale
4. Pyrimethamine 25 mg/tab
5. Quinine sulfate 300 mg/tab
6. Tetracycline HCl 250 mg/cap
7. Quinidine sulfate 200 mg/durules
PREVENTION AND CONTROL
1. Mosquito control
2. Chemical methods-use of insecticides
3. Biological methods-stream seeding
4. Zooprophylaxis-larvae-eating fish,
5. farm animals should be kept near the house
6. Environmental methods-cleaning and hospital
immediately if they develop any of irrigating
canals
7. Protective screening of windows and doors of
houses
8. Educational methods
9. Mechanical methods-use of fly swats or traps
10. Universal precaution
11. Screening of blood donors
FILARIASIS
CAUSATIVE AGENT
• Wuchereria bancrofti
• Brugia malayi
MODE OF TRANSMISSION: Bite of mosquito
INCUBATION PERIOD: 8—16 months
VECTOR
• Aedes poecilus
• Culex quinquefasciatus
SIGNS AND SYMPTOMS
• Chills; Fever; Myalgia
• lymphangitis with gradual thickening of the skin
(commonly affecting limbs, scrotum) resulting in
elephantiasis and hydrocele
LAB/DIAGNOSTIC EXAMINATION
Circulating filarial antigen (CFA) —finger prick
TREATMENT: Diethylcarbamazine citrate (Hetrazan)
PREVENTION AND CONTROL: eradication of vectors
WATER-BORNE DISEASE
TYPHOID FEVER
CAUSATIVE AGENT: Salmonella typhosa
MODE OF TRANSMISSION
− ingestion of contaminated food or water with
feces or urine of infected individuals
INCUBATION PERIOD: 7—14 DAYS
SIGNS AND SYMPTOMS
1. Prodromal: headache, fever, anorexia, lethargy,
diarrhea, vomiting, abdominal pain
2. Fastigial: ladder-like curve of temperature, rose
spots on trunks, spleenomegaly
3. Defervescence: fever gradually subsides, onset of
complications such as hemorrhage, peritonits
4. Convalescence or Recovery stage
LAB/DIAGNOSTIC EXAMINATION: Typhidot test
TREATMENT: Chloramphenicol
PREVENTION AND CONTROL
• sanitary disposal of fees
• practice hand washing
• avoid feces, fomites, flies, food, fluids (5 Fs) that
carry the infection
• immunization with Typhoid vaccine 0.5 ml per IM
single dose at any age from 2 years old up
DYSENTERY
CAUSATIVE AGENT: Shigella dysenteriae
MOT: ingestion of contaminated food/water
INCUBATION PERIOD: 3—4 DAYS
SIGNS AND SYMPTOMS
• High grade fever
• colicky abdominal pain with tenderness
• diarrhea with straining
• bloody mucoid stool
LAB/DIAGNOSTIC EXAM: Stool Examination
TREATMENT: Co-trimazole & chloramphenicol
Prevention and Control:
Safe water supply Handwashing
NURSING CARE
• monitor intake and output
• observe for signs of dehydration
• rehydration by inoreasing fluid intake or drink
Oresol
CHOLERA
Causative Agent: Vibrio cholerae (El Tor)
Mode of Transmission: ingestion of contaminated food,
water, or milk
Incubation Period: 1 to 3 days
Signs and Symptoms: rapid explosive watery stool and
vomiting
Laboratory/Diagnostic Examination: Stool
Treatment: Tetracycline, Furazolidone
Prevention and Control
• Boiling and chlorination of water
• sanitary disposal of human waste
• administer vaccine PO with a dosage of 1.5 ml at a
minimum age of 12 months for 2 doses with 2
weeks interval
Nursing Care
• Increase fluid intake
• administer oral rehydrating solutions
MEASLES
Causative Agent
Morbili virus that belongs to the family
paramyxoviridae
Mode of Transmission: Airborne
Incubation Period: 8 to 20 days, average of 10 days
Signs and Symptoms
• acute onset of fever; rhinitis; conjunctivitis;
bronchitis; excessive lacrimation; stomatitis
• Koplik's spots (clustered white lesions) on the
buccal mucosa
• maculo papular rashes that begin on the face and
become generalized
• can progress into severe complications, including
