Principles of control of vectors
(A) Environmental Engineering: - study the habitat and know breeding site of vectors clearing the bush and stagnant water of breeding site of anopheles mosquito.
- prevent vector from breeding
(B) Eliminate the vector at its earliest stages in life point by using (1) chemicals e.g. eliminating the larva form of molluse.
For Dranculus medlensis – eliminate Cyclops by using abate (a larvicide’s)
The adult vectors can be eliminated by using chemicals also e.g. DDT,
The quick knock down chemicals e.g. pyrethrum used to treat insecticide nets. They are short acting but act very quickly.
The chemicals could be in form of:
Spray, powder, fog, emulsion
Advantage – No side and non toxic to humans.
The long acting chemicals called the residual type. If you spray it now, it will have a residual to will kill any inserts that comes later.
This could be toxic to humans.
E.g. DDT, organochloride, organophosphorus and the carbamates.
(C) Biological method can also be used to eliminate early and adult vector for plague. So cats are used to prey on the rats.
- use of larvivirous fish to eat the larvae form of the vector
- Bacillus thurigiensis predates on
(D) Genetic method can eliminate the adult stage
Release a huge population of sterilized male into the environ to complete with no sterilize type. Those that can procreate (no sterilize type) will not feed well, not able to reproduce and the no will start decreasing. The pop of the normal type will therefore the sterized type prey on them.
(E) Personal protection
Screen the door, window – Insecticide treated net and chemicals are used. Ensure body is covered when sleeping.
Use of insert repellants on the body to repel the mosquito.
HEALTH EDUCATION
This is any set of learning experiences to encourage voluntary changes in human behaviour that will result in improved health status. It is a process of influencing, changing or reinforcing health behavior. It is the totality of educational efforts aimed at helping motivating and / or encouraging people to desire to be healthy knows how to stay healthy, do what they can to maintain health, seek helps as and when needed.
Objectives of H/E
(1) To make health a valuable asset
(2) To help people achieve, promote, maintain and protect their health thrl their own efforts i.e. self help and self reliance.
(3) To promote development and proper use of health services
Role of H/E
(1) Promotion of good health practices e.g. sanitation, breast feeding good hygiene etc.
(2) Recognition of early symptoms of dx and promotion of early referral.
(3) Promotion of use of prevention services e.g. immunization, screening antenatal clinic etc.
(4) Promoting the correct use of medication
(5) Promotion of community support for primary health care
Targets of H/E
(1) Individuals
(2) Families
(3) Communities
(4) Political leaders / policy makers
(5) Administrators.
Principles and methods of H/E.
H/E is an essential component of any program to improve the health of a community. The first step in planning any H/E is to decide what the key problems are and what advice should be given. Attempts to introduce new practices may fail if they are incompatible with local beliefs and practices. Any proposal for a behavioral change should:
(1) Be simple to put into practice with exiting knowledge and skill in the community.
(2) Should fit in with existing lifestyle and culture and not conflict with local beliefs
(3) Meet a felt need of the community
(4) Be seen by the people to convene real benefits in the short time and not only distant future.
To achieve success, H/E programmes need to be flexible and modify their advice to fit in with people’s circumstances e.g. education about nutrition should be based on foods available locally
Examples of methods of H/E.
(1) Individual approach – This include personal contact, home visitor, personal letters etc.
(2) Group approach – this include:
(a) Lecture is to carefully prepare oral presentation of facts, organized thoughts and ideas by a qualified person. The use of flip charts and flannel graphs may be important
(b) Demonstrations – carefully prepared presentation to show how to perform a skill or procedure
(c) Role playing or social Drama – the information is communicated drama is to act by members of the group.
(d) Focus group discussion – 6 to 12 members are seated in a circle face to face to participate in a discussion. The educator himself moderates the discussion.
(e) Workshop – series of meetings that involve active participation by the members.
(f) Symposium – series of speeches on selected aspects of a particular topic
(g) Panel discussion – A panel of 4- 8 people is formed to discuss about a particular topic.
Mass approach – This is directed towards a large no of people.
Materials needed include: Television, radio, internets, newspapers posters, direct mailing, bill boards etc.
Barriers of communication
(1) Physiological: - this includes difficulties in hearing, talking etc.
(2) Psychological it may include emotional disturbances
(3) Environmental e.g. noise, poor visibility
(4) Cultural – include illiteracy, beliefs, customs, religion, attitude etc.
Harmful Traditional and cultural practices
Introduction – Definition of culture and Tradition
Effects – Beneficial, Harmful
- Violence against
Prevention / control.
Definition 2: culture – style of living, custom and belief, dressing and language, food habit. Culture is dynamic (changes from time to time caused by industrialization, globalization and urbanization).
Tradition is transfer of culture from one generation to another culture varies from region to region, community to community and society to society
Effects
Beneficial effects on health
(1) Breast feeding beneficial to matter because it serves as a phenomeiunm of family planning. Serves as a link between matter and baby.
(2) Backing
(3) Male circumcision with sterile instruments because it reduces incidence of HIV. Because if the skin covering penis cap is intake during sexual intercourse, it can be brushed and transmission of infection.
