1. Community medicine
5 Concepts of control and
prevention
Prepared by; Dr. Siham Gritly
University of Bahri
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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.
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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
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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 .
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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).
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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”
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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
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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
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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
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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
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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
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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
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14. • 1-Primordial prevention ;
• is the prevention of chronic diseases (obesity,
hypertension) which they have their origins in
childhood
•
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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.
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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
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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
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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
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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
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20. Levels of prevention
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21. intervention
• Intervention defined as;
• “any attempt (effort) to intervene or interrupt
the usual sequence in the development of
disease in human”
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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
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23. • 1-health promotion
• -health education
• -environmental modification
• -nutritional intervention
• -lifestyle and behavioral changes
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24. • 2-specific protection
• -immunization
• -use of specific nutrients
• -chemoprophylaxis
• -protection against occupational hazards
• -protection against accidents
• -protection against carcinogens etc ----
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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)
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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
•
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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
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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
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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
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30. • Park's Textbook of Preventive and Social
Medicine 21 Edition, by K. PARK
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