The relevant authorities responsible for maintaining public health such as local authorities, health trusts, government institutions, voluntary organizations etc are required to measure, monitor and control the incidence of different diseases and conditions which occur in a community. In epidemiology, incidence is a measure of a person’s likelihood or risk of developing some new disease within a specified time period and is best expressed as a rate or a probability. Incidence is also a mathematical quantity that describes the occurrence of a disease Y in a population. It is the proportion of persons in the population, who newly develop the disease Y within a given time period (t): The measure of incidence is stated below:
Incidence in population P =
# who develop the disease Y in population p in a time t
# in population p
The practice of disease monitoring is a complex subject and the method implemented in order to carry out this practice varies slightly according the nature of the disease and the extent of the geographical area in which the disease is to be monitored. Surveillance and monitoring are crucial to provide countries with the information needed about development of policies and programs for non-communicable diseases, and to support the assessment of these initiatives and monitor progress. The capacity to undertake surveillance for these purposes varies greatly around the world and was judged inadequate in many low-income and middle-income countries. Some disease monitoring programs are planned to occur in phases over an approximate period to allow for the collection, processing and assimilation of all of the sample material and its association with other recorded parameters. Once results have been obtained and analyzed, the findings of the study will be published and will be made available to all of the health and social care authorities and professionals of the area studied. The results of the disease monitoring projects and knowledge gained from the study will be very helpful with regards to future treatment protocols, therefore improving the health care in addition to aiding the understanding of the disease thereby ultimately assisting in its prevention. The reports and findings arrived at while conducting the research is as follows:
Preliminary outbreak assessments
Qualitative risk assessments
A surveillance framework, including a minimum set of indicators covering exposures and outcomes, is essential for policy development and assessment and for monitoring of trends in disease. Data must be collected, analyzed and used in a regular and systematic way. The interval between the episodes of data collection may vary depending on the measurements involved and the infrastructure available to conduct surveys. Surveillance involves commitment to data collection on an ongoing repeated basis, as well as the use of the data for public health policy.
Four considerations guide the choice of risk factors for inclusion in surveillance activities:
The significance of the risk factor for public health in terms of the nature and severity of the morbidity, disability and mortality of the NCDs associated with these risk factors.
The cost of collecting valid data on a repeated basis;
The availability and strength of the evidence that intervening on the factor will reduce non communicable diseases in the community.
The ability to measure the risk factor burden uniformly in different settings to ensure comparability and to measure changes over time.
The next most important aspect in maintaining public health after disease monitoring is conducted (and if a disease appears to be rampant) is the process of disease control. Control of a disease is the reduction in its incidence, prevalence, mortality and morbidity and elimination of a particular disease in a geographical area may be achieved as a result of intervention programs such as individual protection by the use of vaccines etc. Public Health applies a wide variety of tools for the prevention and control of infectious disease and their transmission by following a range of activities including the filtration and disinfection of community drinking water to environmental vector control, immunization programs etc. Another important program implemented by health and social care authorities in an effort to control the spread of disease is by organizing programs to promote self- protection, case findings and effective treatment of infections to stop their spread to other people (eg: HIV, Tuberculosis, malaria etc). Most importantly planning measures need to be in place. Health promotion is one of the most essential instruments of infectious disease control. It promotes community support of preventive measures. Means of controlling communicable diseases is mentioned below:
Laboratory research and confirmation
Epidemiology of Malaria in South Africa
Incidence Rates- In 2006, South Africa reported 12,098 cases of malaria (incidence rate 25.9 per 100000 person-years) including 87 deaths.
Geographical Distribution- South Africa
Non- Immune Pregnant Women
Semi- Immune Pregnant Women
People with HIV/AIDS
International travelers from non-endemic areas
Immigrants from endemic areas and their children
Causes- Malaria is caused by Plasmodium parasites. The parasites are spread to people through the bites of infected Anopheles mosquitoes, called “malaria vectors”, which bite mainly between dusk and dawn. The intensity of transmission depends on factors related to the parasite, the vector, the human host, and the environment.
