5 Metoda Pencegahan dan

aplikasinya
 Concepts of Prevention

• The objective of preventive medicine is to

intercept or oppose the “cause” and thereby
the disease process.
• Levels of Prevention:
1. Primary prevention : 2 model
2. Secondary prevention : 1 model
3. Tertiary prevention: 2 model
 Modes of Intervention

• Any attempt to intervene or interrupt the

usual sequence in the development of
disease.
Modes of intervention:
1. Health promotion
2. Specific protection
3. Early diagnosis and treatment
4. Disability limitation
5. Rehabilitation
Pencegahan
Pencegahan primer
 MODEL EKOLOGI
EPIDEMIOLOGIC TRIANGLE
(MODEL SEGITIGA EPIDEMIOLOGI)

Host
vektor

Agent Environment
FAKTOR PENJAMU (HOST)

1. Keturunan atau genetik

2. Umur
3. Jenis kelamin
4. Ras/Etnis
5. Ukuran keluarga
6. Agama
7. Status perkawinan
8. Pekerjaan
9. Status gizi dan konstitusi tubuh
10. Perilaku hidup
11. Daya tahan tubuh
PENYEBAB PENYAKIT (AGENT)
Penyebab penyakit adalah suatu faktor yang
harus ada (a sine qua non) pada proses
terjadinya penyakit.

Agent merupakan benda hidup atau benda

mati (unsur, zat, atau kekuatan) yang oleh
karena adanya kontak yang efektif dengan
penjamu yang rentan (suspectible) pada
kondisi lingkungan yang tepat akan berlaku
sebagai rangsang (stimulus) proses
terjadinya penyakit.
 KLASIFIKASI PENYEBAB PENYAKIT :
1. Penyebab biologis : virus, ricketsia, bakteri,
jamur(fungi), protozoa (mis. cacing, plasmodium).

2. Penyebab nutrisi : dapat karena kelebihan, mis.

hiperkolesterolemia, atau karena kekurangan, mis.
kekurangan yodium, zat besi.

3. Penyebab kimiawi : merupakan bahan kimia yang

bersifat racun (gas, uap, larutan).
.
4. Penyebab fisik : merupakan zat fisik yang
dapat menimbukan gangguan pada
manusia, mis. tekanan atmosfir,
kelembaban, bising, vibrasi, panas, cahaya
dan radiasi.

5. Penyebab mekanik : merupakan kekuatan

yang dapat menimbulkan sobekan, tembus,
kehancuran dan dislokasi.
FAKTOR LINGKUNGAN

Lingkungan : keseluruhan kondisi luar yang

mempengaruhi kehidupan dan perkembangan
organisme penyebab penyakit dan penyebab
penyakit yang lain.

Komponen lingkungan terdiri atas :

1. Lingkungan fisik terdiri atas semua benda mati
dan semua sifat yang dimiliki.
2. Lingkungan biologis tersusun atas benda-benda
hidup atau organisme, yaitu :
 a. Flora : sebagai sumber makanan dan
penyebab penyakit.
b. Fauna : sebagai sumber makanan,
penampung (reservoir) dan perantara
(vektor) penyebab enyakit.
3. Lingkungan sosial-ekonomi :
a. Wilayah pemukiman
b. Pembangunan ekonomi
c. Gangguan sosial
 Pencegahan
Levels of Pencegahan primer Pencegaha Pencegahan Tertier
prevention n sekunder

Modes of Health Specific Early Disability Rehabilitation

intervention promotion promotion diagnosis limitation
and
treatment
Nature of Promotion Preventive Restorative Rehabilitative
measures
 Pencegahan
PRIMARY PREVENTION
• This is the measure undertaken in the period of
prepathogenesis (i.e.before the development of the
disease) which removes the possibility of occurence of
the diseases,for which removes the possibility of
occurrence of the disease.
• Specially,it is all the more important in those
diseases, for which no treatment is available, e.g. AIDS,
cancer, rabies, carries tooth, etc.
• Primary prevention can be adopted by two modes
of intervention—namely health promotion and Specific
protection.
 PRIMARY PREVENTION
Health Promotion
This consist of “General measures”, which will strengthen the individual/host and
prevents the occurrence of the disease by interrupting the interaction among the three
factors of epidemiological triad.
The various measures of health promotion are:
✓ Health education (on personal hygiene, oral hygiene, nutrition education, life-style,
etc.).
✓ Sex education.
✓ Adequate nutrition.
✓ Improvement in the environmental sanitation (such as control of insects, provision
of protected water supply, sanitary disposal of sewage, etc.).
✓ Promotion of breast –feeding and proper weaning.
✓ Family planning and spacing of births.
✓ Genetic counseling (premarital and marriage counseling)
✓ Efficient ante-natal care and post natal care.
✓ Recreation facilities (sports, games, cultural activities, etc.).
✓ Improvement in the literacy level.
✓ Yoga exercises and meditation.
 PRIMARY PREVENTION
• Specific Protection
This consist of “specific measure’,which prevent specific diseases. The
various measures are:
✓ Immunization against vaccine preventable diseases,
✓ Silver nitrate or Penicillin eye drops against ophthalmia neonatorum,
✓ Condom against AIDS
✓ Use of specific nutrients (Vit. A against nutritional blindness, IFA
against nutritional anemia, Iodised salt against Iodine Deficiency
Disorders),
✓ Helmet against head-injury,
✓ Masks against pneumoconiosis,
 PRIMARY PREVENTION
Specific Protection
✓ Ear plugs against noise induced deatness,
✓ Lead apron against radiation hazards,
✓ Visor against welding keratitis,
✓ Barrier cream against occupational skin cancer,
✓ Avoidance of allergens and carcinogens,
✓ Sterilization procedures of surgical instruments,
✓ Pasteurization of milk,
✓ Traffic signals against road accidents,
✓ Quality control of foods, drugs and cosmetics, etc.
 PRIMARY PREVENTION
Specific Protection
• Immunization e.g. Vaccine preventable
diseases.
• Specific nutrient e.g. Iron.
• Protection against injuries (seat belt)
• Chemoprophylaxis e.g. against Malaria.
• Control of consumer product quality and
safety of foods, drugs, cosmetics etc.
Pencegahan sekunder dan tersier
 Secondary Prevention

