Concept Of Disease 4th year community medicine, health department.pptx

It is causation of disease and prevention

1. 2 ) Concept of Disease By : Dr. Hamid Mahmood MBBS, Dip. Card, DPH, Dip. Nuatrition M. Sc Community Health MBA (Health Management) Associate Prof. Comm. Med .

2. 4 CONCEPTS OF DISEASE DEFIN I TIO N S ‘ a m a ladj u s tme n t of h u m a n o r g anism t o t h e e n vi r onm e n t ’ “Disease is c on s ide r ed a social p h eno m en o n, oc c uring in a ll s o ci e ties and d e fined and f oug h t in t erms of the particul a r c u ltu r al f o r ces p r e v a l e n t in the soci e t y . ” “ The c ond i t i on of b ody or s o me part of o r g an of body in wh i ch i t s f u nct i ons a r e d i sru p t ed or de r an g ed . ” “ A c on d ition in which body f u n c tion is i m p a i r ed, de p a r tu r e f r om a s t a t e of he a lth, an al t e r a tion of the human bo d y i n t er r upting the per f ormance of the vi t al f u n c tions . ”

3. TO KEEP IT SIMPLE Si m p l e s t d e fi n i t ion – O P P O SITE T O H E A L TH . Any de v i a tion from normal funct i oning or st a te of comple t e physic a l or ment a l we l l - b e i ng. 5

4. D IS E ASE i s a p h y sio l ogi c al p s y c ho l ogi c al d ys fun c t i on. I LL N E SS i s a s u bj e c t iv e s t a t e of the p e r son who f e e l s a w a r e of not SICKN E SS i s a s t a t e of so c i al d y s f u nc ti on i . e . a r o l e th a t t he Disease is a physiological/ psychological dysfunction Illness is a subjective state of the person who feels aware of not being well Sickness is a state of social dysfunction DISEASE ILLNESS SICK N ESS i nd i vidu a l a s s u mes normal role as before sickness b e i ng w el l . 6 S usser

5. CONCEPT E ARL I ER TH E ORI E S OF CAUS A TION • Sup ernat u ral t h eo r y • T h eo r y of H u m o rs • C o n ce p t o f c ontagi o n Dis c o v ery of mi c rob i o l o g y - turn i n g p o i n t • Mia s matic t h eo r y • GERM T HEO R Y O F D ISE A SE • T h eo r y of s p onta n eous generati o n • M ic r o b es as so l e c au s e of d i s e a s e 7

6. EPIDEMIOLO G ICAL TRIAD • Fact o rs relati n g host and env i ronment • M iss i on o f e p idemi o logy – break one of the l e gs of t r ia n g le an d d i sr u pt t he connection the r eby stopp i ng outbreak. b e t w een these and 8

7. THE TETRAD OF EPIDEMIO L OGY 9

8. MU L TI F ACT O RIAL CAU S A TION • C O NCEP T - disease a si n gle on e . PE T TEN K OFER p r o p o ne n t o f th i s i s due t o m ulti p le f a c t o r s a n d n o t • OF MUN I CH ( 1819 - 190 1 ) - e ar l y c o ncep t . “ Germ theo r y of d i sease ce n t u r y "or “ s i n g le c ause i d ea " i n c ause l at e 19 o v e r shad o w ed the mul t i p le theor y . 10

9. Causat i ve Fact o rs Causative factors AD V ANCED MODEL OF THE T R IANGLE OF EPIDEMIOLOGY En v i r onment behav i ou r , cu l tu r e physiological fac t ors eco l ogical ele m ents 11 G r ou p s or po p ula t ions and the i r charac t er i st i cs TIME

10. WEB OF CAUS A TION • • Su g g e s t ed by - Mac Mah o n and P u gh Conside r s all the p r ed i spos i ng f a c t o r s of a n y t y pe and their c ompl e x i n t e r a c tion with e a ch othe r . 12

11. Ch a ng e s i n l i fe s t y l e Str es s S m o k in g E m o t i on a l s t r e s s A gin g H T N O be s i ty Ch a ng e s i n t h e w all s o f a r t e r i e s H y pe r lip i de m i a Cor o na ry O c c l u s i o n My o c a r dia l I s c h e m i a Cor o na ry At h e r o sc l e r o s i s My o c a r dia l i s c h e m i a 41 13 e x e r c i s e P h y s i c a l La c k o f i n t a k e P len ty o f f o o d F i g : W e b o f c au s a t i o n o f M I

12. N A TURAL HISTO R Y OF D ISEASE It ref e rs to the progress of a d ise a se pro c ess in an indi v idu a l o v er tim e , in the ab s e n ce of in int e r v e n tion. e pidemiolo g y . • History of disea s e is a key con c ept 14

13. 15

14. PRE P A THO G E NESIS PHA S E • Disease a g ent has f a v ouri n g dise a se not entered ma n , but facto r s exist in the e n viron m e n t. • Wh a t requir e d is an int e raction of th e se factors to in i ti a te the dise a se process. A g ent Host E n viro n me n t 16

15. P A THOGENESIS PHASE • Entry of disease agent i n suscept i ble human hos t . • Dise a se a ge n t mul t ipl i e s and ind u c e s t i s sue a n d phys i olog i cal change s . • f i nal outcome- re c over y , disab i l i ty or death. • This su c h phase may be m odif i ed by in t ervent i o n measures as im m unizat i on, chemotherapy 17

16. 18 AGENT F ACTORS Substa n ce l i ving or non l i ving , or a force, tangib l e or in t angible, the excessive pre s ence or re l at i ve la c k of w hi c h may ini t iate o r per p etuate a disease process. 1. 2. 3. 4. 5. 6. Biological Agents – Infec t iv i ty Nutrient Physical Chemical Mecha n ical A b sence or i n s u f f iciency of a f actor Soci a l Pathogenici t y V i r ulence 7.

