DISEASE ESSAYS Flashcards
“POVERTY IS ONE OF THE MAIN CAUSES OF COMMUNICABLE DISEASES”
Use Vector Borne & Water Borne
Fits Omran Model
Use Malaria
USE Bangladesh
Use Guinea Worm in Ghana
AGREE
Poverty is a driver of communicable Diseases
Evidence - WHO recognises that TB, Malaria, HIV/AIDS more prevalent in LIDC
Explanation - Poverty creates ideal conditions for spread of disease
Poor nutrition, education , housing, WASH,
Poverty in Hazardous Areas - LIDC
Few Healthcare resources
But COMPLEX
interlinked with culture & governance
Can exist within ACs
COUNTER
Other Factors Drive Communicable Disease
Land Use Changes
Climate Change
Globalisation
Conflict
Poor Governanace
MITIGATion startegies need to address all issues
Physical Factors have a stronger impact than human factors on disease patterns.
BOth important 0d epends on disease - transmission, spread, prevention & control
Malarai - PHYSICAL FACTORS more imoortnat
CVD - Human Factors more importnat
PHYSICAL FACTORS MOST IMPORTANT
- GEOGRAPHY CAN SPREAD DISEASE
E Malaria found in tropical areas - SEASONAL VARIATIONS PLAY BIG ROLE
Adaptation of virus to certain conditions eg Influenza - PHYSICAL BARRIERS CAN LIMIT DISEASE
Eg Mountains, oceans, altitude
4.CLIMATE FACTORS CAN EXACERBATE DISEASE CONDITIONS
Eg Wind affects dispersal of air pollution
5.AFFECT SURVIVAL & REPRODUCTION OF DISEASE VECTORS
Eg Malarai /Mosquito
EXAMPLE
Malaria good example - also dengue fever
Vector Borne Disease
Geography - tropical areas
Affected by relief - altitude
Seasonal - after monsoon season - stagnant water
affected by precipitation (eggs in water)
temperature (warm temp–> more egge–. more mosquitos
humidity (vegetation growth–> evapotranspiration–> humidity)
HUMAN FACTORS MORE IMPORTANT
- HUMAN/GLOBAL MOBILITY CAN SPREAD DISEASE
Eg Swine Flu - ECONOMIC DEVELOPMENT AFFECTS PATTERNS OF DISEASE
Eg Diabetes, Cholera - LIFESTYLE AFFECTS DISEASE
Eg CVD - HUMAN FACTORS INFLUENCE EFFECTIVENESS OF CONTROL
Eg Vaccines - eradication & Control - HUMAN FACTORS AFFECT PREVALENCE
Eg Genetics eg Breast Cancer gene
EXAMPLE - CVD
Prevalent in AC s- Omran model
Linked to social inequality - effects lower income populations
Linked to lifestyle choices eg diet, sedintary lifestyles, smoking
Linked to access to healthcare - monitoring & prevention
eg blood pressure checks
Linked to stress
Linked to health policies & resources & givernance
Evaluate Effectiveness of STRATEGIES USED BY GOVERNMENTS to Combat a Global PANDEMIC
AIDS
Identified 1991
32 million people dead
84 million infected
26 million now on Retrovirals
Sub Saharan Africa worst effected.
Also consider
Swine Flu,
COvid 19
Ebola
** THIS DOES NOT INCLUDE PHYSICAL BARRIERS
These can help or hinder spread of disease
AIDS
INTERNATIONAL AGENCIES - GLOBAL AIDS STRATEGY
Crucial involvement (funds & leadership) of:
UN, WHO, UNICEF, Global Fund
National Governments
Local Community Groups
STRATEGIES
1.Prevention - direct (condoms, screening) & indirect (education)
2. Diagnosis - Routine screening, mobile testing
3. Treatment - ART - Anti Retro-virals
CHALLENGES
Inequality, Stigma, cultural barriers (religion) , illiteracy , resources, quality of national/local governance, conflict.
EFFECTIVENESS
2000-2021 Infections FELL by nearly 50%
Deaths fell by 61%
18.6 million lives saved by retrovirals
CONCLUSION
Signifucant progress made
Challenges to be addressed including physical barriers
Requires strong governance (global, national & local) and international co-operation & investment.
Examine the role played by GLOBAL MOBILITY in the spread of disease and the ability to respsond to it.
