METHODS USED IN THE PREVENTION AND

CONTROL OF DISEASES

SYAPIILA M. PAUL
Copperbelt University
Public Health Lecturer
Date: 27/03/2018
Prevention and Control of Communicable Diseases and Community
Diagnosis

By the end of this lecture, students should be able to:

 Identify the two main ways of classifying communicable diseases, and
illustrate their usefulness.
 Describe and give examples of prevention and control measures
targeting the reservoir of infection.
 Describe and give examples of prevention and control measures
targeting the mode of transmission of communicable diseases.
 Describe and give examples of prevention and control measures that
protect the susceptible host from communicable diseases.
 Describe the basic processes involved in community diagnosis and
give examples of how you would apply these methods.

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Classification of infectious diseases
 Classification will helps in selection and application of appropriate
prevention and control measures that are common to a class of
communicable diseases.
 Apart from classifying infectious diseases based on the types of

infectious agents there are two main ways of classifying them.

 These are:

1. Clinical classification is based on the main clinical manifestations

(symptoms and signs) of the disease.
2. Epidemiologic classification is based on the main mode of
transmission of the disease.

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Clinical classification

 This is based on the main clinical manifestations of the disease. It

helps in treating the symptoms and signs that are common to (shared
by) individuals who suffer from different diseases.
 Clinical classification is illustrated by the example given below.
 Some diseases are classified as diarrhoeal diseases whose main
clinical symptom is diarrhoea, which means passage of loose stool
(liquid faeces) three or more times per day.
 People with watery diarrhoeal disease suffer from loss of fluid from
their bodies. Therefore, even though the infectious agent might be
different, as in the examples of shigellosis and cholera, the common
management of patients with diarrhoeal disease includes fluid
replacement.

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Other clinical classifications

 Febrile illnesses, because they all have the main symptom of fever, for
example, malaria. 
 Respiratory diseases are another clinical classification; their main
symptoms include cough and shortness of breath, as in pneumonia.
 Using the method of clinical classification will help one decide to treat
the main symptom.
 For most diseases, treatment of the main symptom is only supportive
(that is it will not cure the disease).
 Therefore, you have to give treatment specific to the infectious agent.

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Epidemiologic classification

 This is based on the main mode of transmission of the infectious

agent.
 This helps in selection of prevention and control measures which are
common to (shared by) communicable diseases in the same class, so
as to interrupt the mode of transmission.
 Examples.
 Cholera and typhoid fever are two different diseases which can be
transmitted by drinking contaminated water. Therefore, they are
classified as waterborne diseases.
 The common prevention measures for the two diseases, despite
having different infectious agents, include protecting water sources
from contamination and treatment of unsafe water before drinking.

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 Based on the mode of transmission of the infectious agent,
communicable diseases can be classified as:
 Waterborne diseases: transmitted by ingestion of contaminated water.
 Foodborne diseases: transmitted by the ingestion of contaminated
food.
 Airborne diseases: transmitted through the air.
 Vector-borne diseases: transmitted by vectors, such as mosquitoes
and flies.

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 E.g. malaria,
 Clinically is a febrile disease. Thus in addition to treatment

with anti-malarial drugs, measures to lower the fever

by giving paracetamol should be taken. 

 Epidemiologically, malaria is vector-borne, measures to

prevent and control malaria in the community, includes
advocating protection from mosquito bites by using bed
nets, and drainage of small collections of water where
mosquitoes breed.

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General prevention and control approaches

 prevention it refers to measures to prevent the occurrence of a

disease.
 control it refers to measures to prevent transmission after the disease
has occurred.
 Prevention and control of communicable diseases involves
interventions to break the chain of transmission.

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General prevention and control approaches
 The chain of infection consists of six factors (infectious agent, the
reservoir, the route of exit, the mode of transmission, the route of
entry, and the susceptible host).
 For this discussion, these six factors are merged into three groups:

1. Infectious agents in the reservoir of infection and the route of exit

from the reservoir are discussed under the heading ‘Reservoir’.
2. The ‘mode of transmission’ is the second category that we will
discuss.
3. The route of entry and the susceptible host are discussed under the
heading ‘susceptible host’

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measures for tackling human and animal
reservoirs
Human reservoir
Early Diagnosis and Treatment
 There are two ways to identify an infected individual: clinical
diagnosis and by screening.
 Identifying and treating cases early,

1. reduces the severity of the disease for the patient,

2. avoiding progression to complications, disability and death; and

3. it also reduces the risk of transmission to others.

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measures for tackling human and animal
reservoirs
Animal reservoirs
 Different measures can be undertaken against the animal.
 Depending on the usefulness of animal reservoir and

availability of treatment, these ranges from treatment to

destroying the infected animal.
 For example to prevent and control a rabies outbreak, the

measures to be taken are usually to destroy all stray dogs in

the area, and vaccinate pet dogs if the owner can afford this
protection and the vaccine is available.

