PSM - Golden Points
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SECTION
Annexures
1.
Incubation Incubatio n Period o Diseases
2.
Important Days o Public Health Importance
3.
Instruments o Importance in Public Health
4.
Mode(s) o Transmission Transmission o Diseases
5.
Some Important Health Legislations Passed in India
6.
Some Important Important Health Programmes o India
7.
Vectors and Diseases Transmitted
8.
New Tuberculosis Diagnosis (RNTCP) Guidelines in India India (w.e.. 01 April, 2009 onwards)
9.
National Population Population Policy (NPP) 2000
10.
National Health Policy (NHP) 2002
11.
Millennium Development Goals (MDGs)
12.
New Malaria Treatment Guidelines in India (2013 onwards)
13.
Draf Guidelines Guidelines:: Biomedical Waste Waste Management Guidelin Guidelines es 2011
14.
Golden Poin Points ts (Sets 1–5)
15.
Current Public Health Related Statistics o India* India*
16.
Newer Concepts in Preventive Preventive and Social Medicine Medicine
17.
Honors in Health and Medicine
18.
High Level Expert Group Group (HLEG) Report on Universal Universal Health Health Coverage (UHC)
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SECTION
Annexures
1.
Incubation Incubatio n Period o Diseases
2.
Important Days o Public Health Importance
3.
Instruments o Importance in Public Health
4.
Mode(s) o Transmission Transmission o Diseases
5.
Some Important Health Legislations Passed in India
6.
Some Important Important Health Programmes o India
7.
Vectors and Diseases Transmitted
8.
New Tuberculosis Diagnosis (RNTCP) Guidelines in India India (w.e.. 01 April, 2009 onwards)
9.
National Population Population Policy (NPP) 2000
10.
National Health Policy (NHP) 2002
11.
Millennium Development Goals (MDGs)
12.
New Malaria Treatment Guidelines in India (2013 onwards)
13.
Draf Guidelines Guidelines:: Biomedical Waste Waste Management Guidelin Guidelines es 2011
14.
Golden Poin Points ts (Sets 1–5)
15.
Current Public Health Related Statistics o India* India*
16.
Newer Concepts in Preventive Preventive and Social Medicine Medicine
17.
Honors in Health and Medicine
18.
High Level Expert Group Group (HLEG) Report on Universal Universal Health Health Coverage (UHC)
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Disease
Causative organism
Incubation Period (IP)
Chicken pox
Human (alpha) herpes virus 3
14 – 16 days
Measles (Rubeonella)
RNA paramyxovirus
10 – 14 days
Rubella (German Measles)
RNA Togavirus
14 – 21 days
Mumps
RNA Myxovirus
14 – 21 days
Orthomyxovirus
18 – 72 hours
Diphtheria
Corynebacterium diphtheriae
2 – 6 days
Pertussis (Whooping cough)
Bordetella pertussis
7 – 14 days
Meningococcal meningitis
Neisseria meningitis
3 – 4 days
SARS
Corona virus
3 – 5 days
Tuberculosis
Mycobacterium tuberculosis
Weeks – years
Poliomyelitis
Poliovirus
7 – 14 days
Hepatitis A
Enterovirus 72 (Picornavirus)
15 – 45 days
Hepatitis B
Hepadna virus
45 – 180 days
Hepatitis C
Hepacivirus
30 – 120 days
Cholera
Vibrio cholerae
1 – 2 days
Typhoid fever
Salmonella typhi
10 – 14 days
Staphylococcal food poisoning
Staphylococcus aureus
1 – 6 hours
Ascariasis
Ascaris lumbricoides
2 months
Ancylostomiasis (Hookworm)
A. duodenale
5 weeks – 9 months
Malaria
Plasmodium vivax
8 – 17 days
Plasmodium falciparum
9 – 14 days
Plasmodium malariae
18 – 40 days
Plasmodium ovale
16 – 18 days
Wuchereria bancrofti
8 – 16 months
Rabies
Lyssavirus type 1 (Rhabdovirus)
3 – 8 weeks
Yellow fever
2 – 6 days
Japanese encephalitis
Group B arbovirus (Flavivirus)
5 – 15 days
KFD
Arbovirus (Flavivirus)
3 – 8 days
Chikungunya fever
Chikungunyavirus (Arbovirus A)
4 – 7 days
Leptospirosis
Leptospira interrogans
4 – 20 days
Bubonic plague
Yersinia pestis
2 – 7 days
Pneumonic plague
Yersinia pestis
1 – 3 days
Septicemic plague
Yersinia pestis
2 – 7 days
