HISTORY OF PUBLIC HEALTH IN THE PHILLIPINES AND INTRODUCTION TO COMMUNITY AND
PUBLIC HEALTH
1. Pre-American Occupation (up to 1898)
2. American Military Government (1898-
1907)
3. Philippine assembly (1907-1916)
4. The Jones law (1916-1936)
5. The Commonwealth (1936-1941)
6. Japanese occupation ( 1941-1945)
7. Post World war II (1945-1972)
8. Post EDSA revolution (1986 to present
Read and understand the story
I. Pre American Occupation
- Public health works began at the old
Franciscan Convent in Intramuros
- Fr. Juan Clemente put up a dispensary in
1577
- became the San Juan de Dios Hospital.
During Spanish time:
creation of Board of vaccinators to prevent
smallpox
Creation of board of health
Construction of carried waterworks
First medical school in the Philippines- UST
School of Midwifery
Public health laboratory
Forensic medicine
Hospitals before the Americans came to
Philippines:
1. General hospitals
a)San Juan de Dios Hospital
b)Chinese General hospital
c)Hospicio de san Jose in Cavite
d) Casa dela Caridad in Cebu
e) Enfermeria de Santa Cruz in Laguna
2. Contagious Hospitals
a)San lazaro Hospital
b)Hospital de palestina in CamarinesSur
c)Hospital delos Lesprosos in Cebu
d)Hospital de Argencina in Manila for
smallpox and cholera
3. Military hospital
a) Hospital Militar de Manila
b) Hospital Militar de Zamboanga
4. Naval Hospital
a) Hospital dela Marie in Cebu
b) Hospital de basilan
5. Other hospital/Asylums
a) Hospicio de San Pascual Baylon in
Manila
b) Asylum of St. Vincent de Paul in Manila
for poor girls
c) Hospital of San Jose for orphaned
children and mentally ill
II. American military Government
- Control of epidemics such as cholera,
smallpox and plague
- Fight against communicable diseases such
as leprosy, diarrhea, malaria, beri-beri
Projects and activities
- Approved the first sanitary ordinance
and rat control
- Amoebic dysentery caused by
contaminated water and unclean vegetables
- malaria Anopheles minismus
flavirostris was pointed out as vector.
- Cholera vaccine was first tried
- Confirmed that plague in man comes
from infected rat
- Opened a leper colony in Culion
- Opened the UP College of Medicine
III. Philippine Assembly
 Nursing school at Philippine Normal
School
 Anti-TB campaign was started
 Philippine Tuberculosis Society was
organized
 Pasteur prophylaxis treatment against
rabies was offered
 Opening of the Philippine General
Hospital (PGH)
 Use of anti-typhoid vaccine was
initiated
 Hypochlorite of lime was first used for
treating the water supply of Manila
 Etiology of Amoebic dysentery was
made clear
 Dry vaccine against smallpox was first
used
IV.Jones Law years
Retrogression rather than progression in so
far as the health was concern
 Schick test was used to determine the
causes of diphtheria
 Campaign against Hookworm was
launched
 Anti-dysentery vaccine was first tried
 Construction of Novaliches dam
V. The Commonwealth period
 The epidemiology of life threatening
diseases was studieddiphtheria, yaws,
dengue
 1939, creation of Department of Public
Health and Welfare- Dr. Jose fabella as
the first secretary
VI. Japanese occupation
 All public health activities were
practically paralyzed THE WORLD WAR
II
 General sanitation has been reduced to
level enough to constitute a national
hazard
 US congress passed an emergency
measures to control diseases: TB, VD,
malaria. Leprosy, malnutrition
 Immunization program
VII. POST WORLD WAR II
 Completion for a research on
Dichlorodiphenyl trichlorothanel (DDT)
saw dust as larvicide and DDT residual
spraying of houses in the control of
malaria
 Construction of the National Chest
Center-for control case registry for TB,
mass immunization with BCG
 Industrial hygiene laboratory
 Introduction of one infection method
for gonorrhea with penicillin
 Creation of central Health laboratory in
the Philippines
 Manila was selected as Headquarters
for the WHO Western pacific Office.
