Diseases of public health

Dr. Edward K .Emma.

Disease and Health

Health is a state of physical, social, mental, psychological and spiritual wellbeing and not merely absence of disease or infirmity. (WHO) Disease may be passed on from one person to another. We refer to it as Communicable disease. Some diseases afflict man but are not transmitted from the patient to another person. They are referred to as non communicable diseases

Communicable diseases
Caused

by Bacteria Viruses Fungi Protozoa

Non communicable diseases

Include
Cancer Diabetis

mellitus Heart disease Hypertension Cause not known but lifestyle, viruses, diet, stress implicated.

Diseases may affect people

In human beings a disease is referred to as endemic if it occurs in natural and moderate rates. It is referred to as an epidemic if it occurs in proportions that are higher than the usual ones both in numbers and area. When it goes beyond the borders and affects many countries, it is known as a pandemic.

Diseases in animals
Here it is termed a zoonosis Examples of zoonoses are Rabies Sleeping sickness Brucellosis

Determinants of disease causation

There are factors other that the causative agents that influence the occurrence of diseases. They can be classified in various groups. Can you identify these? Geographical Economical Political Biological (genetic, gender, age)

Malaria

Mal air Had to do with smell from the swamp which coincided with the occurrence of malaria fever. This was in fact because of the stagnant water that harboured mosquitoes leading to malaria transmission

Aetiology Causative agent

By a protozoon:
Plasmodium (falciparum, ovale, malarie, vivax)

Transmitted by mosquitoes

Female anophelis moquitoes

Other mosquitoes
Culex - Elephantiasis Aedes Yellow fever

Presentation
Fever (raised temperature) Joint pains Chills Others (not always present) Diarrhoea Headache Convulsions Mouth sores

Complications

If missed, not well treated or if it resists medicines it may lead to Fits (cerebral malaria) Recurrent fever ( comes and goes) Drug resistant Malaria

Management

Reduce Temperature History of mosquito bite Living in endemic zone Test for malaria parasites (blood slide or rapid test). ANY SERIOUS FEVER SHOULD BE TREATED AS MALARIA ESPECIALLY IN CHILDREN. SOME PEOPLE REFUTE THIS

TREATMENT
Drug of choice Coatem (Atenenum + Lumefantrin) Fansidar Quinine Previously Chloroquine was drug of choice but now heavily resisted.

Correction of imbalances

Rehydrate Give pain killers Continue to give antipyretics to reduce temperature Diarrhoea will go after malaria is treated.

Epidemiology of malaria

This is the commonest disease in the tropics Among top killers Was previously uncommon in highlands of Mbale and Kabale but with climatic degradation, now it is rampant sometimes resulting into outbreaks. Rare malaria may sometimes end up as the severe cerebral malaria which has a high mortality rate.

Question

What is the difference between malaria and AIDS?

Public health importance of malaria

Loss of working days Increased morbidity in children with adulthood sequalae Drug resistance often gives many cases in the pool and increases the burden increasing transmissibility Malaria accounts for a the biggest fraction of the Health sector budget.

Resume

What causes malaria? What is the transmitter of malaria? Give two main signs and symptoms of malaria Give one complication of malaria What is the drug of choice in the treatment of malaria In which area of Uganda is cerebral malaria likely to occur more?