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Dr. Siham Gritly 1
Community medicine5 Concepts of control and prevention
Prepared by; Dr. Siham GritlyUniversity of Bahri
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Concept of control
• The term disease control describes ongoing operations aimed at reducing:
• -The incidence of disease• -The duration of disease and consequently
the risk of transmission • -The effects of infection, including both the
physical and psychosocial complications• -The financial burden to the community.
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Control activities focus on primary prevention or secondary prevention, but
most programs combine both; control-----elimination-----eradication
• Elimination is used to describe interruption of
transmission of disease as elimination of
measles, polio, diphtheria from geographic
regions
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• Eradication “tear out by roots” It is the
process of “Termination of all transmission of
infection by extermination (termination) of the
infectious agent through surveillance and
containment” االحتواء.
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Monitoring and Surveillance
• Monitoring is "the performance and analysis of routine measurements aimed at detecting changes in the environment or health status of population"
• monitoring of air pollution, • water quality• , growth and nutritional status, etc).
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Surveillance
• Surveillance means to watch over with great attention,
• surveillance is defined as "the continuous
scrutiny (inspection) of the factors that
determine the occurrence and distribution
of disease and other conditions of ill-health”
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The main objectives of surveillance are:
• (a) to provide information about new and changing trends in the health status of a population, e.g.,
• morbidity, • mortality, • nutritional status or other indicators• and environmental hazards,• health practices • and other factors that may affect health
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• (b) to provide feed-back which may be expected to modify the policy and the system itself and lead to redefinition of objectives, and
• (c) provide timely warning of public health disasters so that interventions can be mobilized
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Evaluation of control
• Evaluation is the process by which results are
compared with the objectives
• Evaluation is the assessment of how well a
program is performing
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Concept of prevention
• The goals of medicine are to ;• Promote health• Preserve health• Restore health• Minimize suffering and distress• These goals are enclosed in the word
prevention
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Successful prevention depends upon:
• a knowledge of causation, • dynamics of transmission, • identification of risk factors and risk groups, • availability of prophylactic or early detection
and treatment measures, • an organization for applying these measures to
appropriate persons or groups, and • continuous evaluation of and development of
procedures applied
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Levels of prevention
• Prevention defined in terms of four levels
• 1-Premordial prevention
• 2-primary prevention
• 3-secondary prevention
• 4-tertiary prevention
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• 1-Primordial prevention ;
• is the prevention of chronic diseases (obesity,
hypertension) which they have their origins in
childhood
•
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• consists of actions and measures that inhibit the emergence of risk factors in the form of
• environmental,• economic, • social, • behavioral conditions • and cultural patterns of living etc.
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• 2-Primary prevention defined
• as “action taken prior to onset of disease which
removes the possibility that the disease will ever
occur
• it means intervention in the pre-pathogenesis
phase of disease or health problems
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• Primary prevention includes the concept of
positive health that will enable every
individual to lead a socially and economically
productive life
• it is the less expensive level
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• 3-Secondary prevention defined as “action which
halts (stop) the progress of disease at its incipient
(initial) stage and prevent complication”
• Secondary prevention is an imperfect tool in control of transmission of disease
• It is more expensive and less effective than primary prevention
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• 4-Tertiary prevention defined as “all measure
available to reduce or limit impairments and
disabilities, minimize suffering caused by
existing departures from good health
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intervention
• Intervention defined as;
• “any attempt (effort) to intervene or interrupt
the usual sequence in the development of
disease in human”
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Five mode of intervention
• Five mode of intervention have been described;• 1-health promotion
• 2-specific protection
• 3-early diagnosis and treatment
• 4-disability limitation
• 5-rehabilitation
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• 1-health promotion
• -health education
• -environmental modification
• -nutritional intervention
• -lifestyle and behavioral changes
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• 2-specific protection
• -immunization
• -use of specific nutrients
• -chemoprophylaxis
• -protection against occupational hazards
• -protection against accidents
• -protection against carcinogens etc ----
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• 3-early diagnosis and treatment are the main interventions of disease control achieved
• -through primary prevention
• 4-disability limitation • Concept of disability; the sequence of events
leading to disability and handicap stated as follows;• (disease---impairment-------disability-----handicap)
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• - impairment; In health, defined as “any loss or
abnormality of physiological, psychological, or
anatomical structure or function”
• For example mental retardation, loss of foot
•
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• - Disability is the consequence of an impairment • Defined as “ any restriction or lack of ability to
perform any activity in the manner or within the range considered normal for a human being”
• may be physical, cognitive, mental, sensory, emotional, developmental, or some combination of these.
• A disability may be present from birth, or occur during a person's lifetime
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• - handicap “as a result of disability, the person experiences certain disadvantages in life and is not able to discharge the obligations required of him and play the role expected of him in society”
• a disadvantage for a given individual, resulting from an impairment or disability, that limits or prevent the fulfillment of a role that is normal
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• 5-rehabilitation
• -the combined and coordinated use of medical,
social, educational and vocational measures
for treating and retaining the individual to the
highest possible level of functional ability