Disease
In the absence of a WHO definition, I will only cite those definitions of ‘disease’ which other people have mentioned.
1. Ecologist—“A maladjustment of the human organism to his environment”
2. Physician—“Any deviation from normal functioning or state of physical and mental well being”
3. Microbiologist—“Disruption of equilibrium in the epidemiological triad of host, agent and environment”.
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| Figure 01. Disease stages |
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| Figure 02. Iceberg of disease |
Risk Factors
An attribute or exposure that is significantly associated with development of a disease. They are only suggestive and not absolute proof of disease occurrence.
Actually, risk factors represent unclarified ‘agents’—This means the cause effect relationship is usually lacking in them.
Types
1. Additive: Smoking + dyes cause additive effect on bladder CA
2. Synergistic: Hypertension and hypercholesterolemia potentate each other in development of CHD
3. Modifiable: Smoking, hypertension, increased cholesterol in CHD
4. Non-modifiable: Age, sex and genes. This is the risk for which risk groups are mostly defined.
Prevention
Preventive medicine is the art and science of health promotion, disease prevention, disability limitation and rehabilitation (Fig. 1.6).
Primary prevention
These are the activities directed to prevent the occurrence of disease in a human population. The aim is to prevent disease and prolong life.
1) Health promotion. “The process of enabling people to increase control over their health and its determinants, and thereby improve their health”.
• Health education
• Environmental modification
• Engineering lifestyle
• Genetic and marriage counseling
• Increasing the standard of living
• Health legislation,
2) Specific protection. The measures which target particular diseases. The idea
of specific protection, especially that killer diseases could be stopped.
• Immunization
• Nutrient supplementation
• Chemoprophylaxis
• Protection against occupational hazards.
• Avoiding allergens
Secondary prevention
Those actions which halts the progress of a disease in an individual at the incipient stage and prevents further complications. It is indeed prevention because it prevents further spread of that disease from that individual.
• Early diagnosis
1. Screening tests
2. Case finding
3. Special medical examination of risk groups.
• Prompt treatment:
A quick cure, helps the patient as well as stops further spread of disease.
Tertiary prevention
All measures available to
• Reduce or limit impairment and disabilities
• Minimize suffering caused by existing disease
• Promote the patients adjustments to irremediable conditions.
Tertiary prevention alleviates the pain of the patient who has already been scarred by a disease.
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| Figure 03. Prevention |
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