pneumonia, encephalitis and death
Laboratory/Diagnostic Examination:
tissue culture of naso-pharyngeal secretions and
serological testing
Treatment: supportive care, antibiotic if with
complications like pneumonia
Prevention and Control: administer measles vaccine
(MMR vaccine) at the age of 9 and 12
months
Nursing Care
• administer antipyretic
• provide eye, nasal and oral care
• strict isolation
• increase fluid intake
MUMPS LABORATORY/DIAGNOSTIC EXAMINATION 3. Paralytic-with paralysis depending on part
Causative Agent: Mumps virus from • serological testing affected (small red spots) on the soft palate
paramyxovirus • and throat culture, stool examination, lumbar
MODE OF TRANSMISSION TREATMENT LABORATORY/DIAGNOSTIC EXAMINATION
• airborne or droplets • supportive care but for pregnant woman in 1" • Blood and throat culture
• direct contact with saliva of infected person trimester or 2nd trimester, serum immune globulin • stool examination
INCUBATION PERIOD is administered to protect the fetus • lumbar tap
• 16 to 18 days, range of 14 to 25 days PREVENTION AND CONTROL
Treatment: Symptomatic and supportive
COMMUNICABILITY PERIOD • Rubella vaccine of food and immunization? PREVENTION AND CONTROL
• 2 days before to 4 days after onset of parotitis but • 9-12 months: oral polio vaccine (MMR vaccine) • Proper disposal of fecal waste
range can be 7 days before to 15 days after onset. • given for 3 doses starting at 6 months old • hand washing
SIGNS AND SYMPTOMS NURSING CARE • proper preparation of food
• acute onset of fever, painful swelling of the salivary • administer antipyretic • immunization of polio vaccine is given for 3 doses
or parotid glands, headache; complications range • increase fluid intake starting at the age of 6 weeks
from meningo-encephalitis to permanent hearing • bed rest NURSING CARE
impairment and orchitis in post pubescent males, CHICKEN POX • enteric isolation
but rarely sterility Causative Agent: Varicella Zoster Virus • bed rest
Laboratory/Diagnostic Examination Mode of Transmission: Direct and indirect contact • passive range of motion exercises
• isolation of virus from oral and throat spray, urine with droplets from respiratory passages or vesicle
and cerebrospinal fluid fluid PARASITIC INFECTIONS
Treatment: Supportive care Signs and Symptoms: Body malaise, fever, itchy
ASCARIASIS
PREVENTION AND CONTROL vesiculo-pustular lesions first appearing on the chest
Causative Agent: Ascaris lumbricoides (round worm)
• Mumps vaccine (MMR vaccine) given at 9-12 and trunk spreading to extremities
Mode of Transmission: fecal-oral
months Incubation Period: 14 to 16 days, range 2 to 3 weeks
Incubation Period: 8 weeks
NURSING CARE Treatment: Supportive care, anti-viral drugs
Laboratory/Diagnostic Examination: SE
• apply warm and cold compress for pain on affected Prevention and Control: Immunization (Varivax) for 2
Signs and Symptoms: abdominal pain, and passing
area doses at 12 to 18 months
out of worms
• strict isolation Nursing Care: Antipyretic for fever, strict Isolation, Treatment: Mebendazole or Albendazole
• use of mask when handling patient handwashing, trim fingernails, daily bath
PREVENTION AND CONTROL
• terminal disinfection • Proper disposal of feces
• provide oral care POLIOMYELITIS
• avoid using feces as fertilizer
• provide soft to semi-solid food Causative Agent: Legio debilitans or polio virus • handwashing
RUBELLA OR GERMAN MEASLES Mode of Transmission: Fecal-oral, droplet incubation • proper washing of vegetables before consumption.
