College aantekeningen
College aantekeningen Containment strategies of infectious diseases
These are notes of all lectures with screenshots of important aspects
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Containment strategiesHC 1
Quarantine because you needed to be on ships for 4 days.
Punishment of God, or bad air.
Influenza 1918 the Spanish flu. Much more reporting of the disease in Spain. And during the
war everyone was pointing fingers at each other.
Penicillin 1928 Mr. Fleming. To tackle bacteria.
Smallpox were eradicated by vaccines.
Jenner discovered the vaccines, other people also investigated vaccines.
Ottoman empire and Chinese realm they already experimented with vaccinations.
Developing containment strategies, context relevant, important to know what the context is and
preferably the medicines locally.
1953 start of Dutch vaccine program EPI
HIV/AIDS led to a variety of containment approaches
- VCT
- Treatment campaigns
- MTCT
- Micro-credits
- Small groups
COVID how rapidly we can develop vaccines and how we are struggling with the behavioral side.
EIDM evidence informed decision making. It is difficult to say where you have to go, you can get
an idea of where to go, but not necessarily a strict direction of where to go.
If you have the evidence then you will make this decision where to go/what to do evidence
based.
The assignment/frameworks
- Precede/proceed: Green and Kreuter. Precede is how we design an intervention (what are
the problems) and proceed is how to continue (what causes these problems). This model
consists of 9 phases. It ends with evaluating the problem.
- Intervention mapping: consists of 6 steps. They talk about clear change objectives, what
does the campaign has to achieve and what will the impact and what is it that you want to
change. If we don’t know what we want to achieve, we don’t know what path to walk.
- Understanding the behavior – knowing the change. Behavior is hard to change. Perceived
threat and perceived outcome influence someone’s behavior.
Jenkins 5 interventions steps for the assignment
1. What is the problem?
a. Is it a priority issue to address? Many different measures such as mortality,
incidence, DALY, global burden of disease
b. Socio-economic impact
, c. For whom is it a problem?
2. What factors cause the problem
a. What pathways lead to the problem?
b. Tools to identify causes are epidemiological triangle and problem tree
i. Epidemiological triangle: agent (cause of disease: transmission, infectivity,
pathogenicity and virulence), host (susceptibility: biological and behavioral),
environment (favorable: socio-economic factors, physical factors and
cultural factors).
ii. Vector is what is needed to transmit the disease. For Lyme the thick is the
vector, this goes through different phases, e.g., mice. But a mouse is a host,
this develops the disease more and then the tick transmits and therefore is a
vector.
iii. Disease occurrence: is the result of interaction between host, agent and
environment. Web of etiology high level of uncertainty and complexity
iv. Problem tree: a lot of asking but why? Use social determinants of
health/ecological models.
3. How can these factors be changed?
a. What can we do about it? Think of things you can do. Epidemiological triangle helps
to determine where to intervene.
b. Five basic strategies
i. Remove the agent
ii. Raise host resistance
iii. Modify environment
iv. Separate agent from host
v. Interrupt transmission
c. Preventative programs deal with complex web of etiology (causation), hence, web
of interventions needed in many conditions, primary/secondary/tertiary
prevention.
4. What overall intervention strategies are most applicable/appropriate and cost-effective?
a. Multi criteria decision making: criteria for the best intervention. Choose the right
intervention, that can be implemented with limited negative side effects?
i. Medical-technical effectiveness: extent to which it controls disease
ii. Organizational feasibility: implementation of intervention
iii. Social, cultural and political feasibility: acceptability of intervention to
community and leader
iv. Financial feasibility: costs for personnel and material
5. What is needed to be done to reach the goals?
a. What are policy implications and what are the negative effect?
b. Set objectives that can be measured
c. Work with/within the community
No do gap is that there is a lot of knowledge, but it doesn’t get implemented. It is important to
bridge this gap. Means to a conversation, push it to people.
d.m.bon@vu.nl
Lecture 2: A refresher on immunology
Brief history:
, - Robert Koch and Louis Pasteur in 19th century microorganisms are cause of infectious
diseases.
- In 1890 discovery of passive immunotherapy of diphtheria with anti-diphtheria toxin
antibodies derived from a horse by Emil von Behring.
Key players in immune system:
Organs and tissue of the immune system:
Innate immune system:
, Adaptive immune system:
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