Prevention of Disease

Prevention may be:

1.       Primordial Prevention

2.       Primary Prevention

3.       Secondary Protection

4.       Tertiary Prevention

 

The goals of prevention are:

·         To promote health

·         To preserve health

·         To restore health when it is impaired

·         To minimize suffering and distress

·         Levels of Prevention

Primordial Prevention

Prevention of the emergence or development of risk factors in a population in which they have not yet appeared is known as primordial prevention.

Example:

Obesity origin is in childhood and depends on life styles e.g. eating patterns and physical exercise.

Main intervention in primordial prevention is through individual and mass education. It is directed towards discouraging children from adopting harmful life styles.

Example – smoking leading to COPD, it should be discouraged to prevent development of COPD. 

Primary Prevention

Action taken prior to the onset of disease is known as primary prevention. It removes the possibility that the disease will ever occur. It is the intervention in the pre pathogenesis phase of a disease or health problem and involves:

·         Health Promotion

·         Specific Protection

Health Promotion

Measures to promote optimal level of health including:

·         Provision of adequate nutrition

·         Health counseling to parents and community

·         Provision of adequate housing

·         Health education, counseling

·         Periodical health examinations

·         Environmental changes

·         Provision of safe water

·         Sanitary latrines

·         Insect and rodent control 

Specific Protection

Measures applicable to a disease or group of diseases to intercept the cause before the involvement e.g.

·         Specific immunization -Communicable diseases

·         Specific Nutrient – Nutritional deficiency

·         Dental carries — Fluoride

·         Goiter – Iodine

·         Protection against hazards  Cancer–  smoking

·         Chemoprophylaxis

Secondary Protection

Secondary prevention involves early diagnosis and prompt treatment. It starts when patient comes in contact with health worker or health facility and includes actions which halts the progress of a disease at its early stage and prevent complication.

The aim is to arrest the disease process and restore health.

Example

For Tuberculosis skin and sputum test for early detection.

Tertiary Prevention

All measures to reduce or limit impairments and disabilities, minimize suffering from disease and to promote the patients adjustment in society e.g.

·         Disability limitation

·         Limiting further progress of disability

Measures of prevention at this level is provision of therapeutic substances to arrest the disease and prevent further disability 

Concepts of Control

• Disease control
• Disease Elimination
• Disease Eradication

Aim is to reduce:

1. The incidence of disease
2. The duration of disease
3. The effects of infection
4. The financial burden

Disease Elimination

Disease elimination lies between control and eradication. It is the INTERRUPTION of transmission of disease. Examples include Polio and Measles.

Disease Eradication

Disease elimination is tearing out by roots. It is the termination of all transmission of infection by extermination of infectious agent. Examples include Small pox.

Universal prevention

Universal prevention addresses the entire population (national, local community, school, district). Aim to prevent or delay the abuse of alcohol, tobacco, and other drugs. All individuals, without screening, are provided with information and skills necessary to prevent the problem.

Selective prevention

Selective prevention focuses on groups whose risk of developing problems of alcohol abuse or dependence is above average. The subgroups may be distinguished by characteristics such as age, gender, family history, or economic status.

For example, drug campaigns in recreational settings or polio

Indicated prevention

Indicated prevention involves a screening process, and aims to identify individuals who exhibit early signs of substance abuse and other problem behaviors.  Identifiers may include falling grades among students, known problem consumption or  conduct disorders, alienation from parents, school, and positive peer groups etc.

Prophylaxis

Prophylaxis ” is to guard or prevent beforehand . Any medical or public health procedure whose purpose is to prevent, rather than treat or cure a disease.

Prophylactic measures include:

1.       Primary prophylaxis (to prevent the development of a disease)

2.       Secondary prophylaxis (whereby the disease has already developed and the patient is protected against worsening of this process).

Prevention is better than cure

This is a proverbial saying of 17th century. This proverb is often used in relation to health and disease. It’s better to take care that a problem so that it does not happen than to have to solve the problem afterwards. It’s easier to stop something bad from happening in the first place than to fix the damage after it has happened.

Latin saying of 13th century

It is better and more useful to meet a problem in time than to seek a remedy after the damage is done.