Principal of Communicable Diseases

Prevention and Control

Dr. Rajan Bikram RayamajhiSchool Of Public Health and Community Medicine

B. P. Koirala Institute of Health Sciences

04/11/23SPHCM 20131

The goal of medicine :

o promote health

o preserve health

o restore health when it is impaired

o minimize suffering and distress

04/11/23SPHCM 20132

Control of disease:

o To identify the weak points and break the weakest links in the chain of transmission.

o Disease control involves - community participation, political support and inter sectoral co-ordination

04/11/23SPHCM 20133

Preventive Medicine

o Applied to healthy people

o The concept of preventive medicine also includes:

Health promotion Specific protection Treatment Prevention of disability

04/11/23SPHCM 20134

Prevention Diseases can be prevented by appropriate preventive measures

which include:

o Good site planningo Provision of basic clinical serviceso Provision of appropriate sheltero Clean water supplyo Sanitationo Mass vaccination against specific diseaseso Regular and sufficient food supplyo Control of vectors

04/11/23SPHCM 20135

LEVELS OF PREVENTION1. Primordial prevention

Prevention of the emergence or development of risk factors in countries or population groups in which they have not yet appeared.

2. Primary prevention Action taken prior to the onset of disease, which removes the possibility that a disease

will ever occur.

3. Secondary preventionAction which halts the progress of a disease at its incipient stage and prevents

complication.

4. Tertiary preventionAll measures available to reduce or limit impairments and disabilities, minimize

suffering caused by patients adjustment to irremediable conditions

04/11/23SPHCM 20136

04/11/23SPHCM 20137

MODES OF INTERVENTION

o Intervention can be defined as any attempt to intervene or interrupt the usual sequence in the development of disease in man

o They are:1. Health promotion2. Specific protection3. Early diagnosis and treatment4. Disability limitation5. Rehabilitation

04/11/23SPHCM 20138

Health Promotion

o Health Education

o Environmental Modification

o Nutritional intervention

o Lifestyle & behavioral changes

04/11/23SPHCM 20139

Health Education

04/11/23SPHCM 201310

Environmental Modification

04/11/23SPHCM 201311

Nutritional intervention

04/11/23SPHCM 201312

Lifestyle & behavioral changes

04/11/23SPHCM 201313

Specific Protection

04/11/23SPHCM 201314

Early Diagnosis & Treatment

04/11/23SPHCM 201315

DISABILITY LIMITATION

ImpairmentsImpairments

DiseaseDisease orordisorderdisorder

DisabilitiesDisabilities HandicapsHandicaps

04/11/23SPHCM 201316

Impairment:

Any loss or abnormality of psychological, physiological or anatomical structure or function.

Ex: loss of foot, defective vision or mental retardation

04/11/23SPHCM 201317

Disability

o Any restriction or lack of ability to perform an activity in the manner or within the range of considered normal for a human being

o Ex: can not walk due to accident

04/11/23SPHCM 201318

Handicap

o A disadvantage for a given individual, resulting from an impairment or a disability, that limits or prevents the fulfillment of a role that is normal (depending on age, sex and social and cultural factors) for that individual.

o Reduction in a person’s capacity to fulfill a social role

o E.g., unemployed due injury or not being able to walk

04/11/23SPHCM 201319

Disability Prevention

o Reducing the occurrence of impairment ( primary prevention)

Ex: immunization against polio

o Disability limitation by appropriate treatment (secondary prevention)

o Preventing transition of disability into handicap ( tertiary prevention)

04/11/23SPHCM 201320

Rehabilitation

Aim:o Reducing the impact of disabling and

handicapping conditions

o Enabling the disabled and handicapped to achieve social integration (the active participation of disabled and handicapped people in the mainstream of community life)

04/11/23SPHCM 201321

Disability limitation by appropriate treatment

04/11/23SPHCM 201322

Control

o To control a disease is “to exercise restraint or regulation, to correct or restore to normal

o In another word the term control describes(ongoing) operations aimed at reducing the prevalence of the disease to a level where it is not a major public health problem

04/11/23SPHCM 201323

Aim at reducing:o The incidence of disease

o The duration of disease and consequently the risk of transmission

o The effects of infection, including both the physical and psychosocial complications

o The financial burden to the community

04/11/23SPHCM 201324

o Control activities may focus on primary prevention or secondary prevention, most control programmes combine the two.

o The concept of tertiary prevention is comparatively less relevant to control efforts.

04/11/23SPHCM 201325

General measures for controlA) Measures directed against reservoir/

source:

a. Extra human (Animal) reservoir:

Testing of animal/ herd for infection Destruction Treatment of infected animals Avoidance of close contact Meat inspection Licensing, restraint and vaccination of pets

04/11/23SPHCM 201326

b. Human reservoir

o Active case detectiono Passive surveillanceo High index of suspiciono Early diagnosiso Isolation o Quarantineo Chemotherapyo Health educationo Management of potential sourceso Notification

04/11/23SPHCM 201327

B) Measures for interrupting transmission:

o Avoidance of physical contacto Disinfection/ disinfestationso Barrier nursingo Water disinfectiono Food hygieneo Pasteurization/ boiling milk

o Good housingo General ventilation

o Avoidance of overcrowdingo Dust suppression

o Vector control

o Sterilization of syringes and needleso Safety of blood and blood productso Health education

04/11/23SPHCM 201328

c) Measures to increase host resistance:

Better health / nutritional status Immuno prophylaxis Chemoprophylaxis

04/11/23SPHCM 201329

Thank You

04/11/23SPHCM 201330