Public Health

PUBLIC
3
PHAR CARE
______________________________
HEALTH
COURSE OUTCOMES:
At the end of the course,
you will be able to:
 Understand Public Health
and related concepts
 Explain relationship of
public health and
FOCUS
pharmacy practice This course primarily focuses on factors
Course Overview
 Appreciate the roles of affecting health, indicators of general
pharmacists in a health subject
This in the community,
focuses paston and current
factors
issues (drug and non-drug related, local
collaborative health affectingand
health, indicators of general health
international) pertinent to Public
setting in addressing in the community,
Health and lawspast
andand current
policies, issues
interventions
public health issues (drug and non-drugthatrelated,
and programs address local and
these issues,
 Understand existing and determination of roles of Pharmacists
international) pertinent to Public Health and
policies, laws, laws and in Public Health, and
policies, application of and
interventions these
concepts.
interventions, and programs that address these issues. With
programs that address this, you will now what are the roles of a
public health issues pharmacist in the community, especially in
 Demonstrate saving and prolonging lives.
understanding on the
determinants of health,
public health issues and
government and non-
COURSE CONTENT:
government programs  Unit I. Public Health Concepts
PRELIMS
 Demonstrate  Unit II. Factors that Affect Health

understanding on the roles  Unit III. Etiology of Diseases
of pharmacists in
improving public health
 Unit IV. Disease prevention and control
 Demonstrate
MIDTERMS
 UNIT V: Health Promotion in Industry

understanding on the  UNIT VI: Governmental and Non-Governmental
definition, types, Health Programs and Services
importance, roles of
pharmacists and process
FINALS
of administration of
 UNIT VII: Infectious
PreparedDiseases
by: in the Philippines
Immunization
Kathleen P. Buncab, RPh

Faculty, College of Pharmacy
Lorma Colleges
PUBLICHEALTH
PREPARED BY: K A T H L E E N B U N C A B, R P h
IMPORTANT: This module is only a COMPILATION from various sources
and only a SUPPLEMENTAL NOTE. Please refer to the
suggested readings for more comprehensive discussion.
PUBLICHEALTH
UNIT I. PUBLIC HEALTH CONCEPTS
OBJECTIVES:
At the end of the topic, you will be able to
1. Be familiar and understand the definition PUBLIC HEALTH
2. To know the history of Public health
3. To know the essential functions of public health and its different approaches towards health.
4. To differentiate the different levels of prevention
5. To know the determinants of health
6. To be familiar with the contributors in the evolution of public health and their contributions
LECTURE NOTES
HISTORY OF PUBLIC HEALTH
In pre-historic people, they usually assume that people who are sick are caused by a cursed or punished by spirits
which they call as gods/goddesses. Their so-called doctor during those times are known as “shaman” or “medicine
man”. These pre-historic doctors use medicinal herbs, amulets, charms, or spell that would drive away the “evil spirits”.
They also conduct ceremonies to please the supernatural spirits and giving advice to the public on how to maintain life.
Some of the practices that are being performed by the shamans are somewhat disturbing but occurred in real life.
Examples are Geophagy or the ingestion of clay .
Another is the so-called Trepanning where the human skull is being drilled to produce a whole. For them, drilling the skull
will release the spirit that is dwelling within the patient.
PUBLICHEALTH
According to the history, Shamans have different skills in
healing. They use medicinal herbs, amulets, charms or spells (ward of
evil spirits). They also conduct ceremonies (appease gods, revert the
curse that cause illness) and giving advice to individuals on how to
maintain an illness-free life
Luckily, these practices have been eradicated. As the time went on, they have discovered that diseases are caused by
microorganisms such as bacteria, fungi, viruses, and the like. With these they are able to formulate drugs and other
interventions for them to be able to deal with various kinds of diseases.
Here is a link for you to watch about the timeline of the evolution of public health:
https://www.youtube.com/watch?v=sQgVGuxiH5w
WHAT IS PUBLIC HEALTH?
Let us ask the following contributors of public health
Public Health is the science and art of preventing disease,

prolonging life, and promoting physical health and efficiency
through organized community efforts for the:
a. sanitation of the environment,
b. the control of community infections,
c. the education of the individual in principles of personal
hygiene,
d. the organization of medical and nursing services for the early
diagnosis and preventive treatment of
disease,
Charles Edward Armory Winslow e. and the development of the social machinery which will
1923 ensure to every individual in the community a standard of living
Public Health is one of the efforts organized by society to

protect, promote, and restore the peoples’ health.
It is the combination of sciences, skills, and beliefs that is
directed to the maintenance and improvement of the health
of all the people through collective or social actions. The
programs, services, and institutions involved emphasize the
prevention of disease and the health needs of the population
as a whole. Public health activities change with changing
technology and social values, but the goals remain the same:
to reduce the amount of disease, premature death, and
disease-produced discomfort and disability in the population.
It is thus a social institution, a discipline, and a practice.
Jhon M. Last
2001
PUBLICHEALTH
the science and art of preventing disease, prolonging life, and promoting health
through organized efforts of society.
Deals with:
a. Surveillance of emergence of diseases
b. Identification of diseases among community regarding ways that will prevent
them from acquiring the diseases
c. Investigating factors that contribute to the existence of diseases
d. Educating the community regarding ways that will prevent from acquiring diseases
5. Creation of strategies that will ensure sustained well – being among the
community
6. Provision of health services to address community members who are already
having the disease or recuperating from complications of the disease
7. Institutionalize lessons learned through policies and structures that will prevent
occurrence of similar or other diseases
8. Monitoring the health status of the community and providing means that will
th f t i i th i h lth d ll b i
From the definitions stated by the contributors, we can

conclude that Public Health’s aim is to prolong the life of people
and prevent the emergence of diseases. Now that we
understand the definition of public health, let me discuss to you
a brief history of Public health
Since we said that the aim of Public health is to

prolong the life of people and to prevent the
emergence of disease, you might be wondering how
it is being fulfilled. For you to better understand,
here are the functions of public health for them to
be able to achieve its goal.
ESSENTIAL FUNCTIONS OF PUBLIC HEALTH
1. Monitor health status to identify community health

problems.
2. Diagnose and investigate health problems and health
hazards in the community.
3. Inform, educate, and empower people about health
issues.
4. Mobilize community partnerships to identify and solve
health problems.
5. Develop policies and plans that support individual and
community health efforts.
6. Enforce laws and regulations that protect health and
ensure safety.
7. Link people to needed personal health services and
assure the provision of health care when otherwise
unavailable.
8. Assure a competent public health care workforce.
9. Evaluate effectiveness, accessibility, and quality of
personal and population-based health services.
10. Research for new insights and innovative solutions to
health problems.
For essential functions of public health to

be fulfilled, here are the approach or steps
to be conducted.
PUBLICHEALTH
PUBLIC HEALTH APPROACH
STEPS:
1. Define the health problem.
- Requires the collection, analysis, and interpretation of data to define the problem and outline:
• What
• Where
• When
• Who
• How
2. Identify risk factors associated with the problem.
3. Develop and test community-level interventions to control or prevent the cause or the problem.
-Requires a determination of:
• Preventable or not preventable
• Controllable or not controllable
• Priority
4. Implement interventions to improve the health of the population.
-The potential for prevention or control frequently requires:
• A plan
• A champion
• A strategy/method
• A method
• The will
• Funding
5. Monitor those interventions to assess their effectiveness.
- After implementation the cycle begins again, but this time to evaluate the program results.
 Did the strategy work as intended?
 Were the results as expected?
 If yes, can you expand or replicate the program?
 If no, do you abandon or revise and try again?
Since public health’s focus is health, let us define health.

According to the World Health Organization, Health is
defined as, a state of complete physical, mental, and
social well-being and not merely the absence of disease or
infirmity. It is the absence of any disease or impairment.
They also said that health is a state that allows the individual
to adequately cope with all demands of daily life. It is also a
state of balance, an equilibrium that an individual has
established within himself and between himself and his
social and physical environment.
Basing on its definition, do you consider a deaf without any other disease healthy?
Please watch: https://www.youtube.com/watch?v=XQkYIpCmTDw
PUBLICHEALTH
HEALTHCARE CONCEPTS
defined as multitude of the services rendered to the individuals, families, community

by the agent of the health services, for the purpose of promoting, maintenance,
monitoring and restoration of health.
KEY CONCEPTS
Health care Includes general care and medical care, must be appropriate,
Comprehensive, Adequate, Available, Accessible, Affordable
Health system It constitutes the delivery of health services, Involves Policy,
Management, Planning, Resources, Action
Components of Concepts, Health and Disease, Ideas, Coverage, equity, effectiveness,
health care objects, Hospitals, THQ, RHC, BHU, Dispensaries, Persons, Consumer and
providers
LEVELS OF HEALTHCARE
1.PRIMARY HEALTHCARE- First level of contact between the individuals and the health system
- In the PI, provided by the barangay or village midwife or the PH Nurse or GP (General
practitioner) as Primary Care Physicians
- Usually available in RHU (Rural Health unit) or BHC (Barangay Health Center) or family
clinics
- Preventive care, promotion of optimal health and well – being strategies &
interventions
- MCH services (immunization, FP, pre/post-natal care)
- Largely community based
2. Secondary care - consist of specialized care, more complicated and sophisticated diagnosis and treatment
than is provided by the Primary health care level. Normally involves hospitalization
- Secondary care involves curative services and is given by the district hospitals
- More focused in its form of service and type of patients
- More complex in nature than the ones provided in 1o care
3. Tertiary care- This care involves super specialist care

- Provided at the central or regional level
- Far more advanced considering the medical cases are far more complex
- More difficult, procedures are more complicated and advanced
** The process of transferring a patient from one level of care to another is called the Referral process. The
patient may assess him or herself on which level of care shall he or she seek wherein she can choose to look for
an alternative treatment such as herbal remedies up to seeking care from a health care professional.
Promptness of deciding to seek care may affect prognosis. Such delay of seeking care are termed as follows:
a. 1st delay
Delay in seeking care
Detrimental to the patient
b. 2nd delay
Delay to transfer a Px from 1O to 2O health facility
c. 3rd delay
Inability to provide urgent and appropriate care
DETERMINANTS OF HEALTH
There are different factors that may affect health. These factors may include the place we live, our genes, nature
of work, income, family, relationships, and the like. These factors are known as Determinants of health and they
are classified into different categories such as: Policymaking, Social factors, Health services, individual behavior,
Biology, and genetics.
 Policymaking- some policies affect entire populations over extended periods of time while
simultaneously helping to change individual behavior. For example, the prohibition of dispensing
antibiotics without prescription to prevent the emerging of antibiotic resistance.
 Social factors- social determinants of health reflect to the social factors and physical conditions of the
environment in which people are born, live, learn, play, work, and age. Also known as social and physical
PUBLICHEALTH
determinants of health, they impact a wide range of health, functioning and quality-of-life outcomes.
For example, discriminations, exposure to crime, social interactions, and the like. (Najorda, 2019)
 Health services- the limited and lack access of health services may affect the health of individual.
Examples are the expensive hospital bill, the unavailability of needed devices (such as MRI), delayed
intervention of healthcare practitioners due to lack of manpower and many other more.
 Biology and genetics Age can be a factor of health. An old adult may have poor health than the younger
ones due to the degeneration of their body functions caused by aging. Heredity, aside from age may also
affect health. For example, cancer can be passed on from a parent to their offspring.
FUTURE OF PUBLIC HEALTH
*Dr. Jeffrey Koplan oversees the future of public health and he stated that “over the course of the past century,
public health has grown both in depth and breadth
- Today, it addresses a wide range of issues:
a. All infectious diseases
b. All chronic diseases
c. Violence
d. Injury prevention
e. Birth defects
f. Bioterrorism
- In addition to the Doctors, Nurses, Engineers and Nutritionists who hold Public Health degrees, the field also
embraces a wide range of professionals in the behavioral and social sciences –
a. Demographers
b. Communications specialists
c. Specialists in evaluation science
d. Specialists in decision science
RESEARCH ACTIVITY:
Search for the following and note their contributions on the evolution of public health.
1. Egyptians 9. Anton Van Leeuwenhoek
2. Greeks 10. Schola Medicana
3. Hippocrates 11. Carl Linnaeus
4. Galen 12. Edward Jenner
5. Al-Razi 13. Edwin Chadwick
6. Girolamo Fracastoro 14. Dr. John Snow
7. Andreas Vesalius 15. Louis Pasteur
8. William Harvey 16. Declaration of Alma Ata
ASSESSMENT TEST:
LINKS IN GOOGLE FORM:
REFERENCES:
Nillos, B. E. (2015). Introduction to Public Health first edition. Educational Publishing House
Najorda, G.S (2019). Community and Public Health. EDRIC Publishing House
PUBLICHEALTH
UNIT II. FACTORS THAT AFFECT HEALTH
(COMMUNITY HEALTH, EPIDEMIOLOGY AND HUMAN BEHAVIOR)
OBJECTIVES:

1. To know the different factors that may affect or cause disease
2. To know the different measures and methods to control the spread of disease
3. To be familiar with the laws that promulgates rules and methods to counteract vectors of diseases
4. To know the concept of Epidemiology
LECTURE NOTES
DEFINITION OF TERMS
COMMUNITY HEALTH- according to WHO, it is defined as environmental, social, and economic resources to
sustain emotional and physical well-being among people in ways that advance their
aspirations and satisfy their needs in their unique environment.
- It mainly focuses on improving the health of a group or community
EPIDEMIOLOGY- it is the study of the distribution and determinants of diseases and injuries in human
populations
(Mausner and Kramer, 1985)
- the study of the distribution and determinants of health-related states or events in specified
Populations, and the application of this study to the control of health problems.
HUMAN BEHAVIOR- responses of individuals or groups of humans to internal and external stimuli. It refers
to the array of every physical action and observable emotion associated with individuals, as well
the human race.
LOCAL FACTORS THAT MAY AFFECT HEALTH OF COMMUNITIES
1. PHYSICAL ENVIRONMENT – the quality of air and water as well as the surroundings of a community may affect
their health. The air and water pollution may cause certain diseases such as
cholera
lung cancer and the like.
2. SOCIAL ENVIRONMENT – level of social and emotional support people received from friends and or family
PUBLICHEALTH
3. POVERTY – significant factor worldwide, shortens and reduces enjoyment of life and the access to health.
4. BEHAVIOR AND LIFESTYLE – daily exercise, balanced diet, sedentary life, unhealthy diet, vices such as smoking
and other lifestyle.
5. FAMILY GENETICS AND INDIVIDUAL BIOLOGY – if you come from a healthy family you have a better chance
of staying well.
The Said factors reminds us that Public Health or community

Health is not just a matter or absence of a disease. This
includes our emotional, social, and mental health as well.
PUBLICHEALTH
ENVIRONMENTAL SANITATION
Sanitation is a very important tool in order to sustain good health. According to centers for disease control and
prevention (CDC) Basic sanitation is described as having access to facilities for the safe disposal of human waste (feces
and urine), as well as having the ability to maintain hygienic conditions, through services such as garbage collection,
industrial/hazardous waste management, and wastewater treatment and disposal. Thus, sanitation provides protection
between excreta and humans to prevent the transmission of diseases.
Fig. F-diagram
In the Philippines, sanitation is governed by Presidential Decree No. 856 also known the Code on Sanitation
of the Philippines issued by the past President Ferdinand Marcos in 1975. This decree contains the regulation on
water supply, food establishments, markets, school sanitation and health services, public bathing places, camps
and picnic ground, massage clinics and hostels and apartments, public laundry, industrial hygiene, and dance
halls. It also contains regulation on sewage control and disposal, vermin control, refuse and excreta disposal
including disposal of dead persons.
WATER SANITATION
One of the most source of infection if not controlled is the body of water. For drinking water, there is a
standard set by the Code of sanitation of the Philippines to make sure that the drinking water is safe and free
from contamination. The examination performed are as follows:
a. Initial examination. – The physical, chemical and bacteriological examinations of water from newly
constructed systems or sources are required before they are operated and opened for public use. Examination
of water for possible radio-active contamination should also be done initially.
b. Periodic examination – Water from existing sources is subject to bacteriological examination as often as
possible but the interval shall not be longer than six months, while general systematic chemical examination
shall be conducted every 12 months or oftener. Examination of water sources shall be conducted yearly for
possible radioactive contamination.
PUBLICHEALTH
(WHO, 1997)
From the same decree on Section 13, to protect drinking water from contamination, the following measures
shall be observed:
a. Washing clothes or bathing within a radius of 25 meters from any well or other source of drinking water is
prohibited.
b. No artesian, deep or shallow well shall be constructed within 25 meters from any source of pollution.
c. No radioactive sources or materials shall be stored within a radius of 25 meters from any well or source of
drinking water unless the radioactive source is adequately and safely enclosed by proper shielding.
d. No person charged with the management of a public water supply system shall permit any physical
connection between its distribution system and that of any other water supply, unless the latter is regularly
examined as to its quality by those in charge of the public supply to which the connection is made and found to
be safe and potable.
e. The installation of booster pump to boost water direct from the water distribution line of a water supply
system, where low-water pressure prevails is prohibited.
WATER ANALYSIS
In order to be sure that the water that is being supplied to the public is clean and secured, certain
procedures for analysis must be obtained. This analysis includes, Physical, Chemical, radiological, and
bacteriological analysis.
 PHYSICAL ANALYSIS- this test may be performed using the organoleptic measures which includes color,
turbidity and odor and taste of water. Water must be clear and free from bad odor.
 CHEMICAL ANALYSIS- pH level, hardness level of water, toxic chemicals and the level of oxygen are the
properties that are analyzed before distributing to the public
 BACTERIOLOGICAL TEST- some of the infectious disease may be due to fecal contamination particularly
Escherichia coli. The tests used to analyze its safety is through multiple-tube method, membrane
filtration method, on-site testing method and presence-absence test.
WASTE DISPOSAL
PUBLICHEALTH
Aside from water, waste disposal has also a big contribution in health. Improper disposal of waste may
lead to several diseases such as diarrhea and many other more. There are several types of waste such as solid
waste and human waste. For this manual, we will only tackle this two.
Solid waste management

- According RA 9003, it is described as discipline associated with the control of generation, storage, collection,
transfer and transport, processing, and disposal of solid waste. This type of waste can be segregated from
biodegradable, non-biodegradable, hazardous and recyclable.
- this law also categorizes and describes different types of wastes and they are as follows:
1. Agricultural waste- refer to waste generated from planting or harvesting of crops, trimming, or pruning of
plants and wastes or run-off materials from farms or fields
2. Bulky wastes- refer to waste materials which cannot be appropriately placed in separate containers because
of either its bulky size, shape, or other physical attributes. These include large worn-out or broken household,
commercial, and industrial items such as furniture, lamps, bookcases, filing cabinets, and other similar items.
3. Consumer electronics- refer to special waste that includes worn-out, broken, and other discarded items such
as radios, stereos, and TV sets.
4. Hazardous waste- refer to solid waste management or combination of solid waste which because of its
quantity, concentration or physical, chemical, or infectious characteristics may:
a. cause, or significantly contribute to an increase in mortality or an increase in serious irreversible, or
incapacitating reversible, illness; or
b. poses a substantial present or potential hazard to human health or the environment when improperly
treated, stored, transported, or disposed of, or otherwise managed.
5. Municipal waste- refer to wastes produced from activities within local government units which include a
combination of domestic, commercial, institutional, and industrial wastes and street litters.
6. Yard waste - refer to wood, small or chipped branches, leaves, grass clippings, garden debris, vegetable
residue that is recognized as part of a plant or vegetable and other materials identified by the Commission.
** RA 9003 also mandated that sanitary landfills must have the following:
(a) Liners - a system of clay layers and/or geosynthetic membranes used to contain leachate and reduce or
prevent contaminant flow to groundwater.
(b) Leachate collection and treatment system - installation of pipes at the low areas of the liner to collect
leachate for storage and eventual treatment and discharge.
(c) Gas control and recovery system - a series of vertical wells or horizontal trenches containing permeable
materials and perforated piping placed in the landfill to collect gas for treatment or productive use as an energy
source.
(d) Groundwater monitoring well system - wells placed at an appropriate location and depth for taking water
that are representative of ground water quality.
(e) Cover - two (2) forms of cover consisting of soil and geosynthetic materials to protect the waste from long-
term contact with the environment:
(i) a daily cover placed over the waste at the close of each day's operations
(ii) a final cover, or cap, which is the material placed over the completed landfill to control infiltration of
water, gas emission to the atmosphere, and erosion.
(f) Closure procedure with the objectives of establishing low maintenance cover systems and final cover that
minimizes the infiltration of precipitation into the waste. Installation of the final cover must be completed within
six (6) months of the last receipt of waste.
(g) Post-closure care procedure - During this period, the landfill owner shall be responsible for providing for the
general upkeep of the landfill, maintaining all of the landfill's environmental protection features, operating
monitoring equipment, remediating groundwater should it become contaminated and controlling landfill gas
migration or emission.
HUMAN WASTE
PUBLICHEALTH
- excreta can be managed by putting up of sanitary toilets. A toilet can be built with septic tank which eliminates
waste by using the natural filtering process of the soil.
PD 856 has regulations construction of septic tank which are as follows:
a. It shall be generally rectangular in shape. When a number of compartments are used, the first
compartment shall have the capacity from one-half to two-thirds of the total volume of the tank.
b. It shall be built of concrete, whether pre-cast or poured in place. Brick, concrete blocks, or adobe may
be used.
c. It shall not be constructed under any building and within 25 meters from any source of water supply.
FOOD AND MILK SANITATION
Spoiled and contaminated food are one of the major causes of diarrhea and meningitis, cancer and even
death. With this reason, there is a need to protect the food from contamination through heating or cooling of
food and protecting it from flies and other insects that can contribute to its contamination. With this reason, PD
865 established a law that all establishments that prepares or manufactures food must secure a permit from
local health office. This is to ensure that the food handlers and manufacturers follows the standard guidelines in
preparing food and milk products. Here are the following requirements promulgated by PD 856:
a. Meats, meat products and fish shall be procured from sources under sanitary or veterinary supervision.
b. All meat and fish shall be properly cooked before serving.
c. No meat products, fish, vegetables and other food sources shall be procured from sources or areas known to
have been affected by radioactivity as for example, areas contaminated with a very large amount of radioactive
fallout.
d. Milk and fluid milk products shall be obtained from sources approved by the local health authority. Milk
obtained from other sources must be sterilized, pasteurized or otherwise heated.
e. Milk shall be stored in a refrigerator. Canned or package milk, other than dry milk powders, shall be
refrigerated after the container has been opened.
f. All perishable and potentially hazardous foods shall be stored at 45°F (7°C) or below.
g. Cooked food intended to be served hot shall be kept at a temperature not lower than 140°F (60°C).
h. Raw fruits and vegetables shall be thoroughly washed before they are used.
The World Health Organization explains basic principles that the whole community should know in preparing
food.
MILK SANITATION
Milk sanitation is very important since milk is a very good vehicle of diseases which may be carried out
by different sources such as the utensils that is used to prepare the milk, the handlers, water and as well as the
environment. Contaminated milk may cause diseases such as streptococcal infection, typhoid, cholera, and
diarrhea.
Here are the things that must be checked to ensure the safety of milk:
a. Source of milk (Animals) must be healthy, free from any kind of disease and must be clean
b. the setting of where the milk was obtained shall be sanitized to avoid contamination
c. All utensils or materials used from collecting down to packaging of milk must be sterilized.
d. Milk handlers shall have their PPE and must observe proper hygiene.
e. Milk handlers must be healthy and free from communicable diseases
PUBLICHEALTH
METHOD OF PASTEURIZATION:
Pasteurization was introduced by Louis Pasteur. This process is done to prevent the growth of
harmful bacteria that is harmful to health.
Procedure:
1. Milk is heated in a 63°C for not less
then 30 minutes (or 72°C for not less
than 16 sec.) while agitated. After 30
minutes, milk will be cooled down
and stored in a suitable container and
shall be placed inside the refrigerator
CONTROL OF AIR POLLUTION
Pollution is the introduction of contaminants into the natural environment that cause adverse change
(Nillos, 2015). These contaminants are known as pollutants and they can be in the form of chemical substances
coming from factories, car, pollutants like noise, heat light, and scattered trash on places like soil and water.
According to Republic act 8749, Air pollution is defined as any alteration of the physical, chemical and
biological properties of the atmospheric air, or any discharge thereto of any liquid, gaseous or solid substances
that will or is likely to create or to render the air resources of the country harmful, detrimental, or injurious to
public health, safety or welfare or which will adversely affect their utilization for domestic, commercial,
industrial, agricultural, recreational, or other legitimate purposes. This law also defines Air pollutants as any
matter found in the atmosphere other than oxygen, nitrogen, water vapor, carbon dioxide, and the inert gases
in their natural or normal concentrations, that is detrimental to health or the environment, which includes but
not limited to smoke, dust, soot, cinders, fly ash, solid particles of any kind, gases, fumes, chemical mists, steam
and radio-active substances.
PUBLICHEALTH
To control and lessen the exacerbation of air pollution, the Republic Act of 8749 or also known as Philippine
Clean Air Act of 1999 formulated guidelines, and here are some of the guidelines:
 Pollution from Smoking- Smoking inside a public building or an enclosed public place including public
vehicles and other means of transport or in any enclosed area outside of one's private residence, private
place of work or any duly designated smoking area is hereby prohibited under this Act. This provision
shall be implemented by the LGUs.
 Pollution from Other Mobile Sources: - The Department, in coordination with appropriate agencies,
shall formulate and establish the necessary standards for all mobile sources other than those referred to
in Section 21 of this Act. The imposition of the appropriate fines and penalties from these sources for
any violation of emission standards shall be under the jurisdiction of the DOTC.
 Ozone-Depleting Substances. - Consistent with the terms and conditions of the Montreal Protocol on
Substances that Deplete the Ozone Layer and other international agreements and protocols to which
the Philippine is a signatory, the Department shall phase out ozone-depleting substances.
 Greenhouse Gases. - The Philippine Atmospheric, Geophysical and Astronomical Service Administration
(PAGASA) shall regularly monitor meteorological factors affecting environmental conditions including
ozone depletion and greenhouse gases and coordinate with the Department in order to effectively guide
air pollution monitoring and standard-setting activities.
 Persistent Organic Pollutants. - The Department shall, within a period of two (2) years after the
enactment of this Act, establish an inventory list of all sources of Persistent Organic Pollutants (POPs) in
the country. The Department shall develop short-term and long-term national government programs on
the reduction
INSECT AND RODENT CONTROLand elimination of POPs such as dioxins and furans. Such programs shall be formulated
within a year after the establishment of the inventory list.