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Spread- The parasites that cause malaria are transmitted by a species of insects which are known as the female Anopheles mosquitoes. These parasites multiply within the red blood cells. Malaria spreads when the amount of this particular type of mosquito multiplies.
Controls- Vector control is the primary public health intervention for reducing malaria transmission at the community level. It is the only intervention that can reduce malaria transmission from very high levels to close to zero. In high transmission areas, it can reduce child mortality rates and the prevalence of severe anemia. For individuals personal protection against mosquito bites represents the first line of defense for malaria prevention. Two forms of vector control are as follows:
Insecticide treated mosquito nets
Indoor spraying with residual insecticides
South African Department of Health Malaria case statistics
Provincial distribution of notified malaria cases, South Africa, 2000
Notified malaria cases by age group, South Africa, 2000-2002
Epidemiology of Cardio Vascular Disease in South Africa
Incidence Rates- 165.3 and 101.2 per 100,000 South Africans of Indian descent and 5.3 per 100,000 among black African people.
Geographical Distribution- South Africa
Vulnerable Groups- Smokers, drinkers, drug addicts and drug abusers, obese and inactive individuals and individuals with high cholesterol who consume unhealthy food.
Causes- Any disease that affects the normal functioning of blood vessels, arteries, veins and the heart are categorized under cardiovascular diseases. They are also called as heart diseases. The most common causes are smoking, alcohol and drugs, unhealthy diet and an inactive sedentary lifestyle.
Control- Being active and eating the right foods will go a long way in preventing or controlling heat diseases. If you already have coronary heart disease it is never too late to adopt a healthy dietary change and a more balanced lifestyle. The only means of controlling this non communicable disease is by promoting and educating the public on transforming their unhealthy lifestyles into a healthier one.
There are different approaches and strategies used in order to control the incidence of disease in a community. These approaches are surveillance, screening, immunization, education, legislation, improving social welfare and environmental controls. All these different approaches serve their purpose of being efficient tools for controlling the onset and spread of disease but they have to be used in combination with one another in order to be effective. For example, in the case of malaria epidemic in South Africa, an effective strategy to control the spread must begin with an immunization program directed at the vulnerable groups in the region. At the same time, environmental controls need to put in place in order to ensure that there is not a place left for the mosquitoes to breed freely. Thereafter disease surveillances and screenings must be carried out in order to track the patterns and identify the trends in order to develop more efficient prevention strategies. Government legislature too will help in this regard, if governments decide to grant more aid to local health institutions and authorities, it will be able to offer better facilities to the ill and infected and treat more patients whilst at the time, possessing more resources in order to vaccinate a broader range or people and provide them with the necessary insecticides.
The personal health of the health and social care workers plays a paramount role in any community in the world. These professionals work at hospitals, nursing and personal care facilities, individual and family services etc and there main area of focus in on treating and caring for the ill. It is due to this reason that they need to be in a strong physical and mental state in order for these individuals to give their best to the people who are ill, as the sick need extra care and a lot of energy is required to fulfill their needs. Sick people have weak immunity systems and because these individuals work with the ill and injured on a day to day basis, it is very important that they too are very healthy so that they won’t pass on any diseases to those people who can contract it very easily and make their condition worse. In order for the health professionals to be passionate about health and promoting health, they have to be in their best state of physical and mental health in order to make an impact.
