2010

1 1 2010

Collections in Community Part 1

DOF3A GDEDA 2013 [Some of these collections are taken from dr. Ashraf lessons]

1/1/2010

Collections in Commuinty Part 1

Percentages:
*Public sector of health care 40 % *Health insurance organization 15 % Of health services *University hospitals 10 % *PHC 80% , *secondary 15 % ,* Tertiary 5 % *17 % of married females don't use controllable measures. *> 38% of preg. Are unintended, (6 10%) of them ends by induced abortion. *Tetanus imm. Level among preg. Females 72.7% total body ca bone loss in females : anually 0.1 0.2 % after 40 years 0.5% after menopause 1% * Estrogen by 60% with major reduction in estradiol at menopause * women of rural egyptian population 56%. * women in child bearing period (15-49 y) 52%. * Elderly woman 5.6%. * illitracy in women 30%. very underestimated * plasma zinc about 30% in preg. * breast cancer in egypt 30%. * cervical cancer in egypt 13.6 % of genital cancers & 6.4 %of cancer cases among women in Egypt * endometrial cancer in egypt 2.6%. of cancer cases among women.
Morbidity Anemia: preg. Lactating Non, Non Hypertension UII

45% 32% 26% 18% 14%

Mortality Hge: Toxemia of preg Inf.

32% 16% 8.4%

toxemia of preg. Is 6-8% of all pregnancies. Gestational diabetes. Is 2-5% of all pregnancies.

FGC. Female Genital Cutting

97% of all married women. 50.3% in 10 18 years old girls. 61.7 % in rural schools 9.2 % in private urban schools 65% of cases performed at home

Toxoplasma:
30-40 % of infected preg. Female will be affected. st nd Inf. In 1 or 2 trimester: 15% of babies will be affected rd Inf. In 3 trimester:70% of babies will be affected

Daily requirements
Non preg Preg Total Folate 180 + 220 400 mg Iron 15 + 15 30 microg Calcium 800 + 400 1200 daily caloric intake: 1875 2925 kcal lday. daily iron intake: 2.8 mg /day. folate preconceptional: 500 mg/day. Extra nutrient during pregnancy: 240-300 kcal/day. Extra nutrient during pregnancy 60.000 kcal through all pregnancy adipose increase during preg. About: 27 kg. During lactation iron requirements 30 mg /day. Reduce BMI to 27.3 for women after menopause for prev of OA. The net reproductive rate NRR in Egypt is 2.9 & the aim is to reach NRR = 1

The most common:

The most common Cause of physical disability in Elderly and Females is MSDS musculoskeletal diseases. 2. The most common Cancer in women is Breast cancer. 3. The 3rd most common cancer in the world is breast cancer. th 4. The 5 most common cancer in developing countries is breast cancer. 5. The most common Genital cancer in women is cervical cancer. nd 6. The 2 most common cancer among females is cervical cancer. 7. The most common Imp. Enhancer of iron absorption in developed countries is Meat. 8. The most common Enhancer of iron absorption in developing countries is ascorbic acid. 9. The most common Cause of Nutritional anemia is iron def. anemia. 10. The most imp. Host factor in person distribution of a disease is Age. 11. The most preventable & controllable cause of maternal mortality is Puerperal sepsis 12. The most common cause of maternal mortality in developing countries is Haemorrage. 13. The most common Endemic disease in the world: "Malaria". 14. The most common malaria "vivax ". 15. The most common Cause of chronic hemolytic anemia in children in Egypt Beta thalassemia. 16. The most common Cause of anemia iron deficiency anemia. 17. The most common childhood cancer leukemia 30% 18. The most commonType of leukemia in children is a cute lymphocytic leukemia. 19. The most common Cause of home and school injury mortality in Egypt is fire and burns. 20. The Leading cause of death is road accident. 21. The most common mode of transmission of diseases in school children is Air borne. 22. The most common Health problem in infants and preschool children in Egypt is diarrheal dis And dysenteries. 23. The most common Source of infection of meningitis is carrier & if more than 20% "danger of Epidemic"
1.

24. The

most common risk factor for meningitis is over crowding & the specific one is "Dryness and crackling of M.M".