17. 19 HOST Host - SO I L SEED F ACTORS • Disease agent – Cl a ssified as • Demog r aphic cha r ac t eri s tics Biolo g ic Social & E co n omic Li f e s tyle f ac t o r s • • •

18. 20 ENVIRONMEN T AL F ACTORS All t h at w hich is external to the individu a l human host, liv i ng and n o n -liv i n g , and with which he is i n consta n t inte r act i on. -M a cr o -environment (e x terna l ) Ph y sic a l Biol o gic a l Ps y cho so c i a l • • • •

19. RISK F ACTORS • Where the f i rm l y ae t io l ogy discussed fa c to r s. The te r m disease a g ent i s not es t ab l ish e d, the is i n terms gene r al l y o f risk • r i sk fac t or i s used w i th at by dif f erent authors lea s t two meanin g s -  An at t rib ut e or e x p osu r e as s o c ia t ed that is si g n i f i c a n tl y w i t h d e v e l o pme n t of dis e as e . A d e t e r m inant t h at c an b e m odi f ied  by i nt erve nt i o n, thereby r educ i n g t h e pos s i bili ty of o ccur r ence of d i se a se or o t her spec i fi e d outcom e s. 21

20. RISK GROUPS • Som e th i ng for all but more for those in need- in proport i on to the nee d . Anot h er approach de v elo p ed a n d p romoted by • WHO is to ident i fy precise l y the r i sk gr o ups or t a rg e t g r o u ps in popul a tion by cer t ain acti o n defi n ed crit e r ia and dir e ct approp r ia t e to th e m fir s t- risk approac h . 22

21. 23 SPECT R UM OF DISEASE • G r ap h ic representation of varia t ions in the manifestations of d i seas e . Infectio u s d i se a se – grad i e n t o f infection •

22. ICEBERG OF DISEASE • Di s e a se i c eb e rg. in a c ommunity is comp a r e d to a n 24

23. CONCEPTS OF CONTROL The t erm dis e ase c o n t r ol re f e r s on g o i ng op e r a ti o n aimed a t o The o The risk r educin g : in c ide n ce of dise a se. du r a ti o n of dis e ase and t he c o nse q ue n tly of t r ansmission. the o The e f f ect of i n f ection includ i ng p h y sic a l p s y cholo g i c al c o mplic a tion. o The f inancial bu r den t o the c o m m unit y . and 25

24. • DIS E ASE E L I MIN A TI O N : R edu c tion o f c ase t r ansmissi o n t o a p r ede t e r mi n ed v e r y l o w le v el o r i nt e r ru p tion in t r ans mi ssi o n. E . g. me a sle s , poli o , lep r o s y f r om the la r g e g eog r aphic r egi o n or a r e a . • DISEA S E E R AD I C A TI O N : T e r min a tion o f all t r ansmissi o n of i n f e c tion b y e x t ermi n a tion o f the i n f e c tious a g e n t th r ou g h su r v eillance and c o nt a i nme n t. “ All o r n o ne phenomen o n ” . E . g . Sm a ll p o x . 26

25. • DIS E A S E MONI T ORING: • D e fin e d as “the pe r f ormance a nd anal y sis of r outine m e asu r e m e n t aim e d a t d e t e c t ing or he a lth s t a tus o f p o pul a tio n . ” c h ild, Moni t oring o f air polluti o n, e t c . c h an g es in the e n vi r onm e n t e . g. g r o wth moni t oring of moni t oring of w a t er qual it y • DIS E A S E S U R VEIL L A N C E : • D e fin e d as “the c o n t i nuous scruti n y of the f a c t o r s t h a t de t e r mine t he oc c ur r ence and d i s trib u tion of dis e ase a nd oth e r c onditi o ns o f ill h e a lt h . ” p r og r am m e o f WH O . E . g. P oli o m y elit i s su r v e i lla n c e 27

26. REFERENCES • Par k , Park ’ s T ex t book of P r ev e nt i ve &So c i a l Me d i c in e , 22nd Edi t i o n, Ja b a l pu r : Banar s idas Bhanot,2013. • Sob e n Pete r . Essen t ia l s of Pub l ic Heal t h Denti s t r y . 4th ed. New De l hi: Arya Publis i ng H o use; 2013. • Epi d e m i o l o g y , L. Gordi s , Four t h e d, 2009, Saunde r s • M o a l e m , S., & Prin c e, J. ( 2007). Surv i val of the sick e st: A medi c al maver i ck dis c ov e rs why we ne e d dis e as e . New Y ork: W i l l i am M o r r o w . 53

27. Thank Y ou !