(4) Maintenance of female virginity before marriage
(5) Pregnant women are not allowed to work under the sun.
(6) Extended family system because of moral and financial support from them.
Harmful effects This is detrimental to the physical, social and mental wellbeing of the individual. Female and children are more prone to these harmful effects than the males.
Violence against women
The gender based violence act that results or likely to result in physical, sexual or psychological harm to women.
Types of violence
(1) Female genital mutilation
(2) Male preference:
(3) Societal approval of male infidelity
(4) Early marriage
(5) Practices during Labour, marriage and pureperum
(6) Nutritional taboos
(7) Wife hospitality
(8) Widowhood rites
Female genital mutilation
Definition 2: cutting of part or the whole female genital organ
Types: clitoridectomy; Excision; Infibulations; Gishiri cut.
Clitoridectomy is removal of prepuce of clitoris
Excision – clitoris is removed with labia minora
Infibulations – involves removal of clitoris, labia minora and major
The surface is stitched together leaving opening for urination and menstruation.
Gishiri cut – common among the Hausa. Incision is made in the female genital part. The incision can be done anterioly or posteriorly. When the incision is made anterriorly, it damages the bladder giving vesicovaginal fistula. If the incision is made posteriorly, it damages the rectum giving rectovaginal fistula.
Prevalence
Chtoridectomy and Excision is common in western part of Nigeria.
Infibulation is common in Eastern part of Nigeria
Gishiri cut is common in the Northern part of Nigeria.
Why do we perform these types of female genital mutilation?
- Prevention of promiscuity
- Preservation of virginity
- Religious reasons because Islam belief clutoridectomy is a form of cleanness
- Social acceptability
- Identify and
When are these processes done?
- During pregnancy and labour
- At puberty stage
Where and how it is done.
The operators are the TBAS, local barbers, olounla.
Instruments: special knifes, glass, stones
Done in a septic environment under no anesthesia
Time / Duration depend on the skill of the operators.
Compensation can be I kind or cash before or after the operation.
Consequences of these procedures.
Immediate: Bleeding, pain (intolerable), fracture due to baby struggling with the operator, shock
Intermediate consequence: Delayed wound healing, keloid formation cyst formation, dysmenorrhoea, absence.
Late consequences: Infertility, prolong and obstructed labour
Resicovaginal and rectovaginal fistula, recurrent urinary tract infection.
Complications:
Mental Effects:
Anxiety, frigidity, depression-on, lack of organism etc.
Psychoses, neuroses.
Wife hospitality: Their wives are used to entertain visitor consequences: mental effects, unwanted pregnancies and incidence of HIV and veneral dxs. Common among the TIVS and Benue state.
Male preference
The parents prefer male child because they carry on the family name.
Societal approval of male infidelity
Male having many girl friends is approved by the society consequences: STI, HIV, Early marriage (marriage below 12- 13 years
Early marriage:
Set up a marriage at age of 12 or 13 because of honour and bride price.
Consequences: Teenage pregnancy, prey induced hypertension, anemia and malaria in prey, Ecclampsia, prolonged and obstructed labour, vesicovaginal and retrovaginal fisturm
Nutritional taboo
Individual is denied of food rich in vitamin, protein and other mineral. Pregnant women and children are the most susceptible. Kids are not given meat resulting in kwashiorkor.
Pregnant women are not allowed to eat snail (so baby will not be salivating)
Practices
Abdominal massage
Incision during labour done by the TBAS
Cutting umbilical cord with septic instrument with ending up in neonatal tetanus
Domestic violence again women – verbal violence, physical abuse in form of slap ending with bruises, sexual abuse..
Prevention and control:
- Mutidisciplancy approach where health workers, police, religious leaders, policymakers, NGO community leaders, journalists are involved.
-The first thing to be done is research; (i) situation analysis (how many individual are abused, bringing out those affected, reasons beliefs and customs under such act, (ii) clinical and rehabilitation research.
- Raise awareness and break the silence using special languages and terminologies.
- Advocacy: - creating awareness and support from community leaders, opinion leaders, religion leaders and organizations
- Empower women: Improve asses to education, improve their skill asses to employment, asses to money
- Involvement of NGOS, some are involved in eradication of such practices WOTCLEF: women trafficking child labour eradication foundation by Titi Abubakar.
- Training the TBAS to become carpenters, driver etc. so as to earn their income from other means.
- Community involvement in eradication of the practices by spreading the news the media, giving health talk etc.
Q – Which of these pratises enhances transmission of HIV.
Insects of public Health Importance
Beneficial effects of inserts
(1) Pest control – praying mantis feed on anvil
(2) Pollination e.g.
(3) Honey bees produce honey which is a sweetner and an antibiotic
(4) They constitute natural manure when they die and their bodies’ decomposer
(5) Of cultural value. E.g. Butterfly is the symbol of the God they are serving (in the ancient Ephesians)
(6) They serve as food e.g. the termites
(7) Assist in soil eration e.g. burrowing beetles
(8) In aviation industries, assist in flying studies
(9) Are of great great ornamental values.
