This document discusses concepts of control, prevention, and intervention in community medicine as presented by Dr. Siham Gritly. It defines disease control, elimination, eradication, monitoring, surveillance, levels of prevention (primordial, primary, secondary, tertiary), modes of intervention (health promotion, specific protection, early diagnosis, disability limitation, rehabilitation). It also describes concepts related to impairment, disability, and handicap. The overall purpose is to outline key terms and approaches in public health.

1. Community medicine
5 Concepts of control and
prevention
Prepared by; Dr. Siham Gritly
University of Bahri
Dr. Siham Gritly 1

2. Concept of control
• The term disease control describes ongoing
operations aimed at reducing:
• -The incidence of disease
• -The duration of disease and consequently
the risk of transmission
• -The effects of infection, including both the
physical and psychosocial complications
• -The financial burden to the community.
Dr. Siham Gritly 2

3. Control activities focus on primary
prevention or secondary prevention, but
most programs combine both; control----
-elimination-----eradication
• Elimination is used to describe interruption of
transmission of disease as elimination of
measles, polio, diphtheria from geographic
regions
Dr. Siham Gritly 3

4. • Eradication “tear out by roots” It is the
process of “Termination of all transmission of
infection by extermination (termination) of the
infectious agent through surveillance and
containment”‫االحتواء‬ .
Dr. Siham Gritly 4

5. Monitoring and Surveillance
• Monitoring is "the performance and analysis
of routine measurements aimed at detecting
changes in the environment or health status of
population"
• monitoring of air pollution,
• water quality
• , growth and nutritional status, etc).
Dr. Siham Gritly 5

6. Surveillance
• Surveillance means to watch over with great
attention,
• surveillance is defined as "the continuous
scrutiny (inspection) of the factors that
determine the occurrence and distribution
of disease and other conditions of ill-health”
Dr. Siham Gritly 6

7. The main objectives of surveillance
are:
• (a) to provide information about new and
changing trends in the health status of a
population, e.g.,
• morbidity,
• mortality,
• nutritional status or other indicators
• and environmental hazards,
• health practices
• and other factors that may affect health
Dr. Siham Gritly 7

8. • (b) to provide feed-back which may be
expected to modify the policy and the system
itself and lead to redefinition of objectives,
and
• (c) provide timely warning of public health
disasters so that interventions can be
mobilized
Dr. Siham Gritly 8

9. Evaluation of control
• Evaluation is the process by which results are
compared with the objectives
• Evaluation is the assessment of how well a
program is performing
Dr. Siham Gritly 9

10. Concept of prevention
• The goals of medicine are to ;
• Promote health
• Preserve health
• Restore health
• Minimize suffering and distress
• These goals are enclosed in the word
prevention
Dr. Siham Gritly 10

11. Successful prevention depends upon:
• a knowledge of causation,
• dynamics of transmission,
• identification of risk factors and risk groups,
• availability of prophylactic or early detection and
treatment measures,
• an organization for applying these measures to
appropriate persons or groups, and
• continuous evaluation of and development of
procedures applied
Dr. Siham Gritly 11

12. Dr. Siham Gritly 12

13. Levels of prevention
• Prevention defined in terms of four levels
• 1-Premordial prevention
• 2-primary prevention
• 3-secondary prevention
• 4-tertiary prevention
Dr. Siham Gritly 13

14. • 1-Primordial prevention ;
• is the prevention of chronic diseases (obesity,
hypertension) which they have their origins in
childhood
•
Dr. Siham Gritly 14

15. • consists of actions and measures that inhibit
the emergence of risk factors in the form of
• environmental,
• economic,
• social,
• behavioral conditions
• and cultural patterns of living etc.
Dr. Siham Gritly 15

16. • 2-Primary prevention defined
• as “action taken prior to onset of disease which
removes the possibility that the disease will ever
occur
• it means intervention in the pre-pathogenesis
phase of disease or health problems
Dr. Siham Gritly 16

17. • Primary prevention includes the concept of
positive health that will enable every
individual to lead a socially and economically
productive life
• it is the less expensive level
Dr. Siham Gritly 17

18. • 3-Secondary prevention defined as “action
which halts (stop) the progress of disease at its
incipient (initial) stage and prevent complication”
• Secondary prevention is an imperfect tool in
control of transmission of disease
• It is more expensive and less effective than
primary prevention
Dr. Siham Gritly 18

19. • 4-Tertiary prevention defined as “all measure
available to reduce or limit impairments and
disabilities, minimize suffering caused by
existing departures from good health
Dr. Siham Gritly 19

20. Levels of prevention
Dr. Siham Gritly 20

21. intervention
• Intervention defined as;
• “any attempt (effort) to intervene or interrupt
the usual sequence in the development of
disease in human”
Dr. Siham Gritly 21

22. Five mode of intervention
• Five mode of intervention have been described;
• 1-health promotion
• 2-specific protection
• 3-early diagnosis and treatment
• 4-disability limitation
• 5-rehabilitation
Dr. Siham Gritly 22

23. • 1-health promotion
• -health education
• -environmental modification
• -nutritional intervention
• -lifestyle and behavioral changes
Dr. Siham Gritly 23

24. • 2-specific protection
• -immunization
• -use of specific nutrients
• -chemoprophylaxis
• -protection against occupational hazards
• -protection against accidents
• -protection against carcinogens etc ----
Dr. Siham Gritly 24

25. • 3-early diagnosis and treatment are the main
interventions of disease control achieved
• -through primary prevention
• 4-disability limitation
• Concept of disability; the sequence of events
leading to disability and handicap stated as
follows;
• (disease---impairment-------disability-----
handicap)
Dr. Siham Gritly 25

26. • - impairment; In health, defined as “any loss
or abnormality of physiological, psychological,
or anatomical structure or function”
• For example mental retardation, loss of foot
•
Dr. Siham Gritly 26

27. • - Disability is the consequence of an impairment
• Defined as “ any restriction or lack of ability to
perform any activity in the manner or within the
range considered normal for a human being”
• may be physical, cognitive, mental, sensory,
emotional, developmental, or some combination
of these.
• A disability may be present from birth, or occur
during a person's lifetime
Dr. Siham Gritly 27

28. • - handicap “as a result of disability, the person
experiences certain disadvantages in life and is
not able to discharge the obligations required
of him and play the role expected of him in
society”
• a disadvantage for a given individual, resulting
from an impairment or disability, that limits or
prevent the fulfillment of a role that is normal
Dr. Siham Gritly 28

29. • 5-rehabilitation
• -the combined and coordinated use of medical,
social, educational and vocational measures for
treating and retaining the individual to the
highest possible level of functional ability
Dr. Siham Gritly 29

30. • Park's Textbook of Preventive and Social
Medicine 21 Edition, by K. PARK
Dr. Siham Gritly 30