Levels of Prevention

1. Levels of Disease
Prevention

2. Levels of Disease Prevention
• A description of the concept of prevention is
provided as the term is used to refer to the efforts
of society to promote, protect and sustain the
health of population
• This description is based on the public health
categorization of primordial prevention, primary
prevention, secondary prevention and tertiary
prevention.

3. Levels of Prevention
• Primordial prevention
• Primary prevention
• Secondary prevention
• Tertiary prevention

4. Exposure
Pathologic
changes
Onset of
symptoms
Stage of
susceptibility
Stage of
Subclinical Disease
Stage of
Clinical Disease
Stage of
Recovery,
Disability or
Death
Usual time of
Diagnosis
Natural History and Spectrum of Disease
Primordial+
Primary
Prevention
Secondary
Prevention
Tertiary
Prevention

5. Principles of prevention
Disease prevention and control depend on
the phase in the natural history of disease;
• Pre-pathogenic phase
• Pathogenic phase

6. Primordial prevention
• In Primordial prevention we prevent emergence of
risk factors
• Most useful in preventing CHRONIC DISEASES e.g.
Diabetes Mellitus & Hypertension
• Risk factors like Smoking, Obesity, Sedentary life
style etc. are prevented

7. Risk
Factor
Disease
Healthy
Primordial Prevention

8. Methods of Primordial prevention
Health education
• Individual
• Mass (Group)

9. Primary prevention
Primary prevention is action taken before the
onset of disease.

10. Methods of Primary prevention
Population (mass ) strategy
We do the intervention to the entire
population.
•High risk strategy
We do intervention only to people at high
risk

11. Methods of primary prevention
Population strategy
• Rubella vaccination to all children
• Hepatitis B vaccination to everybody
High risk strategy
• Rubella vaccination to only girls
• Hepatitis B vaccination to doctors, laboratory
workers etc.

12. Secondary prevention
• Action is taken AFTER the disease process has
occurred to prevent progression of disease
• Pulmonary tuberculosis if not treated can lead
to hemoptysis, pneumothorax and even death
• Diabetes Mellitus leading to renal failure

13. Healthy Disease
Progression
Secondary Prevention

14. Tertiary prevention
• Disease has already occurred and even it has
progressed but we try to prevent further
consequences of disease
• Paralysis due to Poliomyelitis has occurred but we
try to prevent further injury due paralyzed legs

15. Healthy Disease Complications
Further
problems
Tertiary Prevention

16. Healthy Disease Progression
Further
Complications
Risk
factor
Primordial Primary Secondary Tertiary
Levels of Prevention

17. Modes/Methods of intervention
• Primary
Health promotion
Specific protection
• Secondary prevention
Early diagnosis and treatment
• Tertiary prevention
Disability limitation
Rehabilitation

18. Health promotion
The goal is to improve health, make the body
strong to prevent diseases:
• Health education
• How to prevent diseases e.g. washing hands
• Environmental improvement
• Safe drinking water, prevent breeding of
mosquitoes

19. Health promotion
• Nutritional intervention
Give balanced diet
• Lifestyle changes
Prevent smoking, do physical exercises

20. Specific protection
• Immunization
• Chemoprohylaxis e.g. against Malaria
• Nutrient supplementation e.g. Folic acid,
Iron, Vitamin A

21. Early diagnosis and treatment
• Diagnose disease early and treat to
prevent complications- e.g.
• Tuberculosis Screening for Diabetes
Mellitus, Hypertension

22. Disability limitation and
Rehabilitation
• In case of paralysis due to Poliomyelitis
• Providing crutches/calipers will prevent
further injury to the leg
• It will also help the patient to walk, work -
Rehabilitation