Classification of insects:
Insert belong to the family arthropod.
(1) Diptera (True flies) with head, thorax and abdomen with 2pairs of wings on the thorax e.g. (a) mosquito will transmits malaria, filariasis and some viral dx.
Mosquito < anopheles e.g. female anopheles mosquito Culex e.g. the culex and the acdes. (b) Black fillies (simulium spp) transmit onchocerciasis and the parasite transmitted is onchocerca volvulus. The infective agent is the onchocerca larva or the filarial. (c) Glossina spp (tsetse fly) transmits trypanosomiasis (African type) the parasites are Trypanaroma gmbiense and T. rhodiensilence. (d) Chooser’s (horseflies, dear files) transmitted of Loaisis (calabar swelling) parasite is Loa Loa. (e) Sandfly (phlebotomus) cause Leishmaniasis (f) Muscaspp (House fly) transmit many parasite and amoebic dxes, brucellosis, salmonellosis, Hepatitis A and viral dxes (g) Blow files e.g. mango flies (bees found on mango plantation). Do not have the parasite inside of them but transmit dx by a mechanism called Myiasis. (2) Bugs Bed bugs (cimex bugs) Reduvid bug (kissing bug) Bedbugs do not transmit dxes. Their only problem is that their bite is very painful and there could be dermatitis. Reduviid bug (kissing or assassin bugs) – cause South American type of trypanosomiasis called chages dx. Survives on crevices of abandoned building (open walls). The insets feed at night – exhibit norctunal type of periodicity As the insect is feeding, it is also defeacating and the feaces contain the parasite called Trypanosome cruzi. By reflex you rub the feaces on your face and the parasite penetrate the body which will result in a swelling called chagoma which will disappear into the blood stream in some few minutes. Lice (pediculus) Human louse (pediculus humanus). There are 3 main species. (i) Pediculus captis on the head (ii) Pediculus corporis on the body They are transmittere of 3 main dxes (1) Typhus fever caused by rickettsia (2) Trench fever (3) Relapsing fever The insect allow survival of rickettsia. The lice lives on the body and excrete on the body when an infected feaces come in contact with a traumatized skin, the rickettsia penetrate the body anol enter during the blood stream where it either cause typhus or trench fever depending on the type of ricjettsia that penetrated the body - Rickettsia prowerzekis causes typhus fever - Rickettsia Quintana cause Trench fever Relapsing fever is caused by Borealis recurrent which is a spirochete. The spirochete survive also on the body and excrete on the body when the infected feaces come in contact with a braided skin, the parasite penetrate the body and enter the blood stream causing relapsing fever. Factors assisting insects in dxes transmission (1) Anatomy of the body of adult insects is divided into head, thorax and abdomen (a) Head: head of mosquitoes and tsetse files bear the mouth part to generally posses’ highly specialized blood sucking appendage. The sensory system e.g. of housefly is much developed that is able to locate any dead body and to sense predators. (b) Thorax: the thorax (true files) bears wings which allow for possible escape during predation, cyst and ova of parasite accidental attachment thus aiding mechanical transmission of dxes. The 3 parts of legs of houseflies are provided with glandular hairs which exudes substances that keep the legs constantly wet and sticky which the result that particles readily adhere to them so that a fly visiting feaces and subsequently setting on fresh food may act as a direct conveyer of feacal material from human exercetement to substances intended for human consumption. (c) Abdomen: The internal anatomy of certain insects e.g. anopheles mosquitoes and tsetse files are suitable for developing parasites into infective stages e.g. sporozoites (infective stage of plasmodium), bankrofti larva and trypomastigate (infective stage of trypanosome) (2) Habitat: (3) (temperature, rainfall, relative humidity) Habitat plays a major role in survival of adult insects and larva and to a greater extent the type of dx associated with a particular region. Mosquitoes (e.g. are vectors of many dxes eg malaria filariasis, viral dxes) survive in tropical regions thereby eliminating dx associated in cold region. Most eggs and larva of insects thrive in swampy, dampy cold environment. In warmer weather, mosquitoes are more active. Hotter temperature even reach inside the mosquito gut and intensify the reproduction rate of dx causing parasite (plasmodium or wuchereria) thereby increasing the like hood that a single bite will cause infection. (3) Feeding habit Mosquitoes, tsetse fly, black files and other blood feeders introduce germs during blood meals. Although Musca domestica is non blood sucking pathogenic organism are easily transmitted because the feeding habit of fly involves regurgitation of its crop content and defeacation while feeding. The bite of pediculus humanus, simuluium files are usually very painful and cause discomfort, skin irritations and dermatitis periodicity (period when insect feeds) is also contributory to successful dx transfer. Mosquitoes and reduviid bugs show nocturnal periodicity and are able to carry out their deadly act when human subject is as sleep. (4) Nature of food: It is well noted that while male insects feed on plant juice (nectar), female insects with mouth parts feed on blood. Female mosquitoes suck blood because of protein derived for reproduction of egg.
No comments:
Post a Comment