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PREVENTION AND

CONTROL OF TROPICALCOMMUNICABLE
DISEASES

THE BASICS
The goals of medicine:
1. To promote health
2. To preserve health
3. To restore health when it is impaired
4. To minimize suffering and distress
WHICH MEANS

PREVENTION

THE BASICS
From the epidemiological concept of disease
epidemiological triangle
Disease occurs as a consequence of an
imbalance of the AGENT, HOST, and
ENVIRONMENT

HOST-AGENT & ENVIRONMENT


INTERACTION (TROPICAL DISEASE)
HOST
geneticAge, sex, f
amily size,
marital status,
religion, occupation,
intercurrent disease,
Ethnic or racial factors,
habits & customs,
resistance/immunity, etc

AGENT
-MOSTLY
-BIOLOGICAL
-AGENT

At equilibrium

ENVIRONMENT
(TROPICAL ENVIRONMENT)

TROPICAL DISEASE
BIOLOGICAL AGENTS
1. Bacteria
2. Viruses
3. Rickettsia
4. Spirochaeta
3. Protozoa
4. Fungi
5. Arthropoda
6. Helminths

TROPICAL DISEASE
BACTERIA : Tuberculosis, Leprosy, Diphtheria,
Anthrax, Tetanus, Typhoid.
VIRUS : Bird Flue, Dengue, Poliomyelitis, HIVAIDS, Rabies, Chicken-pox , Mumps, Herpeszoster, Herpes-simplex, RSV, Ebola, Hantavirus,
Nipah Virus
PROTOZOA : Malaria
SPIROCHAETA : Leptospirosis
HELMINTHS : STH, Filariasis,

AGENTS
1. Natural characteristics of AGENTS
a. Biological and chemical characteristics:
b. Resistance (physical, chemical, viability )
2.

Characteristics of AGENTS associated with HOST : Infectivity, pathogenecity,


virulence, antigenecity
3. Characteristics of AGENTS associated with ENVIRONMENT : Source of infection
(reservoir) could be human or animal
4. Modes of transmissions

a.
.

HOST
Characteristics :
Age, sex, ethnic, hereditary / genetics,
behavior, immunity, nutritional status, etc

ENVIRONMENT
Physical , chemical, biological, social
-environment

PREVENTION
Eradicating, eliminating, minimizing the
impact of disease and disability, retarding
the progress & disability
Traditional concept (Leavells : primary,
secondary, tertiary )
Modern concept with primordial prevention

DETERMINANTS OF
PREVENTION
A knowledge of causation
Dynamics of transmission
Identification of risk factors and and risk groups
Availability of prophylactic or early detection
and treatment measures
An organization to apply these measures
appropriately
Continuous evaluation

PREVENTABLE CAUSES
Biological factors and Behavioral factors
Environmental factors
Immunological factors
Nutritional factors
Genetic factors
Services, Social factors, Spiritual factors

LEVELS OF PREVENTION
Primordial prevention
Primary prevention
-Health promotion
-Specific protection
Secondary prevention
- Early diagnosis & prompt treatment
Tertiary prevention
- Disability limitation
- Rehabilitation

PRIMORDIAL PREVENTION
Prevention in the form of action to inhibit
the emergence of risk factors in the form
of environmental, economic, social, and
behavioral conditions and cultural pattern
of living, etc
Prevention of the emergence of risk
factors countries and populations groups
in which they have not yet appeared

PRIMARY PREVENTION
Action taken prior to the onset of diseases
which removes the possibility that the
disease will ever occurs
- Health promotion
- Specific protections

Health promotion
The process of enabling people to
increase control over the determinants of
health and thereby improve their health

THE NATURAL HISTORY OF ANY DISEASE OF MAN


Before man involved

death

The course of the disease in man

Interrelations of the various

Chronic
state

AGENT

Disability
illness

HOST

Defect

and
ENVIRONMENTAL
factors

CLINICAL HORIZON

Known or unknown

Tissue and
physiologic
changes

Bring AGENT and


HOST together

PREPATHOGENESIS
PERIOD

Immunity and
resistance

STIMULUS and AGENT


BECOMES established and
increases by multiplication or
increment

STIMULUS or
AGENT becomes
Or Produce a
disease-provoking
STIMULUS

Signs and
symptom

in
huma
n
HOST

Interactions of HOST
and SIMULUS

HOST REACTION
Discernible

Early
pathogenesis

PERIOD

RECOVERY

early lesions

OF

Advanced
disease

PAT H O G E N E S I S

Convalescence

THE NATURAL HISTORY OF ANY DISEASE OF MAN


Interrelation of Agent, Host, and Environmental
factors
Production of STIMULUS

PREPATHOGENESIS PERIOD

Reaction of the HOST to the STIMULUS


Early
pathogenesis

Discernible
earlylesions

PERIOD

SPECIFIC PROTECTION

EARLY DIAGNOSIS and


PROMPT TREATMENT

Health education

Use of specific
Immunizations

Case-finding measures,
individual and mass

Good standard
of nutrition

Attention to
personal hygiene

Screening survey

Provision of adequate
Housing, recreation,
and agreeable
work conditions

Use of environmental
sanitation

HEALTH PROMOTION

Protection against
occupational hazards

Marriage counseling
and sex education

Protection from accidents

Genetics

Use of specific nutrients

Selective examinations
Objectives :
To cure and prevent
disease processes
To prevent the spread of
communicable diseases
To prevent complications
and sequele

Protection from carsinogens To shorten period of disability


Avoidance of allergens

PRIMARY PREVENTION

SECONDARY PREVENTION

Advanced
disease

OF

Convalescence

PATHOGENESIS

REHABILITATION
Provision of hospital
and community facilities
DISABILITY LIMITATION
for retraining and

Adequate treatment
to arrest
the disease process
and to prevent
further complication
and sequelae

education for
maximum use
of remaining capacities
Education of the public
and industry to utilized
the rehabilitated
as full employment

Provision of
Selective placement
facilities to limit
disability
Work therapy in hospitals
and to prevent death
Use of sheltered colony

TERTIARY PREVENTION

LEVELS OF APPLICATION of PREVENTIVE

MEASURES

CONTROL OF DISEASE
Ongoing actions aim at reducing ;
- The incidence of disease
- The duration of disease the risk of
transmission
- The effect of infection
- The financial burden to the community

CONTROL ELIMINATION ERADICATION

TASK

CONTROL OF TB
Keypoints of successful prevention and
control ???? (slide 11)
Primordial : ???
Primary : ???
Secondary : ???
Tertiary : ???