 This is thru RHU program (per
municipalities with 5,000-10,000
population)
1 Municipal Health Officer (MHO)
1 Public health Nurse (PHN)
1 Midwife
1 sanitary Inspector
 Each barrio was provided with midwife
 For, the first time, dengue virus was
isolated from typical H fever cases
VIII. MARTIAL LAW YEARS
 Implementation of restructure Health
care delivery system (primary,
secondary, tertiary)
 Construction of tertiary hospitals
(Philippine heart center, Lung center,
Kidney center,Lunsod ng kabataan)
 adaptation of the Primary Health Care
 Promotive and preventive rather than
curative care
 Philippines was the first country to
implement PHC
IX. EDSA REVOLUTION
 Morbidity and Mortality rates from
preventable causes stabilized at high
rates
 Declined in infant and child mortality
decelerated
 Increased incidence of malnutrition
 Declined practice of family planning
X. AQUINO ADMINISTRATION
 1987 constitution – more provision on
health making comprehensive health
care available
 Major activities influencing public
health during this period
 1. Milk code- EO51- required the
marketing of breast milk substitute
 2. Universal child and mother
immunization
 3. International safe and motherhood
initiative was launched to reduced
maternal mortality rate.
 Act prohibiting discrimination against
women (RA6725)
XI. RAMOS ADMINISTRATION
“Health in the Hands of People” and “Lets
DOH it”- by the Sec. Juan Flavier
National Immunization Day – BCG, DPT,
OPV, MMR
Mother and Friendly Hospital Initiative
This strategy ensures the survival and
health of children through breast feeding
Yosi Kadiri- Anti smoking campaign
Araw ng Sangkap pinoy- aimed to prevent
vitamin A, iron and iodine deficiency
Kung Sila’y Mahal mo Magplano- Family
planning program
LAWS:
1. RA 7394- Consumer Act of the
Philippines- an act providing penalties for
manufacture, distribution and sales of
adulterated foods, drugs and cosmetics
2. RA 7610- Special protection of Children
against child abuse, exploitation and
discrimination act
3. EO 39- which created the Philippines
National AIDS Council as a national policy
and advisory body in the prevention and
control of HIV-AIDS
4. RA 7432 - Senior Citizen’s Act - which
grant benefits and special privileges in order
to maximize the contributions of senior
citizen to nation building
5. RA 7719 - The National Blood services
Act of 1994 which was passed to promote
voluntary blood donation
6. RA 8172 - An Act of Salt Iodization
Nationwide- providing salt iodization
nationwide approved in 1996 and renamed
FIDEL _fortified for Iodine Elimination)
Reodica’s Seven Strategy Program
1. Expanded Program on Immunization
(Oplan Alis Disease)- to eliminate polio,
measles and neonatal tetanus
2. Nutrition- vitamin A, iron and iodine
utilization (Araw ng Sangkap pinoy)
3. Family Planning
4. Tuberculosis prevention (Target, Stop TB)
5. Environmental sanitation (TKO)
6.STD-AIDS awareness prevention
7. Healthy Lifestyle program
 INTRODUCTION TO COMMUNITY AND PUBLIC HEALTH
The 3 Core Functions of Public health
Assessment
 Policy Development
 Assurance
 assessment
CHARACTERISTICS OF PUBLIC HEALTH
1. It deals with preventive rather than
curative aspects of health.
2. It deals with population level rather than
individual-level health issues.
Community
It is a group of people with common
characteristics or interests living together Community as Setting in CHN Practice
within a territory or geographical (physical) - Place where people under usual or normal
boundary
Community as Client World Views on
Community :
1. Family, community and society
A. Individual
a. Patient- an individual who is sick.
b. Client- an individual who is well/not
sick.
B. Family
A. Role/Relationship-Parents;Biparenting
*Mother is expected to have the ABILITY
to provide care and usually takes the role
of keeping the family well and healthy by
combining:
1. Knowledge
2. Attitudes
3. Skills
C.Community
CHN serves up to this level only. -
Everything that affects the individual
affects the family and eventually the
community.
2. Contradictions / Conflicts
1. Individual: intrapersonal conflicts
(conflict within the person/personal
conflicts)
2. Family: interfamilial conflicts
(conflict within the family/interpersonal
conflicts)
3. Community: intercommunity (interfamilial
conflicts)
4.Society: intra-societal conflicts
(intercommunity conflicts
Stereotyping
People tend to have negative perspectives. In
the Philippines, negative regional
stereotyping is very common such as
a. Ilocanos: kuripot---
(positive : call them resourceful)
b. Kapampangans: mayabang---
(positive : maybe they are assertive/artistic)
c. Bicolanos: malibog---
(positive : could be loving/warm hearted)
d.Bisaya: aswang---
(positive : they are mysterious/interesting
people)
e. Mindanaoans: mamamatay tao (Muslims
esp)---(positive : brave/courageous)
3.Change
-is inevitable because a community is a
dynamic and is always changing
conditions are found
1. Home- you render Family Health Nursing
2. Workplace- you render Occupational
Health Nursing
3. Schools- you render School Health
Nursing *Outside of purely curative
institutions such as hospitals.
