Module 5

Preventing and fighting against diseases for good health

Process of infections and reasons for it, how to protect from different types of transmitted infections such
as…., Current trends of socio-economic impact of reducing your risk of disease, how to reduce risks for good
health, reducing risks and coping with chronic conditions, Management of chronic illness for Quality of life,
Health and Wellness of youth: a challenge for the upcoming future Measuring of health and wealth status.

Content
1. Management of chronic illness for better quality of life
2. Health and Wellness of Youth- a challenge for upcoming future
3. Measuring of health and wellness

Process of Infections and the Reasons for it:

Disease Vs Illness:

• According to this way of thinking, disease is something that needs to be cured, such as infection, injury,
toxic exposure, cell degeneration, etc.
• Illness is something that needs to be managed such as feelings of pain, discomfort, distress, weakness,
fatigue, etc.

Germs according to CDC (CENTER FOR DISEASE CONTROL AND

PREVENTION)
Germs are a part of everyday life and are found in our air, soil, water, and in and on our bodies. Some germs
are helpful, others are harmful. Many germs live in and on our bodies without causing harm and some even
help us to stay healthy. Only a small portion of germs are known to cause infection.
• An infection occurs when germs enter the body, increase in number, and cause a reaction of the body.
• Three things are necessary for an infection to occur:
o Source: Places where infectious agents. (germs) live (e.g., sinks, surfaces, human skin)
o Susceptible Person with a way for germs to enter the body.
 o Transmission: way germs are moved to the susceptible person.

Sources of Infections
A Source is an infectious agent or germ and refers to a virus, bacteria, or other microbe. In healthcare settings,
germs are found in many places. People are one source of germs including:
• Patients
• Healthcare workers
• Visitors and household members
People can be sick with symptoms of an infection or colonized with germs (not have symptoms of an infection
but able to pass the germs to others). Germs are also found in the healthcare environment. Examples of
environmental sources of germs.

Reasons for Infection from Sources

• Dry surfaces in patient care areas (e.g., bed rails, medical equipment, countertops, and tables)
• Wet surfaces, moist environments, and biofilms (e.g., cooling towers, faucets and sinks, and equipment
such as ventilators)
• Indwelling medical devices (e.g., catheters and IV lines)
• Dust or decaying debris (e.g., construction dust or wet materials from water leaks)

Susceptible People for infections

A susceptible person is someone who is not vaccinated or otherwise immune, or a person with a weakened
immune system who has a way for the germs to enter the body. For an infection to occur, germs must enter a
susceptible person’s body and invade tissues, multiply, and cause a reaction.
• Patients in healthcare who have underlying medical conditions such as diabetes, cancer, and organ
transplantation are at increased risk for infection because often these illnesses decrease the immune
system’s ability to fight infection.
• Certain medications used to treat medical conditions, such as antibiotics, steroids, and certain cancer
fighting medications increase the risk of some types of infections.
• Lifesaving medical treatments and procedures used in healthcare such as urinary catheters, tubes, and
surgery increase the risk of infection by providing additional ways that germs can enter the body.

Transmission of infection
Transmission refers to the way germs are moved to the susceptible person. Germs don’t move themselves.
Germs depend on people, the environment, and/or medical equipment to move in healthcare settings.
• Contact moves germs by touch. Touching the eye, nose, mouth or wounds after contact.
• Sprays and splashes occur when an infected person coughs or sneezes, creating droplets which carry
germs short distances (within approximately 6 feet). These germs can land on a susceptible person’s
eyes, nose, or mouth and can cause infection (example: pertussis or meningitis).
• Inhalation occurs when germs are aerosolized in tiny particles that survive on air currents over great
distances and time and reach a susceptible person. (example: Nontuberculous mycobacteria or
aspergillus).
• Sharps injuries can lead to infections (example: HIV, HBV, HCV) when bloodborne pathogens enter
a person through a skin puncture by a used needle or sharp instrument.