25. specific

prevention of type B meningitis is chemo prophylaxts. 26. The most common complication of measles is Gastroentritis. 27. The most common chronic pediatric illress is Bronchial asthma 28. The most common wide spread form of Malnutrition is PEM. 29. The most effective way of dealing with disability problems in developing countries is primary prevention. 30. The only virus that has chemoprophylaxis prevention in part 1 is influenza virus

Meningitis

A Most common 90% Sulphonamide

B C Chronic sporadic Few are sulphonamide sulphonamide resistant Sporadi c Small Out break

Influenza

sensitive resistant Most common epidemic

Para Typh Polio G6PD Thalassemia

A Type I A Black Americans Alpha Asia

B II B Mediter area Beta Mediter. Area

C III

Incubation period & period of communicability

Meningitis

I.P . 2-10 days . Epidemic 1-3 days 1-3 days 10 days 10-20 days 2-3 weeks 2-3 weeks 1-3 days 2-4 h. 30 min 8 h. 12-36 hrs 10-12 hrs 1-3 weeks

P.O.C After 24 h. of eff. III or prolonged in carrier state The longest p.o.c 10-20 24 h. in well ttt cases 4 rash 4 7 rash 7 2 rash 6 Along eruptive stage 3-4 days after onest of symptoms No man to man transmission Thought course of carrier state No man to man From last day of I.P through illness contacts are considered

Streptococcal inf. Measles Rubella Chicken pox Herpes Zoster Influenza Staph. Salmonella food poisoning Clostridium Salmonella

Botulism Malaria Bilharziasis

12- 36h up to days 2 weeks 4-6 weeks

inf. For 2 weeks (I.P) No man to man transmission Vector borne as long as there is live ova in urine or stool no man to man

Diphtheria Woophing cough

3-5 days 1-3 weeks

transmission After 2 negative culture in treated cases From start of catarrhal star till 3 weeks of paroxysmal 8tage

Ages & sex of diseases

Sex Age Infants & Children 5-15 2-10 5-15 Children & adults Mostly young Mostly adult 1-10+ Late adolescence + Adults Infants & Preschool Any age High risk pregnants 5-15 mostly But all affected Age of weaning >6 month 6 month Mostly children 5-9yrs <6 yrs & adolescents

Both Meningitis

Rh. Fever Measles Mumps Rubella Chicken pox Herpes zoster Salmonella

Diarrheal dis. Malaria

Schsitosoma

G6PD

Thalassemia Leukemia Playgroundinjuries Poisoning


A child with strept inf. & treated with penicillin 1ry prev- for Rh-Fever For 10 days a PT with old Rh. Fever taking long acting penicillin every 2 weeks 1ry prev- strept. inf
2ry, 3ry prev- Rh-Fever 2ry prev- for strept-inf

Influenza and Mumps are uncontrollable Carrier is most imp. In salmonella and meningitis. All air borne diseases are common in winter except pertussis. All air born diseases are the same in both sexes except Rh. Fever female / male = 5: 3. Life expectancy among women is 69 & among men is 65 yrs Newborne of 2500 gms weight is of high risk Temp. in refrigerator of cold chain is 2-8 degrees IMCI is for children up to 5 yrs Colostrom is secreted in the first 7-10 days after birth Mother secretes about 450 ml milk per day during the first week & 600-700 ml per day during the first year of lactation The amount of caffeine after a cup of coffee is only 2% of the maternal dose Cyclic trend in prevaccination era of measles every 2-3 yrs & Rubella every 6-9 yrs Most of bacterial vaccines are killed BCG is an exception Most of viral vaccines are live attenuated Any bacterial disease bec. Of organism not toxin , has no passive immunization

 Prevention of communicable diseases is General & Specific Prevention of any other disease is Primary , secondary , tertiary Highly purified poly saccharide meningococal capsule HPPMC. Nutritional diarrheal disease control program NDDCP.

PASSWORDS
Determinats of child health SENGA . Risk Factors of Air borne disease

MINES. . MEMO. I
.Inf

Control of Epidemic of meningitis Risk Factor of Rh. Fever. B

G
Genetic but Not hereditary

Behavioral

Epidemic measures for typhoid

VHS Studies.

Community efforts in prev. of handcapping in child and youth MANI. Ten golden rules ESR CCU KAP + hand washing protocol