CONCEPTS OF

HEALTH – DISEASE
AND
HISTORY OF DISEASE
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 AGENT – HOST
ENVIRONMENT
INFECTION DISEASE
DEPEND UPON FACTORS – CONTACT BETWEEN
INFECTIOUS AGENT AND A SUSCEPTIBLE
PERSON KNOWN AS THE HOST.
THE DURATION AND EXTENT OF ITS EXCRETION
FROM AN INFECTED PERSON.
THE CLIMATIC CONDITION AFFECTING
SURVIVAL OF THE AGENT.
RELATIONSHIP AMONG INFECTIOUS
AGENTS OF DISEASE , THE HUMAN
HOST AND HIS ENVIRONMENT
ALSO EXIST AMONG
NON INFECTIOUS ETIOLOGICAL
AGENTS - HOST - ENVIRONMENT
For example:
CANCER
Maybe depend apon the extent of EXPOSURE to the
CARCINOGENIC AGENT , the dose of the agent, the
genetic and the environment.
 CLASSIFICATION OF AGENTS, HOST
AND ENVIRONMENTAL FACTOR
AGENTS OF DISEASE AS EXAMPLE
Etiological Factors
1.Nutritive elements
Excesses --------------- Cholesterol
Deficiencies --------------- Vitamins, Proteins
2.Chemical agents
Poisons --------------- CO gas, CCl4, Drugs
Allergens --------------- Regweed, Medication
3.Physical agents ----------------------------------- Ionizing radiation
4.Infectious agents Bacteria ------------- Typhoid, TBC.
Parasite ------------- Hookworm
Virus ------------- Hepatitis A, Mumps
HOSTS FACTOR (INTRINSIC FACTORS) – INFLUENCE
EXPOSURE , SUSCEPTABILITY OR RESPONSE TO AGENTS

Example

1.Genetic Sickle cell disease

2.Physiologic State Fatique, Fregnancy, Stress.

3.Human Behavcior Personal hygiene

Food handling
Diet
Recreation
Utilization of Health Resources
 ENVIRONMENT FACTOR
(EXTRINSIC FACTORS)

1.BIOLOGICAL ENVIRONMENT
- Infectious agent of disease
- Reservoir of infection (animal)
- Vector which transmit disease
(flies and mosquito)
- Plants and animals
(food )
 ENVIRONMENT FACTOR
(EXTRINSIC FACTORS)

2.SOSIAL ENVIRONMENT
- Economic
- Political organization
- Culture
- Community
 ENVIRONMENT FACTOR
(EXTRINSIC FACTORS)

3.PHYSICAL / CHEMICAL ENVIRONMENT

- Heat
- Light
- Air
- Water
- Radiation
- Gravity
- Atmospheric pressure
- Chemical agents of all kinds
 INTERRELATION OF FACTORS)
(ECOLOGIC MODELS)

THE EPIDEMIOLOGIC TRIANGLE

HOST

AGENT ENVIRONMENT
 WHEEL MODELS OF MAN-ENVIRONMENT
INTERACTION

HOST Genetic
core

Physical
Environment

Social
Environment
BIOLOGI
ENVIRONMENT
ENVIRONMENTAL FACTOR (EXTRINSIC FACTORS) –
INFLUENCE EXISTENCE OF THE AGENTS , EXPOSURE OR
SUSCEPTABILITY TO AGENTS
Example

1.Physical environment Geology , Climate

2.Biologic environment
Human population Density
Flora Source of food
Fauna Food sources, Vector

3.Sosioeconomic
Environment occupation Exposure to chemical agents
Urbanization Urban crowding
 CAUSATION OF DISEASES
GENETIC FACTORS

