Health
Health is state of
complete physical and mental well being not merely an absence
of disease or infirmity.
Determinants of health
v
Heredity
v
Environment
v
Life-style
v
Socioeconomic
v
Health and family welfare
v
Other factors like health related systems ( eg: food and
agriculture, education, industry, social welfare, rural
development )
Indicators of health
Characteristics
«
Valid
«
Reliable
«
Sensitive
«
Specific
Indicators may be
classified as
1.
Mortality indicators
a)
Crude death rate: The number of deaths per 1000 population
per year in given community
b)
Expectation of life: Life expectancy at birth is “the average
number of years that will be lived by those born alive into a
population if the current-age specific mortality persists.
c)
Infant mortality rate: Ratio of deaths under 1 year of age in
a given year to the total number of live births in the same
year.
d)
Child mortality rate: Number of deaths at ages 1-4 years in a
given year per 1000 children in that age group at the mid
point of the year concerned.
e)
Under-5 proportionate mortality rate: Proportion of total
deaths occurring in the under 5 age group.
f)
Maternal (puerperal) mortality rate:
g)
Disease specific mortality
h)
Proportional mortality rateMorbidity indicators
They are
i)
Incidence and prevalence
j)
Notification rates
k)
Attendance rates at out patient departments, health centres,
etc
l)
Admission readmission and discharge rates
m)
Duration of stay in hospital
n)
Spells of sickness of absence from work or school
2.
Disability rates
a)
Event type indicators
(i)
Number of days of restricted activity
(ii)
Bed disability days
(iii)
Work loss days (or school loss days) with in a special period
b)
Person type indicators
(i)
Limitation of mobility
(ii)
Limitation of activity
|
Sullivan’s index:
This index (expectation of life free of disability) is
computed by subtracting from the life expectancy the
probable duration of bed disability and inability to
perform major activities. |
3.
Nutritional status indicators
a)
Anthropometric measurements of pre school children
b)
Heights (and some weights) of school children at school entry
c)
Prevalence of low birth weight (less than 2.5 kg)
4.
Health care delivery indicators
a)
Doctor population ratio
b)
Doctor-nurse ratio
c)
Population-bed ratio
d)
Population per health/subcentre
e)
Population per traditional birth attendant
5.
Utilization rates
6.
Indicators of social mental health
7.
Environmental indicators
8.
Socio-economic indicators
9.
Health policy indicators
10.
Indicators of quality of life
11.
Other indicators
IMMUNIZING AGENTS
VACCINES
BCG
Typhoid oral
Bacterial
Plague
Live
Oral polio
attenuated
Yellow fever
vaccines
Measles
Rubella
Viral
Mumps
Influenza
Epi. typhus
Rickettsial
Typhoid
Cholera
Pertussis
Bacterial
C.S.
meningitis
Plague
Rabies
Inactivated
Salk (polio)
or killed
Influenza
Viral
vaccines
Hepatitis B
Japanese
encephalitis
KFD
Diphtheria
Toxoids
Bacterial
Tetanus
IMMUNO-
Hepatitis A
GLOBULINS
Measles
Human
Rabies
Human normal Ig
Immuno-
Tetanus
globulins
Mumps
Hepatitis B
Varicella
Human specific
Ig
Diphtheria
Diphtheria
Non -human
Tetanus
(Antisera)
Gas gangrene
Bacterial
Botulism
Rabies
Viral
|
|
Attenuated
Vaccines |
Killed
Vaccines |
|
Vaccine dose
Antibody
persistence (immunity)
Booster needed
Revaccination
Latency
Oncogenicity |
Low (replicates)
Long
Infrequently
Possible
Possible
? |
High
Short
Frequently
None
None
None |
|
INCUBATION PERIOD & CAUSATIVE ORGANISM |
|
|
|
Respiratory infections |
|
Small pox |
12 days, 7-17 days |
Variola virus |
|
Chickenpox |
14 -16 days
Extreme 7-21 days |
Varicella zoster virus |
|
Measles |
10 days average 7 days |
Measles virus ( RNA paramyxovirus) |
|
Rubella |
2 - 3 weeks
average 18 days |
RNA virus of Togavirus family |
|
Mumps |
2 - 3 weeks
usually 18 days |
Myxovirus parotiditis (RNA virus) |
|
Influenza |
18 - 72 hours |
Influenza virus 3 types A,B&C |
|
Diphtheria |
2 - 6 days |
Corynebacterium Diphthariae |
|
Whooping cough |
7 - 14 days |
B. pertussis |
|
Meningococcal meningitis |
3 - 4 days |
N. menigitiditis |
