This document discusses concepts related to disease prevention, including the iceberg of disease model and levels of prevention. It explains that the iceberg model represents undiagnosed cases below the waterline and clinical cases above. It also outlines the goals of disease control as reducing incidence, duration, and complications. Finally, it describes the three levels of prevention - primary, secondary, and tertiary - including their goals and examples of interventions.

1. Iceberg of DiseaseIceberg of Disease
Concepts of control andConcepts of control and
Levels of PreventionLevels of Prevention
Dr. Jai Kershan, MD, MSPHDr. Jai Kershan, MD, MSPH
(USA)(USA)
http://jaikershan.blogspot.comhttp://jaikershan.blogspot.com

2. We will learn in this presentationWe will learn in this presentation
 Concepts of iceberg of diseaseConcepts of iceberg of disease
 Concepts of disease controlConcepts of disease control
 Concepts of prevention, likeConcepts of prevention, like
• Primary, secondary & tertiary preventionPrimary, secondary & tertiary prevention

3. Iceberg of DiseaseIceberg of Disease

4. continuecontinue
 The floating tip of ice bergThe floating tip of ice berg
represents clinical casesrepresents clinical cases
 Submerge portion showsSubmerge portion shows
undiagnosed cases or hidden mass ofundiagnosed cases or hidden mass of
diseasedisease
 Undiagnosed reservoir of disease is aUndiagnosed reservoir of disease is a
challenge to modern techniques inchallenge to modern techniques in
preventive medicinepreventive medicine

5. Disease controlDisease control
 Aimed at reducingAimed at reducing
• Incidence of diseaseIncidence of disease
• Duration of diseaseDuration of disease
• Physical and psychological complicationsPhysical and psychological complications
• Reducing financial burden of communityReducing financial burden of community
 Activities consist of primaryActivities consist of primary
preventionprevention
 Can be secondary preventionCan be secondary prevention

6. Primordial preventionPrimordial prevention
 This is special in the sense ofThis is special in the sense of
preventing chronic diseases likepreventing chronic diseases like
• obesity and hypertensionobesity and hypertension
 Prevention of risk factors inPrevention of risk factors in
population which have yet notpopulation which have yet not
appearedappeared
 Smoking, eating patterns, exerciseSmoking, eating patterns, exercise
 Main intervention is mass educationMain intervention is mass education

7. Primary preventionPrimary prevention
 Defined as action taken prior toDefined as action taken prior to
onset of diseaseonset of disease
 Intervention in prepathogensis ofIntervention in prepathogensis of
diseasedisease
 WHO recommended two approachesWHO recommended two approaches
 Population strategyPopulation strategy
 High risk strategyHigh risk strategy

8. Population strategyPopulation strategy
 Directed at whole populationDirected at whole population
 Education of exerciseEducation of exercise
 Lowers serum cholesterolLowers serum cholesterol
 Lowers risk of cardiovascular diseasesLowers risk of cardiovascular diseases
 High risk strategyHigh risk strategy
 Preventive care to people at special riskPreventive care to people at special risk
 Safety and lower cost justifies its widerSafety and lower cost justifies its wider
applicationapplication

9. Secondary preventionSecondary prevention
 Action taken at incipient stage ofAction taken at incipient stage of
diseasedisease
 Specific interventions areSpecific interventions are
• ScreeningScreening
• Case finding programsCase finding programs
• more expensive and less effective thanmore expensive and less effective than
primary preventionprimary prevention
 Draw back is patient feels pain &Draw back is patient feels pain &
productivityproductivity

10. Tertiary preventionTertiary prevention
 When disease is advanced beyond itsWhen disease is advanced beyond its
early stagesearly stages
• All measures available to reduce painAll measures available to reduce pain
and diseasesand diseases
• When disability stabilized then applyWhen disability stabilized then apply
rehabilitationrehabilitation
• Consist of psychosocial, vocational andConsist of psychosocial, vocational and
medical componentsmedical components