Health-Illness Continuum Models:
A. Dunn’s High-Level Wellness Grid
B. Travis’ IllnessWellness Continuum
A. Dunn’s High-Level Wellness Grid: -
describes a health grid in which a health axis
and an environmental axis intersect. - the
grid demonstrates the interaction of the
environment with the illness-wellness
continuum.
1. High-level wellness in a favorable
environment :
- Ex is a person who implements healthy
lifestyle behaviors and has the bio
psychosocial, spiritual , and economic
resources to support his lifestyle.
2. Emergent high-level wellness in an
unfavorable environment :
- Ex is a woman who has the knowledge to
implement healthy lifestyle practices but
does not implement adequate self-care
practices because of family responsibilities,
job demands, or other factors.
3. Protected poor health in a favorable
environment :
- Ex is an ill person whose needs are met
by the health care system and who has
access to appropriate medications, diet, and
health care instruction.
4. Poor health in an unfavorable
environment: - Ex is a young child who is
starving in a drought-stricken country.

B. Travis’ Illness-Wellness Continuum:
-Ranges from high-level wellness to
premature death. - It demonstrates two
arrows pointing in opposite directions and
joined at a neutral point.
Movement to the right of the neutral point
indicates increasing levels of health and
well-being for an individual achieved in
three steps :
1. Awareness
2. Growth
3. Education
Variables influencing health status, beliefs
and practices :
1. Internal variables
include those which are usually non-
modifiable such as:
a. Biologic dimension - genetic makeup, sex,
age, and developmental level all significant
to a person’s health.
b. Psychological dimension - emotional
factors which include mind-body
interactions and self-concept.
c. Cognitive dimension - intellectual factors
which include lifestyle choices and spiritual
and religious beliefs.
2. External variables
the macrosystem which include:
a. Environment - geographical locations
determine climate, and climate affects
health; environmental hazards.
b. Economics - standards of living reflecting
occupation, income and education is related
to health, morbidity and mortality.
c. Family and cultural beliefs: - the family
passes on life patterns of daily living and
lifestyles to offsprings (e.g.
physical/emotional abuse or climate of
open communication).
d. Social support networks: -
political/systems of governance;
religion/church; mass media.
3. Agent-Host-Environment Model:
also called the ecologic model by
Leavell and Clark refers to the interplay of
agent(causative/etiologic factor), host
(possessing intrinsic factors), and the
environment (extrinsic factors)
A. Etiologic Factors
1. Biological agents
- virus, fungi, bacteria, helminthes,
protozoa, ectoparasites
2. Chemical elements:
a.Carcinogens: - e.g. those contained in
Pringles, Toblerone
b. GMO:contained in Nesvita
c. Poisons: MSG
d. Allergens
e. Transfats
3. Nutritive elements :
- excesses and or deficiencies e.g.
marasmus & kwashiorkor
4. Mechanical factors
- accidents
5. Physical
- as when one is struck (strike) by
lightning
6. Psychological
- such as stress
B. Host:
Intrinsic factors include
1. Exposure
2. Response (reaction)
C. Environment:
Extrinsic factors includes:
1. Natural boundaries
2. Biological environment
3. Socio-economic (political boundary)
3.Health Belief Model: -
refers to the relationship between a
person’s belief and his behavior in health.
- It pertains to three components of an
individual’s perception
1. Susceptibility to an illness
2. Seriousness of an illness
3. Benefits of taking the action Example:
In one HIV infection study
4. Evolutionary-based Model:
- states that illness and death sometimes
serve an evolutionary function.
What is Community Health?
- A part of paramedical and medical
intervention or approach which is concerned
with the health of the whole population. Its
aims are :
1. Health promotion
2. Prevention of disease
3. Management of factors affecting health
Major concepts of Public health:
1. Health promotion and disease prevention
2. People’s participation towards self-
reliance : active and full involvement with
people in the decision-making process:
Assessment, planning, implementation,
monitoring and evaluation.