• Actions which halts the progress of a disease at

its incipient stage and prevents complications.
– Intervention in early pathogenesis phase : Early
diagnosis and adequate treatment.
• Largely the domain of a clinical medicine.
– Kelemahan fase ini:Already there is suffering of
mental anguish, pain.
– Loss of productivity
– More expensive and less effective
 Secondary prevention

Early diagnosis and Treatment

• The detection of disturbances of homoeostatic
and compensatory mechanism while
biochemical, morphological and functional
changes are still reversible.
• Important in reducing high morbidity and
mortality.
 Secondary prevention
This helps in the following ways:
Helps in recovery from the disease (restoration)
Reduces the duration of illness in the individual,
Minimizes the suffering,
Prevents the development of complications,
Prevents further spread of the diseases in the
community,
Prevents or postpones the deaath of the individual.
 Tertiary Prevention

• All measures available to reduce or limit

impairments and disabilities, minimize
suffering caused by existing departures from
good health and to promote the patient’s
adjustment to irremediable conditions.
• Intervention in late pathogenesis phases to
prevent squeal and limit disability.
Tertier prevention
Disease Impairment Disability Handicap

Accident Loss of foot Inability to waalk Loss of job

Vit A deficiency Corneal xerosis Blurring of vision Blindness and loss

of job

Leprosy Involvement of Inability to work Unemployment

nerves because of claw
hand
 Tertier prevention
Rehabilitation
The combined and coordinated use of medical,
social, educational and vocational measures for
training and retraining the individual to the
highest possible level of functional ability.
Medical rehabilitation
Vocational rehabilitation
Social rehabilitation
Psychological rehabilitation
 Example rehabilitation care:
1. Establishing the schools for the blind
2. Providing aids for crippled, such as artificial
limb
3. Reconstructive surgery in leprosy
4. Graded exercises in paralysis
5. Intraocular implantation of learn among
cataract patient.
Level, modes of intervention, nature of
measure
Rehabilitatif
• type:fisik, vokasional,sosial,spikhologik
• contoh: sekolah untuk anak buta (braile);
lengan artifisial/palsu; alat bantu pendengar;
lensa intraokuler untuk penderita katarak;
bedah rekonstruksi untuk penderita lepra
Functions of a doctor:
• The care of the individual
• The care of community Community diagnosis
& Community treatment

• As a teacher
Contoh aplikasi promkes di Iingkup
negara Indonesia
latihan
Level, modes of intervention, nature of
measure
• Pendidikan kesehatan
• Pendidikan seksual untuk pelajar
• Nutrisi yang adekuat
• Perbaikan sanitasi
• Promosi menyusui
• Keluarga berencana
• Konseling genetik
• Fasilitas rekreasi
• Latihan Yoga
Level, modes of intervention, nature of
measure
• Imunisasi
• Kondom untuk mencegah AIDS
• Vitamin A untuk mencegah kebutaan karena
nutrisi
• Helm mencegah injury kepala
• Pemakaian apron untuk melindungi dari bahaya
radiasi
• Pelindung dari alergen dan karsinogenik
• Pasteurisasi susu
Level, modes of intervention, nature of
measure
prosedur skrining untuk diagnosis dini
• mencatat berat badan untuk mendiagnosis
malnutrisi
• investigasi/pengawasan ibu hamil
• pelacakan kontak dan test kelompok untuk std
• pemeriksaan urin dan darah untuk dm
• periksa berkala untuk pekerja pabrik
• pap smear untuk ca cervix
•
Level, modes of intervention, nature of
measure
MODALITAS TREATMENT
• kemoterapi
• pembedahan
• imunoterapi
• radioterapi
• psikhoterapi
• terapi rehidrasi oral