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Review of Preventive and Social Medicine
s e s a e s i D f o d o i r e P n o i t a b u c n I
Scrub typhus
Rickettsia tsutsugamushi
10 – 12 days
Q fever
Coxiella burnetti
2 – 3 weeks
Taeniasis (Tapeworms)
T. solium, T. saginata
8 – 14 weeks
L. donovani
1 – 4 months
Trachoma
Chlamydia trachomatis
5 – 12 days
Tetanus
Clostridium tetani
6 – 10 days
Yaws
Treponema pertenue
3 – 5 weeks
HIV/ AIDS
HIV/ HTLV – III/ LAV
Months – 10 years
Swine Flu
H1N1
1–4 days
Crimean Congo Fever
Nairovirus (Bunyavirus)
1–9 days
H7N9
H7N9
1–10 days (3.3 days)
MERS
Betacoronavirus
12 days
Ebola disease
Ebolavirus
2-21 days
Anthrax
Bacillus anthracis
1-7 days
Brucellosis
Brucella melitensis
5-60 days
4
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30th January
Anti-Leprosy Day
2nd Wednesday of March
No Smoking Day
8th March
International Women’s Day
15th March
World Disabled Day
24th March
Anti-TB Day
7th April
World Health Day
25th April
World Malaria Day
8th May
World Red Cross Day
31st May
No Tobacco Day
5th June
World Environment Day
14th June
World Blood Donor Day
26th June
1st July
Doctors Day
11th July
World Population Day
28th July
World Hepatitis Day
8th September
World Literacy Day
28th September
World Rabies Day
1st October
International Day for Older Persons
1st October
National Voluntary Blood Donation Day
2nd Wednesday of October
World Disaster Reduction Day
9th October
World Sight Day
10th October
World Mental Health Day
24th October
UN Day
10th November
Universal Immunization Day
25th November
International Day for Elimination of Violence against Women
1st December
World AIDS Day
3rd December
International Day of Disabled Persons
10th December
Human Rights Day
Last Week of April
World Immunization Week
1–7th May
Anti–Malaria Week
1–30th June
Anti–Malaria Month
1–8th August
World Breast Feeding Week
25th August–8th September
Eye Donation Fortnight
15–21st November
Newborn Care Week
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Instrument
Use
Ice Lined Refrigerator (ILR)
Cold chain temperature maintenance
Dial Thermometer
Cold chain temperature monitoring
Horrock’s Apparatus
Chlorine demand estimation in water
Chlorinator, Chloronome
Mixing/regulating the dose of chlorine in water
Chloroscope
Measuring level of residual chlorine in drinking water
Winchester Quart bottle
Assess physical and chemical quality of drinking water
Kata Thermometer
Assess cooling power of air and air velocity (Latter Currently)
Anemometer
Assess air/wind velocity
Hygrometer and Sling Psychrometer
Assess air humidity (moisture content of air)
Assman Psychrometer
Assess air humidity (moisture content of air)
Mercurial Barometer
Atmospheric pressure
Anaeroid Barometer
Atmospheric pressure
Wind Vane
Assess air/wind direction
Salter’s scale
Field Instrument for Low Birth Weight (LBW)
Infantometer
Length of infants
Stadiometer
Height of adults
Shakir’s Tape
Mid-Arm Circumference (MAC)
Sound Level Meter
Measures intensity of sound
Band Frequency Analyzer
Characteristic of sound (pitch)
Audiometer
Hearing ability assessment
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Disease
Mode(s) of transmission
Remarks
Chicken Pox
Droplet infection, droplet nuclei.
Face to face transmission
Measles
Droplet infection, droplet nuclei, through conjunctiva
4 days before rash to 5 days later
Rubella
Droplet infection, droplet nuclei, vertical
1 week before rash to 1 week later
Mumps
Droplet infection, direct contact
Droplet infection, droplet nuclei
Diphtheria
Droplet infection, direct contact, fomite borne
Whooping Cough
Droplet infection, direct contact, fomite
Meningococcal
Droplet infection
Carriers most important source of infection
TB
Droplet infection, droplet nuclei.
