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Community Medicine V Dr. Mehrdad Askarian MD, MPH Professor of Community Medicine

Community Medicine V Dr. Mehrdad Askarian MD, MPH Professor of Community Medicine. GI infections & Infestations. Salmonella infections. Age, sex, job and socioeconomic class

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Community Medicine V Dr. Mehrdad Askarian MD, MPH Professor of Community Medicine

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  1. Community Medicine VDr. Mehrdad Askarian MD, MPHProfessor of Community Medicine

  2. GI infections & Infestations

  3. Salmonella infections • Age, sex, job and socioeconomic class • In endemic area; >1y/o children are prone, in which the disease is more sever together with complications, in all areas; >5y/o and old age groups are more prone, 75% of patients<30y/o • Higher in low socioeconomic classes • Laboratory workers, travelers to endemic areas, jobs with contact to animals. • More common in summer

  4. Salmonella infections • Predisposing factors • Low level of hygiene in community • Achlorhydria • Antibiotic prescription before contact with organism • Hemolytic disorders • Immune condition of patient (more common in AIDS patients(*60)

  5. Salmonella infections • Primary prevention • Education of hygiene in community • Personal hygiene (handwashing is the most important) • Environmental health • Decrease antibiotic prescription in animals • Quality control of food preparing areas • Proper cleaning of food preparing devices in industry • Healthy water • Proper disposal of sewage • Vaccination

  6. Salmonella infections • Secondary infection • Proper disinfection of stool and contaminated items (20 PPM of Cl) • Chloramphenicol, ciprofloxacin, amoxicillin, co-trimaxozol

  7. Salmonella infections • Control • Approach to epidemics • Document diagnosis • Epidemic confirmation • Case finding • Treat patients (48 hrs after finishing therapy having 3 negative stool culture. • Treat carriers • Environmental health (chlorination of water) • Health education • Healthy water in public areas • To control making and distribution of ice • To ensure healthy food by close observation • To ensure hygienic disposal of sewage, wastes

  8. Shigellosis • Primary prevention • Provide healthy water (chlorination of water) • Insecticides • Vaccination?? • Disinfection of sewage

  9. Shigellosis • Secondary prevention • Early treatment causes decrease in bacterial passage

  10. Shigellosis • Tertiary prevention • No any important complication

  11. Shigellosis • Control measures • Close observation of food preparing areas • Educate handwashing • Don’t prescribe antibiotic as prophylaxis • Enabling of laboratories • Preparing adequate amount of IV fluids

  12. Amebiasis & Giardiasis • Prevention and control • Environmental health, healthy water and food • To find healthy carriers and treat them • Health education • Resistant to chlorination of water • Heat (55 degree centigrade) kills them • Filtering of water • Ozone • Proper disposal of sewage • To find cases and treat them • Mass campaign

  13. Helminthes • Importance • Consumption of patient’s food • Micro bleeding • Organ damage • Hypertrophy or hyperplasia of involved organ

  14. Helminthes • Transmission roots • Direct (pin worm, H. Nana) • Soil (ascaris, hook worms, trichuris trichura) • Snail (schistosoma) • Arthropod :(dracunculiasis) • Animal food :(taenia saginata)

  15. Helminthes • Incubation period • 2 wks in pin worm, 1 year for dracunculiasis, years for Hydatid cyst.

  16. Helminthes • Clinic • Differs from asymptomatic to hyper acute, chronic. • Things in common • Spontaneous recovery • No immunity

  17. Helminthes • Geographic distribution • Soil composition of area, hygiene status of area • Some of helminthes are special for areas

  18. Helminthes • Time trend • No time trend • Age, sex, job, social status • More in childhood, in low social • Predisposing factors • Culture and beliefs • Steroids, poor people • Sensitivity and resistance • No resistance against it • Secondary attack rate • Not known

  19. Helminthes • Primary prevention • General hygiene of the population • Facilities for proper disposal of sewage • Proper handwashing • Hygienic food preservation • Nail cutting • Monitoring of meat

  20. Helminthes • Secondary prevention • Diagnosis and proper treatment • Mass treatment

  21. Helminthes • Tertiary prevention • Removal of obstruction

  22. Any Comments or Questions?

  23. DISCUSSION & QUESTIONS??

  24. Thank you for your kind attention

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