Prevention of malnutrition, STIs & Cancer -PDF

Public health assignment Public health
public health assignment Public health
assignment public health Public health
Public health assignment public health
Class Assignment
Prevention of Malnutrition,
STIs & Cancer
7/11/2011

Submitted to :
Diphendra kumar yadav
Submitted by:

Sagun paudel

Roll no: 22

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Prevention of malnutrition, STIs & Cancer…..

Malnutrition:

General concept:
Malnutrition is defined as a pathological state resulting from relative or absolute deficiency or any excess
of one or more essential nutrients. It comprises four forms:

 Under nutrition: results when insufficient food is eaten over long time.
 Over nutrition: consumption of excessive quantity of food over a long time.
 Imbalance: pathological condition resulting from a disproportion among essential nutrients with
or without the absolute deficiency of any nutrients.
 Specific deficiency: state resulting from a relative or absolute lack of individual nutrients.

Preventive measures:
There is no simple solution to the problem of PEM. Many types of action are necessary. The preventive
measures can be described in following ways:

Prevention at different level:

Prevention at family level:
 Encourage exclusive breast feeding of infants for first 4-5 years completely,
 Additional nutritive supplementation introduce by age of 4-5 months,
 As much as milk, meat, eggs, or foods of biological value as family can afford should be
offered.
 Adequate immunization.
 Restriction of feeding in fever and diarrhea should be encouraged.
 Maternal care and ANC & PNC visit also plays a role to minimize or prevent
malnutrition.
 Equal distribution of nutritive foods among male & female children.
 Minimize or keep far from maternal malnutrition & other infectious diseases such as
malaria, TB, diarrhea etc.

Prevention at community level:
 Promotion of health through health intervention & education in community to reduce the
malnutrition.
 Non formal education for pre- school age children, lactating mother and pregnant women.
 Nutritional education & mass communicative approaches.
 Early detection of malnutrition and intervention.
 Vigorous promotion of family planning.
 Income generation activities.
 Integrated child development services (ICDS).
 Food fortifications;

Public Health Assignment ……………………… 1


 Iodination of salts.
 Supplementation of vitamin A.
 Distribution of iron-folic acid. Etc.
 Anthropometric assessment of the developing children such as:
 Height
 Weight
 Mid upper arm circumference
 Head circumference
 Weight for height etc.

Prevention at national level:
 Good nutritional planning, implementation & also evaluate the success.
 Nutritional rehabilitation services.
 Nutritional intervention programs such as Distribution of iron and folic acid tablet to
pregnant mother.
 Good Nutritional supplementation strategy.
 Rural development & Stabilization of population.
 Diet and nutrition surveys should be carried out.
 Increase agricultural/ food production & appropriate fortification & formulations.
 Nutritional surveillance to detect the cause, character & magnitude of nutritional
problems. Etc.

Prevention at international level:
 Food & nutrition are global problems. International cooperation in solving problems of
malnutrition.
 Plays important role in mitigating the effect of acute emergencies caused by floods &
droughts.
 Multilateral coordination with organizations such as: WHO, FAO, UNICEF, WORLD
BANK, UNDP etc.

Preventive levels & interventions:

Primordial & primary prevention:

Health promotion:
 Measures directed to pregnant & lactating women (education, distribution, and
supplementation).
 Promotion of breast feeding.



 Development of low cost weaning foods: the child should be made to eat more
food at frequent intervals.
 Measure to improve family diet.
 Nutritional education: promotion of correct feeding practices.
 Home economics.
 Family planning & spacing of births.
 Family environments.

Specific protection:

 The child’s diet must contain protein and energy- rich foods, milk, eggs, fresh fruits
should be given if possible.
 Immunization.
 Food fortification.

Secondary prevention:

Early diagnosis & treatment:

 Periodic surveillance.
 Early diagnosis of any lag in growth.
 Early diagnosis & treatment of infections & diarrhea.
 Development of programmes for early rehydration of children with diarrhea.
 Development of Supplementary feeding programmes during epidemics.
 De-worming of heavily infested children.