Types of Infections

Infectious agents come in many shapes and sizes. Categories include

• Bacteria: Bacteria are one-celled organisms that can be seen only with a microscope. Strep throat,
Tuberculosis, Urinary tract infections
• Viruses: Viruses are much smaller than cells. AIDS Common cold, Ebola, Genital herpes, Influenza,
Measles Chickenpox and shingles, Corona virus disease 2019 (COVID-19)
• Fungi There are many varieties of fungi, and people eat several of them.
• Protozoans: Protozoans are single-celled organisms that behave like tiny animals — hunting and
gathering other microbes for food. There are many varieties of fungi, and people eat several of them.
Giardiasis, Malaria, Toxoplasmosis
• Helminths: Helminths are among the larger parasites. Tapeworms and Roundworms.

How to protect from different types of transmitted infections

Preventing infections and avoid spreading infections through simple tactics:
• Avoid close contact with people who are sick.
• Cover coughs and sneezes.
• Avoid touching your face.
• Stay home if you’re sick.
• Clean and disinfect surfaces that are touched often.
 • Avoid contaminated food and water.
• Prevent contaminated medical equipment’s.
• Avoiding the contact with the body fluids of infected.
• Hand-washing, Medicines and Vaccines.
• Prevent infections by sexual transmission

Current trends of socio-economic impact of reducing your risk of disease

• Reducing inconvenience as well as economic costs appropriate utilization of all healthcare
professionals and lay experts, as well as physicians.
• Reducing inappropriate and costly use of resources such as antibiotics and specialist time;
• Engagement of the public and providers in national dialogue about risk benefit decision making,
prioritization of use resources, and a focus on prevention rather than cure.
• Support economic evaluation of NCD programs, such as the HEARTS approachexternal icon for CVD
prevention in primary care
• Increase scientific research on the economics of NCDs
• Create tools to evaluate NCD costs
• Train global partners on economic analysis and evaluation
• Use evidence to inform NCD strategy development
• Low socioeconomic status has significant consistent impact on mortality and morbidity.

How to reduce risks for good health

• Be a non-smoker and avoid second hand smoke. If one smokes need to get help to quit.
• Be physically active every day.
• Eat healthy foods.
• Achieve a healthy weight.
• Control your blood pressure.
• Limit your intake of alcohol.
• Reduce your stress.
• Be screened or tested regularly.
• Practice Hygiene.
• Remain Social

Reducing risks and coping with chronic conditions

Chronic illness
• What is chronic disease/illness?
• Chronic diseases are defined broadly as conditions that last for one year or more and require ongoing
medical attention, as well as limit activities of daily living.
• Example: heart disease, cancer, diabetes
• They are also leading drives of the nation’s large scale health care costs.
• Based on the latest data from C D C (centre for disease control), 10 most expensive chronic diseases
are:
• Cardio vascular diseases
• Smoking related health issues
• Alcohol related health issues
• Diabetes
 • Alzheimer’s disease
• Cancer
• Obesity
• Arthritis
• Asthma
• Stoke
• At any given time 50% of the population has a chronic condition.
• The medical management of chronic disorders accounts for three quarters nation’s health spending
excluding nursing home care.
• The chronically sick account for 90% of home care visits
• 83%of prescription drug use
• 80% of the days spent in hospitals
• 66% of doctors visit
• 55% of visits to hospital emergency rooms
• These conditions are not confined to the elderly. More than one third young adults of ages 18 to 44
have at least one chronic disability.
• At time each one of us will hear a physician say that our condition is chronic and cannot be cured. It
can be managed.

Additional demands of chronic illness

As well as needing to find ways to deal with the stress involved with chronic illness, you also need to:
• Understand the condition
• Know about the treatment and therapy
• Maintain trust and confidence in the doctors,
• Especially when recovery isn’t possible
• Know how to control the symptoms
• Maintain social relationships and a strong
• Support network when faced with an uncertain
• Medical future or when symptoms arise
• Avoid social isolation.

