LEVELS OF PREVENTION

DEFINITION:

Prevention is the action aimed at eradicating, eliminating or minimizing the impact of disease and disability, or if none of these are feasible, retarding the progress of the disease and disability.

LEVELS OF PREVENTION:

PRIMORDIAL PREVENTION:

Primordial prevention is defined as prevention of risk factors themselves, beginning with change in social and environmental conditions in which these factors are observed to develop, and continuing for high risk children, adolescents and young adults.
The main intervention in primordial prevention is through individual and mass education.

Examples:

National policies and programes on nutrition involving the agricultural sector, the food industry, and the food import export sector
Comprehensive policies to discourage smoking
Programes to promote regular physical activity
Making major changes in lifestyle e.g. in CHD prevention

PRIMARY PREVENTION:

Primary prevention can be defined as the action taken prior to the onset of disease, which removes the possibility that the disease will ever occur.
It signifies intervention in the pre-pathogenesis phase of a disease or health problem.
It includes the concept of “positive health”, a concept that encourages achievement and maintenance of “an acceptable level of health that will enable every individual to lead a socially and economically productive life”.
Primary prevention may be accomplished by measures designed to promote general health and well-being, and quality of life of people or by specific protective measures.

ACHIEVED BY:

Health promotion:

Specific protection:

Immunization and seroprophylaxis
Chemoprophylaxis
Use of specific nutrients or supplementations
Protection against occupational hazards
Safety of drugs and foods
Control of environmental hazards, e.g. air pollution
The WHO has recommended the following approaches for the primary prevention of chronic diseases where the risk factors are established: –

SECONDARY PREVENTION:

It is defined as “ action which halts the progress of a disease at its incipient stage and prevents complications.”
The specific interventions are: early diagnosis (e.g. screening tests, breast self examination, pap smear test, radiographic examinations, case finding programme, etc) and adequate treatment.
Secondary prevention attempts to arrest the disease process, restore health by seeking out unrecognized disease and treating it before irreversible pathological changes take place, and reverse communicability of infectious diseases.
It thus protects others from in the community from acquiring the infection and thus provide at once secondary prevention for the infected ones and primary prevention for their potential contacts.
Early diagnosis and treatment

WHO Expert Committee in 1973 defined early detection of health disorders as “ the detection of disturbances of homoeostatic and compensatory mechanism while biochemical, morphological and functional changes are still reversible.”
The earlier the disease is diagnosed, and treated the better it is for prognosis of the case and in the prevention of the occurrence of other secondary cases.

TERTIARY PREVENTION:

It is used when the disease process has advanced beyond its early stages.
It is defined as “all the measures available to reduce or limit impairments and disabilities, and to promote the patients’ adjustment to irremediable conditions.”
Intervention that should be accomplished in the stage of tertiary prevention are disability limitation, and rehabilitation

Disability limitation:

Disease
Impairment:Any loss or abnormality of psychological, physiological or anatomical structure or function.
Disability :Any restriction or lack of ability to perform an activity in the manner or within the range considered normal for the human being

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

Primary prevention includes Health promotion, Specific protection & Health education
Control of tobacco, Radiation protection,Installation of sanitary latrines,Provision of safe water,Use of mosquito net & Cancer education comes under primary prevention stratagies
Primordial prevention is the prevention of diseases through modification of their risk factors
Tendon transplant in leprosy, Physiotherapy in residual polio myelitis & Provision of spectacles for refractive errors are examples of tertiary level prevention-
Prevention of disease by immunization comes under Primary prevention
Primary level of prevention means action taken prior to the onset of disease, which removes the possibility that a disease will ever occur
Cervical pap smear checking comes under secondary level of prevention
Prevention of developing risk factors in CAD comes under Primordial prevention
Exercises, Weight control & Health education are included in the primary prevention for hypertension
Mode of prevention in CHD is Primordial prevention
Using seatbelt is which level of prevention is Secondary
Secondary level of prevention is important in TB, leprosy

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