Introduction To Public Health

Introduction to Public Health
Module # 2 (New)
DR. SHAIKH ABDUS SALAM
Dept. of Public Health
North south University
Major Public health Problems in
Bangladesh
1. Population problem
2. Communicable Diseases problem
3. Non communicable Diseases problem
4. Nutritional problem
5. Drug addiction/dependence problem among the high
risk group
6. Road/ traffic accident and other accidents e.g. drowning
7. Medical care problem
8. Environmental Sanitation problem
Dr. Shaikh Abdus Salam

Bangladesh
10.Violence against women
11.Violence against men (small extent)
12.Child abuse/ child labor
13.Unemployment problem
14.Food adulteration problem
15.Problem of Social violence (Anti-social activities) e.g.
hijacking, snatching etc.

Major
Public health Problems in Bangladesh
Population problem: The problems arising due

to Overpopulation in Bangladesh are:
1. Unemployment problem
2. Poverty problem
3. High dependency

Bangladesh
Communicable Diseases problem: High mortality
And high Morbidity due to following communicable
diseases: Diarrheal diseases, TB,Typhoid,STIs
HIV/AIDS, Dengue fever, Malaria etc.

COMMUNICABLE DISEASES
An illness due to a specific infectious agent or

its toxic products capable of being directly or
indiectly transmitted from man to man, animal to
man or from the environment to man or animal.

Contagious disease: A disease that is

transmitted through contact.
Infectious disease: A clinically manifest disease

of man or animals resulting from an infection.

Source: The source of infection is defined as the person, animal,
object or substance from which an infectious agent passes or is
disseminated to the host.
Reservoir: A Reservoir is defined as any person,
animal,arthropode,plant,soil or substance(or combination of
these)in which an infectious agent lives and multiplies, on which
it depends primarily for survival, and where it reproduces itself in
such manner that it can be transmitted to a susceptible host.
In short ,the reservoir is the natural habit in which the organism
metabolizes and replicates.

CASES:A case is defined as a person in the population or study
group identified as having the particular disease, health disorder
or condition under investigation".
A variety of criteria (e.g., clinical, biochemical laboratory)may be
used to identify cases.
(b)Intestinal

CARRIER
:A carrier is defined as an infected person or animal
that harbours a specific infectious agent in the absence
of discernible clinical .disease and serves as a potential
source of infection for other

CARRIER
Carrier may be classified as below:

A. Type
(a) Incubatory
(b)Convalescent
(c)Healthy
B . Duration
(a)Temporary
(b)Chronic.
C .Portal of Exit
(a) Urinary. (C)Respiratory. (d)Others.

Mode of Transmission:
Mode of Transmission: a) Direct Transmission

b) Indirect Transmission

A. Direct Transmission
1.Direct contact.
2.Droplet infection.
3.Contact with soil
4.Inoculation into skin or mucosa
5.Transplacental (Vertical)

B. Indirect Transmission
(1)Vehicle-borne
(2)Vector borne
(a)Mechanical
(b)Biological
(3)Air-Borne
(a)Droplet nuclei
(b)Dust.
(4)Fomite-borne
(5)Unclean hands and fingers.

:
Epidemiological classification of
vector borne disease
1.By Vector:
(a)Invertebrate type: Arthropod vector fall into seven orders largely
(1) Dipteral-flies and mosquitoes
(2) Siphonaptera
(3) Orthoptera cockroaches
(4) Anoplura -sucking lice.
(5) Hemiptera- Bugs, including kissing bugs
(6)Acarina ticks and mites
(7)Copepoda- cyclops
( b)Vertebrate type : Mice ,rodent, bats

11.By transmission chain: Vector- borne diseases are classified under
heterogeneous infection chain involve three principal pattern:
(a)Man and a non-vertebrate host:
1)Man-arthropod man(malaria)
2)Man-snail-man(schistosomiasis)
(b) Man another vertebrate host, and a non-vertebrate host
1)Mammal-arthropode man(plague)
2)Bird-arthropode-man(encephalities)

(c)Man and 2 intermideate host1)Man-cyclops-
fish-man(fish tape worm)
2)Man-snail-fish-man(Clonorhis sinesis)
3)Man-snail-crabe-man(paragonimiasis)

(111)By methods in which vector trasmit agent:
A)Bitting
B) Regurgitation
C)Scratching in of infective faeces
D)Contamination of host with body fluids of vectors

1v)By method in which vector are involved in the transmission
and propagation of parasites:
a)Mechanical transmission
b)Biological transmission: Propagative,
Cyclo-propagative
Cyclo-developmental

Enteric Fever
Typhoid Fever: Source,Reservoir,Agent, Mode of

Transmission, Risky people, HRG, Control and
prevention.
Paratyphoid fever
Level of Prevention
1. Primordial Prevention
2. Primary Prevention
3. Secondary Prevention
4. Tertiary Prevention

PREVENTION
Is process of protection some one from getting

any health problems.

Primordial Prevention
Primordial prevention, a new concept, is receiving special
attention in the prevention of chronic disease. This is primary
prevention in its purest sense, that is, prevention of the
emergence or development of risk factors in countries or
population groups in which they have not yet appeared. 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.

