Lec levels of prevention intervention 2021-22

Lec levels of prevention intervention 2021-22

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  Dr Muhammad TauseefJaved. MBBS. DPH,MSc Medical Addm. Dip-Card, M.Phil, FCPS,PhD Asct Professor Community Medicine Services Institute Of Medical Sciences Lahore. Ex-Prof Umulqurah University Makah KSA
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  level of prevention
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  General Approach toDisease Prevention
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  Goals of prevention •The goals of medicine are to promote health, to preserve health, to restore health when it is impaired, and to minimize suffering and distress. • These goals are embodied in the word "prevention" 4 Dr. M. Tauseef Javed SIMS LAHORE
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  Prevention; Definition andConcept • Actions aimed at eradicating, eliminating or minimizing the impact of disease and disability, or if none of these are feasible, retarding the progress of the disease and disability. • The concept of prevention is best defined in the context of levels, traditionally called primary, secondary and tertiary prevention. A fourth level, called primordial prevention, was later added. 5 Dr. M. Tauseef Javed SIMS LAHORE
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  General Community Medicine •Designing community based health interventions • Based on principles of: • Acceptability • Affordability • Accessibility • Cost effectiveness • Implementing suitable interventions Dr. M. Tauseef Javed SIMS LAHORE 6
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  Determinants of Prevention •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 7 Dr. M. Tauseef Javed SIMS LAHORE
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  So Prevention • Thegoals of medicine are to promote health, to preserve health, to restore health when it is impaired, and to minimize suffering and distress. • These goals are embodied in the word "prevention" Dr. M. Tauseef Javed SIMS LAHORE 8
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  Levels of Prevention Stageof disease Level of prevention Type of response Pre-disease Primary Prevention Health promotion and Specific protection Latent Disease Secondary prevention Pre-symptomatic Diagnosis and treatment Symptomatic Disease Tertiary prevention •Disability limitation for early symptomatic disease •Rehabilitation for late Symptomatic disease 9 Dr. M. Tauseef Javed SIMS LAHORE
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  Levels of prevention Primordialprevention Primary prevention Secondary prevention Tertiary prevention 10 Dr. M. Tauseef Javed SIMS LAHORE
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  Primordial Avoiding appearance of riskfactors Target is whole population through public health policy Primary Reducing risk factor and avoiding disease occurrence Targets are healthy selected groups or whole population Secondary Avoiding irreversible damage by detection and treatment in pre- clinical phase Targets are high risk or selected exposed groups Tertiary Avoiding disability and restoration of functions Targets are patients in terminal clinical phase Health and Disease Spectrum Positive Health Disability/ death Conceptual Model for Levels of Prevention Level 1 Level 2 Level 3 Level 4 Susceptibility phase Un recognized illness Clinical illness with or without complications Better Health Dr. M. Tauseef Javed SIMS LAHORE 11
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  Dr. M. TauseefJaved SIMS LAHORE 12
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  Levels of prevention Dr.M. Tauseef Javed SIMS LAHORE 13
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  Primordial prevention • Primordialprevention consists of actions and measures that inhibit the emergence of risk factors in the form of environmental, economic, social, and behavioral conditions and cultural patterns of living etc. Dr. M. Tauseef Javed SIMS LAHORE 14
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  Primordial prevention (cont.) •It is the prevention of the emergence or development of risk factors in countries or population groups in which they have not yet appeared • For example, many adult health problems (e.g., obesity, hypertension) have their early origins in childhood, because this is the time when lifestyles are formed (for example, smoking, eating patterns, physical exercise). Dr. M. Tauseef Javed SIMS LAHORE 15
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  Primordial prevention (cont.) •In primordial prevention, efforts are directed towards discouraging children from adopting harmful lifestyles • The main intervention in primordial prevention is through individual and mass education Dr. M. Tauseef Javed SIMS LAHORE 16
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  “Genes load thegun. Lifestyle pulls the trigger” Dr. Elliot Joslin Lifestyle Factors 17 Dr. M. Tauseef Javed SIMS LAHORE
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  Modes of intervention Dr.M. Tauseef Javed SIMS LAHORE 18 Stage of disease Level of prevention Modes of intervention Pre-disease Primary Prevention Health promotion and Specific protection Latent Disease Secondary prevention Pre-symptomatic Diagnosis and treatment Symptomatic Disease Tertiary prevention •Disability limitation for early symptomatic disease •Rehabilitation for late Symptomatic disease
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  Primary Prevention Achieved by Achievedby Specific protection Health promotion Nutritional interventions Life style and behavioral changes Environmental modifications Health education Immunization and seroprophylaxis chemoprophylaxis Use of specific nutrients or supplementations Safety of drugs and foods Control of environmental hazards, e.g. air pollution 19 Dr. M. Tauseef Javed SIMS LAHORE
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  WHAT IS HEALTHPROMOTION? Health promotion is the process of enabling people to increase control over, and to improve their health. Dr. M. Tauseef Javed SIMS LAHORE 20 Enabling the people to have informed choices for the behaviors conducive to health
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  THE PROCESS OFHEALTH PROMOTION Dr. M. Tauseef Javed SIMS LAHORE 21 FOCUS STRATEGIES IMPACT OUTCOMES Individuals Groups Population Education counseling Medical Empowerment Social change Behavioral educational change Social, economic and environment change Better Health Quality of life
