CONCEPTS OF HEALTH – DISEASE AND HISTORY OF DISEASE

CONCEPTS OF CONCEPTS OF HEALTH – DISEASE HEALTH – DISEASE

ANDANDHISTORY OF DISEASE HISTORY OF DISEASE

sudarmajisudarmaji

• 0878 520878 5271 628871 6288• 0857 3079 78880857 3079 7888• 0813 3030 32790813 3030 3279• darmaji sudarmajidarmaji sudarmaji• [email protected]• [email protected]• [email protected][email protected]

AGENT – HOSTAGENT – HOSTENVIRONMENENVIRONMEN

TTINFECTION DISEASEINFECTION DISEASE

DEPEND UPON FACTORS – CONTACT DEPEND UPON FACTORS – CONTACT BETWEENBETWEEN

INFECTIOUS AGENT AND A SUSCEPTIBLE INFECTIOUS AGENT AND A SUSCEPTIBLE PERSON KNOWN AS THE HOST.PERSON KNOWN AS THE HOST.

THE DURATION AND EXTENT OF ITS THE DURATION AND EXTENT OF ITS EXCRETIONEXCRETION

FROM AN INFECTED PERSON.FROM AN INFECTED PERSON.

THE CLIMATIC CONDITION AFFECTING THE CLIMATIC CONDITION AFFECTING SURVIVAL OF THE AGENT. SURVIVAL OF THE AGENT.

RELATIONSHIP AMONG RELATIONSHIP AMONG INFECTIOUS AGENTS OF INFECTIOUS AGENTS OF

DISEASE , THE HUMAN HOST DISEASE , THE HUMAN HOST AND HIS ENVIRONMENT AND HIS ENVIRONMENT

ALSO EXIST AMONG ALSO EXIST AMONG NON INFECTIOUS ETIOLOGICAL NON INFECTIOUS ETIOLOGICAL AGENTS - HOST - ENVIRONMENTAGENTS - HOST - ENVIRONMENT

For example:For example:

CANCERCANCER

Maybe depend apon the extent of Maybe depend apon the extent of EXPOSURE to the CARCINOGENIC AGENT , EXPOSURE to the CARCINOGENIC AGENT , the dose of the agent, the genetic and the the dose of the agent, the genetic and the

environment. environment.

CLASSIFICATION OF AGENTS, CLASSIFICATION OF AGENTS, HOST AND ENVIRONMENTAL HOST AND ENVIRONMENTAL

FACTORFACTOR

AGENTS OF DISEASE ASAGENTS OF DISEASE ASEXAMPLEEXAMPLE

Etiological FactorsEtiological Factors

1.Nutritive elements1.Nutritive elements

ExcessesExcesses --------------- Cholesterol--------------- Cholesterol

Deficiencies --------------- Vitamins, Deficiencies --------------- Vitamins, ProteinsProteins

2.Chemical agents2.Chemical agents

Poisons --------------- CO gas, Poisons --------------- CO gas, CCl4, DrugsCCl4, Drugs Allergens --------------- Allergens --------------- Regweed, MedicationRegweed, Medication

3.Physical agents ----------------------------------- 3.Physical agents ----------------------------------- Ionizing radiationIonizing radiation

4.Infectious agents Bacteria4.Infectious agents Bacteria ------------- Typhoid, ------------- Typhoid, TBC.TBC.

ParasiteParasite ------------- Hookworm------------- Hookworm

VirusVirus ------------- Hepatitis A, ------------- Hepatitis A, MumpsMumps

HOSTS FACTOR (INTRINSIC FACTORS)HOSTS FACTOR (INTRINSIC FACTORS) – – INFLUENCE EXPOSURE , SUSCEPTABILITY OR INFLUENCE EXPOSURE , SUSCEPTABILITY OR RESPONSE TO AGENTS RESPONSE TO AGENTS

ExampleExample

1.Genetic1.Genetic Sickle cell diseaseSickle cell disease

2.Physiologic State2.Physiologic State Fatique, Fregnancy, Fatique, Fregnancy, Stress.Stress.

