Download Communicable and non-communicable diseases

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Dr. Irniza Rasdi
Coordinator for EOH3401
Laboratory Occupational Health and Safety,
Level 4, Block C,
Faculty of Medicine and Health Sciences, UPM
Tel: 0123153360 – Whassap/msg only
Email: [email protected]
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• Name of course: Principles of Health
• Course Code: EOH3401
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• This course covers the concept and definition of health, wellness,
disease processes, basic principles and strategies for disease
prevention.
• The influence of environmental factors, risk factors, causative
agents, lifestyles and behavioural factor; patho-physiology,
impact, treatment, prevention and healthcare strategies are
discussed by giving examples of infectious diseases, non-infectious
diseases, cancer, injury and mental disorders.
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1.
Public health threats
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Health indicators
2.
Brief history of medicine and public health
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Communicable diseases
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Definition & concept health, wellness, illness &
disease in the community; determinants of health:
Multiple causation of diseases
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Non-communicable diseases
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Mental health
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Global trends in Health and Diseases
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Social, cultural and psychological aspects of health
and wellness
10. Health problems: Maternal health, child health,
adolescent and elderly
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Health care system in Malaysia
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Assessments
Percentage (%)
Mid-term examination
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Continuous Assessments A
15
Continuous Assessments B
10
Continuous Assessments C
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Final Examination
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Total
100
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• Choose one communicable disease/illness and create a
newsletter describing about the disease. The newsletter
must at least contain the following information;
1.
Definition of the disease
2. Statistics about the disease
3. Agent, host and environment
4. Mode of diseases transmission
5. Prevention and control mechanism for the disease
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Send the newsletter via email : [email protected]
The newsletter must include your name and matrix number
Due date: By week 5
Assessment will be based on the following;
• Contents
• Creativity/attractiveness
Assignment 2 (10%)
• Choose a non-communicable disease.
• Create a campaign poster to increase awareness about the disease
for workers/public
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Size A0
Send the softcopy via email: [email protected] by week 9
Put your name and matrix number on the poster
Assessment will be based on the following criteria;
• Contents
• Creativity/attractiveness
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Assignment 3 (15%)
• You as a human resource manager/officer are assigned by the top
management to promote healthy lifestyle among workers at your
workplace.
• Develop a proposal on how are you going to conduct such program
• The proposal must have at least 10 pages including pictures and
table if available.
• Font: times new roman, 12 font size, 1.5 spacing.
• It can be in Malay or English
• Email the proposal to [email protected] by week 12
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Definition of HEALTH
…as “a dynamic state of well-being characterized by a physical
and mental potential, which satisfies the demands of life
commensurate with age, culture, and personal responsibility”
(Bircher J. Towards a dynamic definition of health and disease. Med. Health Care Philos 2005;8:335-41.)
HEALTH
• HEALTH-ILLNESS CONTINUUM:
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Measure person’s perceived level of wellness
Health and illness/disease opposite ends of a health continuum
Move back and forth (forward) within this continuum day by day
Wide ranges of health or illness
Definition of WELLNESS
• Wellness further describes health status. It allows health to be placed on a
continuum from one’s optimal level (“wellness”) to a maladaptive state
(“illness”)
Copyright 2008 by Pearson Education, Inc.
WELLNESS
a) emphasizes individual responsibility
for wellbeing through the practice of
health-promoting like style behaviors.
b) The holistic model of health
c) In this model define health in term of
whole person
d) State of optimum health
Encompass:
(Source: ‘Dimension of Wellness’, Copyright 2008 by Pearson Education, Inc.)
Dimension of Optimal Health
SPIRITUAL
• The belief in some force
(nature, science, religion, or
a higher power) that serves
to unite human beings and
provide meaning and
purpose of life
Dimension of Optimal Health: Physical
PHYSICAL
• Biological make-up
• physiological functions (e.g.
pulmonary, cardiovascular,
gastrointestinal system)
• Nutrition
• Lifestyle
Dimension of Optimal Health : Emotional
EMOTIONAL
• The ability to manage stress and to
express emotions appropriately,
Emotional wellness involves the
ability to recognize, accept, and
express feelings.