Causative Agent: togaviridae Incubation Period: 7 to 21 days ENTEROBIASIS
Mode of Transmission: Droplet and direct secretions SIGNS AND SYMPTOMS Causative Agent: Enterobius vermicularis or the
of infected person 1. Abortive-fever, sore throat, low-lumbar human pinworm or seatworm
Incubation Period: 10 to 21 days contact with nasopharyngeal secretions of Mode of Transmission: Vehicle-ingestion of
SIGNS AND SYMPTOMS backache/cervical stiffness on anteflexion of contaminated food
• fever, headache, malaise infected person spine Incubation Period: 4 to 6 hours
• maculopapular rash, enlarged post Incubation Period: 10 to 21 days Signs and Symptoms: perianal itching-disturbed
• spine sleep and nervousness, irritability
2. Non-paralytic-recurrence of fever, poker
• tightness and spasm of hamstring Laboratory/ Diagnostic Examination: scotch tape
spine, tightness and spasm of hamstring,
• sorethroat swab test in the perianal region
auricular occipital and posterior cervical
• rhinitis, Treatment: Mebendazole single dose repeated at
• conjunctivitis
hypersensitiveness of the skin, deep 2nd week for effectivity
• bronchitis, reflexes are exaggerated Prevention and Control: personal hygiene,
• forchheimer's spot handwashing, keeping fingernails short
ANCYLOSTOSOMIASIS
Causative Agent: Ancylostoma duodenale
Mode of Transmission: contact
Incubation Period: 4 to 6 weeks
Signs and Symptoms: dermatitis, abdominal Pain,
anemia, mentally and physically underdeveloped
Laboratory/Diagnostic Examination: SE
Treatment: Mebendazole
Prevention and Control: avoid walking barefooted,
and practice personal hygiene
SCHISTOMIASIS
Causative Agent: Schistosoma japonicum, S.
mansoni, S. haematobium
Vector: Oncomelania quadrasi (snail)
Incubation Period: 2 months
Mode of Transmission: indirect contact
Signs and Symptoms: Rash at site of inoculation,
enlargement of the abdomen, diarrhea,
body weakness
Laboratory/Diagnostic Examination: SE
Treatment: Oxamniquine Praziquantel (Biltricide), for
S. mansoni and S. haematobium
Prevention and Control:
1. Proper disposal of feces and urine
2. Proper irrigation of all stagnant bodies of water
3. Prevent exposure to contaminated water (wearing
of rubber boots)
4. Eradication of breeding places of snails.
5. Use of molluscides
ZOONOSES
WHO (2019) defines zoonoses as diseases and
infections that are naturally transmitted between
vertebrate animals and humans.
A zoonotic agent may be a bacterium, a virus, a
fungus, or other communicable disease agent.
RABIES
Causative Agent: Rhabdovirus
Mode of Transmission: Bite of rabid animal
Source: Saliva of infected animal or human
Incubation Period: 20 to 90 days for humans,
1 week to 7.5 months for dogs
SIGNS AND SYMPTOMS
A. Dog—at first withdrawn, change in mood, shows
nervousness and apprehension, unusual salivation,
paralysis starts on hind legs spreading towards entire
body, death
B. Human
1. Incubation period-flu-like symptoms
2. Prodromal stage-headache, pain and numbness
sensation at the site of the bite, depression, penile
erection, or spontaneous ejaculation for males
3. Acute neurologic phase
a. Spastic—anxiety, confusion, insomnia
b. Dementia, intense, excitement, difficulty in
breathing, swallowing, drooling, hydrophobia
c. Paralytic-flaccid ascending symmetric paralysis,
coma, death
Laborátory/Diagnostic Examination: Postmortem
direct fluorescent antibody staining test
NURSING MANAGEMENT
1. Isolate patient.
2. Encourage family to provide care and company.
3. Darken room and observe silence.
4. Give food if patient is hungry.
5. Keep water out of sight.
6. Observe universal precaution, which are essentially
wearing gloves.