|
SARS |
2 - 7 days
commonly 3 - 5 days |
New strain of corona virus |
|
Tuberculosis |
3 - 6 weeks |
M.tuberculosis |
|
|
|
|
|
Intestinal infections |
|
Poliomyelitis |
7 - 14 days |
Polio virus 3 serotypes 1,2 and 3 |
|
Viral hepatitis A |
15-45 days usually 25-30 |
hepatitis A virus |
|
Viral hepatitis B |
45-180 days average 100 |
hepatitis B virus |
|
Viral hepatitis E |
2 to 9 weeks |
hepatitis E virus |
|
Cholera |
A few hours upto 5 days
commonly 1-2 days |
V. Cholerae |
|
Acute diarrhoeal diseases |
|
|
|
Typhoid fever |
10-14 days short as 3 days long as 3 weeks |
S.tiphy |
|
Food poisoning
Staphylococcal
Botulism
Cl.perfringens
B.cereus |
1-6 hours
12-36 hours
6-24 hours
Emetic form 1-6 hours
Diarrhoeal form 12-24
Hrs |
Staphylococcus aureus
Clostrybium botulinum
Bacillus.cereus |
|
Amoebiasis |
2-4 weeks or longer |
E.histolytica |
|
Ascariasis |
2 months |
Ascaris lumbricoides |
|
Hookworm infections
Nectar americanus
Ancylstoma duodenale |
7 weeks
5 to 7 weeks |
Nectar americanus
Ancylstoma duodenale |
|
|
|
|
|
Arthropod borne infections |
|
Dengue syndrome
Classical Dengue fever
Dengue haemorrhagic
fever (DHF) |
3 to 5 days
(commonly 5-6 days)
4 to 6 days |
Dengue Virus |
|
Malaria -Falciparum
-Vivax
-Quartan
-Ovale |
12 (9-14) days
14 (8-17) days
28 (18-40) days
17 (16-18) days |
|
|
Lymphatic filariasis |
8-16 months |
Wuchereria dancrofti |
|
|
|
|
Zoonoses |
|
Viral |
|
|
|
Rabies |
3-8 weeks |
Lyssa virus type 1 |
|
Yellow fever |
3-6 days |
Flavivirus fibricus |
|
Japanese encephalitis |
|
Flavivirus |
|
KFD |
3 to 8 weeks |
Flavivirus |
|
|
|
|
|
Bacterial |
|
|
|
Brucellosis |
1-3 weeks
as long as 6 months |
B.melitnsis, B. abortus, B.suis, B.canis
|
|
Leptospirosis |
10 days range of 4-20 |
L.interrogans |
|
Plague -bubonic
-Septicaemic
-pneumonic |
2-7 days
2-7 days
1-3 days |
Y.pestis |
|
Human salmonellosis |
6-72 hours |
|
|
Scrub typhus |
10-12 days
Varies 6-21 days |
Rickettsia tsu tsu gamushi |
|
Murine typhus |
1-2 weeks com12 days |
Rickettsia typhy |
|
Tick typhus |
3-7 days |
Rickettsia conorii |
|
Q fever |
2-3 weeks |
Coxiella brunetii |
|
Taeniasis |
8-14 weeks |
T.saginata, T.solium |
|
Hydatid disease |
Months to years |
E.granulosus |
|
Leishmaniasis |
1-4 months
Range 10 days-2years |
Leishmania donovani |
|
Surface infections |
|
Trachoma |
5-12 days |
C.trachomatis |
|
Tetanus |
6-10 days |
Clostridium tetani |
|
Leprosy |
3-5 years or more |
M.leprae |
|
Yaws |
3-5 weeks |
T.pertenue |
|
AIDS |
Uncertain |
Human immuno virus |
VECTOR BORNE DISEASE
CONTROL PROGRAMME
1.
National Anti-Malaria Programme
ŕ
National Malaria Control Programme
(NMCP) was launched in India in April 1953. it was in
operation for 5 years( 1953-58).
ŕ
National Malaria Eradication Progamme (NMEP) launched in 1958.
ŕ
New approach to malaria control was approved by WHO in 1978,
ie. Implementation of malaria control in the context of the
primary health care strategy.
ŕ
An Enhanced Malaria Control Project with world
bank support launched on 30th September 1997.
ŕ
In 1999, the government of India decided to drop the term “National
Malaria Eradication Progamme” and renamed it “National
anti-malaria programme”
2.
National Filaria Control Programme
National Filaria Control Programme (NFCP) has been in
operation since 1955.
3.
Kala-Azar Control Programme
Centrally sponsored programme was lunched in
4.
Japanese Encephalitis Control
5.
Dengue Fever Control
DEMOGRAPHY AND FAMILY PLANNING
Demographic cycle
5 stages
|
|
BIRTH RATE |
DEATH RATE |
POPULATION |
|
1.
FIRST STAGE
(High
stationary) |
HIGH |
HIGH |
STATIONARY |
|
2.
SECOND STAGE
(Early
expanding) |
UNCHANGED |
BEGINE TO DECLINE |
|
|
3.
THIRD STAGE
(Late
expanding) |
TENDS TO FALL |
DECLINE |
|
|
4.
FOURTH STAGE
(Low
stationary) |
LOW |
LOW |
STATIONARY |
|
5.
FIFTH STAGE
(Declining)
|
LOWER |
|
|
QUESTION
In demographic
cycle stage/stages in which population remains stationary
a)
first b) fourth c) both a &
b d) none
FERTILITY
The actual bearing of
children
Reproductive period of
women 15-45 years-a period of 30 years
Factors affecting
fertility
