LECTURES CONTAINMENT STRATEGIES
OF INFECTIOUS DISEASES IN GLOBAL
CONTEXT
LECTURE 1: INTRODUCTION TO THE COURSE AND ASSIGNMENT THEORY
Infectious diseases: EXAM MATERIAL!
Trachoma Tuberculosis Dengue
Gastroenteritis Acute Respiratory Infections Yellow Fever
Cholera Influenza Malaria
Hepatites A Pertusis Leishmaniasis
Poliomelytis Diphteria Plague
Beef and Pork Tapeworms Menigococcol Menigitis Lyme Disease
Hookworms Haemophilis Influenza Rabies
Schistosomisasis Pneumococcal disease Toxoplasmosis
Measles Chlamydia Brucellosis
Leprosy Genital herpes All new and emerging diseases
Human Papilloma Virus
HIV
Hepatitis B
Hepatitis C
Ebola
Quarantine = suspicion that you have the disease
Isolation = We know you have the disease
How to approach designing an intervention within context:
- What causes the problem/What factors contribute to this problem
- What is the problem
- Who has it/ What kind of people have it
DESIGNING AN INTERVENTION: FRAMEWORKS
PRECEED/PROCEED
Green and Kreuter:
Provides a structure that supports the planning
and implementation of health promotion or
disease prevention programs.
Preceed = to go before
Proceed = to move ahead, to continue
,INTERVENTION MAPPING
BEHAVIOUR CHANGE AND COMMUNICATION MODELS
- Theory of planned behaviour
- Health belief model
STEPS IN HEALTH INTERVENTIONS
1. What is the problem (is this a priority problem?)
2. What factors cause the problem?
3. How can these factors be changed?
4. What overall strategies are most appropriate and cost effective (including what do people want and
what are their needs?)?
5. What needs to be done to reach the goals? With what (sub)populations shall work be done, and in
what sequence, to solve the problem?
IS IT A PRIORITY HEALTH PROBLEM?
Burden of disease + potential burden
, - Many different measures
o Mortality/morbidity
o Incidence/prevalence
o DALY: format qualitative estimates developed by world bank and WHO
o Global burden of disease
- Socio-economic impact (economic and social costs)
- For whom? (children, minorities, man, woman?)
➔ In practice this phase, in practice is not purely a desk study. Requires data collection among/with
target group: participation of stakeholders, end-users → NEEDS ASSESMENT
Use of the following research methods
- Routine information: National census data, death certification and registers, hospital and clinic
records, disease notification systems, lab tests
- Epidemiological data: cross-sectional study
- Community appraisals: questionnaires, interviews, focus groups, visualization and diagramming
Neglected tropical diseases (NTD) are called neglected because
we do not spend enough time and money on them globally
WHAT FACTORS CAUSE THE DISEASE?
- What pathways lead to the problem?
- You don’t want to be jumping in conclusions
- Tools to identify causes:
o Epidemiological triangle: points out the origin of the
infectious disease = mind map
o Disease occurrence = Is the result of an interaction
between host, agent (vector) and environment
(Agents/Factors which absence or presence cause
the disease, Susceptible host, Favourable environment)
, o Web of etiology = high level of uncertainty and complexity → Multidisciplinary
research/Transdisciplinarity research
▪ Agent: cause of the disease
• Transmission, infectivity, pathogenicity, virulence
▪ Host: susceptibility
• Biological, behaviour
▪ Environment: favourable
• Physical factors: natural/cultural environment, bush/desert/swamp, air &
water pollution, waste disposal, product design (highways, damns)
• Social/economic: physical factors, ideological/cultural factors
o Social structures of community and nation (business, NGOs,
government; the health system), including physical support
infrastructure (e.g. medical facilities)
o Low economic level strongest predictor of poor health and high
mortality
o Low educational level next strongest predictor
• Interpersonal: ‘significant other(s)’, direct social network (more important
when using for NTD, relates to reinforcing factors)
• Cultural/ideological: knowledge, beliefs, morals, values and behaviors
(regarding a disease)
o Specific views on what is illness and what treatment fits to which
symptoms
o What people say is important to them is not always reflected in
their behavior
o Knowledge does not imply corresponding behavior
▪ ‘eradicating alcohol consumption, drug use, smoking,
personal hygiene’
▪ Vector: doesn’t get infected, only carrier of the disease
o Problem tree = causal tree: ‘but why’ method
➔ Literature/ common sense
o Social determinants of health: Ecological models
HOW CAN FACTORS BE CHANGED?
Five basic strategies:
- Remove the agent
- Raise host resistance
- Modify environment
- Separate agent from host
- Interrupt transmission (infected to non-infected
individual
Strategy: use the epidemiological triangle as mind-map.