Management of chronic illness for Quality of life

Quality of life
• “Quality of life is defined as an individual’s perception of their position in life in the context of the
culture and value systems, in which they live and in relation to their goals, expectations, and
standards”.
• (Standard indicators of life: wealth, employment, the environment, physical and mental health,
education, recreational and leisure time, social belonging, religious beliefs, safety, security and
freedom)
• Simply quality of life means the degree to which an individual is healthy, comfortable, and able to
participate in or enjoy life events.
• Quality of life has a wide range of contexts. It includes the field of international development, health
care, politics and employment.
• Quality of life has several components: Specifically, physical functioning, psychological status,
disease or treatment, related symptomatology
• Health related quality of life is an evaluation of quality of life and its relationship with health. In this
field quality of life is often regarded in terms of how certain ailment affects a patient on an individual
level.
• Until recently quality of life was not considered an issue of psychological importance.
• F or many years it was measured only in terms of length of survival and signs of presence of disease
• In addition there was no consideration of the psychological consequence of illness and treatment.

Components of quality of life

Quality of life has several components. Specifically,
• Physical functioning
• Psychological status
• Social functioning
• Disease or treatment

Assessment of quality of life in chronic illness

Till now the assessment of the quality of life of chronically ill was based on how much the disease and
treatment interferes with the activities of daily living such as
• Sleeping,
• Eating,
• Going to work and
• Engaging in recreational activities
• For patients with more advanced diseases, such assessments include whether the patient is able to
bathe, dress, use toilet, be mobile, be content, and eat without assistance
• Essentially the quality-of-life assessment gauge the extent to which a patient’ normal life activities
have been compromised by disease and treatment

Why we should study quality of life of chronically ill?

• Studying chronically ill patients and their quality of life is important for the following
• Documentation of exactly how illness affects vocational, social, and personal activities. This provides
an important basis for interventions designed to improve quality of life.
 • Quality of life measures can help pinpoint which problems are likely to emerge for patients with
diseases. Example: such measure might indicate that sexual functioning is a problem for a patient.
Such information would be helpful in anticipating the intervention that are required
• Quality of life measures also assess the impact of treatments on quality of life of the chronically ill
• Quality of life information can be used to compare therapies and their outcome
• Quality of life information can inform decision makers about care that will maximize long term
survival with the highest quality of life possible
• Information enables policy makers to compare the impact of different chronic diseases on health care
costs and to assess the cost effectiveness of different interventions
• A chronic health condition is any condition lasting six months or longer. Example: asthma, arthritis,
cancer, obesity, diabetes, chronic pain or heart diseases
• Modern day treatments have made provision for people with chronic condition to live longer with
diseases that previously led to premature death.

What causes chronic illness and associate conditions?

• They are caused by a number of different health factors resulting at simultaneously
• They take some time to develop
• They last for a long time and often lead to other health problems

How to maintain better quality of life in the chronically ill?

• Chronic conditions are not cured completely. So looking after our self about good medical advice,
living healthy life style, and having positive attitude help in maintaining better quality of life
The measures adopted are:
• Finding reliable information about diseases, its treatment and management. This will help the
chronically ill patient to feel that he/she in taking positive step and give a feeling of control over their
illness
• Understanding the medication. This includes what it is specifically for. It provides special instruction
to be followed in taking medicine/ treatment and potential side effects
• Setting the patient’s goal- short term goals will give a sense of how the person is progressing
• Developing skills to manage the chronically ill patient’s pain and fatigue
• Getting emotional support. Speaking to others who are going through what the patient is going through,
and leaning on family and friends when there is need
• Planning for the future
Here are 10 helpful strategies for coping with a chronic condition.
• Get a prescription for information.
• Make your doctor a partner in care.
• Build a team.
• Coordinate your care.
• Make a healthy investment in yourself.
• Make it a family affair.
• Manage your medications.
• Beware of depression.
• Reach out. (Doctors, nurses)
• Plan for end-of-life decisions.
Pain management:
• Taking pain relieving medicine. Medication includes both non-prescription medication and
prescription medication
• Under going physical therapies. There are many non-drug treatments. A combination of treatments
and therapies (Physio therapy) is some time more effective. Non drug therapies include cognitive
behavioral therapy (cognitive behavioral therapy changes how a person thinks and in turn how he feels
and behave).
• Physical therapies also are found in stretching exercises, walking and other exercises
• Relaxation and stress management techniques
• Transcutaneous electrical stimulation therapies
• Applying heat packs and cold packs and
• Acupuncture
Taking care of mental health:
• Symptoms of chronic diseases – tiredness, aches and pains are not quite often visible. It is not just
physical symptoms that affect a chronically ill. They can affect the limits on life styles and living with
constant pain, it can impact mentally too.
• Worrying or thinking negatively adds to the patient’s anxiety or stress. They can affect the overall
health
What are the ways to reduce worrying?
• Write down the concerns and the possible consequences even if they are negative
• Find out the information about prognosis
• Talking to a friend, a supporting group or seek specialist help
• Focusing on a variety of things each day