Tertiary prevention:

Rehabilitation:

 Nutritional rehabilitation services.
 Hospital treatment.
 Follow-up care.

………………………………………………………………………………………………………



Sexually transmitted diseases:

General Concept:
The sexually transmitted diseases (STD) are a group of communicable diseases that are transmitted
predominantly by sexual contact and caused by wide range of bacteria, viruses, protozoan, and fungal
agents and ecto parasites.

Some Examples are:

Gonorrhea, syphilis, chancroid, genital herpes, Chlamydia trachomatis, candidaisis etc

Prevention:
The aim of the prevention & control programme for STIs is the prevention of ill- health resulting from the
various microorganisms through various interventions.

These intervention may have primary prevention focus (the prevention of infection), secondary
prevention focus (minimizing the adverse health effects of infection).

At National level:

Initial planning:
Control programmes have to be designed to meet the unique needs of each country & to be in
line with that country’s health care system, its resources & priorities.

 Problem definition:
 Disease problem must be defined in terms of prevalence, psychosocial consequences, and
other health effects- by geographical areas & population groups.

 Establishing priorities:
 Rational planning requires establishment of priorities.
 Depends upon health problem considerations (magnitude, consequences).
 Availability of resources. Social & political commitment.
 Priority group may also categorize e.g. age, sex, place of residence, occupation, etc.

 Setting objectives:
 Priorities must be converted into discrete, achievable & measurable objectives.
 Broad coverage of the population is crucial for STI control.

 Considering strategies:



 Define the mixture of interventional strategies which are most appropriate.

At community level:
 Health education
 Information system
 Social welfare measures
 Epidemiological treatment
 screening
 STI clinics
 Laboratory services

At individual level:
Personal prophylaxis:
 Mechanical barriers e.g. condom& diaphragm can be recommended for Personal
prophylaxis against STIs.
 Promotion of safer sex behavior.
 Provision of condoms at affordable prices.
 Making the condom accessible.
 Reducing rates of partner.
 Vaccinations: e.g. hepatitis B etc

The 4C’s:
 Compliance: completing all the treatment as prescribed.
 Counseling/ education: about the disease & STIs.
 Contact tracing: making sure all the sexual partners are encountered to get
treatment.
 Condom: promotion & how to avoid catching STIs again.etc.

Level of prevention of STIs:

Primary prevention:

Health education & promotion:
 Health education is an integral part of STI control & prevention programmes.
 To help individual alter their behavior in an effort to avoid STIs.
 Minimize disease acquisition and transmission.
 The target group may be general public, patients, priority groups, community leaders etc



Personal prophylaxis: (see above)

Information system:
 The basis of effective control programme of any communicable disease is the
existence of an information system.
 It is prerequisite for effective programme planning, coordinating, monitoring &
evaluation.


(Early diagnosis & treatment)
 Case detection: it is an essential part of any control programme.
Screening: it is the testing of apparently healthy volunteers from the general
population for the early detection of disease.
 Cluster testing.
 Case holding & treatment: every effort should be made to ensure complete and
adequate treatment.
 STI clinic & laboratory facilities: adequate laboratory facilities & trained staff are
essential for proper patient management. An ideal service is one that is free, easily
accessible to patient & available for long hours each day.
 Clinical follow up.

 Reduce impairments, minimize disabilities & suffering.
 STI is the main cause of pelvic inflammatory disease. So we can prevent in
tertiary level.
 Stop & minimize other complications.
 Disability limitations.etc.

……………………………………………………………………………………………………



Cancer:

General concept:
Cancer may be regarded as a group of diseases characterized by;

 Abnormal growth of cells.
 Ability to invade adjacent tissues & even distant organs.
 The eventual death of the affected patient if the tumor has progressed beyond that stage when it
can be successfully removed.

Cancer can occur at any site or tissue of the body & May involved any type of cells.