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  Examples • Awareness ofrisk factors CHD • Awareness of benefits of breastfeeding • Awareness of dangers of bottle feeding • Nutritional counseling • Growth monitoring Dr. M. Tauseef Javed SIMS LAHORE 22
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  23 Dr. M. TauseefJaved SIMS LAHORE
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  Specific protection Specific actiontaken before the occurrence of a disease Examples • Use of iodized salt • Polio vaccination • Use of Rifampicin as prophylaxis for T.B Dr. M. Tauseef Javed SIMS LAHORE 24
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  25 Dr. M. TauseefJaved SIMS LAHORE
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  Objectives of SecondaryPrevention Complete cure and prevent the progression of disease process. To prevent the spreads of disease by curing all the known cases. To prevent the complications and sequel of disease. To shorten the period of disability. 26 Dr. M. Tauseef Javed SIMS LAHORE
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  SECONDARY PREVENTION Prevention inpre-symptomatic phase Action taken during the disease process to prevent: Complications Physical and mental sufferings Loss of productivity Secondary prevention is applicable to only selective disease not every disease Dr. M. Tauseef Javed SIMS LAHORE 27
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  Diseases suitable forsecondary preventions • Prolong latent or incubatory phase • Reversible with suitable intervention • Suitable community diagnostic techniques available Examples  Breast cancer and cervical cancer  HIV/AIDS  Coronary heart disease Dr. M. Tauseef Javed SIMS LAHORE 28
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  Secondary prevention dependenton length of latent phase Dr. M. Tauseef Javed SIMS LAHORE 29 Unrecognized sickness Mild sickness -Impairment -Disability -Handicap or death Unrecognized sickness Mild sickness -Impairment -Disability -Handicap or death
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  Short Key ToRemember 30 Dr. M. Tauseef Javed SIMS LAHORE
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  (i) Disability Limitation •To prevent or halt the transition of disease process from Impairment & Handicap. • Impairment: any loss or abnormality of psychological, physiological or anatomic structure or function. • Disability: any restriction or lack of ability to perform an activity in the manner considered normal for a human being. • Handicap: disadvantage for a given individual, resulting from impairment or disability, that limits or prevents the fulfillment of a role that is normal for that individual 31 Dr. M. Tauseef Javed SIMS LAHORE
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  TERTIARY PREVENTION All themeasures taken to reduce or limit the Impairment/ disabilities and restoration of functions Main strategies are: 1. Disability limitation 2. Rehabilitation Dr. M. Tauseef Javed SIMS LAHORE 32
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  Dr. M. TauseefJaved SIMS LAHORE 33
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  Dr. M. TauseefJaved SIMS LAHORE 34
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  Disease Impairment DisabilityHandicap Accident Loss of foot Inability to walk unemployment Concept of impairment, disability and handicap Dr. M. Tauseef Javed SIMS LAHORE 35
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  ACCIDENT Impairment: Loss ofan anatomical structure Disability: Lack of ability to perform an activity Handicap: Prevents fulfillment of normal role 36 Dr. M. Tauseef Javed SIMS LAHORE
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  Disease - dentalcaries Impairment – loss of tooth Disability – cant talk Handicap – cant socialize 37 Dr. M. Tauseef Javed SIMS LAHORE
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  Dr. M. TauseefJaved SIMS LAHORE 38
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  (ii) Rehabilitation • Rehabilitationis “ the combined and coordinated use of medical, social, educational, and vocational measures for training and retraining the individual to the highest possible level of functional ability.” • Requires cooperation from different sections of society. 39 Dr. M. Tauseef Javed SIMS LAHORE
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  Disability limitation (Tertiary levelprevention) Actions taken to restore the functionality of the disable organs Surgery Organ transplantation Plastic surgery Hearing aid Dr. M. Tauseef Javed SIMS LAHORE 40
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  REHABILITATION (Tertiary Prevention) Dr. M.Tauseef Javed SIMS LAHORE 41 Rehabilitation is the combine coordinated use of medical, social, educational and vocational measures for retaining the individual to highest functional ability  Medical Rehabilitation  Vocational Rehabilitation  Social Rehabilitation  Psychological Rehabilitation
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  Rehabilitation Medical rehabilitation Vocational rehabilitation Social rehabilitation Psychological rehabilitation Types of Rehabilitation 42 Dr.M. Tauseef Javed SIMS LAHORE
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  Cont… • Medical rehabilitation:(restoration of Bodily Function). • Vocational rehabilitation:( restoration of the capacity to earn a livelihood) • Social rehabilitation: (restoration of family and social relationship). • Psychological rehabilitation: (Restoration of personal dignity and confidence). 43 Dr. M. Tauseef Javed SIMS LAHORE
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  Examples of Rehabilitation • Establishingschools for the blind. • Exercises in neurological disorders • Prosthetic restoration of lost tooth • Reconstructive surgery in Leprosy. • Change of profession for a more suitable one and modification of life in general in the case of TB,etc., 44 Dr. M. Tauseef Javed SIMS LAHORE
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  Natural History ofdisease prevention model Pathogenic phases Health Spectrum Levels of Prevention Modes of Intervention Risk factor Wellbeing state Primordial prevention Public health policies to avoid risk factors Pre-pathogenic phase Free from sickness Primary prevention Health promotion Specific protection Early Pathogenic Phase Subclinical disease Secondary prevention Pre-symptomatic detection and treatment Late pathogenic phase Clinical disease Tertiary prevention Disability limitation and Rehabilitation Dr. M. Tauseef Javed SIMS LAHORE 45
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  This is My Thank You Dance..! 46 Dr. M.Tauseef Javed SIMS LAHORE