Transcript CONCEPTS OF DISEASE - Keluarga IKMA FKMUA 2010

CONCEPTS OF
HEALTH – DISEASE
AND
HISTORY OF DISEASE
sudarmaji
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darmaji sudarmaji
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[email protected]
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AGENT – HOST
ENVIRONMENT
INFECTION DISEASE
DEPEND UPON FACTORS – CONTACT BETWEEN
INFECTIOUS AGENT AND A SUSCEPTIBLE
PERSON KNOWN AS THE HOST.
THE DURATION AND EXTENT OF ITS EXCRETION
FROM AN INFECTED PERSON.
THE CLIMATIC CONDITION AFFECTING
SURVIVAL OF THE AGENT.
RELATIONSHIP AMONG INFECTIOUS
AGENTS OF DISEASE , THE HUMAN
HOST AND HIS ENVIRONMENT
ALSO EXIST AMONG
NON INFECTIOUS ETIOLOGICAL
AGENTS - HOST - ENVIRONMENT
For example:
CANCER
Maybe depend apon the extent of EXPOSURE to the
CARCINOGENIC AGENT , the dose of the agent, the
genetic and the environment.
CLASSIFICATION OF AGENTS, HOST
AND ENVIRONMENTAL FACTOR
AGENTS OF DISEASE AS
EXAMPLE
Etiological Factors
1.Nutritive elements
Excesses
--------------- Cholesterol
Deficiencies --------------- Vitamins, Proteins
2.Chemical agents
Poisons
--------------- CO gas, CCl4, Drugs
Allergens
--------------- Regweed, Medication
3.Physical agents ----------------------------------- Ionizing radiation
4.Infectious agents Bacteria
------------- Typhoid, TBC.
Parasite
------------- Hookworm
Virus
------------- Hepatitis A, Mumps
HOSTS FACTOR (INTRINSIC FACTORS) – INFLUENCE
EXPOSURE , SUSCEPTABILITY OR RESPONSE TO AGENTS
Example
1.Genetic
Sickle cell disease
2.Physiologic State
Fatique, Fregnancy, Stress.
3.Human Behavcior
Personal hygiene
Food handling
Diet
Recreation
Utilization of Health Resources
ENVIRONMENT FACTOR
(EXTRINSIC FACTORS)
1.BIOLOGICAL ENVIRONMENT
- Infectious agent of disease
- Reservoir of infection (animal)
- Vector which transmit disease
(flies and mosquito)
- Plants and animals
(food )
ENVIRONMENT FACTOR
(EXTRINSIC FACTORS)
2.SOSIAL ENVIRONMENT
- Economic
- Political organization
- Culture
- Community
ENVIRONMENT FACTOR
(EXTRINSIC FACTORS)
3.PHYSICAL / CHEMICAL ENVIRONMENT
- Heat
- Light
- Air
- Water
- Radiation
- Gravity
- Atmospheric pressure
- Chemical agents of all kinds
INTERRELATION OF FACTORS)
(ECOLOGIC MODELS)
THE EPIDEMIOLOGIC TRIANGLE
HOST
AGENT
ENVIRONMENT
WHEEL MODELS OF MAN-ENVIRONMENT
INTERACTION
HOST
Genetic
core
Physical
Environment
Social
Environment
BIOLOGI
ENVIRONMENT
ENVIRONMENTAL FACTOR (EXTRINSIC FACTORS) –
INFLUENCE EXISTENCE OF THE AGENTS , EXPOSURE OR
SUSCEPTABILITY TO AGENTS
Example
1.Physical environment
Geology , Climate
2.Biologic environment
Human population
Flora
Fauna
Density
Source of food
Food sources, Vector
3.Sosioeconomic
Environment occupation
Urbanization
Exposure to chemical agents
Urban crowding
CAUSATION OF DISEASES
GENETIC FACTORS
GOOD HEALTH
ENVIRONMENTAL FACTORS
(INCLUDING BEHAVIOURS)
POOR HEALTH
NATURAL HISTORY OF DISEASE
DEATH
GOOD HEALTH
SUBCLINICAL
CHANGES
CLINICAL
CHANGES
RECOVERY
CLASSIFICATION OF HUMAN INFECTIONS BY
MODE OF TRANSMISSION
CLASSIFICATION OF HUMAN INFECTIONS
BY SELECTED EPIDEMIOLOGIC FEATURE
1.Dynamics of Spread through Human Population Sample
A.Spread by “common vehicle “
-INGESTION WITH: WATER-FOOD-BEVERAGE
-INHALATION IN AIR BREATHED
-INOCULATION (INTRAVENOUS-SUBCUTANEOUS)
Salmonella
Flu
Hepatitis B
B.Propagation by serial transfer
From HOST to HOST.