Health and Wellness of youth:

A challenge for the upcoming

• Youth is the time of life when one is young and often means the time between childhood and adulthood.
 • It is also defined as “the appearance, freshness, vigor, spirit, etc.,
• Its definitions of a specific age range varies, as youth is not defined chronologically as a stage that can
be tied to specific age ranges, nor can its end point be linked to specific activities

Good life style choices for better quality of life

• Maintain a healthy life style can help the chronically ill patient to feel well, while living with chronic
illness and its condition. This includes eating well, doing as much physical activity as the patient’s
condition will allow, and getting good rest
• Trying to do some physical activity each day, even if it is only a small amount, can help with managing
pain and lift your mood. Speak with the doctor or physiotherapist about exercise that may help.
• Sleep is also very important if there is a health condition

Dealing with multiple health condition

• To achieve this chronically ill person need to deal with a number of health care professionals. The
most important thing to remember about seeing multiple healthcare professionals is to let each one
knows who else the patient are seeing and for what health condition.

Getting support from others for better quality of life

• Social support can help chronically ill person to maintain a good quality of life.
• When a chronically ill person has a long-term adverse health condition the person must plan to catch
up with family and friends and inform about their condition and let them know how they can help
• Consider new sources of support such as support groups, clubs, interest group and volunteer
opportunities.

Health and wellness of youth: a challenge for upcoming future

• Youth is the time of life when one is young and often means the time between childhood and adulthood.
• It is also defined as “the appearance, freshness, vigor, spirit, etc.,
• Its definitions of a specific age range varies, as youth is not defined chronologically as a stage that can
be tied to specific age ranges, nor can its end point be linked to specific activities

Health and wellness

• Health is a state of well‐being
• Wellness is the state of living a healthy life styles
• Health refers to physical, mental and social Well-being
• Wellness aims to enhance well‐being. It can affect physical, mental and social well‐being

Health and wellness in youth

• High levels of health and wellness in youth help them flourish in life as well as act as a protective
factor against some of the challenges that may arise during this period.
 • Youth with strong mental well‐being are able to manage their emotions, enjoy positive relationships
with friends and family

Challenges facing youth

• In may 2014 W H O published a major report called “Health for the world’s adolescent.”
• The report analyses what is known about adolescents’ health
• It includes topic of what promotes or undermines it, gaps in policies and services, and draws together
guidance and recommendations

FACTS
• An estimated 1.3 million adolescents died in 2012, mostly from preventable or treatable causes.
• Road traffic injuries were the leading cause of death in 2012, with some 330 adolescents dying every
day.
• Other main causes of adolescent deaths include HIV, suicide, lower respiratory infections and
interpersonal violence.
• Globally, there were 49 births per 1000 girls aged 15 to 19, according to 2010 figures.
• Half of all mental health disorders in adulthood appear to start by age 14, but most cases are undetected
and untreated
• Around 1 in 6 persons in the world is an adolescent: that is 1.2 billion people aged 10 to 19
• Most are healthy, but there is still significant death, illness and diseases among adolescents. Illnesses
can hinder their ability to grow and develop to their full potential. Alcohol or tobaccouse, lack of
physical activity, unprotected sex and/or exposure to violence can jeopardize not only their current
health, but often their health for years to come.
• Promoting healthy practices during adolescence, and taking steps to better protect young people from
health risks are critical for the prevention of health problems in adulthood, and for countries’ future
health and social infrastructure.