Flies, mosquitoes, cockroaches, bedbugs, fleas, lice, ticks, ants, and other insects that are of public health
significance are termed by the VERMIN CONTROL OF THE CODE OF SANITATION OF THE PHILIPPINES as Insects.
They also define Rodents as small mammals such as rat, mice characterized by constantly growing incisor teeth
used for gnawing or nibbling. Insects and rodents are one of the sources of disease such as Leptospirosis,
dengue, malaria and many other more.
** Here are the measures and methods for the abatement of the following
For insects:
For Rodents:
PUBLICHEALTH
EPIDEMIOLOGY
- It is a data driven and relies on a systematic unbiased approach to the collection, analysis, and interpretation of
data (Najorda,2019). It is used to assess the number of cases of emerging disease in a particular group or
community in a particular area and time. It is also concerned with the frequency and pattern of health events in
a population (Najorda,2019).
Frequency- refers to the number of health event and the number of populations. The result will now determine
the occurrence of disease in a certain population.
Pattern- refers to the occurrence of health-related events by time, place and person.
Epidemiologist- focuses on identifying the exposure or source that caused the illness, the exposure or source
that caused the disease, the number of people infected, spread, interventions and prevention of additional cases
and recurrence of disease.
FUNCTIONS OF EPIDEMIOLOGY
 Public health surveillance- systematic collection, analysis, interpretation and dissemination of health
data to guide the public health decision making and actions (Najorda,2019). This is done through the
determination of morbidity and mortality reports which will further help the epidemiologist analyze the
cause and may end up formulating an intervention for the treatment of the community in the disease.
 Field investigation- will help in identifying the unreported or unrecognized cases of disease to prevent
the spread of infection to the community. For example, the contact tracing of the emerging disease
COVID-19.
 Analytic studies- combination of surveillance and field investigation to come up with a hypothesis about
the cause of disease. This will also help them (epidemiologist) in the determination of how it is being
transmitted.
 Evaluation- process of determining, as systematically and objectively as possible, the relevance,

effectiveness, efficiency, and impact of activities with respect to established goals (Najorda,2019).
 Linkages- collaborated with other health allied professionals to come up with the treatment or proper
intervention on the emerging disease or infection.
 Policy development- formulation of policy in order to control the emergence and or spread of diseases
that may cause health problems.
ESSENTIAL DATA IN EPIDEMIOLGY
A. RATES
– the number of events in a given population over a specific period or at a given point in time
-rates can be expressed as CRUDE and SPECIFIC
i. CRUDE BIRTH RATE (CBR) = # of births x 1000

total # of population
- Average annual number of births a year per 1000 persons in the population at the mid-year
- Dominant factor in determining the rate of population growth
ii.CRUDE DEATH RATE (CDR) = # of deaths x 1000

total # of population
iii. INFANT MORTALITY RATE (IMR)= # of deaths under 1 year of age x1000
Total # of births
PUBLICHEALTH
iv. NEONATAL MORTALITY RATE (NMR) = # of deaths within the 1st 27 days x 1000
Total # of births
v. SWAROOP’S INDEX = # of death among 50 years old and above x 100

Total # of deaths
vi. MORBIDITY RATE

**Incidence rate – the number of new cases of a disease in a population at risk in a
given time period
**Prevalence rate – total number of cases (old and new cases) of disease existing in a
population
**Attack rate – the proportion of those who became ill after a specified exposure
vii. CASE FATALITY RATE – is the percentage of cases that result in death
-measure the severity of the disease and is proportionate to the virulence of a disease
agent
CFS = # of deaths from a particular disease x 100
Total # of cases of that same disease
DOH – Administrative order no. 2008-0009
-issuance of a list of notifiable diseases that every health system must be able to monitor and
report on time
- depending on the type of diseases, reporting can be done as frequent as weekly or
immediately as the case is encountered in the field
Example:
Notifiable Diseases or events Reported immediately
(must be reported within 24 hours)
Acute Flaccid Paralysis Paralytic shellfish
poisoning
Notifiable Diseases or Syndrome Reported Weekly
Dengue Malaria
-DOH adopts a “zero-case reporting” policy which means that even if a community has no
reported case of any of the notifiable diseases or events, the health workers still have to report
it as “zero case”
LIFE EXPECTANCY versus LIFE SPAN

- usually interchanged with each other however both are entirely different from each
other.
LIFE SPAN - refers to the number of years a person lives
LIFE EXPECTANCY - refers to the number of years a person is expected to live from a
specific starting point. Example of Life expectancy would be Disability-Adjusted Life
Expectancy (DALE) and Health-Adjusted Life Expectancy (HALE).
NOTE: A person can only have one life span but may have different life expectancy.
METHODS OF COLLECTING DATA
1. Surveillance Reporting
- health facilities are expected to submit monthly and annual reports pertaining to identified
health data being monitored by the National Government.
Example:
Field Health Service Information System (FHSIS) – collate data from their respective BHU,
submitted to Provincial Health office and later to the Regional office of the DOH
2. Surveys
-method of gathering any type of information or data from a sample of individuals. By sample it
is meant that the data is only taken from a portion of the total population under study
Example:
National Household Targeting System (NHTS) of DSWD – databank and an information
management system which identifies who and where the poor are in the country
3. Census
PUBLICHEALTH
- opposite of survey. It is the counting of data gathered from the entire population. It is a
regularly occurring and official count of the human population of a certain local administrative
unit.
Example:
National Statistic Office – municipalities or cities would maintain a Community-based Health
Information System
4. PORTFOLIO – profile data of each household, stored and regularly updated

-include number of members of the household, immunization records, types of housing or
dwelling place, access to safe water and even pet ownership.
Please watch the link for further information https://www.youtube.com/watch?v=r9poHB-ldqk
HUMAN BEHAVIOR
- The behavior of a person may be contributed by their environment, social interactions and culture. This has
great impact with regards to health situation can influence how they behave or act. According to Bandura
(1986), people’s behaviors are driven by external factors and not by inner forces.
Social cognitive theory- Human functioning can be explained by a triadic interaction of BEHAVIOR, PERSONAL,
ENVIRONMENTAL factors.
Theory of Planned Behavior – behavior is dependent on one’s intention to perform the behavior.
-intention is determined by an individual’s attitude (belief and values about the
outcome of the behavior) and subjective norms (beliefs about what other people
think the person should do or general social pressure).
Perceived behavioral control – defined as an individual’s perceptions of their ability or feelings of self-efficacy to
perform behavior
Transtheoretical Model – AKA Stages of Change Model
-A person undergoes at least SIX STAGES OF CHANGE or transformation:
i. Precontemplation – people are not intending to make a change in the near future (next 6 months)
ii. Contemplation – people intend to change (within the next six months)
iii. Preparation – people have a plan of action and intend to take the action in the immediate future
(within a month)
iv. Action – people make the behavior change
v. Maintenance – people work to prevent relapse
vi. Termination – individuals have 100 percent efficacy and will maintain their behavior. The most
difficult to maintain
INDIVIDUAL
Since the main focus of public health is to prevent the spread of disease, one thing that must be considered is the
immunity of an individual. According to studies, human body has various type of immune system that is used to fight
pathogens. Immune system is categorized as Innate immune system and adaptive Immune system .
Please watch this video using this link: https://www.youtube.com/watch?v=PzunOgYHeyg
Cells involved in the Innate Immune System:

White blood cells/Leukocytes Functions
Neutrophil Most abundant; First to attack
Dendritic Cell Present in tissues that are exposed to environment (Skin;
mucosa); link between innate and adaptive immune
system
Basophil Releases histamine in response to parasitic infection
Eosinophil Releases toxic substances to counteract bacterial or
parasitic infection that damages tissue
Mast cell Releases heparin, histamines, chemokines, chemotaxic
cytokines.
Involved in allergic reaction/anaphylaxis and wound
healing.
PUBLICHEALTH
Macrophages Phagocytic cell
Natural Killer cell Destroys virus-infected cells and tumor cells
(Nillos, 2015)
Cells involved in the Adaptive Immune System: B- and T-lymphocytes
T-lymphocytes Functions
T Helper cell aka CD4+T cells; Releases cytokines, Assist in maturation
of B cells; activates cytotoxic T cells and macrophages.
Cytotoxic T cell Aka CD8+ T cells; destroy virus- infected cells
Memory T cell can either be CD4+ or CD8+; Activated upon re-exposure
to similar antigen
Suppressor T cell Shuts down T cell-mediated immunity towards the end of
an immune reaction
Natural Killer T cell Produces cytokines and cytolytic (Cell destroying
molecules)
(Nillos, 2015)
** B-lymphocytes are one of the cells involved in the production of Immunoglobulins or antibodies
Please watch this video https://www.youtube.com/watch?v=Atrx1P2EkiQ
RESEARCH ACTIVITY:
1. What are the top 10 leading causes of disease in the Philippines and Identify which among the discussed
factors that affect health are associated with the diseases
ASSESSMENT TEST:
Google form link:
PUBLICHEALTH
REFERENCES:
Books:
Internet sources:
https://www.cdc.gov/healthywater/global/sanitation/index.html
https://www.who.int/water_sanitation_health/dwq/gdwqvol32ed.pdf?ua=1
http://www.fao.org/3/x5624e/x5624e05.htm
http://noair-rors.weebly.com/indoor-air-pollution.html
https://www.doh.gov.ph/sites/default/files/publications/Chapter_16_Vermin_Control.pdf
https://courses.lumenlearning.com/boundless-biology/chapter/antibodies/
UNIT III. ETIOLOGY OF DISEASES

OBJECTIVES:

1. To differentiate the different factors of diseases
2. To understand the relationship of diseases and its causation
3. To explain the timeline of history of disease
4. To understand the ecologic concepts of disease
LECTURE NOTES
PUBLICHEALTH
DEFINITION OF TERMS
ETIOLOGY- comes from the Greek etio-, which means 'causation' and -ology, which refers to the
scientific study of something.
- Etiology is the cause of a disease or the science that deals with such causes.
INTRINSIC- means coming from within. Therefore, any pathological, or disease-causing, change that has
occurred from inside the body has occurred as a result of intrinsic factors.
Example:
-hemophilia, a disorder that leads to excessive bleeding.
- Metabolic and endocrine, or hormone, disorders. Diabetes mellitus is an endocrine disease
that causes high blood sugar.
- Neoplastic disorders or cancer where the cells of the body grow out of control.
- Problems with immunity, such as allergies, which are an overreaction of the immune system.
EXTRINSIC - the cause of the disease, or pathological change, came from outside of the body.
Example
- Infectious agents like bacteria, viruses, fungi, and parasites
- Animal bites or stings
- Chemicals, electricity, and radiation
IATROGENIC CAUSES- problem resulted from a medical professional's actions or within a medical setting.
Ex. Anaphylaxis, and other drug induced diseases, wrong operating procedures and the
like.
IDIOPHATIC- of unknown cause. An idiopathy is any disease with unknown cause or mechanism of
apparently spontaneous origin.
PUBLICHEALTH
- For some medical conditions, one or more causes are somewhat understood, but in a certain
percentage of people with the condition, the cause may not be readily apparent or characterized.
Example:
- focal segmental glomerulosclerosis or ankylosing spondylitis is the majority of these cases are deemed
idiopathic
- pulmonary fibrosis
- Some congenital conditions are idiopathic
FACTOR OF DISEASE CAUSATION
The analyzation of the cause of disease is very important not only for the purpose of diagnosis but also
for the determination of appropriate intervention or medication and of course for the prevention of disease
progression.
A CAUSE OF A DISEASE is an event, condition, and characteristic of a combination of these factors. A

cause is termed sufficient when it inevitably produces or initiates a disease (Conte, 1999). Diseases may be caused by a
single or multiple factor.
Robert Koch, the father of modern bacteriology, Formulated theory of disease

and they are as follows:
i. The organisms must be present in every case of the disease.

ii. The organisms must be able to isolate and grown in pure culture.
iii. The organisms must cause the specific disease when inoculated into a
susceptible animal.
iv. The organisms must then be recovered from the animal and identified.
From the theory of Robert Koch’s, we can notice that according to him, diseases are caused by different
organisms. However, as we discussed from our introduction, we learned that there are several factors why
people acquire diseases and not just through organisms. With this, let us know several causations of diseases
FOUR FACTORS IN CAUSATION:

1. Predisposing factors such as age, sex and previous illness, which may create a state of susceptibility
to a disease agent.
2. Enabling factors such as low income, poor nutrition, bad housing and inadequate medical care may
favor the development of disease.
3. Precipitating factors such as exposure to a specific disease agent.
4. Reinforcing factors such as exposure and unduly hard work may aggravate an established disease or
state.
PUBLICHEALTH
This model explains that the disease results from the interaction between the agent and the susceptible
host in an environment that supports the transmission of the agent from a source to the host (Najorda,
2019)
NATURAL HISTORY OF DISEASE
Some diseases that are caused by microorganisms is due to the

compromised immune system of an individual wherein these organisms can
easily penetrate the host. According to J.E Conte (1999), Natural history of
disease refers to the progression of a disease process in an individual over time,
in the absence of treatment. For Example, the untreated infection with HIV
causes a spectrum of clinical problems beginning at the time of seroconversion
(primary HIV) and terminating with AIDS and usually death.
This timeline shows the progression of disease which starts with the exposure of the host and has met
the factors for the host to become susceptible with disease Like for example, weak immune system, exposed to
a sufficient number of microorganisms for them to become infected or exposure to a chemical such as asbestos,
harmful components of cigarettes or tobacco or the idiosyncratic changes of body components (Cancer).
PUBLICHEALTH
After the exposure of the host, and made susceptible by the disease-causing substances, this
substance is now causing changes inside the body of the host without any distinct nor detection of signs and
symptoms to be associated in a particular disease. This phase of timeline is now termed as the subclinical stage.
From this phase up until the time that signs and symptoms are starting to appear is now called as incubation
period. Though at this stage, signs and symptoms are not yet apparent, some pathologic changes in the body of
the host can be detected through different kinds of screening method. When the host shows a recognizable
signs and symptoms and a diagnosis was made is now at the stage of clinical disease. During the timeline of
disease, some host were able to conquer these pathologic factors and recover. Some unfortunately become
disabled or even dead. This range of recovery or death is termed as spectrum of disease.
ECOLOGIC CONCEPT OF DISEASE
ECOLOGY is the science of relationship. It is a scientific study of relationship between different organisms and
their environment.
DISEASE ECOLOGIST are professionals the studies the overall patterns of disease in a certain population. They
usually study the study the interactions between pathogens (e.g. viruses, bacteria, fungi) and their human or
non-human hosts.
Example of ecology of disease
Outbreaks caused by infectious diseases could high affect the ecology of the host, the pathogen, or the
environment. Therefore, understanding the incidence, prevalence, or timing of diseases requires
understanding the ecology of the interaction.
PUBLICHEALTH
Parasites has a big contribution in the ecosystem. They have the ability to stimulate the number of an
organism and may cause extinction of humans if not controlled.
AGENTS OF INFECTIOUS DISEASE
PUBLICHEALTH
Infectious agents come in many shapes and sizes. Bacteria and protozoans are microscopic one-celled
organisms, while viruses are even smaller. Fungi grow like plants, and helminths resemble worms (Conte,1999)
 VIRUS- smaller than bacteria, which is made up of 3 major components such as genetic material, Protein coat,
and envelope of lipids.
- Virion- a complete virus particle which is composed of nucleic acid and is enclosed by a
protective coat of protein called as capsid which are formed from its identical protein
subunits called capsomeres.
- HELICAL VIRUSES- composed of a single type of capsomer stacked around a central axis to
form a helical structure. Ex. Tobacco mosaic virus (Nillos, 2015)
- POLYHEDRAL VIRUSES- composed of 20 faces with a minimum number of identical
capsomers requires which is twelve. Ex. Rotavirus
- SPHERICL VIRUSES- “Ball-shaped”- aka “envelope” viruses. Helical structure that is enclosed
by a lipid bilayer membrane. The infectivity of this virus is dependent on the envelope. Ex.
Influenza virus, Hepatitis C and HIV
- COMPLEX VIRUSES- combination of icosahedral and helical shape and may have a complex
outer wall or head-tail morphology. Ex. Pox virus
 BACTERIUM- bacteria use to attach to surfaces and form dense aggregation called biofilm which may form into
their secondary structures such as microcolonies.
PUBLICHEALTH
 PROTOZOA- one-celled organism that can infect and multiply in human. They are usually seen in aqueous
environment and soil. This group composed of flagellates, ciliates and amoebae. Protozoans that are infectious
to humans are the following
a. Sarcodina-e.g. ameba
b. Mastigophora- flagellates
c. Ciliophora- or he ciliates
d. Sporoza- plasmodium
 FUNGUS- there are variety of types of fungus. Some are beneficial to the environment and some are harmful to
humans.
 HELMITHS- worm-like parasites that survive by feeding on a living host to gain nourishment and protection,
sometimes resulting in illness of the host.
PUBLICHEALTH
SOURCES OF INFECTION AND DISEASE IN THE COMMUNITY and MEANS OF TRANSMISSION
The sources of infection can be divided into two main groups. These are exogenous and endogenous sources.
ENDOGENOUS- when the infectious agent comes from the patient’s own body, usually from his own normal flora.
Endogenous sources of infections become important when the person’s own immunity against his normal flora becomes
compromised such as in cases of contamination during surgery, malnutrition, impairment of blood supply and
debilitating diseases such as AIDS, diabetes or any other accompanying infection.
Examples: genera of staphylococci and streptococci which are normally found in the body, but can become pathogenic
in certain circumstances.
EXOGENOUS - introduce organisms from anywhere outside to inside the body, which is the case most of the time. In
addition to being exogenous, most of the time infections are transmitted from person to person or from animal to man.
They can be either human, animal, or environmental in origin.
Humans can be a source of infection in three cases:

a. clinically infected (symptomatic infection)
b. asymptomatically infected
c. they are carriers.
Humans can be a source of organisms which cause diseases that are sexually transmitted such as Treponema pallidum
which causes syphilis and N. gonorrhoae which causes gonorrheal infections or through blood when vectors act as
vehicles as in the case of transmission of Borrelia that causes relapsing fever.
Animals are another source of infection, and an infection derived from this source is called zoonotic infection. Such
infections are usually maintained in animals, and are acquired accidentally. An example of such infections could be
brucellosis caused by brucella mainly from cows and their products such as milk , rabies caused by rabies virus from wild
animals, and plague which is caused by Pasteurella pestis. Moreover, animal products such as meat, milk and eggs can
be sources of infection. Examples are E. Salmonella species and E. Cambylobacter.
Environmental sources are numerous and few environmental saprophytes are pathogenic for man unless in cases of
individuals with severely compromised immune system. But still some parasites may result in complications if
introduced into the body from the environment. Examples are some sporing bacilli of the genera Bacillus and
PUBLICHEALTH
Clostridium. Food is another important and very common source of infection due to the everyday pattern of dealing
with such material. Food can be contaminated and hence a source of infection at several stages.
Water, the commonest and the most important material in life is a major source of infection only in case of being in
contact with sewage. Examples of organisms derived from the previous two sources when contaminated with faeces are
Salmonella typhi associated with food poisoning and Shigella associated with Bacillary dysentery, Brucella causing
undulant fever, Leptospira and Clostridium causing botulism.
Air can be contaminated with organisms shed from skin or the respiratory tract such as S. pneumoniae which causes
pneumonia and S. pyogens which causes Scarlet fever, Corynebacterium diphtheriae which causes diphtheria,
Haemophilus Influenzae, meningococci, anthrax bacilli and Measles and Mumps viruses. Infection with such organisms
occurs by inhalation or ingestion of pathogen-containing droplets produced either orally or by the respiratory tract.
Fomites are another source of infection which can be defined as any porous substance that can absorb and pass on
contagion and almost all the previously mentioned organisms can be derived through this source.
Nosocomial infections are infections that were not present or were incubating at the time of admittance to a health
care facility. They include infections patients acquire during their stay in a healthcare facility or infections that may
manifest after discharge. These infections are considered more difficult to prevent and treat, more unpredictable, and
more resistant to cure than infections contracted in the community. Patients who undergo surgical procedures have a
PUBLICHEALTH
higher incidence of nosocomial infections than others. The source of microorganisms that cause nosocomial infections
can be the patients themselves, the healthcare facility, or the healthcare personnel.
MEASURES OF DISEASE OUTBREAKS
Measures of disease occurrence are used when we are interested only in quantifying an event (the outcome),
and our analysis does not extend further to take into account exposures. When we want to relate the effect of a certain
exposure to an outcome, we will then need to use what we call measures of effects.
RISK - represents a proportion of the number of people developing the disease divided by the number of people in the
population. It can be presented as a proportion (ranging from 0 to 1) or as a a percentage (ranging from 0% to 100%),
and expresses the probability of an outcome (health event, disease etc) in a certain group.
RATES - are used when the occurrence of an event relates to units of time (for example the number of deaths per 100
persons-years). When measuring the occurrence of a new event in relation to units of time, we refer to incidence rates.
PREVALENCE - is a proportion of how many events (for example, people with disease) are present at a specificpoint in
time in a population. It is expressed as a percentage.
ODDS OF AN EVENT ("odds", always plural) are the probability that this event will occur divided by the probability that
the event will not occur. Therefore, a value of the odds of the event occurring can range from 0 to infinity. Odds are a
measure rarely used, though the ratio of two odds (odds ratio) are one of the most commonly used measures of effect
in epidemiology.
Whenever using any of these measures it is important to consider the context in which they are used and whether or
not they properly express what we want to measure.
-
EPIDEMIOLOGICAL METHODS and INVESTIGATION OF EPIDEMICS
techniques for gathering and analyzing epidemiological data vary depending on the type of disease being monitored
PROCESS OF AN EPIDEMIOLOGICAL STUDY:

1. Establish that a problem exists
2. Confirm the homogeneity of the events
3. Collect all the events
4. Characterize the events as to epidemiological factors
5. Look for patterns and trends
6. Formulate a hypothesis
7. Test the hypothesis
8. Publish the results
P U B RESEARCH
L I C H E A LACTIVITY:
TH
1. Choose five kinds of diseases and analyze its causation, what are is agents (If there is any) determine if its
intrinsic or extrinsic.
ASSESSMENT TEST:
Google form link:
REFERENCES:
Books:
Ciabal, Laura Evelyn P. Introduction to Public Health Issues. 1st ed. Manila Educational Publishing House,
1999.
Conte, John E. Manual of Antibiotics and Infectious Diseases (Treatment and Prevention). 1st ed.
Massachusetts, USA: Allen and Bacon Viacom Company, 1999.
Internet sources:
https://courses.lumenlearning.com/boundless-microbiology/chapter/viral-ecology/
UNIT IV. DISEASE PREVENTION

AND CONTROL
OBJECTIVES:

1. To be able to differentiate the different levels of prevention
2. To be able to formulate techniques in prevention of disease
LECTURE NOTES
PUBLICHEALTH
WHAT IS DISEASE PREVENTION
- The action of preventing, eradicating, eliminating or minimizing the impact of disease and
disability (John M. Last)
- includes measures not only to prevent the occurrence of disease, such as risk factor
reduction, but also to arrest its progress and reduce its consequences once established.
Prevention depends upon:
 knowledge of causation
 dynamics of transmission
 identification of risk factors and risk groups
 availability of prophylactic or early detection of treatment measures
 facilities of these treatment procedures
 evaluation and development of these procedures
WHAT IS DISEASE CONTROL
describes ongoing operations aimed at reducing:

- the incidence of disease
- Duration of disease
- Effects of infection
- Financial burden to the community
PUBLIC HEALTH APPROACH TO DISEASE CONTROL

1. Define problem
2. Identify the risk factors
3. Intervene
4. Evaluate intervention
DISEASE CONTROL INCLUDES:

1. CONTROL- public policy intervention that restricts the circulation of an infectious agent
beyond the level that would result from spontaneous individual behaviors to protect against
infection
2. ELIMINATION- reduction to zero of the incidences of a specified disease in a defined

geographical area as a result of a deliberate efforts
3. ERADICATION- termination of all transmission of infections by extermination of infectious

agents
4. EXTINCTION- the specific infectious agent no longer exists in nature or in the laboratory.
5. MONITORING- Performance and analysis of routine measurements aimed at detecting

changes in the environment or health status of a population. E.g. Monitoring of air poluution,
water quality, growth and nutritional status
6. SURVEILLANCE- continuous scrutiny of the factors that determine the occurrence and
distribution of disease and other conditions of ill-health
Primary activities
- Collection of relevant data for a specified population, time period and/or
geographic area
- Meaningful analysis of data
- Routine disseminatatin of data with accompanying interpretation
DUTIES OF HEALTH CARE PROFESSIONALS IN SURVEILLANCE