Global mobility - facilitated by Globalisation
Showcase
Disease = SWINE FLU (H1N1) 2009/2010
Spread fast due to social mobility
Emerged Mexico 2009
Emergency April
Spread to USA
Pandemic June
Went Global
150-500K people dead mainly young & middle aged
RED CROSS HAITI
Global Mobility–> FAST & WIDE DISEASE DIFFUSION
Global trade in pork–> movement of pigs–> spread
Humans ‘import or Export’ Disease - tourists, migrants
Affected size and prevalence of outbreak
Economy Disruption - sickness/restrictions
Regional Differences in disease prevalence
Risk of Mutation of disease
–> NEED FOR ROLE INTERNATIONAL ORGANISATIONS
Eg WHO, UNICEF, MSF &
Provide Fast well-resourced response
Predict (Monitor outbreaks / Surveillance)
Control strategies to prevent Spread
Eg Swine Flu Disease Control Strategies
Direct strategy = TAMI FLU Antiviral
Indirect - “Catch it bin it - kill it)
BRITISH RED CROSS - HAITI
V poor country - 60% in poverty
an 2010 mag & 7 EQ
300K dead
Displacement–> camps–> Cholera outbreak
strategies
Delivered clean drinking wataer
Hygiene programme - latrines for 250K
Provided medical supplies to main hospital in ST MArc
18,000 Cholera treatement units
Raised awareness of hygiene to stop spread
CONCLUSION
Globalisation/Global mobility is DIMINISHING the role of physical distance in preventing diffusion.
Rol eof international organisations is important but careful co-ordination, co-operation & evaluation with national governemnets essential.
Evaluate contribution and roles of INTERNATIONAL ORGANISATIONS organisations in the MITIGATION of disease including the WHO, UNICEF and NGGOs
Use examples
INTERNATIONAL ORGANISATIONS ARE GREAT
WHO/UNICEF lead way
Eg Global Polio Initiative & Small pox examples of effectiveness
NGOS can be useful
Eg Haiti - British Red Cross
INTERNATIONAL ORGANISATIONS NOT SO GREAT
Local strategies better
Eg Guinea WOrm Eradication Programme
Can be badly co-ordinated
Eg Haiti
Links to Governance
International organisations play a CRUCIAL Role
- THEY PROVIDE LEADERSHIP & CO-ORDINATION IN GLOBAL HEALTH MATTERS
WHO sets guidance, standards, norms an dpromotes universal healthcare
eg Global Erdaication of Polio Eradication of Polio - WHO PROMOTES RESEARCH & INFORMATION DISTRIBUTION.
Eg Covid 19 - UNICEF PROMOTES CHILD HEALTH & NUTRITION
Eg Healthcare in South Sudan - nutrition & vaccinations - NGOs ROLE IN DISEASE PREVENTION & CONTROL
Often during conflict and after natural disasters
Eg Haiti - British Red CRoss - NGOS FILL GAPS WHEN LACK OF RESOURCES
Eg HIV education in sub-Saharan Africa - COLLABORATION WHO/MSF/UNICEF/GOV’T –> EFFECTIVE
Eg Global Eradication of Small Pox
EG Polio eleimated fro 125 countries now only in 2.
CHALLENGES/CRITICSM
1.DON’T INVOLVE LOCAL COMMUNITY
Eg dont understand gender roles/culture
Eg Guinea Worm Eradication Programme
Short-term effects only
REQUIRES EFFECTIVE COLLABORATION/COMMUNICATION
Eg HAITI
UN accepted funds to provide clean water but hadn’t done it
MSF spotted it
Helped spread cholera
Despite huge $$$$ donations six months later only one waste management site opertaional in Haiti
CONCLUSION
Excellent if well resources, co-ordinated & respectful og context
Evaluate the effectiveness of Top Down and Bottom Up STRATEGIES to Deal with DISEASE RISK & ERADICATION
Important - STRATEGIES EXIST AT DIFFERENT SCALES - GLOBAL & LOCAL
Global Polio Eradication Initiative (GPEI) (top Down)
Infectious contagious disease
Severe effects
Guinea Worm Eradication In Ghanaa (bottom up)
Parasite
Spread by larvae in water
180,000 cases in 1989
PROS OF TOP-DOWN GLOBAL (POLIO - GPEI)
- LARGE SCALE, CO-ORDINATED EFFORT
Planning, Expertise, Surveillence.
