Inhoud
Lectures and important notes......................................................................1
Lecture 1: Introduction..............................................................................1
Lecture 2: Control of infectious diseases..................................................4
Lecture 3: The Dutch National Immunization Program (NIP).....................8
Lecture 4: Pandemic Preparedness...........................................................8
Lecture 5: Sanquin Transfusion safety and blood-borne infections.........10
Lecture 6: Malaria...................................................................................12
Lecture 7: Leishmaniasis Control............................................................14
Lecture 8: Global Health Perspective on Antimicrobial Resistance (AMR)
................................................................................................................17
Lecture 9: Tuberculosis Control...............................................................25
Lecture 10: HIV & AIDS...........................................................................27
New and emerging diseases......................................................................36
,Lectures and important notes
Lecture 1: Introduction
- Quarantine is used when someone is suspected of being exposed to a contagious
disease but is not yet confirmed to have it. The goal is to prevent the potential
spread of the disease to others.
o This applies to individuals who have been in close contact with an infected
person or have traveled to areas with outbreaks of a contagious disease.
o Lasts often the incubation period of the disease, during which symptoms
may develop.
- Isolation is used for individuals who have already been diagnosed with a
contagious disease. The goal is to separate these individuals from healthy people
to prevent the spread of the disease.
o This applies to anyone confirmed to have an infectious disease
o The duration of isolation depends on the disease and the individual's
recovery
EIDM: Evidence Informed Decision Making
EIDM combines evidence, understanding local context, and
including diverse knowledge to create effective health interventions
that meet the specific needs of communities.
A way to make decisions based on the best available evidence,
ensuring that solutions are based on research and a good
understanding of the local context.
EIDM highlights the need to thoroughly understand a health issue
before finding solutions.
Evidence includes data and research about a health problem: agent
(factor causing the issue), causes (factors that contribute to the
problem), effectiveness of solutions (looking at past interventions to
see what worked and why).
To design an effective intervention, start by assessing social factors, health issues,
behaviors, education, policies, and organizational capabilities. Once the intervention is
implemented, evaluate its process, impact, and outcomes to understand its effectiveness
and make any needed adjustments.
What is a policy brief: a short document that explains a specific issue and suggests
actions for policymakers or stakeholders. Makes complex issues easy to understand and
helps guide policy decisions.
- Purpose: It informs decision-makers about a problem and recommends solutions.
- Audience: Written for people who make policies, like government officials, who
may not be experts in the topic.
- Evidence-Based: Uses reliable research to support its suggestions.
Agent:
o The agent is anything that can cause sickness.
o This includes things like germs (bacteria, viruses, parasites), toxins, or
other harmful substances. Key terms:
Transmission: How the agent spreads (e.g., through air, water,
contact).
Infectivity: The ability of the agent to infect a host.
Pathogenicity: The ability of the agent to cause disease in a host.
Virulence: The severity of the disease caused by the agent.
,Infectivity (ability to infect, how easily the disease can spread in a population) =
- If 100 people are exposed to a virus and 80 of them become infected, the
infectivity is 80%
Pathogenicity (ability of an agent to cause disease (symptoms)) =
- If 80 people are infected with a virus, but only 60 develop symptoms (clinical
disease), the pathogenicity is 75%
Virulence (ability of an agent to cause death among those who develop disease) =
- If 60 people develop clinical disease, and 15 of them die, the virulence is 25%
Host:
o A host is a person or animal that can get sick.
o Susceptibility refers to how likely a host is to get infected based on their
health and biological makeup (like age or immune system).
o Biological Behavior: This includes how the host interacts with their
environment and their lifestyle choices that may affect their health.
Environment:
o The environment is the setting where disease can occur.
o It includes:
Favorable Conditions: Aspects that promote the spread of disease
(like poor sanitation).
Socio-Economic Factors: These can affect health, such as access
to healthcare or education.
Physical Factors: Geography and climate can influence disease
transmission.
Ideological/Cultural Factors: Beliefs and practices that impact
health behaviors.
Vector:
o Sometimes, a vector (like mosquitoes or ticks) is included in this triangle.
o A vector is an organism that transmits the disease agent from one host to
another.
, Triangle of Disease Occurrence
Disease occurrence happens when the host, agent, and environment
interact.
For example, if a susceptible host (like someone with a weak immune system)
encounters a harmful agent (like a virus) in a favorable environment (like a
crowded area), the chances of getting sick increase.
Prevention Levels
1. Primary Prevention:
o This aims to prevent disease from occurring at all.
o Examples include vaccinations, healthy lifestyle choices, and health
education.
2. Secondary Prevention:
o This focuses on early detection and treatment to prevent the disease from
getting worse.
o Examples include regular screenings and check-ups.
3. Tertiary Prevention:
o This aims to reduce the impact of an already established disease by
preventing complications and improving quality of life.
o Examples include rehabilitation programs and support groups.
Overall, understanding the relationships between the agent, host, and environment helps
in developing effective strategies for preventing diseases at different levels.
Vaccines come in four main types:
1. Live attenuated vaccines use weakened organisms to induce strong, long-
lasting immunity from a single dose. However, there's a risk the organism could
revert to a harmful form. Examples include measles, oral polio, and BCG.
2. Killed vaccines use inactivated organisms and require multiple doses to build
immunity. They are less effective than live vaccines. An example is the pertussis
(whooping cough) vaccine.
3. Conjugate vaccines are made from active components of organisms, offering
good immunity but are costly to produce. Hepatitis B is an example.
4. Toxoid vaccines use inactivated bacterial toxins to produce antibodies against
toxins, not the infection itself. Several doses and boosters are needed. Examples
include diphtheria and tetanus toxoid vaccines.