Dimension of Optimal Health : SOCIAL
SOCIAL:
• The ability to interact successfully with
people and within the environment.
• Personality trait.
• Health care services
• Food safety & security
• Disparities – gender
• Social support network
• Risky behaviour
Dimension of Optimal Health : Intellectual
INTELLECTUAL
• Education
• The ability to learn and use information
effectively for personal, family, and career
development
Dimension of Optimal Health
ENVIRONMENTAL
• Living condition – housing, environment
• The ability to promote health measures
that improve the standard of living and
quality of life in the community.
DIMENSION OF WELLNESS
OCCUPATIONAL
• Employment
• Economy
• Affects also the SOCIAL
aspects
Definition: Public Health
• The art and science of preventing disease, prolonging life and
promoting health through the organized efforts of society (WHO,
2011)
• Population
• Complete physical mental and social well-being
• To protect and improve health of the population
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Definitions
• Communicable disease: a disease that can be spread to a person
from another person, an animal or object. Ex: common cold,
influenza, mononucleosis, etc.
• Non-communicable disease: a disease that can NOT be spread
from person to person. Ex: cancer, heart disease, cirrhosis, etc.
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Definitions Continued
• Disease: Any condition that interferes with the normal or proper
functioning of the body or mind.
• Not all types of fungi, bacteria, viruses and protozoa are diseasecausing agents
• Germs: The microorganisms that cause diseases. They are so small
they can only be seen through a microscope.
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What is infectious disease?
A case is a risk factor …
Infection in one person can be transmitted to others
(www)
Infectious Diseases are
Caused by Pathogens
What’s a
pathogen?
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What kills more people: infectious diseases or noncommunicable diseases?
• Non-communicable diseases were responsible for 68% of all deaths
globally in 2012.
• The 4 main NCDs are cardiovascular diseases, cancers, diabetes
and chronic lung diseases.
• Communicable, maternal, neonatal and nutrition conditions
collectively were responsible for 23% of global deaths,
• Injuries caused 9% of all deaths.
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Are cardiovascular diseases the number 1
cause of death throughout the world?
• Cardiovascular diseases killed 17.5 million people in 2012, that is
3 in every 10 deaths.
• Of these, 7.4 million people died of ischaemic heart disease and
6.7 million from stroke.
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Do most NCD deaths occur in high-income
countries?
• 28 million of the 38 million of global NCD deaths in 2012 occurred
in low- and middle-income countries.
• In terms of proportion of deaths that are due to NCDs, highincome countries have the highest proportion – 87% of all deaths
were caused by NCDs.
• Followed by upper-middle income countries (81%).
• The proportions are lower in low-income countries (37%) and
lower-middle income countries (57%).
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What are the main differences between rich and
poor countries with respect to causes of death?
• In high-income countries, 7 in every 10 deaths are among people
aged 70 years and older.
• People predominantly die of chronic diseases: cardiovascular
diseases, cancers, dementia, chronic obstructive lung disease or
diabetes.
• Lower respiratory infections remain the only leading infectious
cause of death. Only 1 in every 100 deaths is among children
under 15 years.
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What are the main differences between rich and
poor countries with respect to causes of death?
• In low-income countries, nearly 4 in every 10 deaths are among
children under 15 years, and only 2 in every 10 deaths are among
people aged 70 years and older.
• People predominantly die of infectious diseases: lower respiratory
infections, HIV/AIDS, diarrhoeal diseases, malaria and tuberculosis
collectively account for almost one third of all deaths in these
countries.
• Complications of childbirth due to prematurity, and birth asphyxia
and birth trauma are among the leading causes of death, claiming
the lives of many newborns and infants.
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How has the situation changed in the past
decade?
• Ischaemic heart disease, stroke, lower respiratory infections and chronic
obstructive lung disease - top major killers during the past decade.