Not Fomite borne
Poliomyelitis
Faeco-oral, droplet infection
Hepatitis A
Faeco-oral, parenteral, sexual
Hepatitis B
Hepatitis C
Perinatal, parenteral, sexual
Hepatitis D
Perinatal, parenteral, sexual
Hepatitis E
Feco-oral
Cholera
Feco-oral, contaminated foods/drinks, direct contact
Typhoid
Feco-oral, urine-oral
Amoebiasis
Feco-oral
Ascariasis
Feco-oral
Ancylostomiasis
Direct penetration(skin), oral
Transmission may be perennial
Dracunculiasis
Consumption of water containing cyclops
Water based disease
Dengue
Aedes bite
Water breeding disease
Leptospirosis
Urine, feces, tissues of rats
Direct skin contact
Nipah virus
Consumption of bats-eaten fruits
Person-to-person in India
Ebola virus
sweat, saliva)
–
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95% transmission from carriers
Super-infection/co-infection to HBV
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National Family Planning Programme: National Malaria Control Programme (NMCP): Lymphatic Filariasis Control Programme: National Leprosy Control Programme: National Malaria Eradication Programme (NMEP): National Tuberculosis Programme (NTP): National Goitre Control Programme (NGCP): National Trachoma Control Programme: Urban Malaria Scheme (UMS): Integrated Child Development Services (ICDS) Scheme: National Cancer Control Programme: National Programme for Control of Blindness (NPCB): Kala Azar Control Programme: National Mental Health Programme: National Leprosy Eradication Programme (NLEP): National Guineaworm Eradication Programme: National AIDS Control Programme (NACP): Baby Friendly Hospital Initiative (BFHI) : Revised National Tuberculosis Control Programme (RNTCP): Child Survival and Safe Motherhood (CSSM) Programme: National AIDS Control Programme I (NACP I): Yaws Eradication Programme: Revised Lymphatic Filariasis Control Programme: Enhanced Malaria Control Project (EMCP): Reproductive and Child Health Programme I: National Anti Malaria Programme (NAMP): National AIDS Control Programme II (NACP II): National Vector Borne Disease Control Programme (NVBDCP): Integrated Disease Surveillance Project (IDSP): Reproductive and Child Health Programme II: National Rural Health Mission (NRHM): Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), 2006 National AIDS Control Programme III (NACP III): National Tobacco Control Programme (NTCP): National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS): National Program for Health Care of the Elderly (NPHCE): Pradhan Mantri Jan Dhan Yojana (PMJDY), 2014
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Vector
Disease(s) transmitted
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Objectives of National Population Policy 2000
–
Immediate objectives: To meet unmet need of contraception; to strengthen health infrastructure; to strengthen health personnel and to promote integrated service delivery for basic RCH care
–
Mid-term objective: ‘To bring the total fertility rate (TFR) to Replacement Level; i.e. TFR to 2.1’
National Socio-demographic Goals of NPP 2000 (achieve by 2010)
–
Long-term objective: To stabilize population by 2045
–
Address the unmet needs for basic reproductive and child health services, supplies and infrastructure
–
Make school education up to age 14 free and compulsory, and reduce drop outs at primary and secondary school levels to below 20 percent for both boys and girls
–
Reduce infant mortality rate to below 30 per 1000 live births
–
Reduce maternal mortality ratio to below 100 per 100,000 live births
–
Achieve universal (100%) immunization of children against all vaccine preventable diseases
–
Promote delayed marriage for girls, not earlier than age 18 and preferably after 20 years of age
–
Achieve 80 percent institutional deliveries and 100 percent deliveries by trained persons
–
Achieve universal access to information/counseling, and services for fertility regulation and contraception with a wide basket of choices
–
Achieve 100 percent registration of births, deaths, marriage and pregnancy
–
