NATURAL HISTORY OF DISEASE

Joko Mulyanto
CHEM I - 2010
DEFINITION
• The progress of a disease process in an
individual over time, in the absence of
intervention.
• The process begins with exposure to or
accumulation of factors capable of causing
disease.
• Without medical intervention, the process ends
with recovery, disability, or death.
CHARACTERISTICS
• Most of diseases have its own (usually different)
natural history.
• It’s not always understandable for many disease
(remain unclear).
• For the same disease but different individual, the
specific manifestation and progress (time
frame) of disease can be various.
• Influenced by preventive and therapeutic
measures, host factors, and other factors.
STAGE OF DISEASE
STAGE 1 : SUSCEPTIBILITY
• Appropriate exposure to or accumulation of
factors sufficient to begin the disease process in
a susceptible host.
• Agents which assist the development of disease
exist, but disease has not developed
• Infectious disease : microorganism
• Non-infectious (degenerative) disease : risk
factors.
STAGE 2: SUBCLINICAL DISEASE
• Also known as pre-symptomatic stage .
• Inapparent pathologic changes follows exposure,
ending with the onset of symptoms
• Changes have occurred, but not clinically
detectable yet.
• Infectious disease: incubation period
• Chronic (degenerative) disease: latency period
Cont’d
• Vary from seconds to decades for different
diseases, usually in a range of period for single
disease.
• Some pathologic change may be detectable by
laboratory, radiographic, or others screening
method.
STAGE 3 : CLINICAL DISEASE
• Marked by clinical signs and or symptoms of the
disease.
• Most of disease diagnosis made in this stage.
• The progress of disease may vary in individuals
depend on agent, host, and other factors.
• In term of infectious disease, there are three
common terms: infectivity, pathogenicity,
virulence.
Cont’d
• Infectivity: refers to the proportion of exposed
persons who become infected
• Pathogenicity: refers to the proportion of
infected persons who develop clinical disease.
• Virulence: refers to the proportion of persons
with clinical disease who become severely ill or
die.
• Iceberg phenomenon & carrier.
STAGE 4 : RECOVERY, DISABILITY, OR
DEATH
• Fully recovered, no residual effect.
• Disability: disease has progressed to the point of
causing residual effect.
• Not fully recovered, functional and or organic
change (damage), temporary or permanent.
djokomoeljanto©2010