- Identify and describe each individual having an infection as quickly as
possible after exposure.
PUBLICHEALTH
- Determine the source of infection
- Identify exposed individuals to whom the infection may have transmitted
- Specify the frequency of occurrence of infection in population groups at risk
by person, place and time
- Identify populations that are experiencing, or might experience, an
increased frequency of infection
- Prepare and distribute surveillance reports to healthcare professionals
participating in disease and control activities.
TYPES OF SURVEILLANCE
A. PASSIVE SURVEILLANCE- receipt of reports of infections/disease from
physicians, laboratories and other health care professionals required to submit
such reports as defined by public health legislation.
B. ACTIVE SURVEILLANCE- active disease surveillance is also based on public

health legislation and refers to daily, weekly or monthly contacting of
physicians, hospitals, laboratories, schools or others to “actively” search for
cases
STAGES OF DISEASE DEVELOPMENT

Prodromal period- occurs after the incubation period. During this phase, the pathogen continues to
multiply, and the host begins to experience general signs and symptoms of illness, which typically result
from activation of the immune system, such as fever, pain, soreness, swelling, or inflammation. Usually,
such signs and symptoms are too general to indicate a particular disease.
Period of illness-during which the signs and symptoms of disease are most obvious and severe.
Period of decline- during which the number of pathogen particles begins to decrease, and the signs and
symptoms of illness begin to decline. However, during the decline period, patients may become
susceptible to developing secondary infections because their immune systems have been weakened by
the primary infection.
Period of convalescence-During this stage, the patient generally returns to normal functions, although
some diseases may inflict permanent damage that the body cannot fully repair.
LEVELS OF PREVENTION
1. PRIMORDIAL PREVENTION- consist of actions and measures that inhibit the emergence and
establishment of environmental, economic, social, and establishment of environmental, economic,
social and behavioral conditions, cultural patterns of living known to increase risk of disease
- It is the prevention of the emergence or development of risk factors in countries or population
groups in which they have not yet appeared
2. PRIMARY PREVENTION- Action taken to prior to the onset of disease will ever occur
-It signifies intervention in the prepathogenesis phase of a disease or health problem
2. SECONDARY PREVENTION- “Action which halts the progress of disease at its incipient stage and
prevent compilations”- John M. Last
3. TERTIARY PREVENTION- this type of prevention is to limit the disability of the patient and minimize
the suffering caused by existing departures from good health and to promote the pateint’s adjustment
to irremediable conditions
** in 2001 Froom and Benbassat formulated 7 categories of prevention and they are as follows:
LEVEL 1- Reducing the exposure to an etiologic agent
LEVEL 2- Increasing resistance to the disease
LEVEL 3- Defining it as screening for risk factors for disease (in asymptomatic individuals) in
order to reduce them
LEVEL 4- Prevention of recurrence (in asymptomatic individuals after a disease related event)
PUBLICHEALTH
LEVEL 5- treatment aimed at prevention of complications (in asymptomatic individuals after a
disease related event)
LEVEL 6- Treatment of symptomatic patients for cure, palliation, or reduction of mortality
LEVEL 7- Rehabilitation for adjustment to irremediable conditions.
TECHNIQUES
1. PRIMORDIAL PREVENTION- this includes formulation of programs and policies on:

- Food nutrition
- Against smoking and drugs
- Promote regular physical activity
2. PRIMARY PREVENTION-
A. health promotion- which enables the public to increase awareness and to control the
development of disease ad also to improve the health.
B. Specific protection-actions taken to prevent or protect themselves from a specific disease
3. SECONDARY PREVENTION-
A. Early diagnosis – Screening test, case finding programs
B. Adequate/ Prompt treatment
4. TERTIARY PREVENTION-
A. Disability limitation- to prevent the transition of disease process from impairment to
handicap
B. Rehabilitation- physical restoration of a sick or disabled person by therapeutic measures and
re-education- (webster’s New Medical Dictionary new edition)
TYPES OF REHABILITATION
1. PHYSICAL THERAPY
- exercises to reduce muscle pain, spasticity, and weakness, and improve
your balance and coordination.
Examples of mobility devices include single-point or quad canes, motorized
scooters, rolling walkers, and manual or power wheelchairs.
PUBLICHEALTH
2. OCCUPATIONAL THERAPY
- focus on cognitive rehabilitation (helping you improving thinking, memory,
reasoning, and concentration) and vocational rehabilitation (assessing job readiness and
ways to maintain or find jobs that meet your needs).
3. SPEECH AND SWALLOW THERAPY

-include techniques to clear mucus from the throat, exercises to ease
breathing, and medical therapies like nebulizers or oxygen in some people.
- A speech and swallow therapist may recommend eating techniques that will
maximize nutritional intake while minimizing the risk of aspiration. These techniques
often include:
-resting before eating
-sitting in an upright position
-keeping your chin parallel to the table
-performing double swallows.
4. COGNITIVE REHABILITATION
- is a system of therapeutic activities, based on brain- behavior relationships,
directed to achieve functional change by: Re-establishing or reinforcing previously
learned patterns of behavior Establishing new patterns of cognitive activity through
compensatory cognitive mechanisms Establishing new patterns of activity through
external compensatory mechanisms Enabling persons to adapt to their cognitive
disability to improve overall functioning
PRINCIPLES OF REHABILITATION
- Enable timely recovery
- Re-stabilize
- RE-train
- Re- motivate
- Re- integrate
PUBLICHEALTH
ACTIVITY:
1. Make a COVID-19 prevention from level 1-4 and make a technique in order to prevent
ASSESSMENT TEST:
Google form link:
REFERENCES:
Books:
Ciabal, Laura Evelyn P. Introduction to Public Health Issues. 1st ed. Manila Educational Publishing House,
1999.
Conte, John E. Manual of Antibiotics and Infectious Diseases (Treatment and Prevention). 1st ed.
Massachusetts, USA: Allen and Bacon Viacom Company, 1999.
Websters New Explorer Medical Dictionary New Edition. Federal Street Press. pg. 664
Internet sources:
https://www.ump.edu.pl/files/8_483_epidemiology_and_prevention.pdf
UNIT V. HEALTH PROMOTION IN

INDUSTRY
OBJECTIVES:

1. To know the different objectives of occupational health
PUBLICHEALTH
2. To be familiar with the different hazards of occupational health
3. To know the different ways to prevent the occurrence of occupational hazards
LECTURE NOTES
HEALTH PROMOTION “the process of enabling people to increase control over, and to improve their
health.” Health Promotion Glossary, 1998
- any combination of health education and related organizational, economic and political interventions
designed to facilitate behavioral and environmental changes conductive to health (Green LW ,1972)
OCCUPATIONAL HEALTH
- Referred to as Occupational health and safety (OHS) or workplace health

and safety (WHS), is a multidisciplinary field concerned with the safety,
health, and welfare of people at work. The goal of occupational safety and
health programs include to foster a safe and heathy work environment. OSH
may also protect co-workers, family members, employers, customers, and
many others who might be affected by the workplace environment
(Najorda,2019)
OBJECTIVES OF OCCUPATIONAL
Joint ILO/WHO Committee stated that Occupational Health should aim at the promotion and
maintenance of the highest degree of physical, mental and social well-being of workers in all occupations; the
prevention amongst workers of departures from health caused by their working conditions; the protection of
workers in their employment from risks resulting from factors adverse to health; the placing and maintenance of
the worker in an occupational environment adapted to his physiological and psychological capabilities; and, to
summarize: the adaptation of work to man and of each man to his job.
Objectives by WHO Regional Office for Europe (Rantanen 1990)

 protecting workers' health against hazards at work (the protection and prevention principle)
 adapting work and the work environment to the capabilities of workers (the adaptation
principle)
 enhancing the physical, mental and social well-being of workers (the health promotion principle)
 minimizing the consequences of occupational hazards, accidents and injuries, and occupational
and work-related diseases (the cure and rehabilitation principle)
 providing general health care services for workers and their families, both curative and
preventive, at the workplace or from nearby facilities (the general primary health care
principle).
HEALTH AND SAFETY PROGRAMS

 Workplace hazards are controlled- at the source whenever possible
 Records of any exposure are maintained for many years
 Both workers and employees are informed about health and safety risk in the workplace
 Worker health and safety efforts are ongoing
PUBLICHEALTH
OCCUPATIONAL HAZARD
Danger to health, limb, or life that is inherent in, or is associated with, a particular occupation, industry,
or
work environment. Occupational hazards include risk of accident and of contracting occupational
diseases.
TYPES OF OCCUPATIONAL
Physical hazard
 Heat
 Cold
 Light
 Noise
 Ultraviolet radiation
 Vibration
 Ionizing radiation
Chemical hazard
 Local action- (formaldehyde, cleaning agent etc.)
 Inhalation- (Cigarette smoke, carbon monoxide, carbon dioxide etc.)
Biologic hazard
 Exposure to infectious substances or microorganism
Mechanical hazard
 lack of knowledge with the machine
 Carelessness
Psychosocial hazard
 Job insecurity
 Lack of job satisfaction
 Poor human relationship
 Emotional tensions
 Bullying in the workplace
 Long working hours
MOST FREQUENT WORK-RELATED DISEASES AND INJURIES

 Lung diseases- caused by asbestos, lead, silica, cotton dust
 Musculoskeletal injuries
 Cancers
 Severe trauma
 Cardiovascular disorder
 Disorder of Reproductive system
 Neurotoxic disorders
WAYS TO CONTROL A HAZARD

 ELIMINATION- (including substitution): Remove the hazard from the workplace, or substitute
(replace) hazardous materials or machines with less hazardous ones
 ENGINEERING CONTROLS- includes designs or modifications to plants, equipment, ventilation

systems, and process that reduce the source of exposure.
Ex. Process Control- involve changing the way a job activity or process is done to
reduce the risk. Monitoring should be done before and as well as after change is
implemented to make sure the changes did, in fact, control the hazard.
PUBLICHEALTH
Enclosure and isolation- aim to keep the chemical “in” and the worker “out”. An
enclosure keeps a selected hazard “physically” away from the worker. Examples
include “Glove boxes”, abrasive blasting cabinets, or remote-control devices.
Isolation places the hazardous process “geographically” away from the majority
of the workers. Common isolation techniques are to create a contaminant-free
or noise-free booth either around the equipment or around the employee
workstation
Ventilation-method of control that strategically “adds” and “removes” air in the

work environment. Ventilation can remove or dilute an air contamination if
designed properly. Local exhaust ventilation is very adaptable to almost all
chemicals and operation.
 ADMINISTRATIVE CONTROLS- controls that alter the way the work is done, including timing of
work, policies and other rules, and work practices such as standards and operating procedures
(Including training, housekeeping, and equipment maintenance, and personal hygiene practices)
Methods:
- Restricting access to a work area
- Restricting the task to only those competent or qualified to perform the
work.
- Scheduling maintenance and other high exposure operations for ties when
few workers are present (such as evenings, weekends)
- Using job-rotation schedule that limits the length of time a worker is
exposure to hazard.
 Work practices- developing and implementing safe work procedures or standard
operating procedures
 Training and education of employees about the operating procedures as well as
other necessary workplace training
 Establishing and maintaining good housekeeping programs
 Keeping equipment well maintained
 Preparing and training for emergency response for incidents such as spills, fire
or employee injury.
 PERSONAL PROTECTIVE EQUIPMENT- equipment worn by individuals to reduce exposure such as

contact with chemicals or exposure to noise, eye and face protection, respiratory protection,
head protection, hand and arm protection, safety belt, lifelines and safety nets, safety shoes
LEGAL CONTROL OF OCCUPATIONAL HEALTH SERVICES
Preventive activities oriented to workers

 assessment and surveillance of workers' health status by pre-placement, screening and periodic
examinations which may be general as well as focused on the biological effects of particular hazards
to which the workers may have been exposed
 Adaptation of the job, the work station and the workplace environment to promote workers'
ongoing health and safety with special attention to such vulnerable groups as the very young, the
elderly and those with acquired diseases and disabilities
PUBLICHEALTH
 Providing workers with health education and training in proper work practices
 providing education and training for owners/managers and supervisors that will inculcate awareness
of the health needs of workers and motivation to initiate appropriate prevention and control
measures.
Curative activities
 provide or arrange the delivery of the appropriate diagnostic, therapeutic and rehabilitative services
for occupational injuries and diseases
 provide or arrange for early rehabilitation to obviate avoidable disability and encourage and oversee
adjustments in the job that will permit early return to work
 provide education and training (and periodic retraining) in first aid and emergency procedures
 establish procedures and conduct training drills for coping with major emergencies such as spills,
fires, explosions and so on
 provide or arrange for workers' involvement in programmes that promote general health and well-
being.
Record keeping and evaluation

 make and retain appropriate records on occupational accidents, injuries and diseases and if
possible, on exposure; evaluate the overall health and safety status of the enterprise on the
basis of such data
 monitor the effectiveness of hazard prevention and control measures.
REASERCH ACTIVITY:
1. Search for the Philippine laws that are made to protective workers. List down the article or section that
pertains to the protection of health of the employees.
ASSESSMENT TEST:
Google form link:
REFERENCES:
Books:
Internet sources:
https://www.who.int/health-topics/health-promotion#tab=tab_1
https://www.who.int/occupational_health/topics/workplace/en/index1.html
http://www.ilocis.org/documents/chpt16e.htm
http://www.businessdictionary.com
UNIT VI. GOVERNMENT AND