7. Wash hands frequently.
8. Remove oral and nasal secretions.
9. Dispose contaminated materials.
10. Perform terminal disinfection
LEPTOSPIROSIS
Causative Agent: Leptospira interrogans (bacteria)
Mode of Transmission: Inoculation into
toxin and suture if severe wounds broken skin,
mucous membrane, or ingestion
Incubation Period: 7 to 13 days
Signs and Symptoms:
1. Sepsis stage - high fever, 4-7 days, calf pain,
abdominal pain
2. Immune or toxic stage
A. Anicenteric stage- disorientation
B. Icteric stage - jaundice
3. Convalescence - symptoms will disappear but
relapse may occur 4th or 5th weeks
Laboratory and Diagnostic examination
1. Blood urine culture is done on the 1st week
2. Leptospira agglutination test (LAT) done on 2nd
or 3 rd week
Treatment: Penicillin or tetracycline, doxycycline
Prevention and control: eradication of rodents, avoid
wading in floor water
NURSING CARE: symptomatic care, increase fl intake
SCABIES
Causative agent: itch mite, sarcoptes scabiei
Mode of transmission: prolong skin to skin contact
with infected humans or indirect contact either
infested linens or clothing
Intubation period: 4-8 weeks
Signs and symptoms: itchy papulo-vesicular
eruptions on warm folds and areas of friction of the
body
Laboratory/ Diagnostic examination: scraping the
skin off burrow, ink test, mineral oil or flourescence
tetracycline test
Treatment: permethrin cream or scabicide lotion
applied to all areas of the body from the neck down
to the feet and toes
Prevention and control: laundry and iron soiled
clothes, practice personal hygiene, terminal
disinfection
ANTHRAX
Causative Agent: Bacillus anthracis
Mode of transmission and signs and symptoms:
1. Cutaneous (skin) anthrax - handling sick animals
or contaminated animal wool, hair, or bone meal
products.
2. Inhalation anthrax - breathing anthrax spores
into the the lungs / woolsorther’s disease
3. Gastrointestinal anthrax - is difficult to diagnose.
It can produce sores in the mouth and throat. A
person who has eaten contaminated products
may feek throat pain or have difficulty
swallowing
Laboratory or diagnosis examination: (+) Gram stain
Treatment: formaldehyde, fluoroquinolones,
ciprofloxacin
Prevention and control: biothrax, although its
commonly called anthrax vaccine adsorbed (AVA)
Sexually transmitted infections (STI)
4Cs in Syndromic Case Management for STI:
1. Compliance of clients in the treatment,
prevention, and successful recommendation
for preventing recurrence of disease
2. Counseling and education on the nature if
the disease, signs and symptoms,
management, and prevention
3. Contact tracing facilities the process of
partner treatment to prevent the spread of
the disease
4. Condom use and promoting them to risk
individuals to reduce the chance of
acquiring the disease
GONORRHEA
Causative agent: Neisseria gonorrhoeae
Mode of transmission: sexual contact
Incubation period : 2-7 days
Signs and symptoms : thick Purulent, urethral
discharge, mong females frequency of urination
Laboratory/Diagnostic Examination: Culture of
specimen in cervix-female, Gram stain—male
Treatment: Ceftriaxone
Prevention and Control: for adults avoid contact with
secretions, practice monogamous sexual contact, for
newborn babies of infected women who gave birth
via vaginal delivery apply Crede's prophylaxis through
administration of tetracycline eye ointment
SYPHILIS
Causative Agent: Treponema pallidum
Mode of Transmission: Sexual contact
Incubation Period: 10-90 days
Types and Signs and Symptoms:
1. Primary-chancre that appears within 3 weeks at
area of contact
2. Secondary—condylomata, sore throat, mucous
patches of the mouth, macupapular rash
3. Tertiary-gumma formation, cardiovascular and
nervous system involvement
Laboratory/Diagnostic Examination:
• Darkfield illumination test
• venereal disease research laboratory (VDRL) test
• Fluorescent treponemal antibody test
Treatment: Penicillin, tetracycline, erythromycin
Prevention and Control: Practice monogamy, Sex
education
CHLAMYDIA
Causative Agent: Chlamydia trachomatis
Mode of Transmission: sexual contact, or contact
with exudates from mucous membranes, childbirth
Incubation period: 7-14 days
Signs and Symptoms:
• urethritis with purulent discharge from anterior
urethra males)
• mucopurulent cervicitis often
asymptomatic(females) that may lead to
endometritis,salpingitis and pelvic peritonitis
Laboratory/DiagnosticExamination: Culture &
Nucleic acid amplification test(NAAT) of
urine or swab samples
Treatment: Doxycycline, Azithromycin single dose
Prevention and Control: safe sexual practices, test
pregnant women
GENITAL HERPES
Causative Agent: Herpes simplex virus (HSV) types 1 & 2
Mode of Transmission: direct contact with infected
skin and mucous membranes, childbirth
Incubation Period: 2 to 12 days
Period of Communicability: during and up to 7 weeks
after primary lesions appear
Signs and Symptoms: localized vesicular lesions at an
area of contact but may spread to surrounding
tissues or disseminated in the body.
