Remaining Note of 3

Concept of control
Disease control is reducing the transmission of disease agent at low level that it ceases to be a
public health problem.
It describes operations aimed at reducing-
1. The incidence of disease.
2. The duration of disease, and consequently the risk of transmission.
3. The effects of infection, including both the physical and psychosocial complications.
4. The financial burden of the community.

Disease Control Involves

1.Controlling the reservoir
 Early diagnosis
 Notification
 Epidemiological investigations
 Isolation
 Quarantine
2.Interruption of transmission : Means changing some components of man’s environment to
prevent the infective agent from a patient or carrier from entering the body of susceptible person.
Eg: chlorination method to prevent water borne disease, personal hygiene.
3. The susceptible host
 Immunization
 Chemoprophylaxis : this means administration of drugs before occurrence of disease, for
complete prevention of infection or prevention of appearance of clinical symptoms. Some
eg: INH in child contacts of tuberculosis
 Nutrition
4. Non Specific Measures:
 Mainly interrupt pathways of transmission.
 Improvements on the Quality of Life (eg better housing, water supply, nutrition,
education)
 Formulation of legislative measures and integrated program.
 Have played a dominant role in decline of diseases like TB, Cholera, Leprosy and Child
Mortality.

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Disease elimination:
The term “elimination” is used to describe interruption of transmission of disease , for example:
elimination of measles, polio and diphtheria from geographic.
It is intermediate step between control and eradication.
Eradication:
Eradication literally means to “tear out by roots” .
It is the process of “Termination of all transmission of infection by extermination (termination)
of the infectious agent through surveillance and containment”.
This term is reserved for cessation of infection and disease from the world.
The only disease eradicated from the world is “Small Pox”.
Monitoring :
Monitoring is "the performance and analysis of routine measurements aimed at detecting
changes in the environment or health status of population“.
 Monitoring of air pollution,
 Water quality
 Growth and nutritional status, etc.

Surveillance:
Surveillance means to watch over with great attention, authority and often with suspicion.
Surveillance is defined as "the continuous scrutiny (inspection) of the factors that determine the
occurrence and distribution of disease and other conditions of ill-health”.
For eg: Poliomyelitis surveillance programme of WHO.
Ongoing, systematic collection, analysis, and interpretation of health-related data essential to the
planning, implementation, and evaluation of public health practice, with the timely dissemination
of these data to those responsible for prevention and control.
Surveillance is information for action.

Sentinel surveillance:

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Sentinel surveillance is the "monitoring of rate of occurrence of specific diseases/conditions
through a voluntary network of doctors, laboratories and public health departments with a view
to assess the stability or change in health levels of a population".
The main objectives of surveillance are:
a) To provide information about new and changing trends in the health status of a
population, e.g.,
 Morbidity,
 Mortality,
 Nutritional status or other indicators
 And environmental hazards,
 Health practices
 And other factors that may affect health.

(b) To provide feed-back which may be expected to modify the policy and the system itself and
lead to redefinition of objectives, and
(c) Provide timely warning of public health disasters so that interventions can be mobilized.
Evaluation of control:
 Evaluation is the process by which results are compared with the objectives.
 Evaluation is the assessment of how well a program is performing
Difference between Monitoring and Surveillance
Monitoring Surveillance
Continuous oversight of activities to ensure Continuous scrutiny of the factors that
that they are proceeding according to plan. determines the occurrence & distribution of
disease.
Can be done by technicians. Done by professionals
One time activity. Continuous cycle
Stop once disease is eliminated or eradicated Continuous even after disease is
eliminated/eradicated
Smaller concept Broader concept
No feedback present Feedback present
No inbuilt action component present Inbuilt action component present
example: monitoring of air pollution, water Example; demographic surveillance,
pollution, noise pollution nutritional surveillance, sentinel surveillance