NON-GOVERNMENTAL HEALTH
PROGRAMS AND SERVICES
PUBLICHEALTH
OBJECTIVES:

1. To know the different Health programs and services offered by the government and non-government
agencies
2. To know the different rights of the public towards health
LECTURE NOTES
GOVERNMEMNT HEALTH PROGRAMS AND SERVICES IN THE PHILIPPINES
PUBLIC HEALTH SERVICES (Philippine Health services Delivery Profile, 2012)

-The Department of Health (DOH) is responsible for developing health policies and
programs regulation, performance monitoring and standards for public and private
sectors, as well as provision of specialized and tertiary level care
-The DOH Centers for health and Development (CHDs) are the implementing
agencies in provinces, cities and municipalities, and link national programs to local
government units (LGUs).
-The CHDs are the DOH offices at the regional level. They assist the LGUs in the
development of ordinances and localization of national policies, provide guidelines
on the implementation of national programs at the LGU levels, monitor program
implementation, and develop support system for the delivery of services by LGUs.
Service Delivery Model
HEALTH AGENCIES
The Department of Health (DOH)
- is the principal health agency in the Philippines. It is responsible for ensuring access to basic
public health services to all Filipinos through the provision of quality health care and regulation of
providers of health goods and services.
PUBLICHEALTH
Philippine Health Insurance Company (PHIC)
- ensure a sustainable national health insurance program for all.
**Six major membership categories
- "Formal" sector
-Indigent sector
- Sponsored members
- Lifetime members
-Senior citizen
- Informal economy
World Health Organization
Primary role is to direct and coordinate international health within the United Nations system.
- support countries as they coordinate the efforts of governments and partners – including bi-
and multilaterals, funds and foundations, civil society organizations and the private sector.
**Main areas of work are health systems:
- Health through the life-course
- Noncommunicable and communicable diseases
- Preparedness, surveillance and response
United Nations International Children’s Emergency Fund
-to save children’s lives, to defend their rights, and to help them fulfil their potential,
from early childhood through adolescence.
Programs:
- Child protection and inclusion
- Child survival
HEALTH PROGRAM
- aims to promote and protect the health of families, prevent and
control non-communicable diseases and non-communicable diseases, and implement environmental
health and sanitation activities
A. FAMILY HEALTH
- it is concerned with the health of the mother and unborn, the newborn, infant, child, the adolescent
and youth, the adult men and women and older persons.
1. The Maternal Health
- Goal: to improve the survival, health and well-being of mothers and unborn through a
package of services for the pre-pregnancy, pre-natal, natal and post-natal stages.
- Essential Health Services Packages available in the Health Care Facilities
- These are the packages and services that every woman has to receive before and after
pregnancy and or delivery of a baby.
1. Antenatal Registration
- guide the mother in pregnancy in care to make her prepare for childbirth
Ex. Prenatal visits, dental check-ups
2. Tetanus Toxoid Immunization
- to protect from deadly disease tetanus toxoid immunization
- a series of 2 doses to tetanus toxoid vaccination must be received by a woman
one month before delivery and 3 booster doses after childbirth. The mother then is
called “Fully Immunized Mother (FIM)”
3. Micronutrient Supplementation
- Vitamin A and Iron supplement for the prevention of anemia and Vit. A
deficiency.
4. Treatment of disease and other conditions
- Conditions that might occur among pregnant woman that may endanger he
health and complication could occur. This includes:
a. Obstruction of airway
b. Unconscious
c. Post-partum bleeding
d. Intestinal parasite infection
e. Malaria
5. Clean and Safe Delivery
PUBLICHEALTH
- provide safe and non-traumatic care, recognize complications and also manage
and refer the woman to a higher level of care when necessary
2. The Family Planning Program
- Goal: to provide universal access to family planning information and services
wherever and whenever these are needed.
**Family planning aims to contribute to:
 Reduce infant deaths
 Neonatal deaths
 Under-five deaths
 Maternal deaths
Interventions: Promote and implement strategies through outreach program
3. The Child Health programs (Newborns, Infants and Children)

- Newborns, infants and children are vulnerable are group for common childhood
disease
a. Infant and young Child feeding
Objective:
- To improve the survival of infants and young children by improving
their nutritional status, growth and development through optimal
feeding
b. New born screening- To detect diseases such as G6PD to prevent
complications
4. Expanded Program on Immunization (EPI)
- Vaccination among infants and newborns (0-12 months) against the seven vaccine
preventable diseases. These includes:
a. Tuberculosis
b. Diphtheria
c. Pertussis
d. Tetannus
e. poliomyelitis
f. Measles and hepatitis
*** The EPI routine schedule of immunization
- The child is said to be “Fully Immunized Child” when a child receives one
dose of BCG, 3 doses of OPV (Oral Polio Vaccine), 3 doses of DPT, 3 doses of
Hep B and one dose of measles before a child’s first birthday
Management of childhood illness
Methods:
a. Assess the patient
b. Classify the disease
c. Treat the patient
d. counsel the patient
5. Micronutrient Supplementation/ Nutrition Program
The common deficiencies are:
a. Vitamin A
PUBLICHEALTH
b. Iron
c. Iodine
- these deficiencies lead to a serious physical, mental, social and economic condition
among children and women.
Goal: To improve the quality of life of Filipinos through better nutrition, improved health
and increased productivity
PROGRAMS AND PROJECTS UNDER NUTRITIONAL PROGRAM:
a. Micronutrient Supplementation
- the twice-a-year distribution of vitamin A capsules through the “Araw ng
Sangkap Pinoy”, known as Garantisadong Pambata (GP), or Child health week
b. Food fortification
- the addition of essential nutrients to a widely consumed food product at levels
above natural state is a cost effective and sustainable intervention to address
micronutrient deficiency
FOOD FORTIFICATION ACT OF 2000
- Provides the mandatory fortification of staples namely: Flour with iron and
vitamin. A cooking oil and refined sugar with Vitamin A and rice with iron
and the voluntary fortification of processed foods through the “Sangkap
Pinoy Seal”
c. Essential maternal and Child Health Services Package
- includes the delivery of essential maternal and child health and nutrition
package of services that will ensure the right to survival, development,
protection and partition as follows:
 Breast feeding
 Complementary feeding
 Micronutrient supplementation
d. Nutrition Information Communication and Education
- these includes the promotion to nutritional guidelines for Filipinos and other
nutrition key messages and training of health workers
e. Home School and Community food production

- includes establishment of kitchens, gardens in homes, schools and in
communities in urban and rural areas to serve as a source of additional food for
the home and establishment of demonstration centers and nurseries and
distribution of planting materials.
6. DENTAL HEALTH/ORAL HEALTH PROGRAM
- dental caries and periodontal disease (gum disease) are the main health problems in
the Philippines
Intervention:
a. Preventive services
 Oral examination
 Oral hygiene
 Pit and fissure sealant program
 Fluoride utilization Program
b. Curative/ Treatment Services
 Permanent filling
 Gum treatment
 Atraumatic restorative treatmend
 Temporary fillinf
 Extraction
 Treatment of post extraction complication
 Drainage of localized oral abscesses and incision and drainage
c. Promotive services
 Health education activites
7. THE ADOLESCENT HEALTH PROGRAM
- WHO define adolescent as the period of life between 15- 24 years of age while youth
refers to those who are between 15 and 24 years old
PUBLICHEALTH
ESSENTIAL HEALTH CARE PACKAGE FOR THE ADOLESCENT AND YOUTH
a. Management of illness
b. Counselling on substance abuse, sexually and reproductive tract infections
c. Nutrition and diet counseling
d. Mental health
e. Family planning and responsible sexual behavior
f. Dental care
8. THE ADULT MEN AND WOMEN PROGRAM (aged 25-59 years old)
ESSENTIAL HEALTH CARE PACKAGE FOR THE ADULT MALE AND FEMALE
b. Counselling on substance abuse, sexuality and reproductive tract infections
c. Nutrition and diet counselling
d. Mental health
e. Family planning and responsible sexual behavior
f. Dental care
g. Screening and management of lifestyle related and other degenerative
disease
9. THE OLDER PERSON PROGRAM
ESSENTIAL HEALTH CARE PACKAGE TO OLDER PERSON
b. Counselling on substance abuse, sexuality and reproductive tract infections
c. Nutrition and diet counseling
d. Mental health
e. dental care
g. Screening and management of lifestyle and other degenerative disease
h. Screening and management of chronic debilitating and infectious diseases
i. Post productive care
B. NON-COMMUNICABLE DISEASE PREVENTION AND CONTROL PROGRAM (NCD PREVENTION AND CONTROL
PROGRAM
FOUR MAJOR NON-COMMUNICABLE DISEASE
 Cardiovascular disease
 Cancer
 Chronic pulmonary disease
 Diabetes mellitus
INTERVENTION:
o Advise smoking cessation
o Encourage Proper nutrition
o Drink alcoholic beverages in moderation
o Promote physical activity
C. COMMUNICABLE DISEASE PREVENTION AND CONTROL
DOH covers the following communicable disease:
 Tuberculosis
 Leprosy
 Schistosomiasis
 Filariasis
 Malaria
o House spraying
o On stream clearing
 Dengue Hemorrhagic fever
 Measles
 Chicken pox
 Mumps
 Diphtheria
 Pertussis
 Tetanus
 Influenza
 Pneumonias
PUBLICHEALTH
 Cholera
 Typhoid fever
 Bacillary dysentery
 Hepatitis A
** Intervention usually starts with Immunization (Free vaccine shot)
HEALTH SERVICES
HEALTH SECTOR REFORM AGENDA
1. Provide fiscal autonomy to government hospitals
2. Secure funding for priority public health programs
3. Promote development of local health systems
4. Strengthen health regulatory agencies' capacities
5. Expand the coverage of the National Health Insurance Program.
**GOALS
- Better health outcomes
- More responsive health system
- More equitable healthcare financing.
FOURmulaONE OBJECTIVES
- Secure more, better and sustained financing for health
- Assure the quality and affordability of health goods and services
- Ensure access to and availability of essential and basic health packages
- Improve performance of the health system
SENTRONG SIGLA
Certifies primary health care facilities that comply with its list of quality standards.
**Methods used:
-Chi-squared tests- statistics
-prevalence ratios- The ratio of the proportion of the persons with disease over
the proportion with the exposure
-Clustered sampling analysis-
-Linear regressions of the rates- values from an existing data
PHILIPPINE GOVERNMENT HEALTH LAWS/PROGRAMS

1. Anti-drunk and Drugged Driving Act of 2013
- ensure road safety through the observance of the citizenry of responsible and ethical driving
standards.
2. National Building Code

- to safeguard life, health, property, and public welfare, consistent with the principles of sound
environmental management and control; and to this end, make it the purpose of this Code to provide
for all buildings and structures, a framework of minimum standards and requirements to regulate and
control their location, site, design quality of materials, construction, use, occupancy, and maintenance
3. Anti-sexual Harassment Act of 1995

- value the dignity of every individual, enhance the development of its human resources,
guarantee full respect for human rights, and uphold the dignity of workers, employees, applicants for
employment, students or those undergoing training, instruction or education. Towards this end, all
forms of sexual harassment in the employment, education or training environment are hereby declared
unlawful.
4. The Philippine Mining Act of 1995

- protect and advance the right of the Filipino people to a balanced and healthful ecology in
accord with the rhythm and harmony of nature;
NON-GOVERNMENT ORGANIZATION (NGO)
PUBLICHEALTH
- Defined by World Bank as Private organization that pursue activities to relieve
suffering, promote interests of the poor, protect the environment, provide
social services or undertake community development.
Types:
-Charitable
-Participatory
- Service
-Empowering
UNIVERSAL AREAS OF NGO’S

- Culture and recreation
- Education and research
- Health
- Social services
- Environment
- Development and housing
- Law, advocacy and politics
- Voluntarism promotion
- Business and professional associations and unions
- Religion
INTERNATIONAL NGO
Wikimedia- Jimmy Wales - goal is to open source content, wiki based project to public for free
Heifer international- Dan West - “Ending hunger, Caring for the earth”
- focuses on sustainable development agro-ecology and sustainable development.
Clinton Health access Initiative- Bill Clinton - Launches several health improvements programs,
immunization programs and supply of second line drugs at cheaper rates.
Mercy Corps- ( Elsa Culver) - Engaged in transitional environment that have experienced sort of shocks
such as natural disaster and the like.
Oxfam International- composed of 11 NGO’s that works together to fight poverty and injustice around
the
world
CARE (Cooperative for assistance and relief everywhere) - One of the world’s largest NGO for relief and
development
- Famous for its “Care Packages” of food and other necessities
- Goals: income; education; health and population services.
Local NGO
Mercy in action- “Birth centers saves mother baby lives”