Laboratory/Diagnostic Examination:
• serological test
• isolation of virus from lesions or tissues
• biopsy specimens
Treatment: antiviral agents
Prevention and Control: safe sexual practices,
cesarean delivery if lesions are present during
late pregnancy
GENITAL WARTS
Causative Agent: Human Papillomavirus with 100 types
Mode of Transmission: direct contact with infected
skin and mucous membranes, childbirth
Incubation Period:
2 to 3 months, range 1 to 20 months
Period of Communicability: as long as lesions persist
Signs and Symptoms:
circumscribed lesions in cervix, vulva, anus, penis,
vagina, oropharynx that may be varying in sizes
Laboratory/DiagnosticExamination:
visualization of lesion, excision and histological
exam of lesion
Treatment: removal of warts by freezing with liquid
nitrogen
Prevention and Control: HPV vaccine for individuals
11-12 years old, and safe sexual practices
Human immunodeficiency virus /
acquired immunodeficiency syndrome
Causative Agent: HIV 1 and 2
Mode of Transmission: Sexual contact, blood
transfusion, contaminated syringes, needles,
nipper, blades, direct contact of open
wounds/mucous membranes with contaminated
blood, body fluids, semen, and vaginal
discharges
Incubation Period: varies from 3-6 months to
many years (8-10 yrs.)
SIGNS AND SYMPTOMS
1.Clinical stage I
• persistent generalized lymphadenopathy
2.Clinical stage II
• weight loss of <10% of body weight
• minor mucocutaneous manifestations
• herpes zoster within the last five years
• recurrent upper respiratory tract infections
3.Clinical stage III
• weight loss >10% of body weight
• unexplained chronic diarrhea for > 1 month
• unexplained prolonged fever for >1 month
• oral candidiasis
• oral hairy leukoplakia
• pulmonary tuberculosis within the past year
• severe bacterial infections
4. Clinical stage IV
• pneumocystic carinipnemonia
• toxoplasmosis of brain
• herpes simplex virus infection
• kaposi's sarcoma
• Extrapulmonary tuberculosis
• Lymphoma
LABORATORY/DIAGNOSTIC EXAMINATION
1. Enzyme Linked Immunosorbent Assay (ELISA)—
presumptive test
2. Western blot-confirmatory test
Treatment: Antiretroviral drugs that suppress the virus
PREVENTION AND CONTROL
1.Blood and blood products
a. Screen blood donors.
b. Observe universal precaution.
c. Refrain from using contaminated needles and
syringes.
2. Sexual transmission
a. Abstain from promiscuous sexual contact.
b. Be faithful to your partner and practice
monogamous sexual contact.
c. Follow correct and consistent use of condoms.
3. Mother-to-child transmission
• For HIV+ mothers, consult with health workers to
have access to care, treatment, and support
services during pregnancy, labor and
delivery,and postpartum.
4. PrEP or Pre-Exposure Prophylaxis
• for people with a high risk of acquiring HIV by
taking the drug Truvada
Acquired immunodeficiency syndrome (AIDS)
− a term which applies to the most ADVANCED
stages of HIV infection
− defined by the occurrence of any of more than 20
opportunistic infections for HIV-related cancers
(WHO, 2018).
Republic Act 11166
HIV AIDS CONTROL AND PREVENTION ACT OF 2018
− Signed into law by the President on December2018
almost twenty years since the first law forAIDS (RA
8504 of 1998) was implemented in the Philippines
SALIENT FEATURES:
• Intensified campaign on prevention and control of
HIV/AIDS specifically on sexual transmission
• Expanded access to diagnosis and treatment for
HIV/AIDS
• Inclusion of HIV/AIDS treatment in the Universal
Health Care platform of the country thru
PhilHealth
• Penalty for discrimination of People Living With
HIV(PLHIV)
• Minors can undergo testing for HIV without
parental or guardian consent (In 2018, 62% of new
cases are among youth population according to
WHO)
PPT QUESTIONS
1. A medical condition that is noninfectious and non-
transmissible AND It is termed CHRONIC DISEASE
due to their long duration.