200 counties involved
2.5 billion vaccinations - COST EFFECTIVE/MULTI AGNECY FUNDING
EG WHO, UNICEF, Gates Foundation - EFFECTIVE
Significant Porgress made
Polio down from 125 countries to 2
but
CHALLENGES
Risk of Corruption $$
Conflict - Afghansistan, Syria
Resisitence at local levels/Culture - Vaccines not “haram”
Corruption - FAe vaccination centres
Relief - Geograohical access difficult
Involvement stops when money runs out/Inititiave ends
PROS OF BOTTOM -UP LOCAL
- PROMOTES COMMUNITY INVOLVEMENT & PARTICIPATION
Trusted, Creates buy-in,Fights stigma
Eg Ghana Red Cross, Womens Groups - EFFECTIVE
Guinea Worm almost eradicated
Last case in 2010 - DRIVES CHANGE & LEADS TO SUSTAINABLE SOLUTIONS
Builds relislience & education for long-term
Volunteers trained to monitor & prevent
EG Volunteers trained toc hange water filters & monitor for signs of disease - CONSIDERS LOCAL CONTEXT / FLEXIBLE & ADAPTABLE
Culture, gender roles
Eg In Ghana, women source water & responsible for food prep & hygiene so trained them
CHALLENGES
Difficult to mobilise large scale effort without leadership & resources
Ethnic Conflict diverted resources
2006 Water source infrastructure broke - costly
At first trained men but reasised it needed to be women
Assess the relationship between disease and levels of economic development.
Use Omran Diagram
- ECONOMIC DEVELOPMENT (ED) INFLUENCES TYPES OF DISEASE
Omran Model - describes complex long-term changes in health & disease patterns.
Patterns are closely associated with demographic and socio-economic transitions that accompany economic development. In particular access to food, clean water & sanitation.
ED AFFECTS TYPES OF DISEASES
Diseases of poverty - COMMUNICABLE
Disease of affluence. - NON-COMMUNICABLE
ED AFFECTS RESOURCES FOR DISEASE CONTROL & PREVENTION
BUT
ED CAN LEAD TO NEGATIVE HEALTH OUTCOMES
Sedentary lifestyles, obesity –> diabetes
ED–> INDUSTRIALISATION
Air pollution, water pollution, climate change
Eg Lung cancer india
ED–> URBANISATION
Land use change - zoonotic diseases
Stagnant water Eg Malaria
ED–> MIGRATION
Exposure to new diseases
Mutation existing diseases
Issues arising from Interantional Trade in Medicinal Plants & Role of pharmaceuticals.
MEDICINAL PLANTS PLAY A CRUCIAL ROLE
Eg Rosy Periwinkle
CONTRIBUTE TO DEVELOPMENT OF DRUGS
Eg Rosy Periwinkle
OVEREXPLOITATION –> CONSERVATION ISSUES
UNSUSTAINABLE HARVESTING–> ECOSYSTEM DEGREDATION
VALUABLE SOURCE OF INCOME FOR INDIGENOUS PEOPLE
CAN CONTRIBUTE TO BIODIVERSITY CONSERVATION
EG UNREDD
CULTIVATION CAN PROTECT SPECIES
BIO PIRACY - BENEFITS OHARMACEUTICALS DAMAGE LOCAL ECONOMIES
Discuss the impact of air pollution on the impacts of cancers.
PATTERNS OF AIR POLLUTION
* Seasonal Variation: winter- severe.
Delhi, PM2.5 levels often exceed safe limits by several times1.
* Geographical Disparity: 21/30 most air-polluted cities in India
SOURCES OF AIR POLLUTION
* Fuel Combustion: The energy sector,
* Vehicular Emissions: rapid increase in vehicle ownership,
HEALTH IMPACTS
* Respiratory Diseases: Air pollution in India causes at least 600,000 deaths per year.
Lung cancer (75,0000 cases- 7% of all new cancers) , bladder cancer
* Mortality: Almost 18% of all deaths in India are attributed to air pollution.
* Life Expectancy: Air pollution reduces locals’ life expectancy by up to nine years
SOCIAL IMPACTS
* Quality of Life: impacts daily life.
* Health Inequality: exacerbated
ECONOMIC IMPACTS
* Healthcare Costs: The economic loss $37 billion in one year alone in India–> less $ for resources
NATIONAL LEVEL SOLUTIONS
* Policy Implementation: The National Clean Air Programme (NCAP) aims to reduce particulate pollution by 20-30% by 20243.
* Public Awareness: Initiatives like the SAMEER app provide real-time air quality status and a platform for lodging complaints3.
GLOBAL LEVEL SOLUTIONS
* International Agreements: Paris Agreement, w to reducing emissions
Assess the impacts & startegies of dealing with a named communicable disease in a country.