3.Human Behavcior3.Human Behavcior Personal hygienePersonal hygiene

Food handlingFood handling

DietDiet

RecreationRecreation

Utilization of Health Utilization of Health ResourcesResources

ENVIRONMENT FACTOR ENVIRONMENT FACTOR (EXTRINSIC FACTORS)(EXTRINSIC FACTORS)

1.BIOLOGICAL ENVIRONMENT1.BIOLOGICAL ENVIRONMENT

- Infectious agent of disease- Infectious agent of disease

- Reservoir of infection (animal)- Reservoir of infection (animal)

- Vector which transmit disease- Vector which transmit disease

(flies and mosquito)(flies and mosquito)

- Plants and animals- Plants and animals

(food )(food )


2.SOSIAL ENVIRONMENT2.SOSIAL ENVIRONMENT

- Economic- Economic

- Political organization- Political organization

- Culture- Culture

- Community- Community


3.PHYSICAL / CHEMICAL 3.PHYSICAL / CHEMICAL ENVIRONMENTENVIRONMENT

- Heat- Heat

- Light- Light

- Air- Air

- Water- Water

- Radiation- Radiation

- Gravity- Gravity

- Atmospheric pressure- Atmospheric pressure

- Chemical agents of all kinds- Chemical agents of all kinds

INTERRELATION OF FACTORS)INTERRELATION OF FACTORS)(ECOLOGIC MODELS)(ECOLOGIC MODELS)

THE EPIDEMIOLOGIC TRIANGLE THE EPIDEMIOLOGIC TRIANGLE

HOSTHOST

AGENTAGENT ENVIRONMENT ENVIRONMENT

WHEEL MODELS OF MAN-WHEEL MODELS OF MAN-ENVIRONMENTENVIRONMENTINTERACTIONINTERACTION

HOSTHOST GeneticGenetic corecore

PhysicalPhysicalEnvironmentEnvironment

SocialSocialEnvironmentEnvironment

BIOLOGI BIOLOGI ENVIRONMENTENVIRONMENT

ENVIRONMENTAL FACTOR (EXTRINSIC FACTORS)ENVIRONMENTAL FACTOR (EXTRINSIC FACTORS) – – INFLUENCE EXISTENCE OF THE AGENTS , INFLUENCE EXISTENCE OF THE AGENTS , EXPOSURE OR SUSCEPTABILITY TO AGENTS EXPOSURE OR SUSCEPTABILITY TO AGENTS

ExampleExample

1.Physical environment1.Physical environment Geology , ClimateGeology , Climate

2.Biologic environment2.Biologic environment

Human populationHuman population DensityDensity

FloraFlora Source of foodSource of food

Fauna Fauna Food sources, Food sources, Vector Vector

3.Sosioeconomic3.Sosioeconomic

Environment occupationEnvironment occupation Exposure to Exposure to chemical agentschemical agents

Urbanization Urbanization Urban crowdingUrban crowding

CAUSATION OF DISEASESCAUSATION OF DISEASES

GENETIC FACTORSGENETIC FACTORS

ENVIRONMENTAL FACTORSENVIRONMENTAL FACTORS

(INCLUDING BEHAVIOURS)(INCLUDING BEHAVIOURS)

GOOD HEALTH POOR HEALTH

NATURAL HISTORY OF NATURAL HISTORY OF DISEASEDISEASE

GOOD HEALTH SUBCLINICAL

CHANGESCLINICALCHANGES

RECOVERY

DEATH

CLASSIFICATION OF HUMAN INFECTIONS CLASSIFICATION OF HUMAN INFECTIONS BY MODE OF TRANSMISSION BY MODE OF TRANSMISSION

CLASSIFICATION OF HUMAN CLASSIFICATION OF HUMAN INFECTIONS BY SELECTED INFECTIONS BY SELECTED EPIDEMIOLOGIC FEATUREEPIDEMIOLOGIC FEATURE

1.1.Dynamics of Spread through Human Dynamics of Spread through Human PopulationPopulation Sample Sample

A.Spread by “common vehicle “A.Spread by “common vehicle “-INGESTION WITH: WATER-FOOD-BEVERAGEINGESTION WITH: WATER-FOOD-BEVERAGE SalmonellaSalmonella-INHALATION IN AIR BREATHEDINHALATION IN AIR BREATHED FluFlu-INOCULATION (INTRAVENOUS-SUBCUTANEOUS)INOCULATION (INTRAVENOUS-SUBCUTANEOUS)Hepatitis BHepatitis B

B.Propagation by serial transfer B.Propagation by serial transfer From HOST to HOST.From HOST to HOST.

-RESPIRATORY ROUTE OF TRANSFER-RESPIRATORY ROUTE OF TRANSFER MeaslesMeasles

-ANAL-ORAL ROUTE-ANAL-ORAL ROUTEShigellosisShigellosis

-GENETAL ROUTE-GENETAL ROUTE SyphilisSyphilis



2.Portal of Entry (and Portal of 2.Portal of Entry (and Portal of Exit) Exit) SamplesSamples

in Human Hostin Human Host--Upper Respiratory TractUpper Respiratory Tract DiphtheriaDiphtheria-Lower Respiratory TractLower Respiratory Tract TuberculosisTuberculosis-Gastrointestinal TractGastrointestinal Tract Typhoid Typhoid feverfever-Genitourinary TractGenitourinary Tract GonorrheaGonorrhea-ConjunctivaConjunctiva TrachomaTrachoma-PercutaneousPercutaneous LeprospirosisLeprospirosis-Percutaneous (bite of arthropod)Percutaneous (bite of arthropod) Yellow Yellow feverfever