The collection of epidemiological data is very important as it helps to curb future epidemiological conditions. Epidemiology recognizes and measures the happenings of events in populations. Therefore modern epidemiology is able to become a science of prediction. It works by developing different models of the incidence of events, so when conditions occur that fit the developed models, events can be predicted and prevented. The practicing epidemiologist, therefore, attempts to describe the natural history of disease by determining why the disease originates and how it spreads in populations, therefore the practice of epidemiology is important because the concepts of epidemiology science is concerned with the circumstances under which people get sick and attempts to alter these circumstances so as to protect individuals from future illness. In addition to that, the inclusion of multiple data sources in the decision making process enables decision makers to make strong and valid decisions on matters pertaining to the countries health sector based on the findings presented in the epidemiological date. (Surveillance data along with social, demographic, geographic, behavioral, and clinical characteristics must all be included in the decision making process to paint a three dimensional picture of the epidemic).
There are many priorities and approaches in the provision of health and social care services in the prevention, treatment, remedial care and palliative care for people with a disease or illness. The priorities of the health and social care professionals in this regard is to fulfill the needs of the patients while in their care and provide them with the necessary treatment required to nurse them back to good health. Disease prevention is the top priority in fighting diseases through immunization, good hygiene and following disease protocols when an epidemic suddenly emerges. The priorities in the treatment of disease are to first identify the illness and then assign the required treatment. The treatment approach will vary depending on the illness or injury but usually involves medicinal drugs and bed rest. If condition is serious, surgical procedures must be performed. However, the required treatment must be identified accurately and a top priority is to ensure the patient is comfortable while in hospital taking treatment.
The current lifestyle choices of the people will affect the future needs of Health and Social Care provision with regards to diet, exercise, substance use, work culture, relaxation etc. This is because in this day and age, many people eat unhealthy and don’t exercise regularly. Also food contains lots of chemicals and artificial preservatives which is detrimental to the health. Work culture is also incredibly stressful and all these factors together can be detrimental to ones health in the long run. Therefore, in the future it will become necessary for the relevant authorities to anticipate the increase in non communicable diseases and develop new technologies and strategies in order to tackle them effectively.
The responsibilities of the health and social care professionals of a region are numerous in the preservation of public health and wellbeing. Their role is imperative in any community. It is these individuals who are faced with the task of ensuring that the needs of the ill and injured are met. It is not an easy task. Health care providers who have experience working on the front line are often placed in the unique position of educating, training, and preparing the environment for change in addition to influencing national health care policy. In addition to treating the sick, health care professionals are also faced with the task of educating the general public; training interns, work with key stakeholders on issues of advocacy, capacity development, and implementation of health policies at country level and their work to help achieve the goals of the government.
It is important to promote a healthy lifestyle among a community and this could contribute positively to the prevention of many communicable and non- communicable diseases. This is due to the reason that many of the non communicable diseases prevalent today are due to lack of exercise, improper eating and abusing drugs and alcohol. These factors alone, contribute significantly to contracting chronic diseases such as heart disease, diabetes, hypertension etc. Therefore, by just making simple changes to ones lifestyle, one can avoid and prevent oneself from developing these diseases. In the case of communicable diseases, these too can be avoided by promoting healthy lifestyles because if one eats right and exercises regularly, one will develop a strong immunity that will protect against contracting various communicable diseases.
“Prevention is better than cure” is a well heard of term. Undoubtedly, with regards to some medical conditions and diseases in our community, prevention is indeed better than cure. This is because in this day and age falling ill is very costly in countries that don’t provide its citizens with free healthcare. Falling sick takes a toll on ones finances and can be very time consuming with hospitalization and repeated visits to the doctors. Also, an individual will have to be on continuous medication depending on the illness and this too will be costly and inconvenient. For example, if a person develops diabetes he will have to take insulin injections on a regular basis which will be very inconvenient. Also it may hinder ones ability of going to work and if the primary bread winner of a family falls sick, it can be very detrimental to the entire family. Also, the patient and his family will have to undergo a lot of hardship and it will effect their mental state of wellbeing. By simply eating right and exercising regularly, while staying away from intoxicants will enable a person to prevent from developing many chronic diseases. Also, he will feel healthier and happier and his immune system will be strong so his chances of developing communicable illnesses are also low.
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