Preventing and Controlling chronic

noninfectious Diseases

For chronic noninfectious diseases

The development of disease is
often an irregularly
progress.There is no obvious
limit from healthy to ill.It’s a
continuous variable progress.
Natural history of disease:
refers to the course of disease
over time,unaffected treatment.
Natural history can be divided into
4 stages.
(1)Stage of Susceptibility:
In this stage,disease has not
developed,but risk factors have been
present.
For example,CHD
Risk factors: smoking, hypertension,high
serum cholesterol level
If someone is healthy now, but he is a
smoker,or his blood pressure is high. He
is in the susceptibility of CHD.
(2)Stage of pre-symptomatic
disease(sub-clinical)
At this stage,there is no manifest
disease, no obvious symptom or
sign, but pathogenetic changes
have started to occur.
For the patients in this stage, we
usually rely on some tests or
examinations to find them.
For example, lung cancer.
In sub-clinical stage,patients has
no symptom or sign, they have
been found usually through
health examination.Through x-
ray test, we can see there is
small cancer tissue in lung.
(3)Stage of Clinical Disease
By this stage sufficient end-organ
changes have occurred,so that
there are recognizable signs or
symptoms to disease.
(4) Stage of disability
Some diseases run their course
and then resolve completely
with or without treatment.
However,there are a number of
conditions which cause
disability.
Disability is defined as “any
temporary or long-term
reduction of a person’s activity
as a result of an acute or chronic
condition.” Such as
blind,deaf,lameness.
Note that the emphasis is on loss
of function rather than on
structural defect.
 Three-step prevention:

primary prevention

secondary prevention

tertiary prevention
(1)Primary prevention
Primary prevention is aimed at
susceptible stage of disease. It
is prevention of disease by
altering susceptibility or
reducing exposure for
susceptible individuals.
Because in this stage, people have
no disease,but they maybe have
already exposed some risk
factors(or cause of disease),we
can according to these risk
factors to prevent disease.
In broad sense, cause of disease
does not refer to a certain cause
of disease, it is the cause of
many diseases.
For example,smoking, drinking,
fat have relation with so much
diseases, such as lung cancer,
hepatitis cancer,
CHD,hypertension and so on.
So,we can take steps according to
these factors ,such as get rid of
smoking,don’t drinking,control
weight ,or loss weight.
Through these methods we can
prevent many diseases.This is
one category of primary
prevention.It is suitable for the
diseases which the cause is
undetermined.
There also has another specific
protective measures.
If we know the risk factor of a
disease, we can take this
measure.
For infectious diseases, we know
the pathogen ,so we can
immunize people using antibody
to this pathogen.
(2)secondary prevention
aim to pre-clinical and clinical
stage
Main contents:
three early---find early
diagnose early
treat early
Find early (basis)
When someone is in the pre-clinical
stage of disease, his tissue may be
occur change but he has no obvious
symptom or specific sign.
So we can not find him by seeing.But,
we can find him early through census,
or sampling survey depending on
more sensitive methods.
Suspicious patients
diagnose early (core)
For suspicious patient, we can
diagnose them exactly by using
of more specificity examination
or test.
Treat early (aim)
For patients diagnosed definitely,
we should treat them according
to their special conditions.

In secondary prevention,even if
we can not stop the occurrence
of disease,but we can slow its
progression ,limit disability and
improve their life quality.
(3) Tertiary prevention
This consists of limitation of disability
and rehabilitation where disease has
already occurred and left residual
damage.
If someone has suffered from a kind of
disease already and has obvious
symptom,he should be treated
according to his symptom.
Doctor should also prevent him
occurring syndrome and
sequela,and prevent disability.
However,if someone has occurred
disability,the major work we
should do is rehabilitation,which
includes two aspects: social and
vocational rehabilitation.
Social rehabilitation means we
should make the people who are
disability feel their roles in
society and self sufficiently. We
can use various methods to
maintain disable people’s social
status.
Vocational rehabilitation:
We should supply suitable work
for them according to their
different characterization of
every disable people.