Dr C E Winslow
promoting health and efficiency through
organized community effort to ensure
everyone a standard of living adequate for
the maintenance of health
Hanlon
It holds this goal as its contribution to the
most effective total development and life on
the individual and this society. (Holistic)
Purdom
It prioritizes the survival of human species,
the prevention of conditions which lead to
the destruction or retardation of human
function and potential in early years of life,
the achievement of human potential and
prevention of the loss of productivity of
young adults and those in the middle period
of life and the improvement of the quality of
life especially in later years.
Nightingale
The act of utilizing the environment of the
patient to assist him in his recovery.
- Any individual is capable of reparative
process.
INTRODUCTION TO STATISTICS
DATA
1.)Primary Data
first hand by the investigator to help
him answer specifically the purposes of his
study
2.)Secondary Data
which are already existing and
which have been obtained by some other
people for purposes not necessarily those of
the investigator’s.
METHOD
refers to orderly processes of data
collection, organization, presentation and
interpretation
DATA
it refers to quantitative data
affected to a marked extent by a multiplicity
of causes. Data are collected in order to
measure something (number of deaths,
births, specific diseases, hospital admissions)
Sources of Data
• Census
• Registries of vital events
• Reports of occurrence of notifiable
diseases
• Different records
• Family Records (kept by RHU)
•Laboratories,Pharmacies,Bloodbanking
centers, and Private practitioners
• Statistical publications
(Phil.Health Statistics, Weekly
DiseaseBulletin,Annual Demographic
yearbook)
Methods of Data Collection
• Documented sources
– Saves time, energy and money – Data
is routinely obtained, did not have in mind
the specific questions of the researcher
• Sample Surveys -studies specific segments
or subsets of population
•Census - studies total population
– De facto people are allocated to the
areas where they were physically
present at the census date regardless of
where they usually live
- De Jure assigns individuals to the
place oftheir usual residence regardless of
where they were actually enumerated during
the censu
Interview
- one on one encounter, use list of
questions, to know opinions or feelings of
subjects
- Questionnaires can be sent for
respondents living in far-flung areas
Classification of Statistical Data
1. Demographic- ex. Population size, age, sex,
geographic distribution, mortality, morbidity,
growth rate
2. Health Status - ex. Causes and distribution
of mortality and morbidity as to residence,
place of occurrence, age, sex
3. Health Resources - ex. Number and
distribution of health facilities, health
manpower, health expenditures
4. Health -related Socio-economic
Environmental Factors- ex. Water supply,
excreta disposal, school enrollment, food
establishment, transports, food
intake/habits
Methods of Data Presentation
• NARRATIVE OR TEXTUAL METHOD
• TABULAR PRESENTATION
• GRAPHICAL PRESENTATION
TABULAR PRESENTATION
TABULATION
It refers to the arrangement of any data in
an orderly sequence
TABLES
- Provide a compact way of presenting
large sets of detailed information
– Simplicity, clarity and directness are
prime considerations in the construction of
tables
Parts of a Table
• Table Number- Arabic numerals are used.
Place it on the first line of the tile.
• Title- it should state the objective of
the table. It should clearly, briefly and
comprehensively what the figures in the
body of the table stand for. How the data are
classified, where and when obtained
• Row Headings/Stubs- indicate the basis of
classification of the rows or horizontal
series of figures
• Column headings -indicate the basis of
classification of the columns or vertical
series of figures.
• Body of the table - this is made up of the
figures filling the cells or compartments
brought about by the coordinates of rows
and columns
• Footnote -indicate the source of
information
Graphical Presentation
• Graphs are simpler to read and appeal to a
greater number of people than tables.
• Large complex data can be presented in a
simpler language
• Trends or patterns which could otherwise
be missed in tables stand out more clearly.
BAR GRAPH
– For comparisons of absolute or relative
counts
PIE CHART
– Shows the breakdown of a group per total
where the number of categories is not too
many
HISTOGRAM
– Similar to a bar graph but groups number
into ranges
FREQUENCY POLYGON
– Same function as histogram
LINE DIAGRAM
– Shows trend data or changes with time or
age with respect to some other variable
SCATTERPOINT/SCATTERPLOT
– Show correlation between simultaneous
measurement
DEMOGRAPHY
is the statistical study of human
population.