Major categories are;

- Carcinomas (mouth, Esophagus , intestine, uterus etc)
- Sarcomas( fibrous tissue, fat, bones)
- Lymphomas (bone marrow, immune system).

Preventive measures:
At least one-third of all cancer cases are preventable. Prevention offers the most cost-effective long-term
strategy for the control of cancer. Cancer control consists of series of measures based on present medical
knowledge in the fields of prevention, detection, diagnosis, treatment, aftercare &rehabilitation, aimed at
reducing significantly the number of new cases, increasing the number of cures and reducing the
invalidism due to cancer.

Primary prevention:
Control of being Physical inactivity, dietary factors, obesity and being overweight:

 Dietary modification is important approach to cancer control. There is a link between
overweight and obesity to many types of cancer (esophagus, colon-rectum, breast,
endometrial and kidney).
 Diets high in fruits and vegetables may have a protective effect against many cancers.
Conversely, excess consumption of red and preserved meat may be associated with an
increased risk of colorectal cancer.
 Healthy eating habits that prevent the development of diet-associated cancers will also
lower the risk of cardiovascular disease.
 Regular physical activity and the maintenance of a healthy body weight, along with a
healthy diet, will considerably reduce cancer risk.
 National policies and programmes should be implemented to raise awareness and reduce
exposure to cancer risk factors, and to ensure that people are provided with the
information and support they need to adopt healthy lifestyles.



Control of Alcohol & tobacco consumption:

 Alcohol use is a risk factor for many cancer types (oral cavity, pharynx, larynx,
esophagus, liver, colon-rectum and breast).
 Risk of cancer increases with the amount of alcohol consumed & substantially increases
if the person is also a heavy smoker.

Maintenance of personal hygiene:

 Can prevent the cancers such as; cancer of cervix.

Prevention from infections:

 Infectious agents are responsible for almost 22% of cancer deaths in the developing
world and 6% in industrialized countries.
 Viral hepatitis B and C cause cancer of the liver; human papilloma virus infection causes
cervical cancer.
 The bacterium Helicobacter pylori increases the risk of stomach Preventive measures
include vaccination and prevention of infection and infestation.

Prevention Occupational carcinogens:

 More than 40 agents, mixtures and exposure circumstances in the working environment
are carcinogenic to humans and are classified as occupational carcinogens
 Occupational Carcinogens are causally related to cancer of the lung, bladder, larynx and
skin, leukemia and nasopharyngeal cancer.
 Occupational cancers are concentrated among specific groups of the working population,
for whom the risk of developing a particular form of cancer may be much higher than for
the general population.

Preventive approaches to Environmental pollution:

 Environmental pollution of air, water and soil with carcinogenic chemicals cause cancer.
 Exposure to carcinogenic chemicals in the environment can occur through drinking water
or pollution of indoor and ambient air.



Prevention from Ultraviolet (UV) radiation & other ionizing & non ionizing Radiation

Cancer education: preventive health education.

Cancer registration:
 Cancer registration provides a base for assessing the magnitude of the problem
and for planning the necessary services.
 Cancer registrations are of two types i.e. hospital-based & population based.
Cancer screening:
 In light of the present knowledge, early detection & prompt treatment of early
cancer & precancerous conditions provide the best possible protection against
cancer for the individual & community.

Early detection of cases:
 Early detection programme will require mobilization of all available resources &
development of a cancer infrastructure starting at the level of primary health care,
ending with complex cancer centers or institutions at the national levels.

Treatment:
 Certain form of cancers is amenable to surgical removal; while some others are
respond favorably to radiation or chemotherapy or both.
 Multi-modality approach to cancer control has become a standard practice in
cancer centers.
 A largely neglected problem in cancer care is the management of cancer pain.

 Disability Limitation.
 Rehabilitation.
 Reduce impairments, minimize disabilities & suffering.
 Prevent from invade adjacent tissues & even distant organs.etc.

Thank you!



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