3-Levels of Prevention PDF

University of Al-Ameed College of Medicine Department of Family and Community Medicine Prof. Saad Ibrahim Al-Ghabban 5 January 2025 Learning objectives Prevention Levels of prevention:  Prevention Prevention is better than cure is on...

University of Al-Ameed College of Medicine Department of Family and Community Medicine Prof. Saad Ibrahim Al-Ghabban 5 January 2025 Learning objectives Prevention Levels of prevention:  Prevention Prevention is better than cure is one of the prime messages of public health. It differentiates public health from the clinical disciplines that are primarily involved with the care of the sick, whilst public health emphasizes the avoidance of illness. Prevention was initially construed narrowly in terms of protective measures like vaccination and improved nutrition that target only healthy people with the aim of preventing the onset of disease.  This concept of prevention was extended to cover the early diagnosis and treatment of sick persons with the aim of preventing advanced diseases and in the case of communicable diseases, in preventing the spread within the community. A further extension of the definition covers the treatment of sick individuals aimed at reversing damage and restoring function. This concept led to the classification of prevention into three levels later to be differentiated into five stages:  Levels of Prevention The four levels of prevention are: 1. Primordial prevention 2. Primary prevention 3. Secondary prevention 4. Tertiary prevention  1. Primordial prevention Primordial prevention consists of actions to modify population health determinants and inhibit the establishment of factors (environmental, economic, social, behavioural) known to increase the future risk of disease. It addresses determinants at the systemic level rather than modifying personal risk factors, which is the goal of primary prevention. e.g. outlawing alcohol, improving sanitation, promoting a healthy lifestyle in childhood (for example, through prenatal nutrition programs and supporting early childhood development programmes), or developing green energy approaches  2. Primary prevention Early intervention during predisease stage may prevent exposure to the agent of disease preventing the disease process from starting, therefore it is called primary prevention It includes two stages: 1. General health promotion 2. Specific prophylaxis A. General health promotion For healthy individuals with no known risk factors: primary prevention should be health promotion (e.g., encouragement of healthy changes in lifestyle, nutrition, and environment). Target population: entire population with special attention to healthy individuals Objective: prevent onset of illness Methods: education, sanitation, life style changes (healthy diet, no smoking, avoidance of alcohol, physical activity, maintenance of a healthy weight, adequate sleep, reduce stress and anxiety) etc.  B. Specific prophylaxis For healthy individuals with disease susceptibility: primary prevention should include specific protection (e.g., recommendations for nutritional supplements, immunizations, and occupational and vehicle safety measures). Target population: entire population with special attention to healthy individuals with disease susceptibility. Objective: prevent onset of specific diseases Methods: education, immunization, nutritional supplements (vitamin A, iodine), chemoprophylaxis (e.g. against malaria).  3- Secondary prevention During the latent stage of the disease when the disease process has begun, but is still asymptomatic screening and giving appropriate treatment may prevent progression to symptomatic disease this is called secondary prevention. Secondary prevention should focus on screening for populations or case findings for the individual in medical care and, if disease is found, treatment. It is the stage of early diagnosis and treatment  secondary prevention … cont. Target population: sick individuals Objective: early diagnosis and treatment to prevent further damage to the individual and in cases of infectious diseases, spread to the community Methods: screening of high risk groups e.g. ECG, Pap smears, sputum examination for TB, blood test for HIV, monitoring of vulnerable groups (children, pregnant women).  4- Tertiary prevention During the symptomatic stage when disease manifestations are evident intervention may slow, arrest, or reverse the progression of the disease, this is called tertiary prevention. It includes two stages: 1. Initial care (disability limitation): 2. Subsequent care (Rehabilitation). A. Initial care (disability limitation): Tertiary prevention should focus on disability limitation (i.e., medical or surgical treatment to limit damage from the disease with primary prevention measures). Target population: sick patients Objective: limit (reduce) damage from disease Methods: skilled clinical care and social support to limit physical and social damage from the disease B. Subsequent care (Rehabilitation). Tertiary prevention should focus on rehabilitation (i.e., teaching of methods to reduce social disability). Target population: convalescent patients Objective: restore function and capability Methods: physical and social rehabilitation  Modes of interventions at the different levels of prevention LEVELS OF Primordial Secondary Primary prevention Tertiary prevention PREVENTI0N prevention prevention Modification of Early MODES OF Health Specific Disability population diagnosis and Rehabilitation INTERVENTION promotion prophylaxis limitation health treatment determinants  Onset of Usual time of symptoms diagnosis Exposure Pathologic changes Stage of Stage of Stage of Stag susceptibility subclinical clinical recov disease disease disabilit de PRIMARY PREVENTION SECONDARY TERTIARY PREVENTION PREVENTION THANK YOU 17