It encompasses the study of the size,
structure and distribution of these
population and spatial and/or temporal
changes in them in response to birth,
migration, aging and death
CENSUS
is the other common direct method of
collecting demographic data.
- is usually conducted by a national
government and attempts to enumerate
every person in a country.
two methods of data collection: direct
and indirect
1. Direct data
statistics registries that track all births
and deaths as well as certain changes in
legal status such as marriage, divorce, and
migration.
2. Indirect methods
of collecting data are required in countries
where full data are not available, such as is
the case in much of the developing world.
-One of these techniques is the sister
method, where survey researchers ask
women how many of their sisters have died
or had children and at what age.
- With these surveys, researchers can then
indirectly estimate birth or death rates for
the entire population.
- Other indirect methods include asking
people about siblings, parents, and children.
1. Crude birth rate
- Refers to the annual number of live births
per 1,000 people.
2. General fertility rate
- Refers to the annual number of live births
per 1,000 women of childbearing age (often
taken to be from 15 to 49 years old, but
sometimes from 15 to 44).
3. Age -specific fertility rates
- Refers to the annual number of live births
per 1,000 women in particular age groups
(usually age 15-19, 20-24 etc.
4. Crude death rate,
- Refers to the annual number of deaths per
1,000 people.
5. Infant mortality rate,
- Refers to the annual number of deaths of
children less than 1 year old per 1,000 live
births.
6. Life expectancy
- Refers to the number of years which an
individual at a given age could expect to live
at present mortality levels
7. Total fertility rate
- Refers to the number of live births per
woman completing her reproductive life, if
her childbearing at each age reflected
current age-specific fertility rates
8. Replacement level fertility -
Refers the average number of children a
woman must have in order to replace herself
with a daughter in the next generation.
9. Gross reproduction rate
- Refers to the number of daughters who
would be born to a woman completing her
reproductive life at current age-specific
fertility rates.
10. Net reproduction ratio
- is the expected number of daughters,
per newborn prospective mother, who may
or may not survive to and through the ages
of childbearing.
11. Stable population
- one that has had constant crude birth
and death rates for such long time that the
percentage of people in every age class
remains constant, or equivalently, the
population pyramid has an unchanging
structure.
12. Stationary population
- one that is both stable and unchanging in
size (the difference between crude birth rate
and crude death rate is zero). - A stable
population does not necessarily remain
fixed in size, it can be expanding or
shrinking
Populations can change through three
processes:
A. Fertility
B. Mortality
C .Migration
Fertility - involves the number of children
that women have and is to be contrasted
with fecundity.
Mortality - is the study of the causes,
consequences, and measurement of
processes affecting death to members of the
population.
Migration - refers to the movement of
persons from an origin place to a
destination place across some pre-defined,
political boundary
One method of measuring the population
size is by determining the increase in the
population resulting from excess of births
compared to deaths.
1. Natural increase
- is simply the difference between the
number of births and the number of death
occurring in a population in a specified
period of time
= number of births - Number of deaths
(specified year) (specified year)
2. Rate of Natural increase
- is the difference between the Crude
Birth Rate and the Crude Death rate
occurring in a population in a specified
period of time
= Crude Birth Rate - Crude Death Rate
(specified year) (specified year)
The second method of measuring determine
the increase in the population using data
obtained during two census periods.
1. Absolute increase per year
Measures the number of people that are
added to the population per year. This is
computed using the following formula: Pt-
Po /t
Where:
Pt= Population size at a late time
Po= Population size at an earlier time
t= number of years between time 0 and the
time t
2. Relative increase
Is the actual difference between the
two census counts expressed in percent
relative to the population size made during
an earlier census. Pt- Po/Po=
Where:
Pt= population size at a later time
Po= population size at an earlier time
Population Composition
The composition of the population is
commonly described in terms of its age and
sex
1. Sex composition
To describe the sex composition of the
population, the nurse computes for the sex
ratio.
Number of males/Number of females x 1000
The sex ratio represents the number of
males for every 1000 females in the
population.
2. Age composition
There are two ways to describe the age
composition of the population.
A. Median age divides the population
into two equal parts
B. Dependency ratio compares the
number of economically dependent with the
economically productive group in the
population.
3. Age and Sex composition
- The age and sex composition of the
population can be described at the same
time using a population pyramid.
- It is a graphical presentation of the age
and sex composition of the population.
