NCM 113 - 5F

Prevention of Communicable Diseases

• Primary Level of Prevention

  • Health Education Initiatives

  • Notification through RA 11332 to initiate health education drives

  • Objective: Mitigate and control the spread of communicable diseases

Diagnosis of Communicable Diseases

• Testing for Confirmation of Disease

  • Role of public health nurses in providing educational resources

  • Importance of diagnosing potential cases of communicable diseases

Levels of Prevention

• Three Major Roles in Disease Prevention:

  • Primary Prevention:

  • Focus on preventing disease before it occurs

  • Approaches:

    • Immunization

    • Health Education

    • Sanitation Practices

    • Example: Removing stagnant water to control vector diseases (e.g., malaria, dengue)

    • Handwashing

    • Vital for prevention of pathogen infection

    • Vector Control

    • Define vector as any animate organism that harbors disease

  • Secondary Prevention:

  • Focus on early disease detection and treatment

  • Approaches:

    • Screening Tests

    • Contact Tracing

    • Early Treatment

    • Isolation Protocols

    • Examples for screening tests:

      • Romberg's test

      • Tourniquet test

    • Purpose: Prevent worsening of the disease (e.g., dengue)

  • Tertiary Prevention:

  • Focus on managing and preventing further deterioration of disease

  • Approaches:

    • Treatment Adherence

    • Example: Directly Observed Treatment Short-course (DOTS)

    • Importance: Prevent drug resistance, particularly in TB

    • Involves monitoring by public health nurses for treatment adherence

    • Follow-Up Care

    • Rehabilitation Services

    • Support Groups

Steps of Infection Prevention

• Six Links in the Chain of Infection:

  • Infectious Agent

  • Reservoir

  • Portal of Exit

  • Mode of Transmission

  • Portal of Entry

  • Susceptible Host

• Definitions: Portal of Exit vs. Portal of Entry:

  • Portal of Exit:

  • Pathway through which the pathogen leaves the host

    • Example: Blood, saliva, feces (coughing represents a mode of transmission)

  • Portal of Entry:

  • Pathway through which the pathogen enters a susceptible host

    • Examples: Mouth, nose, skin breaks

Example of Tracing Links of Infection Using Leptospirosis

• Infectious Agent: Leptospira interrogans

• Reservoir: Rodents

• Portal of Exit: Urine from infected rodents

• Mode of Transmission:

  • Direct contact with contaminated water
    - Skin contact (through cuts)

• Portal of Entry: Breaks in the skin

• Susceptible Host:

  • Individuals working in flood-prone areas (farmers, garbage collectors)

Breaking the Links of Infection

• Objective: Disrupt at least one link of the chain to prevent infection

• Easiest Link to Break: Mode of Transmission

  • Example: Hand hygiene practices and health education

• Hardest Link to Break: Susceptible Host

  • Variances in individual health and treatment efficacy

Vaccine-Preventable Diseases

• Historical Context:

  • Presidential Decree No. 996 (1976): Compulsory immunization for children under 8 years for six diseases

  • RA 10152 (2011): Mandatory vaccinations expanded to ten diseases, children up to 5 years

• Diseases Prevented:

  • From PD 996: Tuberculosis, Measles, Diphtheria, Pertussis, Tetanus, Polio

  • Additional diseases under RA 10152: Hepatitis B, Haemophilus influenzae type b, Mumps, Rubella

Specific Vaccines

• BCG Vaccine

  • Prevents Tuberculosis

  • Route: Intradermal, 0.05 ml in the right deltoid area

  • Cauch Phenomenon: Scar formation at injection site

• Diphtheria, Pertussis, and Tetanus Vaccine (DPT)

  • Route: Intramuscular, 0.5 ml (administered in Vastus Lateralis)

• Oral Polio Vaccine (OPV)

  • Dose: Two drops orally

• Pentavalent Vaccine

  • Combines DPT with Hepatitis B and Hib

  • Route: 0.5 ml intramuscularly in Vastus Lateralis

• MMR Vaccine

  • Combined Mumps, Measles, Rubella vaccine

  • Route: 0.5 ml subcutaneous in deltoid

HIV Overview

• HIV Definition: Human Immunodeficiency Virus

  • Attacks immune system by targeting CD4 lymphocytes

  • Without treatment, can progress to AIDS (Acquired Immunodeficiency Syndrome)

• Origin:

  • Derived from chimpanzee SIV due to hunting practices and blood exposure

• Modes of Transmission:

  • Unprotected sexual contact (anal, vaginal, oral)

  • Blood exposure through needle sharing

  • Perinatal transmission (mother to child)

• Stages of HIV Infection:

  • Acute Stage: Flu-like symptoms, highly contagious due to high viral load

  • Chronic Stage: Years of latent infection; low viral load, less contagious

  • End Stage/AIDS: Immune system severely compromised, high susceptibility to opportunistic infections

HIV Testing and Management

• Testing Methods:

  • Screening Tests:

  • Rapid Antibody Test

  • ELISA (Enzyme-Linked Immunosorbent Assay)

  • Confirmatory Tests:

  • Western Blot

  • Polymerase Chain Reaction (PCR)

• Treatment:

  • Antiretroviral Therapy (ART) to manage viral load

  • Common medications in the Philippines: Tenofovir, Lamivudine, Efavirenz

• Prevention:

  • Safe sex practices

  • PrEP and PEP medications for high-risk individuals

  • Prevent perinatal transmission through ART during pregnancy

• Support and Management:

  • Promote adherence to treatment regimens

  • Provide psychological support and education

  • Maintain patient confidentiality and reduce stigma associated with HIV

• Encouragement for Healthy Lifestyle:

  • Balance in nutrition, nutrition, exercise, and avoidance of harmful substances (e.g., smoking, alcohol)

Conclusion

• Final Remarks:

  • The importance of understanding the prevention, transmission, and management of communicable diseases, particularly HIV, is crucial for public health nursing. Strategies include education, vaccination, and promoting health-seeking behaviors among populations to curb the spread of these diseases.