Main health issue‐ Early pregnancy and childbirth

• Complications linked to pregnancy and childbirth are the second cause of death for 15‐19‐year‐old
girls globally.
• One of the Millennium Development Goals, is to achieve universal access to reproductive health, for
which one of the indicators is the pregnancy rate among the 15 to 19 age group.

HIV
• More than 2 million adolescents are living with HIV. Although the overall number of HIV related
deaths is down 30% since the peak 8 years ago, estimates suggest that HIV deaths among adolescents
are rising
• A second goal of the Millennium Development is to halt the spread of HIV/AIDS

Main health issue‐ Early pregnancy and childbirth

 • Complications linked to pregnancy and childbirth are the second cause of death for 15‐19‐year‐old
girls globally.
• One of the Millennium Development Goals, is to achieve universal access to reproductive health, for
which one of the indicators is the pregnancy rate among the 15 to 19 age group.

Other infectious diseases

• Improved childhood vaccination has resulted in reducing death and disability from measles
• However diarrhea, lower respiratory tract infections and meningitis are among the top 10 causes of
death for 10 to 19 year olds.

Mental health
• Depression is the top cause of illness and disability among adolescents and suicide is the third cause
of death. Violence, poverty, humiliation and feeling devalued can increase the risk of developing
mental health problems.
• Building life skills in children and adolescents and providing them with psychosocial support in
schools and other community settings can help promote good mental health. Programmes to help
strengthen ties between adolescents and their families are also important. If problems arise, they should
be detected and managed by competent and caring health workers.

Violence
• Violence is a leading cause of death. An estimated 180 adolescents die every day as a result of
interpersonal violence. Around 1 of every 3 deaths among adolescent males in the low‐ and middle‐
income countries is due to violence
• Globally, some 30% of girls aged 15 to 19 experience violence by a partner.
• Promoting nurturing relationships between parents and children early in life, providing training in life
skills, and reducing access to alcohol and firearms can help to prevent violence. Effective and
empathetic care for adolescent survivors of violence and ongoing support can help deal with the
physical and the psychological consequences

Alcohol and drugs

• Harmful drinking among adolescents is a major concern in many countries. It reduces self‐control and
increases risky behaviours, such as unsafe sex. It is a primary cause of injuries (including those due to
road traffic accidents), violence (especially by a partner) and premature deaths. It also can lead to
health problems in later life and affect life expectancy.
• Setting a minimum age for buying and consuming alcohol and regulating how alcoholic drinks are
targeted at the younger market are among the strategies for reducing harmful drinking. Drug use among
15- to 19-year-olds is also a concern.

Injuries
• Unintentional injuries are a leading cause of death and disability among adolescents. In 2012, some
120 000 adolescents died as a result of road traffic accidents.
• Young drivers need advice on driving safely
 • laws that prohibit driving under the influence of alcohol and drugs need to be strictly enforced. Blood
alcohol levels need to be set lower for teenage drivers.
• Graduated licenses for novice drivers with zero tolerance for drink‐driving are recommended

Malnutrition and obesity

• Many boys and girls in developing countries enter adolescence undernourished, making them more
vulnerable to disease and early death.
• The number of adolescents who are overweight or obese is increasing in both lowand high‐income
countries.