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Measures targeting the mode of transmission

 The measures that can be applied to interrupt transmission of

infectious agents in water, food, other vehicles and by vectors,
Water
 Measures to prevent transmission of infection due to contaminated

water include;
1. Boiling the water. 

2. Adding chlorine.

3. Physical methods like filtering water through a box of sand, or

pouring it through several layers of fine cloth.
4. Faecal contamination of water should also be prevented by
protecting water sources and through proper use of latrines 

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Measures targeting the mode of transmission
Food
 Measures to prevent transmission in contaminated food include

1. Washing raw vegetables and fruits,

2. Boiling milk, and cooking meat and other food items thoroughly
before eating.
3. Contamination with faeces can be prevented by hand washing and
proper use of latrines.

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Measures targeting the mode of transmission
Other vehicles
 Measures to tackle transmission in or on vehicles other than

water and food include:

1. Contaminated objects like household utensils for cooking,
eating and drinking should be washed with soap and
water.
2. Contaminated medical instruments and clothing can be
sterilised, disinfected or properly disposed of.

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Measures targeting the mode of transmission
Vectors
 Measures against vectors include preventing breeding of vectors
through;
1. proper disposal of faeces and other wastes,

2. eradication of breeding sites, and

3. disinfestation. 
 Disinfestation is the procedure of destroying or removing small

animal pests, particularly arthropods and rodents, present upon the

person, the clothing, or in the environment of an individual, or on
domestic animals.
 This is usually achieved by using chemical or physical agents, e.g.

spraying insecticides to destroy mosquitoes, and removing lice from

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Measures targeting the susceptible host

 These protects the susceptible host either from becoming infected, or

from developing the stage of infectious disease if they are already
exposed.
Vaccination
 This refers to administration of vaccines to increase the resistance of

the susceptible host against specific vaccine-preventable infections

(measles vaccination helps to protect the child from measles
infection, and BCG vaccination gives some protection from
tuberculosis) 

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Measures targeting the susceptible host
Chemoprophylaxis 
 Refers to the drugs given to exposed and susceptible hosts to

prevent them from developing an infection

Maintaining a healthy lifestyle

 Proper nutrition and exercise improves a person’s health

status, supports the effective functioning of their immune

system, and increases resistance to infection.

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Measures targeting the susceptible host
Limiting exposure to reservoirs of infection
1. Condom use to prevent transmission of HIV and other sexually
transmitted infections (STIs).
2. Use of insecticide treated nets (ITNs) over the bed at night,

3. insect repellents and wearing protective clothing to prevent diseases

transmitted by insect vectors.
4. Wearing surgical or very clean gloves and clean protective clothing
while examining patients, particularly if they have wounds, or the
examination involves the genital area.
5. Keeping personal hygiene, like taking a daily bath and

6. Hand washing frequently.

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Measures targeting the susceptible host
When to wash hands with soap and clean water?
 After using the toilet
 After handling animals or animal waste
 After changing a diaper (nappy) or cleaning a child’s bottom
 Before and after preparing food
 Before eating
 After blowing the nose, coughing, or sneezing
 Before and after caring for a sick person
 After handling waste material

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Community diagnosis

 In order to select and apply effective prevention and control

measures, one have to determine which type of diseases are
common in their community.
 The method is called community diagnosis and it involves the

following four steps:

1. Data collection
2. Data analysis
3. Prioritising problems
4. Developing an action plan.

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Community diagnosis
 Data collection refers to gathering data about the health problems
present in the community.

 The following sources of data can be used:

1. Discussion with community members about their main health
problems
2. Reviewing records of the health services utilised by the community
3. Undertaking a community survey or a small-scale project
4. Observing the risks to health present in the community.

 After collecting data it should be analysed to make meaning out of it.

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Community diagnosis
Data analysis 
 Refers to categorising the whole of the data you collected into

groups so as to make meaning out of it.

 For instance you can assess the magnitude of a disease by

calculating its prevalence and its incidence from the numbers
of cases you recorded and the number of people in the
population in your community.

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Community diagnosis
Prioritising health problems
 This refers to putting health problems in order of their importance.
The factors that you should consider in prioritising are:
1. the magnitude of the problem.
2. the severity of the problem.
3. the feasibility of addressing the problem: are the prevention and
control measures effective, available and affordable by the
community?
4. the level of concern of the community and the government about
the problem.
 Health problems which have a high magnitude and severity, which can

be easily solved, and are major concerns of the community and the
government, are given the highest priority.
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Community diagnosis
Action plan
 An action plan sets out the ways in which you will implement

the interventions required to prevent and control the disease.

 It contains a list of the objectives and corresponding

interventions to be carried out, and specifies the responsible

bodies who will be involved.
 It also identifies the time and any equipment needed to

implement the interventions.

 Once you have prepared, then implement the work according

to your plan

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