PRINCIPLES OF DISEASE

PREVENTION

Dini Norviatin, dr., M.KM

Ilmu Kesehatan Masyarakat
Fakultas Kedokteran, Universitas Swadaya Gunung Jati
Stages of disease
 Natural History of Disease
Before man is involved The course of the disease in man
DEATH
Interrelation of the various: Chronic state
- AGENT Defect
- HOST Disability
- ENVIRONMENT factors Illness

(known & unknown) Signs & symptoms

Tissue & physiologic Immunity &

which changes resistance
STIMULUS & AGENT becomes
bring AGENT & HOST established & increases by
RECOVERY
together, or multiplication or increment
produce a disease-provoking in the Interaction of
STIMULUS human HOST & STIMULUS HOST reaction
HOST Advanced
Early pathogenesis Discernible early Convalescence
lesions disease

Pre-pathogenesis Pathogenesis
THE EPIDEMIOLOGIC TRIAD OF A
DISEASE
Host resistance
Influenced by

Several factors
can work
synergistically
 Environment
• Poor restaurant sanitation  Salmonella
infections.
• Social, political, and economic factors.
• Crowded homes and schools
• The political structure and economic
health of a society influence the nutritional
and vaccine status of its members.
The concept of the vector can be applied more widely, however, to include
human groups (e.g., vendors of heroin, cocaine, and meth-amphetamine)
and even inanimate objects that serve as vehicles to transmit disease (e.g.,
contaminated needles associated with hepatitis and AIDS).
Risk Factors and Preventable Causes
 Factors that may be associated with
increased risk of human disease
HOST AGENTS ENVIRONMENT

Age Biologic (e.g. bacteria) Temperature

Sex Chemical (e.g. poison) Humidity
Race Physical (e.g. trauma) Altitude
Religion Nutritional (e.g. deficiency) Crowding
Occupation Housing
Genetic profile Neighborhood
Marital status Water
Family background Milk
Previous disease Food
Immune status Radiation
Air pollution
Noise
Solution of Public Health
Problems
Prevention of disease

Tertiary Prevention

Secondary
Prevention
Primary Prevention
The Level of Prevention
Methods of Primary Prevention:
Health Promotion
SECONDARY
PREVENTION:
Community screening
 PRIMARY PREVENTION
Health Promotion
• Health education
• Good standard of nutrition
adjusted to developmental phases
of life
• Attention to personality
development
• Provision of adequate housing,
recreation & agreeable working
conditions
• Marriage counseling & sex
education
• Periodic selective examination
Specific Protection
• Use of specific immunization
• Attention to personal hygiene
• Use of environmental sanitation
• Protection against occupational
hazards
• Protection from accidents
• Use of specific nutrients
• Protection from carcinogens
• Avoidance of allergens
SECONDARY PREVENTION
Early Diagnosis & Prompt Treatment
• Case-finding measures, individual & mass
• Screening surveys
• Selective examinations

Objectives:
- to cure & prevent disease processes
- to prevent the spread of communicable disease
- to prevent complications & sequelae
- to shorten period of disability
 TERTIARY PREVENTION
Disability limitation
• Adequate treatment to arrest
the disease process & to
prevent further complications
& sequelae
• Provision of facilities to limit
disability & to prevent death
Rehabilitation
• Provision of hospital &
community facilities for
retraining & education for
maximum use of remaining
capacities
• Education of the public &
industry to utilize the
rehabilitated
• As full employment as possible
• Selective placement
• Work therapy in hospitals
 Chain of Infection

Pathogen Portal Portal

Reservoir of exit Transmission of entry Establishment
of disease in
new host
 Prevention & control strategies

Pathogen Portal Portal

of exit of entry Establishment
Reservoir Transmission of disease in
• Pasteurization new host
• Chlorination • Gowns • Masks
• Masks • Condoms
• Antibiotics • Safety glasses • Immunizations
• Antivirals • Condoms
• Hair nets • Insect repellents • Health education
• Disinfectants • Nutrition promotion
• insect repellents • Isolation
• Sexual abstinence
• Hand washing
• Isolation • Vector control
• Surveillance • Sanitary engineering
• Sneeze glass
• Quarantine
• Sexual abstinence
• Drug treatment • Safe sex
DISKUSI KELOMPOK

1. Patogen: strelisasi, imunisasi/vaksinasi, sanitasi

2. Reservoir: 4M, menyuntikan bakteri ke nyamuk
3. Portal of exit: sanitasi yg baik, pemakaian masker, jamban
sehat, imunisasi, kondom
4. Transmission: mengubur, menguras, pakai masker, pakai
kondom
5. Portal of entry: APD (handscoon, masker, kaca mata, alas kaki),
kelambu, fogging, profilaksis, cuci tangan, pakai kondom
6. Establishment new disease: nutrisi yang cukup, PHBS,
pencegahan primer: imunisasi difteri (DT), sekunder: screening
dan pengobatan, tertier: rehabilitasi