Levels of Disease Prevention

Learn Community Medicine along with me : https://t.me/drvkspm
Be my friend by connecting with me through:
Instagram : https://www.instagram.com/drvenkateshkarthikeyan/
Facebook : https://www.facebook.com/drvenkateshkarthikeyan/
Twitter : https://twitter.com/dr_venkatesh_k
Website : www.drvenkateshkarthikeyan.com
LinkedIn : https://in.linkedin.com/in/dr-venkatesh-karthikeyan-8b1234ab

Learn Community Medicine along with me : https://t.me/drvkspm

1. Levels of Prevention 1 Dr Venkatesh Karthikeyan AIIMS Patna

2. Introduction Levels of prevention are defined by considering the point of time when interventions are applied for halting occurrence or progression of disease or its risk factors. Levels of Prevention Primordial prevention Primary prevention Secondary prevention Tertiary prevention 2

3. Primordial Prevention It is the prevention of the initiation or progress of risk factors in a region or people where it has not yet appeared Most of the time primordial prevention is used in reference to prevention of behavioral factors which if not prevented on time can lead to emergence of risk factors, which can lead to lifestyle diseases. Example: Educating school children about effect of smoking or alcohol at early age would deter them from acquiring habit of smoking or alcoholism 3

4. Primordial Prevention Strategies of mass education or individual education can be applied for primordial prevention This is usually applied in susceptible stage in natural history of disease, which will prevent people progressing in subclinical stage 4

5. Primary prevention Efforts or intervention done before the commencement of disease to remove the likelihood of disease in future In primary prevention, all those measures are included which will halt the emergence of diseases even if the person is exposed or living in the environment where disease agent exists. Interventions for primary prevention Health promotion Specific protection 5

6. Primary prevention – Health promotion It is the process of enabling people to increase control over their health and its determinants, and thereby improving their health. Methods of Health promotion: Community development approach for health promotion Health environments and housing Health education Healthy behavior and lifestyles 6

7. Primary prevention – Specific protection Preventing the disease by specific intervention includes applying specific techniques or tools to halt the emergence of specified disease or risk factors Strategies to achieve specific protection Immunization Herd immunity Usage of Pre-and post-exposure prophylaxis Protection against accidents Prevention of NCDs 7

8. Secondary prevention Includes all actions which halt the progress of a disease at its incipient stage and prevent complications Main interventions of secondary prevention Early detection of the disease (Screening) Prompt treatment Surveillance (continuous scrutiny of the factors that determine the occurrence and spread of diseases and other conditions of ill health which are pertinent of effective control) 8

9. Tertiary prevention All the measures available to reduce or limit impairments and disabilities, and to promote the patients’ adjustment to irremediable conditions It focuses on preventing complication and adverse disease outcome among people already suffering from disease, injury or any health related event Overall goal is to improve quality of life by limiting or delaying complications, reducing disabilities, restoring function and providing means for rehabilitation if needed It requires a team approach, including several professionals 9

10. Tertiary Prevention – Disability limitation Impairment – Any loss or abnormality of psychological, physiological or anatomical structure or function. Eg : Paralysis or facial disfigurement in polio Disability – Any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being. Eg : Limited mobility in polio Handicap – A disadvantage for a given individual, resulting from an impairment or a disability, that prevents the fulfillment of a role that is considered normal for that individual. E.g., Limited ability for social interaction, limitations in finding employment 10

11. Tertiary Prevention – Disability prevention It relates to all levels of prevention Reducing the occurrence of impairment Disability limitation by appropriate treatment (Secondary prevention) Preventing the transition of disability into handicap (tertiary prevention) Primary prevention is the most effective way of dealing with the disability problem in developing countries 11

12. Tertiary prevention – Rehabilitation It is the scientific method which is aimed at recovery of a person from disability It helps a person to achieve his near normal function so at least a person is not handicapped and can return to his normal functional state Much emphasis is given to community based rehabilitation, which is more effective and sustainable than hospital based rehabilitation 12

13. Tertiary prevention – Rehabilitation types Neurological rehabilitation Cardiac rehabilitation Drug/alcohol rehabilitation Physical rehabilitation Vocational rehabilitation Community based rehabilitation Palliative care 13

14. Summary Stage of disease No disease or risk factors Pre-pathogenesis stage Early disease stage Late stage of disesase Level of prevention Primordial Primary Secondary Tertiary Target population Not yet susceptible to disease Susceptible Asymptomatic Symptomatic Goals Reduce risk and determinants of risk factors Reduce incidence Reduce prevalence/consequences Reduce complications/limit disability Modes of intervention Individual and mass education Health promotion and specific protection Early diagnosis and Disability limitation and rehabilitation 14

15. Thank you 15