MALARIA
ETHIOPIA
CAUSES (ENVIRONMENTAL & PHYSICAL)
* ENVIRONMANTAL :
o Mosquito Breeding Sites: Stagnant water in
o Climate Conditions: Warm and humid climates in certain regions of EthiOPIA
o Altitude: more in lowland areas
HUMAN
o Deforestation:
o Urbanization:
o Migration: M
PREVALALENCE/PATTERNS
o High Burden: significant proportion of global cases and deaths.
o Regional Variation: Malaria prevalence varies across regions, with higher transmission in lowland areas.
o Seasonal Patterns: Malaria transmission is seasonal, peaking during the rainy season (June to September).
o Statistics: Ethiopia reported 1.7 million confirmed malaria cases in 2019.
IMOACTS
SOCIO ECONOMIC
* Healthcare Costs: Malaria treatment and prevention impose a significant economic burden on the health system.
* Productivity Loss: Malaria-related morbidity and absenteeism reduce workforce productivity.
* Social and Economic Disparities: Malaria disproportionately affects socio-economically disadvantaged groups in Ethiopia.
Direct Strategies to Mitigate Malaria in Ethiopia
* Indoor Residual Spraying (IRS):
o Purpose: Regular spraying of insecticides inside homes to kill malaria-carrying mosquitoes.
o Impact: IRS reduces malaria transmission and prevents new infections.
o Statistics: In 2019, Ethiopia conducted IRS in 1.7 million households.
* Long-Lasting Insecticidal Nets (LLINs):
o Distribution: LLINs are distributed to protect against mosquito bites, especially during sleep.
o Impact: Proper LLIN use reduces malaria incidence.
o Statistics: In 2019, Ethiopia distributed 32 million LLINs.
Indirect Strategies to Mitigate Malaria in Ethiopia
* Health Education and Awareness:
o Community Education: Raise awareness about malaria prevention, symptoms, and the importance of seeking early treatment.
o Impact: Informed communities are more likely to adopt preventive measures and seek prompt treatment.
o Statistics: In 2019, 1.5 million community health workers were trained in Ethiopia to provide health education and malaria prevention messages.
* Environmental Management:
o Vector Control: Proper waste management and environmental sanitation reduce mosquito breeding sites.
o Statistics: Ethiopia has implemented vector control programs, including larviciding and environmental management.
International Agency Involvement
* World Health Organization (WHO):
o Guidelines: WHO provides guidelines for malaria prevention, diagnosis, and treatment.
o Capacity Building: WHO supports Ethiopia’s health system to strengthen malaria control efforts.
o Statistics: In 2019, Ethiopia reported 1.7 million confirmed malaria cases.
These strategies aim to reduce the burden of malaria in Ethiopia and improve prevention, mana
How can a natural Hazard influence outbreak and spread of a named disease.
Which factors have the greatest influence on the outbreak and spread of disease following the flood of Bangladesh .
What are Impacts & Strategies to minimise Imoacts
Discuss
Need to compare to physical factors, environmental and human factors
Need to discuss shirt & long Term Imoacts
Need to discuss national & global strategies
Could also use Haiti
INTRO
2007 Monsoon floods
caused by Abnormal Monsoon rains, glacial melt & Cyclone
DIARRHEAL DISEASE
Affects most vulnerable -old, ill & children
50,000 affected - doubled between 8-11 August.
Pathogens included cholera & Rotavirus
PHYSICAL FACTORS –> SPREAD
Geography - low lying deltaic, extensive rivers
Poor drainage–> vulnerable to flooding
Extensive - 50% floodes
ENVIRONMENTAL FACTORS –> SPREAD
> FLOODING -> stagnation & lack of safe water
Innundation of water, increased humidity, food shortages & contaminated water supply - perfect for vector & water borne diseases
High population density - vulnerable
Displacement - camps - overcrowding & poor hygiene
Land use changes deforestation & Urbanisation
HUMAN FACTORS –_> SPREAD
Socio economic factors eg Inequality, poverty, education levels Response & preparedness
Aid
CONCLUSION Environmental & Physical Factors set the stage but Human factors are catalyst or make it better or worse
SHORT TERM IMPACTS
Dehydration & Kidney issues
LONG TERM IMPACTS
Malnutrition
Risk of catching other diseases & cognitive impairment
socioeconomic issues - orphans & loss of livliehood
NATIONAL STRATEGIES
ST
Immediate relief & care - shelters, food, water & Water purification tablets
LT
W.A.S.H Initiativae Infrastructure water sanitation & hygiene improvements Eg flood resistent latrines
Treatment Centres & Surveillance - early warning systems
INTERNATIONAL STRATEGIES
UNICEF & WHO
ST - Aid & drinking water
LT - R&D for vaccines for Cholera