• NCDs were responsible for 68% (38 million) of all deaths globally in 2012, up
from 60% (31 million) in 2000.
• Cardiovascular diseases alone killed 2.6 million more people in 2012 than in the
year 2000.
• HIV deaths decreased slightly from 1.7 million (3.2%) deaths in 2000 to 1.5
million (2.7%) deaths in 2012.
• Diarrhoea is no longer among the 5 leading causes of death, but is still among
the top 10, killing 1.5 million people in 2012.
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How has the situation changed in the past
decade?
• Tuberculosis, while no longer among the 10 leading causes of
death in 2012, was still among the 15 leading causes, killing over
900 000 people in 2012.
• Maternal deaths have dropped from 427 000 in the year 2000 to
289 000 in 2013, but are still unacceptably high: nearly 800
women die due to complications of pregnancy and childbirth every
day.
• Injuries continue to kill 5 million people each year. Road traffic
injuries claimed nearly 3500 lives each day in 2012 – more than
600 more than in the year 2000 – making it among the 10 leading
causes in 2012.
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How people got the disease?
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Why do we need to know the reasons people
die?
• Assessing the effectiveness of a country’s health system.
• Help health authorities determine their focus for public health
actions.
• Produce high quality cause-of-death data are crucial for improving
health and reducing preventable deaths in these countries.
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Aetiology
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This is the study of what causes a
disease.
It is basically how scientists/doctors
pinpoint what created the disease in
order to better understand how to cure it
or prevent it from spreading.
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Epidemiologic Triad
Disease is the result of forces within a
dynamic system consisting of:
agent of infection
host
environment
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Factors Influencing
Disease Transmission
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Environment
Agent
• Weather
• Infectivity
• Housing
• Pathogenicity
• Geography
• Virulence
• Occupational setting
• Immunogenicity
• Antigenic stability
• Age
• Survival
• Sex
• Air quality
• Food
• Genotype
Host
• Behaviour
• Nutritional status
• Health status
(www)
Epidemiologic Triad Concepts
• Infectivity – ability to invade a host
(# infected / # susceptible) X 100
• Pathogenicity – ability to cause disease
(# with clinical disease / # of infected) X 100
• Virulence – ability to cause death
(# of deaths / # with disease (cases)) X 100
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•Chain of
Infection
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Chain of
Infections
Modes of Disease Transmission
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Direct contact
Indirect contact
Droplet
Airborne
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Direct Contact Transmission
• Microbes directly transferred from an infected person to another
person
• Examples
• Contact with blood or other body fluids
• Ungloved contact with a scabies-infested patient
• Ungloved contact with wounds or mucous membranes
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Indirect Contact Transmission
• Microbes transferred through contaminated intermediate
object/living things
• Examples
• Healthcare personnel not performing adequate hand hygiene between
patients
• Sharing medical equipment without cleaning or disinfection between
patients
• Defective medical equipment allowing for inadequate disinfection or
sterilization
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Vector
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The item that transfers the pathogen to its host.
Vectors are “vehicles” that transport pathogens from one host
to another.
Examples: water, blood, ticks, mosquitoes…
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Droplet Transmission
• Respiratory droplets carrying infectious pathogens
• Generated during coughing, sneezing, talking, or certain medical
procedures (e.g. suctioning)
• Droplets traditionally defined as > 5 µm
• Typically refers to distances within 3 feet of infected patient
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Airborne Transmission
• Dissemination of droplet nuclei containing infectious agents
• Dispersed over long distances
• Face-to-face contact not required
• Special ventilation systems are required to prevent airborne transmission
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Think about it:
Where Do Pathogens Hide When Not
Infecting People and Animals?
The soil
Bodies of water
Surfaces like farm equipment
The skin of people and animals
In the air
In body fluids
Where are
those
pathogens?
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Timeline for Infection
Latent
period
Dynamics of
infectiousness
Infectious
period
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Non-infectious
Susceptible
Susceptible host
Subclinical
disease
Incubation
Clinical
Death/recovery
Time
Timelines for Infection and Disease
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Latent period: time interval from infection to development of infectious (note:
this definition differs from that used for non-infectious diseases).