--NCDs
2. WHAT ARE THE RISK FACTORS FOR
NONCOMMUNICABLE DISEASES, EXCEPT?
a. Physical inactivity
b.Exposure to virus
c. Unhealthy eating
d.Unhygienic environment
3. HOW IS MENTAL HEALTH DEFINED?
--state of social well-being in which every
individual realizes his or her own potential
(self-image), can cope with the normal
stresses of life can work productively and
fruitfully, and is able to make a contribution to
her or his community.
4. An act establishing the national mental health
policy for the purpose of enhancing the delivery of
integrated mental health services, promoting and
protecting the rights of persons utilizing
psychiatric, neurologic, and psychosocial health
services in the PHILIPPINES
--RA 11034
5. General term for impairment, activity limitations
and participations restriction
--DISABILITY
6. WHICH OF THE FOLLOWING IS THE DEFINITION OF
COMMUNICABLE DISEASES, BUT ONE?
--Referred as “lifestyle-related disease” due to
common risk factors such as lifestyle
7. Refers to the activities that reduce morbidity and
mortality of disease at an acceptable level within a
locality (Heymann, 2006)
--CONTROL
REVIEW QUESTIONS the members of the primary health team works In order to prevent and control communicable
Which of the ff are considered risk factors for the collaboratively in the implementation of PEN in the diseases, which of the ff info will be highly significant
development of ncds? health center. What are the responsibilities of the for the nurse?
1. Smoking public health nurse? Ans: nature of the disease
2. physical inactivity 1. counsel individuals about healthy lifestyle
3. unhealthy diet 2. receive NCD referrals for medical management Feces, urine, blood, and other body fluids are
4. excessive alcohol drinking 3. physically examines the individual considered as:
Ans: 1,2,3,4 4. conduct risk assessment and screening Ans: vehicles of transmission
5. measure height, weight, and vital signs
What is the 2nd leading cause of mortality in the Ans: 1,4,5 Which of the ff mosquitoes is known to carry the
Philippines based on the 2016 statistics? dengue infection?
a. Ischemic Heart Disease All but one are included in the strategies to reduce Ans: aedes aegypti
b. Cancer population’s risk in developing NCDs
c. Cerebrovascular Diseases a. promote a smoke free environment In the Philippines, which of the ff groups are
d. Diabetes Mellitus b. read food labels and nurture healthy eating habits commonly affected by Dengue?
c. be present during appointments and consultations Ans: children
In promoting and designing physical activity with mental health professionals or workers
programs in the community, which of the ff d. engage in physical activity and exercise at least once Which of the ff measures is not contraindicated in
conditions should be considered by the community a week for ten minutes Dengue?
health nurse? ans: D Ans: administer ORS or hydrite solution for
1. the act should be based on the interests, rehydration
preferences, and readiness of the individual what are the mental health services that should be
2. the act must be enjoyable provided to communities as stipulated under the Which of the ff infectious agent is the cause of
3. the community leaders should be present in the Mental Health Act? schistosomiasis?
act 1. support services for families and co-workers of Ans: schistosoma Japonicum
4. the act should include a variety of activities to mental health services
encourage participation 2. dissemination of mental health information and What is the intermediary host for schistosomiasis?
5. the physical environment should promote physical promotion of mental health awareness in the Ans: oncomelamia quadrasi
inactivity behaviors. community
Ans: 1,2,3,4 3. Community resilience and psychosocial well-being You know that typhoid fever is caused by which
training in all barangays organism?
In the management of noncommunicable diseases in 4. training and capacity-building programs for local Ans: salmonella
low resource settings like the Philippines, the WHO mental health workers
developed a PEN disease intervention. Which of the 5. availability of mental health and psychosocial asdf
ff diseases is not included in the PEN? support services during and after disasters
a. CDV Ans: 1,2,3,4,5
b. pneumonia
c. DM
d. COPD
e. Cancer