Nutritional assessment by Dr. Rajan Bikram Rayamajhi
Prevention and control of diseases for third year mbbs students
1. Principal of Communicable Diseases
Prevention and Control
Dr. Rajan Bikram Rayamajhi
School Of Public Health and Community Medicine
B. P. Koirala Institute of Health Sciences
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2. The goal of medicine :
o promote health
o preserve health
o restore health when it is impaired
o minimize suffering and distress
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3. 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
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4. Preventive Medicine
o Applied to healthy people
o The concept of preventive medicine also
includes:
Health promotion
Specific protection
Treatment
Prevention of disability
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5. Prevention
Diseases can be prevented by appropriate preventive measures
which include:
o Good site planning
o Provision of basic clinical services
o Provision of appropriate shelter
o Clean water supply
o Sanitation
o Mass vaccination against specific diseases
o Regular and sufficient food supply
o Control of vectors
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6. LEVELS OF PREVENTION
1. Primordial prevention
Prevention of the emergence or development of risk factors in countries or population
groups in which they have not yet appeared.
1. Primary prevention
Action taken prior to the onset of disease, which removes the possibility that a disease
will ever occur.
1. Secondary prevention
Action which halts the progress of a disease at its incipient stage and prevents
complication.
1. Tertiary prevention
All measures available to reduce or limit impairments and disabilities, minimize
suffering caused by patients adjustment to irremediable conditions
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8. 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 promotion
2. Specific protection
3. Early diagnosis and treatment
4. Disability limitation
5. Rehabilitation
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9. Health Promotion
o Health Education
o Environmental Modification
o Nutritional intervention
o Lifestyle & behavioral changes
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17. Impairment:
Any loss or abnormality of psychological, physiological or
anatomical structure or function.
Ex: loss of foot, defective vision or mental retardation
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18. 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
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19. 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
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20. 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)
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21. 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)
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23. 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
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24. 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
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25. 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.
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26. General measures for control
A) 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
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27. b. Human reservoir
o Active case detection
o Passive surveillance
o High index of suspicion
o Early diagnosis
o Isolation
o Quarantine
o Chemotherapy
o Health education
o Management of potential sources
o Notification
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28. B) Measures for interrupting transmission:
o Avoidance of physical contact
o Disinfection/ disinfestations
o Barrier nursing
o Water disinfection
o Food hygiene
o Pasteurization/ boiling milk
o Good housing
o General ventilation
o Avoidance of overcrowding
o Dust suppression
o Vector control
o Sterilization of syringes and needles
o Safety of blood and blood products
o Health education
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29. c) Measures to increase host resistance:
Better health / nutritional status
Immuno prophylaxis
Chemoprophylaxis
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