Children’s joy Foundation-” Hel feed and send to school poor kids”
CANVAS- (Center of Art, New ventures and sustainable Development) “ Give books to
Children”
Tahanan Sta. Lucia- “ Empower Filipino teenage girl survivors of abuse”
Reach out and feed Philippines Inc.- “#Projectbaon: School meals for 300 filipino kids
Angel house orphanage- Care for children from 0-10 y/0
International disaster Volunteer- Build rescue boats in flood prone communities
REASERCH ACTIVITY:
PUBLICHEALTH
1. Search for the following local health programs and identify the health services they cater:
a. GCVP
b. BnB
c. NTP
d. Tapat mo, linis mo
e. SALINTUBIG
f. VMNIS
g. WNTD
h. TB DOTS
i. ASIN Law
j. Bring your own bag
k. MDIS
l. Four o’clock habit
2. What are the Health programs available in your barangay? What are its benefits to your barangay?
ASSESSMENT TEST:
Google form link:
REFERENCES:
Books:
Public Health Nursing in the Philippines, 10th ed., 2017, pages 119-173
Health Services Delivery Profile Philippines 2012 page 3
Internet sources:
https://www.officialgazette.gov.ph/2013/05/27/republic-act-no-10586/
http://ray.dilg.gov.ph/files/national_building_code_of_the_philippines.pdf
https://www.ombudsman.gov.ph/GAD/Laws%20and%20Mandates/republic_act_7877.pdf
https://www.officialgazette.gov.ph/2012/07/06/executive-order-no-79-s-2012/
PUBLICHEALTH
UNIT VI. INFECTIOUS DISEASE IN
THE PHILIPPINES
OBJECTIVES:

1. To know the different infectious disease in the Philippines
2. To know the different treatments and management of diseases
LECTURE NOTES
A. Water/ Food borne diseases
TYPHOID FEVER
 Aka. Enteric fevers

 Causative agent: Salmonella typhi
 History: Spleen secretions and lymph nodes
1896: Serum from animals immunized with
Typhoid bacterial cells. Serodiagnosis is made possible
Typoid “Mary”-Mary Mallon
Salmonella enterica serovar Typhi
-infected 78 people; 5 deaths
 Transmission: ingestion of food and drinks.
 Parathyroid: Salmonella Paratyphi A,B, C
 Clinical Features: Septicemia features, Bradycaria, splenomegaly, abdominal symptoms and “Rose
spots”and intestinal hemorrhage.
 Symptoms: Continuous headache, abdominal tenderness discomfort with constipation.
 Onset of disease: from 3 to 50 days (2 weeks)
 Test used: Widal test
 Treatment: Chloramphenicol,Trimethoprim-sulfamethoxazole (Bactrim), Ciprofloxacin; Vaccines
 Prevention: Proper hand washing
 Treatment: Antibiotics DOC: Chloramphenicol
HEPATITIS A
5 types of Hepatitis
A- fecal-oral
B- Transmission
C- Blood to Blood
D- Travels with B
E-Fecal-oral transmission
 Hepatitis A
-Epidemic Jaundice
-Naked RNA virus (Heptovirus)
PUBLICHEALTH
 Causative agent: Picorna virus (RNA)
 Target: Humans are only host
 Intervention: Can be inactivated by high temperature, Formalin, chlorine
 Transmission:
-Contaminated food, water
-Blood exposure
 Treatment: HBV antiviral agent (interferon), HBC Ribavirin
CHOLERA
 Causative agent: Vibrio cholerae
 Characteristics: Comma shaped, gram negative
 Host factors: Children and elderly, low gastric levels; Blood type: (O,B,A,AB)
 Risk factors: Poor sanitary condition, Raw or undercooked food,Hypochlorhydia,
Type O
 Transmission: Contaminated food,Casual contact
 Incubation:1-3 days
 Symptoms: Usually mild/ no symptom, cramps, painless diarrhea and vomiting of
clear liquid “Rice water”
 Treatment: Prevent dehydration - Hydration is the mainstay of treatment for cholera.
Antibiotics
Vaccine against cholera
AMEBIC DYSENTERY
 Causative agent: Entamoeba histolytica

**3rd leading parasitic cause of death
 Two forms: Trophozoite and cyst form
-Cyst- Small intestine
-Trophozoite-large intestine
 Risk factors: Children, Pregnant who use corticosteroids, Malnourished.
 Incubation: 2-4 weeks
 S/S: Bloody diarrhea, abdominal tenderness, fever, vomiting, frequent loose stools,
abdominal pain, cramps (colic), fatigue, diarrhea with abdominal swelling, flatulence
 Tx: Metronidazole (DOC for invasive disease)
Paromomycin (DOC for non-invasive)
E. COLI DIARRHEAL ILLNESS

 Escherichia coli- gram (-)
 Enterohemorrhagic E coli (EHEC)- cause disease and produces
exotoxins
 Verocytotoxic E. coli (VTEC) also known as Shiga toxin Producing
e.coli
• Transmission: Fecal oral, fomites
• Primary reservoir: Cattle/Sheep
• Transmission of humans: Food, contaminated water
• Incubation: 1-16 days
• S/s: diarrhea, vomiting, body malaise, Loss of appetite, dehydration
• Diagnosis: Stool analysis
• Treatment: resting/drinking water to replenish fluids, antibiotics and
antimotility agents may be useful for traveler's diarrhea.
PUBLICHEALTH
BACILLARY DYSENTERY
• aka- Shigellosis
• Place of lesion: Sigmoid and colon
• S/s: Fever, Abdominal pain, tenesmus, stool mixed with mucus and pus.
• Causative agents:
S. dysenteriae: the most severe
S. Flexneri- Easily turn to chronic
S. Boydii- tropical
S. sonnei- the most mild
• Route of administration: Fecal-oral route
• Incubation: 1-2 days
• S/s: Shiver, abdominal pain,
• Treatment: Ampicillin, Diet, Avoid over work
B. SEXUALLY TRANSMITTED DISEASE
SYPHILIS
 Causative agent: Treponema pallidum
 Stages: primary, secondary, latent, and tertiary
a. primary syphilis - sore or sores on or around the genitals, around the
anus or in the rectum, or in or around the mouth.
b. secondary syphilis include skin rash, swollen lymph nodes, and fever.
c. latent stage, there are no signs or symptoms
d. Tertiary syphilis is associated with severe medical problems. A
doctor can usually diagnose tertiary syphilis with the help of multiple
tests. It can affect the heart, brain, and other organs of the body.
 Spread: direct contact with a syphilis sore during vaginal, anal, or oral
sex. Syphilis can spread from an infected mother to her unborn baby.
 Dx: blood sample
 Treatment: antibiotics
 For primary, secondary and early latent syphilis-Benzathine penicillin
(IM 1),Doxycycline 100mg (2x 14days), tetracycline 500mg (4x, 14 days)
For late latent –Benzathine (3 doses, 1 wk interval),
Doxycycline 100mg(2x,28 days) tetracycline 500mg (4x for 28
days)
For Neurosyphilis-Aqueous crystalline penicillin (IV, 4
hrs,10-14d) Procaine Penicillin (IM) +Probenecid (oral) (both 10-
14 days)
ACQUIRED IMMUNE DEFICIENCY SYNDROME

 Causative agent: HIV (human immunodeficiency virus) which attacks
the T-cells (CD-4 cells) in the immune system
 HIV is a retrovirus.
** AIDS is a medical condition (syndrome)
 HIV infection can cause AIDS to develop. However, it is possible to
be infected with HIV without developing AIDS. Without treatment,
the HIV infection can progress and, eventually, it will develop into
AIDS.
 Dx: blood test
 S/S: fever, chills, joint pain, muscle aches, sore throat, sweats
(particularly at night), enlarged glands, a red rash, tiredness,
weakness, unintentional weight loss
 Treatment: currently no cure for HIV or AIDS. Treatments can slow
the course of the condition - and allow most infected people the
opportunity to live a long and relatively healthy life.
PUBLICHEALTH
NON-GONOCOCCAL URETHRITIS
- Causative agent/s: Chlamydia trachomatis Ureaplasma urealyticum
Trichomonas (rare) Herpes simplex virus (rare) Adenovirus
Haemophilus vaginalis Mycoplasm genitalium.
- S/S: Men (urethral infection): Discharge from the penis Burning or

pain when urinating (peeing) Itching, irritation, or tenderness
Underwear stain
Women (vaginal/urethral infection): Discharge from the vagina
Burning or pain when urinating (peeing) Abdominal pain or abnormal vaginal
bleeding may be an indication that the infection has progressed to Pelvic
inflammatory Disease (PID) Anal or Oral Infections
- Treatments: Azithromycin Tetracycline Alternatives are: Erythromycin
Recommended treatment for recurrent/persistent urethritis:
Metronidazole with Erythromycin
HERPLEX SIMPLEX GENITALIA
 Causative agent: herpes simplex virus type 1 (HSV-1), herpes simplex

virus type 2 (HSV-2
 S/S: herpes simplex virus type 1 (HSV-1) and herpes simplex virus
type 2 (HSV-2
 herpes type 1 causes sores around the mouth and lips (sometimes
called fever blisters or cold sores). HSV-1 can cause genital herpes,
but most cases of genital herpes are caused by herpes type 2.
 In HSV-2, the infected person may have sores around the genitals or
rectum. Although HSV-2 sores may occur in other locations, these
sores usually are found below the waist.
 Dx: lab tests, including DNA -- or PCR -- tests and virus cultures
 Treatment: Famvir, Zovirax, and Valtrex
GONORRHEA
Gale-”Flow of seed”
• Causative agent: Neisseria gonorrhoeae
• Culture media-Thayer martin
• Steps in pathogenesis
-Adherence
- Invasion
-Tissue damage
-Dissemination (ability to resist killing of antibodies)
o S/S- Increased vaginal discharge, Dysuria,
o can infect both men and women. It can cause infections in the genitals,
rectum, and throat.
o very common infection, especially among young people ages 15-24
years.
o Dx: performed on a vaginal swab on women, or urine from both men
and women
o Treatment: ceftriaxone given as an injection combined with
azithromycin (Zithromax, Zmax) or doxycycline (Monodox, Vibramycin)
oral gemifloxacin (Factive) or injectable gentamicin, combined with oral
azithromycin
PUBLICHEALTH
C. AIRBORNE DISEASES/ DROPLET
PULONARY TUBERCULOSIS
 Causative agent: Mycobacterium tuberculosis
 primarily attacks the lungs, however, it can spread to other organs.

Pulmonary TB is curable with an early diagnosis
*Latent TB - aren’t contagious and have no symptoms, it

is possible for latent TB to develop into active TB. Being exposed to M.
tuberculosis doesn’t necessarily mean you’ll get sick. Among the 2.2
billion people who carry the germ, most have latent TB. This means the
immune system protects us from getting sick.
 S/S: cough almost continuously, cough up blood, have a consistent fever,

including low-grade fevers, have night sweats, have chest pains, have
unexplained weight loss
 Dx: check for lung fluids, ask about PMI, CXR, sputum test, blood test,
PPD(skin test)
 Treatment: Treatment of Latent TB. The antimycobacterial rifapentine

(Priftin), which was previously approved for use against active
pulmonary TB caused by Mycobacterium tuberculosis, in combination
with isoniazid.
 TB drugs – the “first line” drugs
 Isoniazid (H/Inh), Rifampicin (R/Rif), Pyrazinamide (Z/Pza), Ethambutol

(E/Emb), and Streptomycin (S/Stm)
 These are the TB drugs that generally have the greatest activity against
TB bacteria. These drugs are particularly used for someone with active
TB disease who has not had TB drug treatment before. All the other TB
drugs are generally referred to as “second line” or reserve TB drugs.
CHICKENPOX
 Causative agent:varicella-Zoster virus (VZV)
 S/S: blister-like rash, itching, tiredness, and fever. The rash appears
first on the stomach, back and face and then spreads over the entire
body causing between 250 and 500 itchy blisters
 Dx: not usually need any medical tests to diagnose chickenpox. if

there are the key symptoms of a mild fever followed by an itchy
rash, blisters and scabs. If there's any doubt about the diagnosis,
chickenpox can be confirmed with laboratory tests, including blood
tests or a culture of lesion samples.
 Treatment: Acyclovir (Zovirax®), an antiviral medication, is licensed

for treatment of chickenpox. Varivax, a two-dose vaccine for
chickenpox, is highly recommended for healthy children,
adolescents, and adults who did not have the disease during
childhood.
PUBLICHEALTH
MEASLES
 Causative agent: togavirus that is enveloped and has a single-

stranded RNA genome
 German measles, also known as rubella
 serious condition in pregnant women, as it may cause congenital

rubella syndrome in the fetus
 S/S: rash, swollen lymphnodes, fever
 Dx: blood test
 Treatment: rest in bed and to take acetaminophen (Tylenol), which

can help relieve discomfort from fever and aches. Pregnant women
may be treated with antibodies called hyperimmune globulin that can
fight off the virus.
 rubella vaccine is usually given to children when they’re between 12

