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LEVELS OF PREVENTION

By Sathish RAJAMANI, Lecturer, BKIN - Moga

Preventive Medicine
The science and art of preventing disease, prolonging life and promoting physical and mental health and efficiency

Public Health
The science and art of preventing disease, prolonging life and promoting physical and mental health and efficiency through organized community efforts for

the sanitation of the environment the organization of medical and nursing services for the early diagnosis, prompt treatment and prevention of disease The development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health

Health
Health is a state of complete physical, mental and social wellbeing and not merely absence of disease or infirmity

Disease

Disease is a state in which body health is impaired

Disease
A departure from a state of health An alteration of the human body

interrupting the performance of vital functions. A condition of the body or some part or organ of the body in which its functions are disrupted or deranged

Causation of disease

Concept of Causation of disease


Various concepts of disease causation
Supernatural theory of disease The theory of humors The concept of contagion Miasmatic theory of disease The theory of spontaneous generation Germ theory of disease

Germ Theory of Disease


Disease agent ----Man ----- Disease

Natural History of Disease


Disease results from a complex interaction
between man, an agent and the environment

Epidemiological Triad

Environment

Agent

Host

Agent Factors
The disease agent is
A substance , living or non living, or a force, tangible or intangible, the excessive presence or relative lack of which may initiate or perpetuate a disease process. Disease may have a single or a number of independent agents or a complex of two or more factors

Agent
Biological agents- living agent of disease

Bacteria, Viruses, protozoa, fungi, rickettsia Nutrient agents- Protein, carbohydrate, vitamins, minerals and water Any excess or deficiency of the nutrient elements may result in nutritional disorders, anemia, goiter, obesity Physical agents Exposure to excessive heat, cold, humidity, pressure, radiation, sound

Agents
Chemical agents- metal fumes, dust,
gases, insecticides Mechanical agents exposure to chronic friction and other mechanical forces may result in crushing, tearing, sprains, dislocations Social agents poverty, smoking, abuse of drugs, unhealthy life style, social isolation

Host
Human host is referred as soil and the disease

agent as seed Host factors play a major role in determining the outcome of an individual's exposure to infection Host factors
Demographic - age, sex, race Biological genetic factors Social and economic factors Lifestyle factors

Environmental factors
All that which is external to the individual
human host, living or nonliving and with which he is in constant interaction This include all surrounding such as air, water, food, housing etc Physical environment Biological environment Psychological environment

Concepts of Control
Disease control Disease Elimination

Disease Eradication

Concepts of Control
Disease control
Aim is to reduce
The The The The incidence of disease duration of disease effects of infection financial burden

Concepts of Control
Disease Elimination
Between control and eradication Interruption of transmission of disease

Polio, Measles

Concepts of Control
Disease Eradication
Tear out by roots Termination of all transmission of infection by extermination of infectious agent Small pox

Prevention

Prevention
The goals are
To To To To promote health preserve health restore health when it is impaired minimize suffering and distress

Levels of Prevention
Primordial Prevention
Primary Prevention Secondary Protection Tertiary Prevention

Primordial Prevention
Prevention of the emergence or development of
risk factors in a population in which they have not yet appeared
Obesity --origin in childhood Life styles- eating patterns, physical exercise Hypertension -Main intervention in primordial prevention is through individual and mass education

Measure taken to prevent disease rather

Primary Prevention

than curing them or treatment of the symptom Action taken prior to the onset of disease Removes the possibility the disease will ever occur Intervention in the prepathogenesis phase of a disease or health problem
Health Promotion Specific Protection

Health Promotion
Measures to promote optimal level of health
Provision of adequate nutrition Health counseling to parents and community Provision of adequate housing Health education, counseling Periodical health examinations

Specific Protection
Measures applicable to a disease or group of

diseases to intercept the cause before the involvement Communicable diseasesimmunization Nutritional deficiency Dietary intervention
Vit A, D, C, B1, B2, B6, B12

Cancer stop smoking Dental carriesFlouride Goitre -- Iodine

Secondary Protection

Early diagnosis and prompt treatment Strategies intend to ovoid the development of disease Patient comes in contact with health worker or health facility Action which halts the progress of a disease at its early stage and prevent complication Arrest the disease process and restore health TB- Skin and sputum test

Tertiary Prevention
All measures to reduce or limit impairments and disabilities, minimize suffering from disease and

to promote the patients adjustment in


society

Tertiary Prevention
Disability limitation limiting further progress of disability Measures of prevention at this level is provision of therapeutic substances to arrest the disease and prevent further disability

Tertiary Prevention
Rehabilitation To train the individual to be useful Psychosocial vocational

Prevention

Universal prevention
Addresses the entire population (national,
local community, school, district) Aim to prevent or delay the abuse of alcohol, tobacco, and other drugs. All individuals, without screening, are provided with information and skills necessary to prevent the problem.

Selective prevention
focuses on groups whose risk of developing

problems of alcohol abuse or dependence is above average. The subgroups may be distinguished by characteristics such as age, gender, family history, or economic status. For example, drug campaigns in recreational settings. Polio

Indicated prevention
involves a screening process, and aims to
identify individuals who exhibit early signs of substance abuse and other problem behaviors. Identifiers may include falling grades among students, known problem consumption or conduct disorders, alienation from parents, school, and positive peer groups etc.

Prophylaxis

Prophylaxis
Prophylaxis " to guard or prevent beforehand
any medical or public health procedure whose purpose is to prevent, rather than treat or cure a disease.

prophylactic measures

primary prophylaxis (to prevent the development of a disease) secondary prophylaxis (whereby the disease has already developed and the patient is protected against worsening of this process).

Prophylaxis

Examples Some specific examples of prophylaxis Influenza vaccines are prophylactic. Antibiotics are sometimes used prophylactically, During the 2001 anthrax attacks scare in the United States, patients believed to be exposed were given ciprofloxacin . Antibiotics are also given prophylactically just before some medical procedures such as pacemaker insertion

Antimalarials such as chloroquine are used both


in treatment and as prophylaxis by visitors to countries where malaria is endemic to prevent the development of the malaria. Condoms are sometimes referred to as "prophylactics" because of their use to prevent pregnancy as well as the transmission of sexually transmitted infections. Professional cleaning of the teeth is dental prophylaxis. Daily and moderate physical exercise in various forms can be called prophylactic because it can maintain or improve one's health Prophylaxis may be administered as vaccine.

Prevention is better than cure


It's better to take care that a problem

does not happen than to have to solve the problem afterwards. happening in the first place than to fix the damage after it has happened. health and disease. proverbial saying, 17th century.

It's easier to stop something bad from


This proverb is often used in relation to

"An ounce of prevention is worth a

pound of cure

Latin saying of 13th century

It is better and more useful to meet a problem in time than to seek a remedy after the damage is done.