-RESPIRATORY ROUTE OF TRANSFER
-ANAL-ORAL ROUTE
-GENETAL ROUTE
Measles
Shigellosis
Syphilis
CLASSIFICATION OF HUMAN INFECTIONS BY
MODE OF TRANSMISSION
CLASSIFICATION OF HUMAN INFECTIONS
BY SELECTED EPIDEMIOLOGIC FEATURE
2.Portal of Entry (and Portal of Exit)
in Human Host
-Upper Respiratory Tract
-Lower Respiratory Tract
-Gastrointestinal Tract
-Genitourinary Tract
-Conjunctiva
-Percutaneous
-Percutaneous (bite of arthropod)
Samples
Diphtheria
Tuberculosis
Typhoid fever
Gonorrhea
Trachoma
Leprospirosis
Yellow fever
CLASSIFICATION OF HUMAN INFECTIONS BY
MODE OF TRANSMISSION
CLASSIFICATION OF HUMAN INFECTIONS
BY SELECTED EPIDEMIOLOGIC FEATURE
3.Principal Reservoir of Infection
Samples
-Man
Infectious hepatitis
-Other vertebrates (zoonoses)
-Agent free living
Tularemia
Histoplasmosis
CLASSIFICATION OF HUMAN INFECTIONS BY
MODE OF TRANSMISSION
CLASSIFICATION OF HUMAN INFECTIONS
BY SELECTED EPIDEMIOLOGIC FEATURE
4.Cycles of Infections Agent in Nature
Samples
-Man – man
-Man – arthropod – man
-Vertebrate-vertebrate-man
-Vertebrate-artropod-vertebrate-man
Inluenza
Malaria
Psitacosis
Viral ence
phalitis
CLASSIFICATION OF HUMAN INFECTIONS BY
MODE OF TRANSMISSION
CLASSIFICATION OF HUMAN INFECTIONS
BY SELECTED EPIDEMIOLOGIC FEATURE
5.Complex Cycles
Samples
In certain helminth infections
Paragonimiasis
The cycle is as follow:
Ovum – miracidium – cercaria – adult – ovum
( in snail ) (in crab,
(in man)
crayfish)
NATURAL HISTORY OF
DISEASE
STATE
NATURAL HISTORY OF
DISEASE
STAGE OF
SUSCEPTIBILITY
PRESYMPTOMATIC DISEASE
3. CLINICAL DISEASE
4. DISABILITY
1.
2.
STATE
OF SUSCEPTIBILITY
RELATION BETWEEN :
HOST – AGENT – ENVIRONMENT
2. RISK FACTOR:
HOST (fatique)  ALCOHOL  PNEMONIA
OBESITAS  SMOKING  CORONAIR HD.
SUSCEPTIBILITY, RELATED TO:
AGE-SEX-LIFE STYLE-CULTURE-ETC
1.
STATE
OF PRESYMPTOMATIC
DISEASE
1.
2.
3.
DISEASE NOT CLEAR
PATHOLOGIC DISORDER IS CLEAR
DISORDER STILL UNDER CLINICAL
HORISON LINE. ( THE BORDERS OF
CLINICAL MANIFESTATION AND PATHOLO
GICAL CONDITION)
Eq. Atherosclerotic (+) before SUDDEN
DEATH
STATE
OF CLINICAL DISEASE
1.
2.
3.
CHANGES OF ANATOMICAL AND
FUNCTIONAL OF ORGANS
SYMPTOMS OF DISEASES (+)
DISEASE CAN CLASIFIED
ACCOEDING TO : LOCATION
HISTOLOGICAL
PSYCHOSOSIAL
STATE
OF DISABILITY
DISEASE  CURE  DISABLE  DEATH
Eq. VIRUS DISEASE SELF LIMITING
DISEASE. COMPLICATION
(ENCHEPHALITIS)
HT  STROKE  HEMIPLEGIA.