and 15 months old, and then again when they’re between ages 4 and
6
PNEUMONIA
 Causative agent: Streptococcus pneumoniae
 It often clears up in 2 to 3 weeks.
 bacteria or viruses usually cause pneumonia.
 S/S: Cough with mucus rusty or green or tinged with blood, Fever.,
Fast breathing and feeling short of breath, Shaking and "teeth-
chattering" chills, Chest pain that often feels worse when you cough
or breathe in, Fast heartbeat, Feeling very tired or very weak, Nausea
and vomiting, Diarrhea.
 Dx: chest X-ray and a complete blood count (CBC)
 Treatment: antibiotics
DIPHTHERIA
 Causative agent: bacterium Corynebacterium diphtheriae
 Diphtheria causes a thick covering in the back of the throat. It can lead to
difficulty breathing, heart failure, paralysis, and even death.
 S/S: Diphtheria can cause a thick gray coating to build up in the throat or
nose that makes it hard to breathe and swallow.
 Dx: blood, stool, respiratory secretions or body tissues sampling
 Treatment: two treatment strategies: antibiotics. The CDC recommends

erythromycin intramuscular penicillin for younger patients, diphtheria
antitoxin.
PUBLICHEALTH
MUMPS
 Causative agent: paramyxovirus
 S/S: It typically starts with a few days of fever, headache, muscle aches,
tiredness, and loss of appetite, followed by swollen salivary glands. Fatigue,
body aches, headache, loss of appetite, low-grade fever
 Dx: Check inside the mouth to see the position of the tonsils - when infected
with mumps, a person's tonsils can get pushed to the side. Take the
patient's temperature. Take a sample of blood, urine, or saliva to confirm
diagnosis.
 Treatment: Rest, OTC pain relievers, such as acetaminophen and ibuprofen,

to bring down your fever, Soothe swollen glands by applying ice packs, Drink
plenty of fluids to avoid dehydration due to fever, Eat a soft diet of soup,
yogurt, and other foods that aren’t hard to chew (chewing may be painful
when your glands are swollen), Avoid acidic foods and beverages that may
cause more pain in your salivary glands.
D. VECTOR BORNE DISEASE
DENGUE HEMORRHAGIC FEVER (DHF)
 Vector: Aedes aegypti mosquitoes carrying the dengue virus
 S/S: mild, moderate, or high fever, headaches, nausea, vomiting,

pain in the muscles, bones, or joints, rashes on the skin, low
platelests, bleeding under the skin, frequent vomiting, abdominal
pain\
 Dx: check your blood pressure, examine your skin, eyes, and glands,
perform blood tests and coagulation studies, take a chest X-ray
 Treatment: hydration with intravenous (IV) fluids, OTC or Rx drugs to

manage pain, electrolyte therapy, blood transfusions, careful
monitoring of blood pressure, oxygen therapy, skilled nursing
observation
MALARIA
 Vector: Anopheles mosquitoes carrying the Plasmodium parasite
 S/S: Fever, Chills, Sweats, Headaches, Nausea and vomiting, Body aches,
General malaise
 Dx: demonstration of parasites in the blood, usually by microscopy,

laboratory findings may include mild anemia, mild decrease in blood
platelets (thrombocytopenia), elevation of bilirubin, and elevation of
aminotransferases.
 Treatment:Quinine (Qualaquin) Quinine is used for malaria treatment

only; it has no role in prophylaxis. It is used with a second agent in drug-
PUBLICHEALTH
resistant P falciparum. For drug-resistant parasites, the second agent is
doxycycline, tetracycline, pyrimethamine sulfadoxine, or clindamycin.
E. ZOONOTIC DISEASES
RABIES
 Causative agent: rhabdovirus
 viral infection that mainly spreads through a bite from an infected

animal, it is an RNA virus of the rhabdovirus family
 There are two types of rabies.
1. Furious, or encephalitic rabies: This occurs in 80 percent of

human cases. The person is more likely to experience
hyperactivity and hydrophobia.
2. Paralytic or "dumb" rabies: paralysis is a dominant symptom

Rabies progresses in five distinct stages:
Incubation - 3 to 12 weeks, but it can take as little as 5
days or more than 2 years
Prodrome - a fever of 38o, headache, anxiety, sore
throat and a cough, n/v, discomfort may occur at the
site of the bite
Acute neurologic period - confusion and aggression,
partial paralysis, involuntary muscle twitching, and rigid
neck muscles, convulsions, hyperventilation and
difficulty breathing, hypersalivation or producing a lot
of saliva, and possibly frothing at the mouth, fear of
water, or hydrophobia, due to difficulty swallowing,
hallucinations, nightmares, and insomnia, priapism, or
permanent erection, in males, photophobia, or a fear of
light (2-10 days)
Coma - If the person enters a coma, death will occur
within a matter of hours, unless they are attached to a
ventilator. Rarely, a person may recover at this late
stage.
Death
 Dx: Lab tests may show antibodies, but these may not appear until later in the development of the disease. The
virus may be isolated from saliva or through a skin biopsy. However, by the time a diagnosis is confirmed, it may
be too late to take action. For this reason, the patient will normally start a course of prophylactic treatment at
once, without waiting for a confirmed diagnosis.
 Treatment: immediately wash any bites and scratches for 15 minutes with soapy water, povidone iodine, or
detergent.
Strategies include:
• A fast-acting dose of rabies immune globulin: Delivered as soon as possible, close to the bite wound, this can
prevent the virus from infecting the individual.
• A series of rabies vaccines: These will be injected into the arm over the next 2 to 4 weeks. These will train the
body to fight the virus whenever it finds it.
ANTHRAX
 Causative agent: Bacillus anthracis that lives in soil
PUBLICHEALTH
 can get anthrax by touching farm animals or game animals
infected with anthrax, can also become infected by inhaling it,
by eating undercooked meat from animals infected with
anthrax.
 S/S:
• Cutaneous - a small, raised sore that’s itchy. It usually looks
like an insect bite. The sore quickly develops into a blister. It
then becomes a skin ulcer with a black center. This doesn’t
usually cause pain. The symptoms typically develop within
one to five days after exposure.
• Ingestion – nausea, loss of appetite, fever, swelling in the
neck, bloody diarrhea, severe abdominal pain
• Inhalation - cold symptoms, a sore throat, a fever, achy
muscles, a cough, shortness of breath, fatigue, shaking,
chills, vomiting
 Dx: blood tests, skin tests, stool samples, a spinal tap, chest X-rays, a
CT scan, endoscopy
 Treatment: the standard treatment for anthrax is a 60-day course of
an antibiotic, such as ciprofloxacin (Cipro) or doxycycline (Monodox,
Vibramycin)
FOOT AND MOUTH DISEASE
• Aka “Aphthous disease”

• Viral disease from Cloven-footed disease
• Causative agent: Aphthovirus, Picornaviridae
• Enterovirus family, most commonly the coxsackievirus A16,
Aphthovirus family Picornaviridae from cloven-hoofed animals
• infection can affect people of all ages, but it usually occurs in
children under age 5. It is generally a mild condition that goes away
on its own within several days.
• These viruses can spread from person-to-person through direct
contact with unwashed hands or surfaces contaminated with feces.
It can also be transmitted through contact with an infected person’s
saliva, stool, or respiratory secretions.
• S/S: fever, a poor appetite, a sore throat, a headache, irritability,
painful, red blisters in the mouth, a red rash on the hands and the
soles of the feet
• Dx: performing a physical exam, check the mouth and body for the
appearance of blisters and rashes.
• Treatment:
• prescription or over-the-counter topical ointments to soothe
blisters and rashes
• pain medication, such as acetaminophen or ibuprofen, to relieve
headaches
• medicated syrups or lozenges to ease painful sore throats
BIRDS FLU
 Causative agent: deadly strain of bird flu, H5N1, pathogenic avian

influenza (HPAI) virus
 Acquired through H5N1 from cleaning or plucking infected birds, via
inhalation of aerosolized materials in live bird markets, after
swimming or bathing in water contaminated with the droppings of
infected birds, handle fighting cocks
 S/S: cough, diarrhea, respiratory difficulties, fever (over 100.4°F or
38°C), headache, muscle aches, malaise, runny nose, sore throat
 Dx: auscultation, white blood cell differential, nasopharyngeal
culture, chest X-ray
PUBLICHEALTH
 Treatment: antiviral medication such as oseltamivir (Tamiflu) or
zanamivir (Relenza), antiviral medications, amantadine and
rimantadine (Flumadine)
MAD COW DISEASE
 AKA bovine spongiform encephalopathy, or BSE
 Causative agent: prion, or an abnormal protein

 slowly destroys the brain and spinal cord (central nervous
system) in cattle
 People cannot get mad cow disease. But in rare cases they may
get a human form of mad cow disease called variant
Creutzfeldt-Jakob disease (vCJD), which is fatal. It can happen by
eating nerve tissue (the brain and spinal cord) of cattle that
were infected with mad cow disease. Over time, vCJD destroys
the brain and spinal cord.
 S/S: Tingling, burning, or prickling in the face, hands, feet, and
legs, Dementia, Psychotic behavior, Problems moving parts of
the body. As the disease gets worse, a person is no longer able
to walk, Coma.
 Treatment: There is no cure for vCJD. Treatment includes
managing the symptoms that occur as the disease gets worse.
F. OTHERS
LEPROSY – Hansen’s disease

 Causative agent: Mycobacterium leprae
 affects the nerves of the extremities, the lining of the nose,
and the upper respiratory tract
 spreads through contact with the mucus of an infected
person
 Two types of leprosy: tuberculoid and lepromatous
 S/S: Symptoms may not appear for as long as 20 years,
muscle weakness, numbness in the hands, arms, feet, and
legs, skin lesions
 Treatment: WHO developed a multidrug, it’s available free
of charge worldwide. Additionally, several antibiotics treat
leprosy by killing the bacteria that causes it. These
antibiotics include:
• Dapsone, rifampin, Clofazamine, minocycline, Ofloxacin
ASSESSMENT TEST:
Google form link:
REFERENCES:
Books:
PUBLICHEALTH
Ciabal, Laura Evelyn P. Introduction to Public Health Issues. 1st ed. Manila Educational Publishing
House, 1999.
PUBLICHEALTH

Public Health

Uploaded by

Copyright:

Available Formats

Public Health

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Public Health

Uploaded by

Copyright:

Available Formats

PUBLIC

 Demonstrate  Unit II. Factors that Affect Health

 UNIT V: Health Promotion in Industry

Kathleen P. Buncab, RPh

HISTORY OF PUBLIC HEALTH

WHAT IS PUBLIC HEALTH?

Let us ask the following contributors of public health

Public Health is the science and art of preventing disease,

Public Health is one of the efforts organized by society to

From the definitions stated by the contributors, we can

Since we said that the aim of Public health is to

ESSENTIAL FUNCTIONS OF PUBLIC HEALTH

1. Monitor health status to identify community health

For essential functions of public health to

Since public health’s focus is health, let us define health.

Please watch: https://www.youtube.com/watch?v=XQkYIpCmTDw

defined as multitude of the services rendered to the individuals, families, community

3. Tertiary care- This care involves super specialist care

FUTURE OF PUBLIC HEALTH

At the end of the topic, you will be able to

The Said factors reminds us that Public Health or community

Solid waste management

FOOD AND MILK SANITATION

CONTROL OF AIR POLLUTION

within a year after the establishment of the inventory list.

 Evaluation- process of determining, as systematically and objectively as possible, the relevance,

ESSENTIAL DATA IN EPIDEMIOLGY

i. CRUDE BIRTH RATE (CBR) = # of births x 1000

ii.CRUDE DEATH RATE (CDR) = # of deaths x 1000

v. SWAROOP’S INDEX = # of death among 50 years old and above x 100

vi. MORBIDITY RATE

LIFE EXPECTANCY versus LIFE SPAN

4. PORTFOLIO – profile data of each household, stored and regularly updated

Please watch the link for further information https://www.youtube.com/watch?v=r9poHB-ldqk

Please watch this video using this link: https://www.youtube.com/watch?v=PzunOgYHeyg

Cells involved in the Innate Immune System:

Please watch this video https://www.youtube.com/watch?v=Atrx1P2EkiQ

UNIT III. ETIOLOGY OF DISEASES

At the end of the topic, you will be able to

FACTOR OF DISEASE CAUSATION

A CAUSE OF A DISEASE is an event, condition, and characteristic of a combination of these factors. A

Robert Koch, the father of modern bacteriology, Formulated theory of disease

i. The organisms must be present in every case of the disease.

FOUR FACTORS IN CAUSATION:

NATURAL HISTORY OF DISEASE

Some diseases that are caused by microorganisms is due to the

ECOLOGIC CONCEPT OF DISEASE

AGENTS OF INFECTIOUS DISEASE

Humans can be a source of infection in three cases:

MEASURES OF DISEASE OUTBREAKS

PROCESS OF AN EPIDEMIOLOGICAL STUDY:

UNIT IV. DISEASE PREVENTION

At the end of the topic, you will be able to

WHAT IS DISEASE CONTROL

describes ongoing operations aimed at reducing:

PUBLIC HEALTH APPROACH TO DISEASE CONTROL

DISEASE CONTROL INCLUDES:

2. ELIMINATION- reduction to zero of the incidences of a specified disease in a defined

3. ERADICATION- termination of all transmission of infections by extermination of infectious

5. MONITORING- Performance and analysis of routine measurements aimed at detecting