Primary Prevention
Primary prevention can be defined as action taken prior to the
onset of disease will ever occur. Primary prevention is far more
than averting the occurrence of a disease and prolonging life. It
includes the concept of positive health, a concept that
encourages achievement and maintenance of an acceptable
level of health that will enable every individual to lead a socially
and economically productive Life. It concerns an individuals
attitude towards life and health and the initiative ha takes about
positive and responsible measures for himself, his family and his
community.

Secondary Prevention
Secondary prevention can be defined as action which halts the
progress of a disease at its incipient stage and prevents
complications. The specific interventions are early diagnosis
(e.g., screening tests, case finding programmes) and adequate
treatment. Secondary prevention is largely the domain of clinical
medicine. The health programmes initiated by Governments are
usually at the level of secondary prevention. The secondary
prevention is an imperfect tool in the control of transmission of
disease.

Tertiary Prevention
When the disease process has advanced beyond its early
stages, it is still possible to accomplish prevention by what might
be called tertiary prevention. Tertiary prevention can be defined
as all measures available to reduce or limit impairments and
disabilities, minimize suffering caused by existing departures
from good health and to promote the patients adjustment to
irremediable conditions.

Bangladesh
Nutritional problems: Major nutritional
problems in Bangladesh are:
1. Protein Energy Malnutrition (PEM)
2. Vitamin A deficiency disorders
3. Iron & Iodine deficiency disorders
4. Khesari dal Intoxication-- Neurolathyrism
5. Disorders due to food adulteration
Major health Problems in Bangladesh
Medical Care problems:

1. Due to lack of proper Planning and lack of
commitment among the Medical personnel ,PHC
Services could not be Provided to the desired
extent.
2.Poorly managed Health Care System in
Bangladesh

Major health Problems in Bangladesh
Environmental Sanitation problems:

1. Lack of safe drinking water in many areas of
the country
2. Primitive methods of excreta disposal.

Public Health Problems in Bangladesh
A number of challenges in health and nutrition remain.
These are:
Improving health care-seeking behavior such as
education, awareness-raising and skills building in
recognizing and treating pneumonia and obstetric
emergencies.
Rapid urbanization which creates conditions that make
slum dwellers vulnerable to disease as a result of
problems of sanitation, hygiene and the supply of clean
water.
The emergence of arsenic in tube well water,
leading to arsenic poisoning.
The potential for HIV/AIDS to develop into a

major problem.
Action on a range of fronts to reduce the number

of deaths from accidents.

Arsenicosis The widespread incidence of arsenic
contamination of water creates health problems
for whole communities. Long-term exposure to low
concentrations of arsenic in drinking ground water
causes painful skin lesions and can result in
cancers of the skin, lungs, bladder and kidneys.
Tackling the problem means identifying who is
suffering from arsenic poisoning (arsenicosis),
monitoring water quality, helping communities to
find alternative sources of safe water and enabling
households to treat water themselves, to make it
safe. Dr. Shaikh Abdus Salam
HIV/AIDS There are an estimated 13,000 adults

living with HIV in Bangladesh. This is below 1 per
1,000 adults in the general population, and less
than 1 per cent among vulnerable groups. But
despite the low incidence, Bangladesh is
considered a high-risk country for several
reasons, including:
sustained high-risk sexual behaviour
very low use of condoms
high levels of HIV/AIDS in the two neighbouring
countries, India and Myanmar
the high proportion of young people, who
constitute one third of the population the highest
in the region. There are signs that initiatives to
change behaviour are having an impact. This is
reflected in declining syphilis rates among female
sex workers in some cities and brothels, and in
declining needle and syringe sharing rates among
intravenous drug users (IDUs). This work needs to
be extended to cover more regions and more of the
at risk population.
Three NCDs-(non-communicable Diseases)

Cancer,
Cardiovascular diseases and
Diabetes mellitus-as major public health
problems.

The communicable Diseases are:

TB, Malaria, Diarrheal Diseases, Dengue Fever,
STIs, Typhoid and Paratyphoid etc.

Rheumatic Heart Disease (RHD)

RHD still remains a public health problem of Bangladesh.
Improvement of skill of doctors is necessary for its surveillance,
prevention and management. The National Center for Control of
Rheumatic Fever and Heart Diseases (NCCRFHD) has been
working for RHD prevention but there is no surveillance
mechanism for RHD.
Networking among these organisations, other research groups in
the country and overseas institutes is necessary for sharing
information, experience and building skills.

Tobacco
A vast majority of the tobacco users are not aware that it is an
important risk factor for cardiovascular diseases, cancer and
chronic obstructive pulmonary disease. Recently, the
Government of Bangladesh has identified it as a modifiable risk
factor for non-communicable disease prevention in Health
Nutrition and Population Sector Programme (HNPSP) which
indicates government's willingness to reduce the harmful effects
of tobacco. On the other hand, tobacco companies are promoting
their products by setting up attractive billboards, and publishing
advertisements in newspapers and magazines.