EPIDEMIOLOGY
“Study the distribution and determinants of
health related states and events in specified
populations, and the application of this
study to the prevention and control of
health problems”
John M. Last, Dictionary of Epidemiology
C-E. A. Winslow, the great public health
leader of the early 20th century, called
epidemiology “the diagnostic discipline of
public health.”
Goal of epidemiology
ultimate goal is to use this knowledge to
control and prevent the spread of disease.
Uses of Epidemiology
1. Study the history of the health population
and the rise and fall of diseases and changes
in their character.
2. Diagnose the health of the community
and the condition of the people.
3. Study the work of health services with a
view of improving them.
4. Estimate the risk of diseases, accidents,
detects and the changes avoiding them.
5. Complete the clinical feature of chronic
disease and describe their natural history.
6. Search for cause of health and disease.
Health vs. Good Health
– The absence or presence of a disease
– Must be “clearly defined
Disease Definitions
• Disease
– State of physiological/biomedical
dysfunction
• Illness
– Subjective state/awareness of not being
well
• Sickness
– state of social dysfunction
(the “sick role”)
• Impairment
– Any loss of abnormality of structure or
function
• Disability
– Restriction or inability to perform in the
manner considered normal of an individual
• Handicap
– Disadvantage that limits or prevents the
fulfillment of a social role
Epidemic
- an increase in the frequency (incidence) of
a disease above the usual and expected rate,
which is called the endemic rate.
- thus epidemiology count cases of a disease,
and when they detect the sign of epidemic,
they ask who, when and where questions.
• Who is getting the disease
• Where and when the disease is occurring
• From this information, they can often
make informed guesses as to why it is
occurring
John Snow
- father of modern epidemiology
- Study about cholera
- Snow would not have been formulated his
hypothesis without the data he gathered
Notifiable disease
- surveillance made by the government
before many people start dying.
A typical Epidemiologic
Investigation Outbreak of hepatitis
What? It is caused by virus that
contaminates food or water
Who? Interviewed and asked question on
what date did the first symptoms
appear?(knowing the hepatitis A virus has
an incubation period of 30 days, it is
possible to work back on the estimated date
of exposure)
The where question is the hardest: where
did the victim obtain their food and water
during the period and what sources did they
have in common?
Two main areas of investigation
1. Describes the distribution of health status
in terms of age, gender, race, geography, and
time.
2. Patterns of disease distribution in terms
of causal factor
• In epidemiology of any disease or event,
one studies the factor which contribute to
its causation and behaviorAGENT, HOST,
ENVIRONMENT
• Epidemiology concept maintains that there
can be no single cause of disease
Agent
- is any element, substance or force whether
living or non-living thing;
Types of Agent:
- living or non-living things, physical or
mechanical in nature
- They could be chemicals- endogenous
(within the body) or exogenous (poison)
 Characteristics of Agent of disease
1. .Inherent characteristics
- physical feature, biological
requirement, chemical composition,
resistance
2. Characteristics in relation to the
environment
- refers to the reservoir and source of
infection and modes of transmission.
Characteristics directly related to man
a. Infectivity
b. Pathogenicity
c. Virulence
d. Antigenicity
Modes of Transmission
1. Direct transmission - immediate
transfer of infectious agent a receptive
portal of entry
2.indirect transmission
a. Vehicle borne - contaminated inanimate
objects or materials
b. Vector-borne- from other living
organism (ex. Insects)
c. Mechanical vector
3.Airborne - dissemination of microbial
aerosols to a suitable portal of entry
usually the respiratory tract
a. Droplet nuclei- usually small
residues which result from evaporation
of fluid from droplets emitted by an
infected host
b. dust
THE HOST FACTOR OF DISEASE
1. Age
2. Sex
3. Race
4. Habits, Customs, and religions
5. Exposure to agent
6. Defense mechanism of the host
❖ Humoral Defense
❖ Cellular Defense
Immunity--This is the total property of an
individual to protect himself from an
infectious agent
Two types of immunity
❖ Non specific resistance - presents at
the time of birth or has developed during
maturation
❖ Specific resistance - acquired as a
result of prior exposure with a foreign
substance
Two folds of specific resistance
Active- What has been introduced to the
individual is the antigen and the body
makes the antibody.
1.Naturally acquired active immunity
- When we get sick the infective agent will
gain entry to the body, act as stimulant for
antibody formation because the organism
acts as antigen.
