Noninfectious Diseases: Preventing And Controlling Chronic

Preventing and Controlling chronic noninfectious Diseases For chronic noninfectious diseases The development of disease is often an irregularly progress.There is no obvious limit from healthy to ill.It’s a continuous variable progress.

Natural history of disease: refers to the course of disease over time,unaffected treatment. Natural history can be divided into 4 stages. 

(1)Stage of Susceptibility: In this stage,disease has not developed,but risk factors have been present. For example,CHD Risk factors: smoking, hypertension,high serum cholesterol level If someone is healthy now, but he is a smoker,or his blood pressure is high. He is in the susceptibility of CHD.

(2)Stage of pre-symptomatic disease(sub-clinical) At this stage,there is no manifest disease, no obvious symptom or sign, but pathogenetic changes have started to occur. For the patients in this stage, we usually rely on some tests or examinations to find them.

For example, lung cancer. In sub-clinical stage,patients has no symptom or sign, they have been found usually through health examination.Through xray test, we can see there is small cancer tissue in lung.

(3)Stage of Clinical Disease By this stage sufficient end-organ changes have occurred,so that there are recognizable signs or symptoms to disease.

(4) Stage of disability Some diseases run their course and then resolve completely with or without treatment. However,there are a number of conditions which cause disability.

Disability is defined as “any temporary or long-term reduction of a person’s activity as a result of an acute or chronic condition.” Such as blind,deaf,lameness. Note that the emphasis is on loss of function rather than on structural defect.

 Three-step

prevention:

primary prevention

secondary prevention

tertiary prevention

(1)Primary prevention Primary prevention is aimed at susceptible stage of disease. It is prevention of disease by altering susceptibility or reducing exposure for susceptible individuals.

Because in this stage, people have no disease,but they maybe have already exposed some risk factors(or cause of disease),we can according to these risk factors to prevent disease.

In broad sense, cause of disease does not refer to a certain cause of disease, it is the cause of many diseases. For example,smoking, drinking, fat have relation with so much diseases, such as lung cancer, hepatitis cancer, CHD,hypertension and so on.

So,we can take steps according to these factors ,such as get rid of smoking,don’t drinking,control weight ,or loss weight. Through these methods we can prevent many diseases.This is one category of primary prevention.It is suitable for the diseases which the cause is undetermined.

There also has another specific protective measures. If we know the risk factor of a disease, we can take this measure. For infectious diseases, we know the pathogen ,so we can immunize people using antibody to this pathogen.

(2)secondary prevention aim to pre-clinical and clinical stage Main contents: three early---find early diagnose early treat early

Find early (basis) When someone is in the pre-clinical stage of disease, his tissue may be occur change but he has no obvious symptom or specific sign. So we can not find him by seeing.But, we can find him early through census, or sampling survey depending on more sensitive methods. Suspicious patients 

diagnose early (core) For suspicious patient, we can diagnose them exactly by using of more specificity examination or test. 

Treat early (aim) For patients diagnosed definitely, we should treat them according to their special conditions. 

In secondary prevention,even if we can not stop the occurrence of disease,but we can slow its progression ,limit disability and improve their life quality.

(3) Tertiary prevention This consists of limitation of disability and rehabilitation where disease has already occurred and left residual damage. If someone has suffered from a kind of disease already and has obvious symptom,he should be treated according to his symptom.

Doctor should also prevent him occurring syndrome and sequela,and prevent disability. However,if someone has occurred disability,the major work we should do is rehabilitation,which includes two aspects: social and vocational rehabilitation.

Social rehabilitation means we should make the people who are disability feel their roles in society and self sufficiently. We can use various methods to maintain disable people’s social status.

Vocational rehabilitation: We should supply suitable work for them according to their different characterization of every disable people.