Iceberg concept of disease

Iceberg Concept of Disease

1. Iceberg Concept of Disease Presenter: ID: PG-11-43-18-007 ID: PG-11-43-18-012 ID: PG-11-43-18-013 STATE UNIVERSITY OF BANGLADESH

2. Iceberg P henomenon The iceberg phenomenon describe a situation in which a large percentage of a problem is subclinical, unreported, or otherwise hidden from view. Thus, only the "tip of the iceberg" is apparent to the epidemiologist.

3. May include controlled and uncontrolled diseases. These are diseases which are commonly and easily identified Diseases which are symptomatic Diagnosed Diseases

4. Example of Diagnosed Disease (Clinical Case) Infection Infection, Arthritis, Obesity, Cancer, Diabetes etc.

5. Undiagnosed or Wrongly Diagnosed Undiagnosed Diseases Unidentified case of disease which are not treated due to its unknown nature Wrongly Diagnosed Diseases An inaccurate assessment of a patients condition that sometimes lead to wrong treatment

6. Example of Undiagnosed or Wrongly Diagnosed Disease (Subclinical Case) Hormonal imbalances, Detoxification imbalances, Toxic chemical exposure, Digestive, absorptive and microbiological imbalances Immune imbalances etc.

7. Risk Factor for Disease People that fall under this category have a high chance of acquiring a said disease

8. People have a high chance of acquiring a disease Smoker Obese Person

9. Free of Risk Factor This people who have low chances of acquiring a disease People who are considered completely healthy

10. Size and shape of Iceberg of a disease depends upon 1. Agent-Host-Environment relationship 2. Natural history of disease (Pathological condition to complete recovery)

11. Agent Factors Virulence, Genetic drifts & Shifts Adaptability Host range Survivability Factors determining the size of a disease Iceberg in a population

12. Factors determining the size of a disease Iceberg in a population Environmental Factor Indoor Environment Unhealthy living system Outdoor Environment Air pollution Sound pollution Water Pollution

13. Factors determining the size of a disease Iceberg in a population Host Factors Genetic makeup Early life events Immunological status Occupation Companions

14. Mistake made by epidemiologist while making an iceberg model Giving importance to ill persons only. No clinical signs, no disease. Only a single agent is cause of infection. False interpretation of clinical intervention. Dependency on clinical records.

15. Uses of Iceberg Concept For detection of sub-clinical and in-apparent cases Treatment of in-apparent cases Control of disease with more number of sub-clinical cases To have a detailed knowledge regarding natural history of disease

16. Use of Iceberg Concept in Disease Control Primary Prevention Secondary Prevention Tertiary Prevention

17. Primary Prevention Primary prevention defined as action taken prior to onset of disease. WHO recommends two approaches Population Strategy High risk Strategy Example: e.g. Tran-boundary measures, Import prohibitions, Vaccination, Eradication

18. Secondary Prevention Secondary prevention is the action that taken at incipient stage of disease Specific interventions are- Case finding programs More expensive and less effective than primary prevention Draw back is patient feels pain & productivity

19. Tertiary Prevention When disease is advanced beyond its early stages Specific interventions are- All measures available to reduce pain and diseases When disability stabilized then apply rehabilitation Consist of psychosocial, vocational and medical components