promote greater integration between the management of reproductive tract Control Organisation
–
Prevent and control communicable diseases
–
Integrate Indian Systems of Medicine (ISM) in the provision of reproductive and child health services, and in reaching out to households
–
Promote vigorously the small family norm to achieve replacement levels of TFR
–
Bring about convergence in implementation of related social sector programs so that family welfare becomes a people centred programme
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Eradicate Polio and Yaws
–
Eliminate Leprosy
–
Establish integrated system of Surveillance, National Health Accounts and Health Statistics
–
Increase state sector health spending from 5.5% to 7% of budget
Goals for 2007
–
Achieve zero level of growth of HIV/AIDS
Goals for 2010
–
Eliminate Kala Azar
–
Reduce mortality by 50% due to TB, Malaria, Vector borne diseases and Water borne diseases
–
Reduce prevalence of blindness to 0.5%
–
Reduce IMR to 30/1000 and MMR to 100/Lac
–
Increase utilization of public health facilities from 75%
–
Increase health expenditure as % of GDP from 0.9% to 2.0%
–
Increase share of central grants to constitute >25% of total health spending
–
Further increase state sector health spending to 8% of budget
–
Eliminate Lymphatic Filariasis
Goals for 2005
Goals for 2015
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Baseline Year for MDGs: 1990
Deadline year for MDGs: 2015
8 MDGs:
Goal 1: Eradicate extreme poverty and hunger Goal 2: Universalize primary education Goal 3: Gender equality and women empowerment Goal 4: Reduce child mortality Goal 5: Improve maternal health Goal 6: Combat HIV/AIDS, malaria and other disease (Tuberculosis) Goal 7: Ensure environmental sustainability Goal 8: Develop global partnerships for development
3 out of 8 goals, 8 out of 18 targets required to achieve them and 18 out of 48 indicators of progress are ‘directly health related’ – Goal 4, 5 and 6 are ‘directly health related’ – Goal 2 and 3 ‘do not pertain to health’
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I.
VIVAX MALARIA
II.
FALCIPARUM MALARIA
– – – – PLEASE NOTE: : Age
Colour code for blister pack
0-1 year
Pink
1-4 years
Yellow
5-8 years
Green
9-14 years
Red
15+ years
White
: – – III. MIXED INFECTIONS (P. VIVAX + P. FALCIPARUM)
– – – – IV. PLASMODIUM MALARIAE
V.
PLASMODIUM OVALE
VI. MIXED INFECTIONS
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Review of Preventive and Social Medicine VII. SEVERE & COMPLICATED MALARIA
) s d r a w n o 3 1 0 2 ( a i d n I n i s e n i l e d i u G t n e m t a e r T a i r a l a M w e N
– – – – Arteether – – VIII. CHEMOPROPHYLAXIS
16
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Dear students, PLEASE NOTE: These guidelines are ‘draft proposed guidelines’ in Gazette of India. They have NOT YET been implemented in India.
Draft BMW Management Guidelines 2011 are NOT valid for:
e
Schedule I: Categories of BMW BMW category
Type of waste
Disposal steps
Category 1
Human anatomical waste
Incineration
Category 2
Animal waste
Incineration
Category 3
Microbiological and Biotechnology waste
1. Chemical treatment/ Autoclaving/ Microwaving 2. Mutilation/ Shredding
Category 4
Wasted sharps
1. Chemical treatment/ Destruction by needle or tip cutters/ Autoclaving/ Microwaving 2. Mutilation/ Shredding
Cat egory 5
Di scarded medicines and cytot oxic drugs
Category 6
Soiled waste
Incineration
Category 7
Infectious solid waste
1. Chemical treatment/ Autoclaving/Microwaving 2. Mutilation/ Shredding
Category 8
Chemical waste
1. Chemical treatment 2. Disposal in drains
Schedule II: Types of Containers and Disposal Color coding
Waste categories
Treatment options
Yellow
1, 2, 5, 6
Incineration
3, 4, 7
1. Chemical treatment/ Destruction (needle/ tip cutters)/ Autoclaving/ Microwaving 2. Mutilation/ Shredding
Blue
8
1. Chemical treatment 2. Disposal in drains
Black
Municipal waste
Municipal dump sites
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PSM: GOLDEN POINTS 1 Father of Medicine/First True Epidemiologist