Exercise and nutrition

• Available survey data indicate that fewer than 1 in every 4 adolescents meets the recommended
guidelines for physical activity –60 minutes of moderate to vigorous physical activity daily.
• Anemia resulting from a lack of iron affects girls and boys, and is the third cause of years lost to death
and disability. Iron and folic acid supplements help to promote health before adolescents become
parents.
• Developing healthy eating and exercise habits at this age are foundations for good health in adulthood.
Reducing the marketing of foods high in saturated fats, trans‐fatty acids, free sugars, or salt and
providing access to healthy foods and opportunities to engage in physical activity are important for all
but especially children and adolescents

Tobacco use
• The vast majority of people using tobacco today began when they were adolescents. Prohibiting the
sale of tobacco products to minors and increasing the price of tobacco products through higher taxes,
banning tobacco advertising and ensuring smoke‐free environments are crucial. Globally, at least 1 in
10 younger adolescents (aged 13 to 15) uses tobacco, although there are areas where this figure is
much higher. Cigarette smoking seems to be decreasing among younger adolescents in some high‐
income countries.

Rights of youth
• The rights of children to survive, grow and develop are enshrined in international legal documents.
The Committee on the Rights of the Child (CRC), which oversees the child rights convention, in 2013
published guidelines on the right of children and adolescents to the enjoyment of the highest attainable
standard of health
• In 2003, the CRC issued guidelines on states’ obligations to recognize the special health and
development needs and rights of adolescents and young people. The Convention on the Elimination of
Discrimination Against Women (CEDAW) also sets out the rights of women and girls to health and
adequate health care.

Health status
• A general term for the state of health of an individual, group, or population measured against defined
standards
 • The W H O definition (2009): The state of health of a person or population assessed with reference to
morbidity, impairments, anthropological measurements, mortality, and indicators of functional status
and quality of life.
• The WHO health indicators provide internationally accepted standards for various aspects of health
status
• WHO guides health policy in its Member States toward priority health problems, the use of solutions
known to them, and relevant directions for problem‐orientated research to improve the effectiveness
and efficiency of investment for health development.

Types of health status - includes

• functional health
• disability days
• activity limitation
• health expectancy and
• disability free life expectancy
What is the best predictor of health status?
• Earlier rising income and subsequent improved standards of living were thought to be the most
important factors contributing to a long and healthy life
• New research has shown that the level of education a person has is a much better predictor of life
expectancy.

Measures of health status

• An individual’s health status is usually measured by a health professional
• Measurement of population health status is carried using statistics and data presented as a set of
measurement or indicators. It includes: Life expectancy; health adjusted life expectancy; morbidity;
under‐five mortality; burden of disease; disability adjusted life year; incidence; and prevalence

Wealth Status
What Is Wealth?
• Wealth measures the value of all the assets of worth owned by a person, community, company, or
country. Wealth is determined by taking the total market value of all physical and intangible assets
owned, then subtracting all debts. Essentially, wealth is the accumulation of scarce resources.
• Specific people, organizations, and nations are said to be wealthy when they are able to accumulate
many valuable resources or goods.
• Wealth can be contrasted to income in that wealth is a stock and income is a flow, and it can be seen
in either absolute or relative terms.

Understanding Wealth
• Wealth can be expressed in a variety of ways. In a purely material sense, wealth consists of all the real
resources under one's control. Financially, net worth is the most common expression of wealth.
 • Definitions and measures of wealth have been different over time among societies. In modern society,
money is the most common means of measuring wealth. Measuring wealth in terms of money is an
example of money's function as a unit of account.

How to Measure Wealth

• Measuring wealth in terms of money overcomes the problem of evaluating wealth in the form of
different kinds of goods. These values can then be added or subtracted together. This, in turn, permits
the convenient use of net worth as a measure of wealth. Net worth is equal to assets minus liabilities.
For businesses, net worth is also known as shareholders’ equity or book value. In common sense
terms, net worth expresses wealth as all the real resources under one's control, excluding those that
ultimately belong to someone else.
• Research has consistently shown that people's perception of their own wellbeing and happiness
depends much more on their estimates of wealth relative to other people than on absolute wealth. This
is also part of why the concept of wealth is usually applied only to scarce economic goods; goods that
are abundant and free for everyone provide no basis for relative comparisons across individuals.