Tobacco
Some private satellite TV channels are also telecasting
advertisements mainly to attract adolescents and young adults.
To the contrary, there are some NGOs who are organising anti-
smoking campaigns along with the government organisations
(such as Health Education Bureau/BCC unit). Intensification of
antismoking activities is therefore, necessary. Meanwhile,
Bangladesh became the first country to sign the FCTC. However,
efforts need to be taken to intensify and expedite the process of
ratification of the FCTC as well as enacting an appropriate anti-
tobacco legislation conforming to the provisions in the FCTC.

Injuries and Disabilities (Blindness)

Increased life expectancy has contributed to a rise in
the population of older persons leading to an increasing
number of persons with disabilities. Injuries are also
increasing due to violence, conflict and road traffic
accident. The disabilities include blindness due to
cataract, trauma, etc. Integrated programmes for
prevention, control and rehabilitation in all these areas
are needed. These issues were not adequately
addressed and WHO support in improving the situation
will be instrumental.

Mental Health and Substance Abuse

Mental disorders impose a range of consequences on the course
and outcome of chronic conditions such as cancer, heart disease
and diabetes. There is an expected rise in the burden of mental
and neurological disorders and substance abuse primarily
because of the projected increase in the number of individuals
entering the age of risks for the onset of those disorders.
Bangladesh is ill equipped to deal with the burden. So, it is
necessary for the government to place mental health and
substance abuse on the health and development agenda in order
to formulate and implement cost-effective responses to mental
disorders and substance abuse.
Violence against mothers in Bangladesh
associated with health problems in young children
Almost half of Bangladeshi women with young

children experience violence from their
husbands, and their children appear to have a
higher risk of recent respiratory infections and
diarrhea.

Despite substantial improvements in childhood

survival in the previous decade, 77 per 1,000
children born in Bangladesh die before age 5,
according to background information in the
article. Diarrhea and acute respiratory infections
are the leading causes of early childhood
deaths.

Violence against mothers by their husbands is a
factor hypothesized to relate directly and
indirectly to the poor health of young children via
exposure to violence, the incapacitation of
mothers and direct mistreatment and neglect of
children,"

Violence against mothers in Bangladesh associated
with health problems in young children
More than two of every five (42.4 percent) of the
mothers had experienced intimate partner violence
from their husband within the past year. Those who
did were more likely to report that their children had
acute respiratory infections (19.2 percent vs. 13.7
percent) or diarrhea (11.6 percent vs. 7.6 percent)
within the past two weeks

Importantly, because the present analyses were

adjusted for potential confounders, these effects
persist after consideration of socioeconomic
status (e.g., poverty), household characteristics
and environmental factors (e.g., sanitation),"

Both direct and indirect mechanisms may be

responsible for the elevated risk of illness among
children exposed to intimate partner violence,
they note. Trauma and anxiety are more
common among children in violent households
and could lead to suppression of the immune
system over time.

The children could also be experiencing direct physical

harm from their fathers. "A growing body of work
demonstrates that intimate partner violence occurs
within a context of male-partner control, which can
include interference in the ability of women to meet
basic health needs for themselves and their children,"
the authors write. For example, women who are being
abused may be less likely to have their children
immunized or to breastfeed, both of which can
compromise child health
Associations of maternal experiences of intimate

partner violence with two leading causes of
childhood mortality strongly suggest that such
abuse threatens not only the health of women
but also that of their children. "Prevention of
intimate partner violence perpetration by men
may be critical to the improvement of maternal
and child health."
THANK YOU

Introduction To Public Health

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Introduction To Public Health

Uploaded by

Copyright:

Available Formats

Introduction to Public Health

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Population problem: The problems arising due

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

An illness due to a specific infectious agent or

Dr. Shaikh Abdus Salam

Contagious disease: A disease that is

Infectious disease: A clinically manifest disease

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Carrier may be classified as below:

Dr. Shaikh Abdus Salam

Mode of Transmission: a) Direct Transmission

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Typhoid Fever: Source,Reservoir,Agent, Mode of

Dr. Shaikh Abdus Salam

Is process of protection some one from getting

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Medical Care problems:

Dr. Shaikh Abdus Salam

Environmental Sanitation problems:

Dr. Shaikh Abdus Salam

The potential for HIV/AIDS to develop into a

Action on a range of fronts to reduce the number

Dr. Shaikh Abdus Salam

HIV/AIDS There are an estimated 13,000 adults

Three NCDs-(non-communicable Diseases)

Dr. Shaikh Abdus Salam

The communicable Diseases are:

Dr. Shaikh Abdus Salam

Rheumatic Heart Disease (RHD)

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Injuries and Disabilities (Blindness)

Dr. Shaikh Abdus Salam

Mental Health and Substance Abuse

Almost half of Bangladeshi women with young

Dr. Shaikh Abdus Salam

Despite substantial improvements in childhood

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Dr. Shaikh Abdus Salam

Importantly, because the present analyses were

Dr. Shaikh Abdus Salam

Both direct and indirect mechanisms may be

Dr. Shaikh Abdus Salam

The children could also be experiencing direct physical