Hippocrates
Father of Public Health
Cholera
First Country to Socialise Medicine completely
Russia
Health as a “State of complete physical, social and mental
WHO
HDI(Human Development Index) comprises
Knowledge (Literacy and Mean years of schooling), Income and Longevity (Life Expectancy at Birth)
Life Expectancy is a
Mortality Indicator (Positive Health Indicator)
“Epidemiological Triad” comprises of
Agent, Host and Environment
Extermination of organism is
Eradication
Action taken prior to onset of disease is
Primary Prevention
Early Diagnosis and Treatment are
Secondary Prevention
Ivory Towers of Disease
Large Hospitals
Diseases
Prevalence is a
Proportion (Total=New + Old Cases)
Total no. of deaths/Total no. of cases is
Case Fatality Rate
Observed Deaths/Expected Deaths is
Standardized Mortality Ratio (SMR)
Prevalence/Duration is
Incidence
Both exposure and outcome have occurred before study starts in
Case Control Study
Cohort Study is
Forward Looking/Prospective Study
Matching
Removes confounding, Ensures Comparability
Relative Risk is
Incidence among Exposed/ Incidence among non-exposed
Framingham Heart Study is a
Cohort Study
Heart of a Control Trial is
Randomization
Occurrence of a Disease Clearly in excess of normal expectancy
Epidemic
Disease imported in a country where it doesn’t occur
Exotic
Iatrogenic Disease is
Physician-induced
First case to come to notice of investigator
Index Case
Pseudo-Carriers are
Carriers of avirulent Organisms
Malaria parasite in Mosquito is
Cyclo-propagative Transmission
Gap between Primary case and Secondary Case is
Serial Interval
Yellow Fever/BCG/Measles are
Live Vaccines/ Lyophilised vaccines
First Vaccine to be discovered
Smallpox Vaccine (Edward Jenner)
Risk of Cold Chain failure is greatest at
Sub-centre and Village level
Quarantine is for
Healthy Contacts
Most effective sterilizing agent
Autoclaving (Steam under pressure)
Beaching Powder contains
33% available chlorine
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Golden Points Advantage gained by screening
Lead Time
True Positives
Usefulness of a screening test is given by
Sensitivity
Small Pox was declared Eradicated on
8 May, 1980
Rash in Chickenpox is
Pleomorphic and Dew-drop like
Koplik Spots are diagnostic of
Measles (upper 2nd molar)
Incubation Period for Measles is
10-14 days
Strain for Measles Vaccine is
Edmonston Zagreb
Strain for Rubella Vaccine
RA 27/3
Type A (H5N1 strain) virus
Hundred Day Cough is
Pertussis (Whooping Cough)
DOC for Chemoprophylaxis of Meningococcal Meningitis
Rifampicin
Positive Schick Test indicates
Susceptible to Diphtheria
Inability to drink is a sign of
Very Severe Disease
SARS is caused by
Corona Virus
Overall Prevalence of TB infection
30 - 40 %
Sputum Smear +ve at or after 5 months ATT
Failure
Only Bacteriostatic drug in Primary ATT Drugs
Ethambutol
Category II treatment (RNTCP) duration is
8 Months (3m IP + 5m CP)
WHO has recommended ‘DANISH 1331’ strain for
BCG Vaccine
Failure in RNTCP
Sputum +ve at/after 5 months treatment
Sputum Smear (ZN Staining)
DOTS is
Directly Observed Treatment, Short Course Chemotherapy
Category II (8 Months treatment)
For every 1 clinical case of Poliomyelitis, there are
1000 subclinical Cases
Polio stool samples are transported in
Reverse Cold Chain (+ 2° to + 8° C)
HBeAg is Marker of
Infectivity/Viral Replication
ORS Solution should be used within
24 Hours
Enteric Fever includes
Typhoid and Para-typhoid Fevers
Chandler’s Index for Hookworms is
Av. No. of Eggs/gm of stool
MC arboviral disease is
Dengue
Presumptive Treatment in Malaria
Chloroquine
Only communicable disease of man that is always fatal
Rabies
Main Vector for Yellow Fever is
Aedes aegypti
Pigs in Japanese Encephalitis are
KFD is transmitted in India by
Haemaphysalis (Hard tick)
Main reservoir of Plague in India
Tatera indica (Wild Rodent)
Scrub typhus is caused by
Rickettsia tsustsugamushi
Leishmaniasis (Kala Azar)
Elimination Level for leprosy
0.85
WHO Blindness is
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