Infectious period: time during which the host can infect another host.
Incubation period: time from infection to development of symptomatic
disease.
Symptomatic period: period in which symptoms of the disease are present.
Infections
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Endemic: Habitual presence of a disease in a given geographic area.
Epidemic: Occurrence of a group of illnesses of similar nature within a
given community or region in excess of normal expectancy, and derived
from a common or from a propagated source.
Pandemic: A worldwide epidemic.
Herd immunity: Resistance of a group of to an attack by a disease to which
a large proportion of members of the group are immune.
Chain of Infection
Filariasis
The painful and profoundly disfiguring
visible manifestations of the disease,
lymphoedema, elephantiasis and
scrotal swelling occur later in life and
lead to permanent disability. These
patients are not only physically
disabled, but suffer mental, social and
financial losses contributing to stigma
and poverty.
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Immune System
• The Immune System is a combination of body
defenses made up of cells, tissues, and organs
that fight pathogens in the body.
• It’s purpose is to help you get better when you are ill
and to prevent you from becoming ill in the first
place.
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How does our body protect us from
pathogens?
• Our body is an amazing machine which has five main
barriers (first line of defense) for keeping our body
healthy. They are:
• Skin – acts as a protective barrier
• Mucous Membranes – line the mouth, nose, throat, eyes and other body
parts. These trap germs. Coughing and sneezing gets rid of the germs
trapped by these mucus membranes.
• Saliva – contains enzyme that destroy many harmful organisms.
• Tears – wash away germs. Contains enzymes that kill some harmful
organisms.
• Stomach Acid – acid kills many germs
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Antigens and Antibodies
• What’s the difference between the two?
• Antigens: a substance that sends your immune
system into action when your body is invaded by
pathogens. The body sees these as “invaders”.
• Antibodies: proteins that attach to antigens, keeping
them from harming the body. How our body responds
to antigens, by producing antibodies – our body’s
“army of soldiers”.
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Iceberg Concept of Infection
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Social
Aspects of
Health
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Source: Dahlgren, G. and Whitehead, M. (1993) Tackling inequalities in
health: what can we learn from what has been tried?
Social, culture and psychological aspects of
health and well-being
Social
Interaction between individuals and groups within
society
Culture
Traditional behavior which has been developed by the
race and successfully learned by each generation
Psychology The study of the soul or mind
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Social Determinants
Availability of resources to meet daily needs, such as educational and job
opportunities, living wages, or healthful foods
Social norms and attitudes, such as discrimination
Exposure to crime, violence, and social disorder, such as the presence of trash
Social support and social interactions
Exposure to mass media and emerging technologies, such as the Internet or cell
phones
Socioeconomic conditions, such as concentrated poverty
Quality schools
Transportation options
Public safety
Residential segregation
Unequal Access to
Affordable, Nutritious Food
• Lack of convenient access to affordable urban supermarkets
• Communities, left with corner convenience stores that do not carry a
large or varied stock.
• Surviving on convenience store food, usually canned or processed, or
fast food
• How to address this issue?
Community Environments that
Promote Quality of Life
• Unsafe, substandard living environments
• Fear of crime keeps many people indoors
• Lack of safe and pleasant parks and green spaces
• Poorly maintained sidewalks
• Difficult to afford memberships at fitness centers
• Difficult to travel to cleaner, safer neighborhoods with good facilities.
Quality, Affordable Housing
• Difficulties to obtain a safe, secure place to live
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Financial
Distance to workplace, schools
Accessibility
Facilities
• Cheaper houses usually located at less quality areas
Education, Literacy, and employment Policies
that Contribute to Employment Status
• Barriers to employment
• Illiteracy or lack of education
• Low employment rate
Social and Health Gradient
• The higher the social position, the better health.
• Infection diseases in poor countries and diseases of a rich person
• Private hospital versus government hospital
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Thank You
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