GOOD HEALTH POOR HEALTH

ENVIRONMENTAL FACTORS
(INCLUDING BEHAVIOURS)
NATURAL HISTORY OF DISEASE

DEATH

SUBCLINICAL CLINICAL
GOOD HEALTH CHANGES
CHANGES

RECOVERY
 CLASSIFICATION OF HUMAN INFECTIONS BY
MODE OF TRANSMISSION

CLASSIFICATION OF HUMAN INFECTIONS

BY SELECTED EPIDEMIOLOGIC FEATURE
1.Dynamics of Spread through Human Population Sample
A.Spread by “common vehicle “
-INGESTION WITH: WATER-FOOD-BEVERAGE Salmonella
-INHALATION IN AIR BREATHED Flu
-INOCULATION (INTRAVENOUS-SUBCUTANEOUS) Hepatitis B
B.Propagation by serial transfer
From HOST to HOST.
-RESPIRATORY ROUTE OF TRANSFER Measles
-ANAL-ORAL ROUTE Shigellosis
-GENETAL ROUTE Syphilis
 CLASSIFICATION OF HUMAN INFECTIONS BY
MODE OF TRANSMISSION

CLASSIFICATION OF HUMAN INFECTIONS

BY SELECTED EPIDEMIOLOGIC FEATURE

2.Portal of Entry (and Portal of Exit) Samples

in Human Host
-Upper Respiratory Tract Diphtheria
-Lower Respiratory Tract Tuberculosis
-Gastrointestinal Tract Typhoid fever
-Genitourinary Tract Gonorrhea
-Conjunctiva Trachoma
-Percutaneous Leprospirosis
-Percutaneous (bite of arthropod) Yellow fever
 CLASSIFICATION OF HUMAN INFECTIONS BY
MODE OF TRANSMISSION

CLASSIFICATION OF HUMAN INFECTIONS

BY SELECTED EPIDEMIOLOGIC FEATURE

3.Principal Reservoir of Infection Samples

-Man Infectious hepatitis
-Other vertebrates (zoonoses) Tularemia
-Agent free living Histoplasmosis
 CLASSIFICATION OF HUMAN INFECTIONS BY
MODE OF TRANSMISSION

CLASSIFICATION OF HUMAN INFECTIONS

BY SELECTED EPIDEMIOLOGIC FEATURE

4.Cycles of Infections Agent in Nature Samples

-Man – man Inluenza
-Man – arthropod – man Malaria
-Vertebrate-vertebrate-man Psitacosis
-Vertebrate-artropod-vertebrate-man Viral ence
phalitis
 CLASSIFICATION OF HUMAN INFECTIONS BY
MODE OF TRANSMISSION

CLASSIFICATION OF HUMAN INFECTIONS

BY SELECTED EPIDEMIOLOGIC FEATURE

5.Complex Cycles Samples

In certain helminth infections
Paragonimiasis
The cycle is as follow:
Ovum – miracidium – cercaria – adult – ovum
( in snail ) (in crab, (in man)
crayfish)
NATURAL HISTORY OF
DISEASE
 STATE
NATURAL HISTORY OF
DISEASE

STAGE OF
1. SUSCEPTIBILITY
2. PRESYMPTOMATIC DISEASE
3. CLINICAL DISEASE
4. DISABILITY
 STATE
OF SUSCEPTIBILITY
1. RELATION BETWEEN :
HOST – AGENT – ENVIRONMENT
2. RISK FACTOR:
HOST (fatique)  ALCOHOL  PNEMONIA
OBESITAS  SMOKING  CORONAIR HD.
SUSCEPTIBILITY, RELATED TO:
AGE-SEX-LIFE STYLE-CULTURE-ETC
 STATE
OF PRESYMPTOMATIC
DISEASE
1. DISEASE NOT CLEAR
2. PATHOLOGIC DISORDER IS CLEAR
3. DISORDER STILL UNDER CLINICAL
HORISON LINE. ( THE BORDERS OF
CLINICAL MANIFESTATION AND PATHOLO
GICAL CONDITION)
Eq. Atherosclerotic (+) before SUDDEN
DEATH
 STATE
OF CLINICAL DISEASE

1. CHANGES OF ANATOMICAL AND

FUNCTIONAL OF ORGANS
2. SYMPTOMS OF DISEASES (+)
3. DISEASE CAN CLASIFIED
ACCOEDING TO : LOCATION
HISTOLOGICAL
PSYCHOSOSIAL
 STATE
OF DISABILITY
DISEASE  CURE  DISABLE  DEATH
Eq. VIRUS DISEASE SELF LIMITING
DISEASE. COMPLICATION
(ENCHEPHALITIS)

HT  STROKE  HEMIPLEGIA.