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Irwin Aras
Community Medicine Dept.
FMUH
Concepts of Disease
Prevention and Control
(I) Prevention
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Determinants of Prevention
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
Primordial prevention
Primary prevention
Secondary prevention
Tertiary prevention
Primordial Prevention
consists of actions and measures that
inhibit the emergence of risk factors in
the form of environmental, economic, social,
and behavioral conditions and cultural
patterns of living etc.
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Primordial Prevention
It is the prevention of the emergence or
development of risk factors in population
groups in which they have not yet appeared
For example;
◦ many adult health problems (e.g., obesity,
hypertension) have their early origins in childhood,
because this is the time when lifestyles are formed
(for example, smoking, eating patterns, physical
exercise).
Primordial Prevention
In primordial prevention, efforts are
directed towards discouraging children
from adopting harmful lifestyles
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Primary Prevention
Primary Prevention
It includes the concept of "positive health“;
a concept that encourages achievement and
maintenance of "an acceptable level of health that
will enable every individual to lead a socially and
economically productive life".
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• Health education
• Good standard of nutrition
• Attention to personality development
• Provision of adequate housing, recreation and
agreeable working conditions
Health • Marriage counseling and sex education
Promotion • Genetics
• Periodic selective examinations
Health promotion
Health promotion is;
“ the process of enabling people to increase
control over the determinants of health and
thereby improve their health”.
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For example;
studies have shown that even a small reduction in
the average blood pressure or serum cholesterol of
a population would produce a large reduction in the
incidence of cardiovascular disease
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High-Risk Strategy
The high -risk strategy aims to bring
preventive care to individuals at special
risk.
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2. Perbaikan lingkungan
a. Lingk fisik - peningkatan air bersih
- perbaikan sanitasi
- perumahan sehat, dll
b. Lingk biologis
- pemberantasan serangga
- binatang pengerat
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Secondary Prevention
It is defined as;
“action which halts the progress of a disease at its
incipient stage and prevents complications.”
Attempts to;
◦ arrest the disease process,
◦ restore health by seeking out unrecognized disease and
treating it before irreversible pathological changes take
place, and
◦ reverse communicability of infectious diseases.
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Tertiary Prevention
It is used when the disease process has
advanced beyond its early stages.
It is defined as;
“all the measures available to reduce or limit
impairments and disabilities, and to promote the
patients’ adjustment to irremediable conditions.”
Intervention that should be accomplished in the
stage of tertiary prevention are disability
limitation, and rehabilitation.
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Upayanya :
- hospitalisasi dan terapi kerja
- pendidikan rehabilitasi
- selective placement
Disability Limitation
disease
impairment
disability
handicap
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Impairment
Impairment is;
“any loss or abnormality of psychological,
physiological or anatomical structure or
function.”
Disability
Disability is;
“any restriction or lack of ability to perform
an activity in the manner or within the range
considered normal for the human being.”
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Handicap
Handicap is;
“a disadvantage for a given individual,
resulting from an impairment or disability,
that limits or prevents the fulfillment of a role
in the community that is normal (depending
on age, sex, and social and cultural factors)
for that individual.”
Rehabilitation
Rehabilitation is;
“ the combined and coordinated use of
medical, social, educational, and vocational
measures for training and retraining the
individual to the highest possible level of
functional ability.”
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◦(II) Control
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.
Disease Elimination
Between control and eradication, an
intermediate goal has been described, called
"regional elimination“
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Disease Eradication
Eradication literally means to "tear out by roots".
Monitoring
Defined as;
"the performance and analysis of routine
measurements aimed to detecting changes in the
environment or health status of population" (Thus
we have monitoring of air pollution, water quality,
growth and nutritional status, etc).
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Surveillance
surveillance means to watch over with great
attention, authority and often with
suspicion.
Defined as;
"the continuous scrutiny (inspection) of the factors
that determine the occurrence and distribution of
disease and other conditions of ill-health"
References
Salama, R. Concept of prevention & control. Lecture
Presiding.
PhD. Community Medicine Suez Canal University
Egypt.
Gerstman, BB (2003). Epidemiology kept simple.
Yarnell, J (2007). Epidemiology and prevention.
Gordis, L (2009). Epidemiology.
Bustan, MN (1997). Epidemiologi penyakit tidak
menular.
Noor, NN (1997). Epidemiologi penyakit menular.
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Terima Kasih
Thank you Arigato
Asante Shohkrahn
Gracias Gànxìe
Multu^mesc
Grazie
Hvala
Dyanavad Ngiyabonga
Spacibo Cámo*n
Merci, Danke Kamsa hamnida
Naishitz Syukron
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