- The immunity is lifelong (ex. Measles,
chicken pox, hepatitis A)
2.artificially acquired active immunity
- When the antigen has been deliberately
introduced like injecting vaccines, they act
as antigen to stimulate antibody formation.
- It makes use of vaccine which is
suspension of killed or living organism
(ex. MMR, OPV, BCG)
Passive- When what has been
introduced to the body is already
antibodies that provide immediate
protection against microorganisms.
1. Naturally acquired passive
immunity
- Exhibited by the transfer of
antibodies from mother’s
placenta to the fetus and
transfer of antibodies from
breast milk to the baby.
2. Artificially acquired passive
immunity
- Injection of artificially prepared
substance like immune serum of
gamma globulin. These two are
antibodies preparation (ex. Anti-
tetanus antibodies, diphtheria
antitoxin)
THE ENVIRONMENTAL FACTORS OF
DISEASE
Environment - sum total of an
organism’s external surrounding
conditions and influences that affect its
life and development
Physical Environment
climate- certain disease
have seasonal distribution
Geography and location
Biologic Environment- living
environment of man consist of
plants, animals and fellow human
beings.
Socio-economic environment
DISEASE CAUSATION
• The occurrence of disease follows
biologic laws which apply to both
communicable and non- communicable
diseases.
• Disease results from imbalance
between the forces of the agent and
host
 Incubation period- Time between exposure
to infectious agent up to the time of
appearance of the earliest signs and
symptoms
1. Clinical incubation period - the time
between exposure to a pathogenic
organism and the onset of symptoms of a
disease.
2. Biological Incubation Period - The time
taken by the parasite to complete its
development in the definite host (from the
time of entry of the infective larvae to the
presence of microfilariae) is called the
intrinsic incubation period (Biological
incubation).
Categories of Isolation
1. Strict isolation
- this category is designed to prevent
transmission of highly contagious or
virulent infectious that may spread by
direct contact or droplet.
2. Contact isolation
- for less highly transmissible or serious
infections, for disease or conditions which
are spread primarily by close or direct
contact.
3. Respiratory isolation
- to prevent transmission of infectious
diseases over short distance through the
air
4. Tuberculosis isolation (AFB isolation)
- for patient with pulmonary
tuberculosis who have a positive
sputum smear or chest x-rays which
strongly suggest active tuberculosis
5. Enteric Precautions
- for infectious transmitted by direct or
indirect contact with feces purulent
material or drainage from an infected
body site
6. Drainage/secretion Precautions
- to prevent infections transmitted by
direct or indirect contact with purulent
material or drainage from an infected
body site.
7. Blood/body fluid Precautions
- to prevent infections that are
transmitted by direct or indirect contact
with infected blood or body fluids.
• QUARANTINE
- Restriction of the activities of well
persons or animals who have been
exposed to a case of
communicable diseases during its
period of communicability to
prevent disease transmission
during incubation of infection
should occur
Categories of Quarantine
1. Absolute or Complete Quarantine -
Limitation of movement of those exposed
to a communicable disease for a period
of time not longer than the longest usual
incubation period of that disease.
2. Modified Quarantine
- Selective, partial limitation of
freedom of movements of contacts
DIFFERENT EPIDEMIOLOGIC STUDIES
1. Descriptive Study
2. Experimental Study
DESCRIPTIVE STUDY.
o Analytical Study:
- Ecological
- Cross-sectional
- Case-Control
- Cohort
-
EXPERIMENTAL STUDIES
Randomized control trial
Subject in a population are randomly
allocated to groups, usually called
treatment and control groups, and the
results are assessed by comparing the
outcome in the two or more groups.
Fields Trial
- It involves people who are disease
free but presumed to be a risk.
-Since the subjects are disease- free and
the purpose is to prevent the occurrence
of diseases that may occur with relatively
low frequency
-field trials are often huge
undertakings involving major logistics
and financial considerations.
Community Trial
In this form of experiment the
treatment groups are the communities
rather than individuals.
THE NATURAL HISTORY OF COMMUNICABLE
DISEASE AND THE LEVELS OF DISEASE PREVENTION
The natural history of diseases
comprises the body of knowledge about
the agent, host and
Phrases
1. Pre pathogenesis -This is the phase
before man is involved. Through the
interaction of the agent, the host and
environmental factors, the agent
finally reaches man.
2. Pathogenesis --This phases includes
the successful invasion and
establishment of the agent in the host