3.Principal Reservoir of Infection3.Principal Reservoir of Infection Samples Samples

--Man Man Infectious Infectious hepatitishepatitis

-Other vertebrates (zoonoses)-Other vertebrates (zoonoses) TularemiaTularemia

-Agent free living-Agent free livingHistoplasmosisHistoplasmosis



4.Cycles of Infections Agent in 4.Cycles of Infections Agent in NatureNature SamplesSamples-Man – man-Man – manInluenzaInluenza

-Man – arthropod – man-Man – arthropod – manMalariaMalaria

-Vertebrate-vertebrate-man-Vertebrate-vertebrate-manPsitacosisPsitacosis

-Vertebrate-artropod-vertebrate-man-Vertebrate-artropod-vertebrate-manViral enceViral ence

phalitisphalitis



5.Complex Cycles5.Complex CyclesSamplesSamplesIn certain helminth infectionsIn certain helminth infections

ParagonimiasisParagonimiasis

The cycle is as follow:The cycle is as follow:

Ovum – miracidium – cercaria – adult – Ovum – miracidium – cercaria – adult – ovumovum

( in snail )( in snail ) (in crab, (in crab, (in (in man)man)

crayfish)crayfish)

NATURAL HISTORY OF NATURAL HISTORY OF DISEASEDISEASE

STATESTATENATURAL HISTORY OF NATURAL HISTORY OF

DISEASEDISEASE

STAGE OFSTAGE OF1.1. SUSCEPTIBILITYSUSCEPTIBILITY

2.2. PRESYMPTOMATIC DISEASEPRESYMPTOMATIC DISEASE

3.3. CLINICAL DISEASECLINICAL DISEASE

4.4. DISABILITYDISABILITY

STATESTATEOF SUSCEPTIBILITYOF SUSCEPTIBILITY

1.1. RELATION BETWEEN :RELATION BETWEEN :

HOST – AGENT – ENVIRONMENTHOST – AGENT – ENVIRONMENT

2.2. RISK FACTOR:RISK FACTOR:

HOST (fatique) HOST (fatique) ALCOHOL ALCOHOL PNEMONIA PNEMONIA

OBESITAS OBESITAS SMOKING SMOKING CORONAIR HD. CORONAIR HD.

SUSCEPTIBILITY, RELATED TO:SUSCEPTIBILITY, RELATED TO:

AGE-SEX-LIFE STYLE-CULTURE-ETCAGE-SEX-LIFE STYLE-CULTURE-ETC

STATESTATEOF PRESYMPTOMATIC OF PRESYMPTOMATIC

DISEASEDISEASE

1.1. DISEASE NOT CLEARDISEASE NOT CLEAR

2.2. PATHOLOGIC DISORDER IS CLEARPATHOLOGIC DISORDER IS CLEAR

3.3. DISORDER STILL UNDER CLINICAL DISORDER STILL UNDER CLINICAL HORISON LINE. ( THE BORDERS OF HORISON LINE. ( THE BORDERS OF CLINICAL MANIFESTATION AND PATHOLOCLINICAL MANIFESTATION AND PATHOLO

GICAL CONDITION)GICAL CONDITION)

Eq. Atherosclerotic (+) before SUDDENEq. Atherosclerotic (+) before SUDDEN

DEATHDEATH

STATESTATEOF CLINICAL DISEASEOF CLINICAL DISEASE

1.1. CHANGES OF ANATOMICAL AND CHANGES OF ANATOMICAL AND FUNCTIONAL OF ORGANSFUNCTIONAL OF ORGANS

2.2. SYMPTOMS OF DISEASES (+)SYMPTOMS OF DISEASES (+)

3.3. DISEASE CAN CLASIFIEDDISEASE CAN CLASIFIED

ACCOEDING TO : LOCATIONACCOEDING TO : LOCATION

HISTOLOGICALHISTOLOGICAL

PSYCHOSOSIALPSYCHOSOSIAL

STATESTATEOF DISABILITYOF DISABILITY

DISEASE DISEASE CURE CURE DISABLE DISABLE DEATH DEATH

Eq. VIRUS DISEASE Eq. VIRUS DISEASE SELF LIMITING SELF LIMITING DISEASE.DISEASE. COMPLICATION COMPLICATION (ENCHEPHALITIS)(ENCHEPHALITIS)

HT HT STROKE STROKE HEMIPLEGIA. HEMIPLEGIA.

CONCEPTS OF HEALTH – DISEASE AND HISTORY OF DISEASE

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