Relate to where the strategies intervene in the problem tree
OF INFECTIOUS DISEASES IN GLOBAL
CONTEXT
LECTURE 1: INTRODUCTION TO THE COURSE AND ASSIGNMENT THEORY
Infectious diseases: EXAM MATERIAL!
Trachoma Tuberculosis Dengue
Gastroenteritis Acute Respiratory Infections Yellow Fever
Cholera Influenza Malaria
Hepatites A Pertusis Leishmaniasis
Poliomelytis Diphteria Plague
Beef and Pork Tapeworms Menigococcol Menigitis Lyme Disease
Hookworms Haemophilis Influenza Rabies
Schistosomisasis Pneumococcal disease Toxoplasmosis
Measles Chlamydia Brucellosis
Leprosy Genital herpes All new and emerging diseases
Human Papilloma Virus
HIV
Hepatitis B
Hepatitis C
Ebola
Quarantine = suspicion that you have the disease
Isolation = We know you have the disease
How to approach designing an intervention within context:
- What causes the problem/What factors contribute to this problem
- What is the problem
- Who has it/ What kind of people have it
DESIGNING AN INTERVENTION: FRAMEWORKS
PRECEED/PROCEED
Green and Kreuter:
Provides a structure that supports the planning
and implementation of health promotion or
disease prevention programs.
Preceed = to go before
Proceed = to move ahead, to continue
,INTERVENTION MAPPING
BEHAVIOUR CHANGE AND COMMUNICATION MODELS
- Theory of planned behaviour
- Health belief model
STEPS IN HEALTH INTERVENTIONS
1. What is the problem (is this a priority problem?)
2. What factors cause the problem?
3. How can these factors be changed?
4. What overall strategies are most appropriate and cost effective (including what do people want and
what are their needs?)?
5. What needs to be done to reach the goals? With what (sub)populations shall work be done, and in
what sequence, to solve the problem?
IS IT A PRIORITY HEALTH PROBLEM?
Burden of disease + potential burden
, - Many different measures
o Mortality/morbidity
o Incidence/prevalence
o DALY: format qualitative estimates developed by world bank and WHO
o Global burden of disease
- Socio-economic impact (economic and social costs)
- For whom? (children, minorities, man, woman?)
➔ In practice this phase, in practice is not purely a desk study. Requires data collection among/with
target group: participation of stakeholders, end-users → NEEDS ASSESMENT
Use of the following research methods
- Routine information: National census data, death certification and registers, hospital and clinic
records, disease notification systems, lab tests
- Epidemiological data: cross-sectional study
- Community appraisals: questionnaires, interviews, focus groups, visualization and diagramming
Neglected tropical diseases (NTD) are called neglected because
we do not spend enough time and money on them globally
WHAT FACTORS CAUSE THE DISEASE?
- What pathways lead to the problem?
- You don’t want to be jumping in conclusions
- Tools to identify causes:
o Epidemiological triangle: points out the origin of the
infectious disease = mind map
o Disease occurrence = Is the result of an interaction
between host, agent (vector) and environment
(Agents/Factors which absence or presence cause
the disease, Susceptible host, Favourable environment)
, o Web of etiology = high level of uncertainty and complexity → Multidisciplinary
research/Transdisciplinarity research
▪ Agent: cause of the disease
• Transmission, infectivity, pathogenicity, virulence
▪ Host: susceptibility
• Biological, behaviour
▪ Environment: favourable
• Physical factors: natural/cultural environment, bush/desert/swamp, air &
water pollution, waste disposal, product design (highways, damns)
• Social/economic: physical factors, ideological/cultural factors
o Social structures of community and nation (business, NGOs,
government; the health system), including physical support
infrastructure (e.g. medical facilities)
o Low economic level strongest predictor of poor health and high
mortality
o Low educational level next strongest predictor
• Interpersonal: ‘significant other(s)’, direct social network (more important
when using for NTD, relates to reinforcing factors)
• Cultural/ideological: knowledge, beliefs, morals, values and behaviors
(regarding a disease)
o Specific views on what is illness and what treatment fits to which
symptoms
o What people say is important to them is not always reflected in
their behavior
o Knowledge does not imply corresponding behavior
▪ ‘eradicating alcohol consumption, drug use, smoking,
personal hygiene’
▪ Vector: doesn’t get infected, only carrier of the disease
o Problem tree = causal tree: ‘but why’ method
➔ Literature/ common sense
o Social determinants of health: Ecological models
HOW CAN FACTORS BE CHANGED?
Five basic strategies:
- Remove the agent
- Raise host resistance
- Modify environment
- Separate agent from host
- Interrupt transmission (infected to non-infected
individual
Strategy: use the epidemiological triangle as mind-map.
Relate to where the strategies intervene in the problem tree
