Disease Dilemmas

Spread by pathogens such as bacteria, viruses, parasites and fungi. Most, but not all can be transferred from one person to another
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Non-communicable and have a variety of causes e.g. nutritional deficiencies like rickets, lifestyle can cause heart disease, diabetes
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Infectious diseases which spread from host to host but do not require quarantine
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A class of infectious diseases that are easily spread by direct or indirect contact between people. Include bacterial infections like typhoid and the plague and viral diseases like yellow fever and ebola
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Some infectious diseases are not contagious - e.g. malaria which is spread by vectors such as mosquitoes
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Diseases that exist permanently in a geographical area or population group e.g. Sleeping sickness or Chagas disease
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Disease outbreak contained because of a physical barrier e.g. Ebola, contained due to the Sahara desert
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An epidemic that has spread worldwide e.g. Bubonic plague in the mid-14th century
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What % of deaths worldwide are due to degenerative diseases?
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What % of these deaths are in low and middle income countries?
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What are they mainly due to?
Unhealthy diets, physical inactivity, smoking and excessive alcohol consumption
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Expansion diffusion
The disease begins in one location and spreads across an area overtime - not limited by physical barriers
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Relocation diffusion
Begins in one location and spreads/ is carried across physical by hosts
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Contagious diffusion
Disease spreads over different regions at different impact levels
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Hierarchical diffusion
A chain reaction where a disease begins in one large connection area e.g. a big city, then spreads by movement of people, trains etc.
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Environmental physical barriers
Sea, desert, forests, mountains, cold environments
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Political barriers
Borders, conflict, immigration control
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language barriers, culture
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Hagerstrand's Diffusion model
No. of people infected by an epidemic approximates an S-shaped curve overtime - after a slow beginning, the number infected accelerates rapidly until eventually levelling as most of the susceptible population have been infected
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Infectious but non-contagious disease - transmitted to humans by mosquitoes which thrive in warm, humid environments
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How many are at risk?
3.2 billion are at risk in 97 countries
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Where is malaria absent?
Where conditions are cooler and drier - deserts, high mountains and plateaux
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Why is malaria not present in the US states bordering the Golf of Mexico and in Northern Australia?
Effective public health measures have eliminated the disease
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Infectious and contagious, spread by bodily fluids.
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How many people infected?
In 2015, 35 million infected worldwide
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Where is the largest concentration?
In Sub-Saharan Africa due to lack of contraception and education. In Swaziland - more than a quarter of the population carry the disease
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Infectious and highly contagious - associated with poverty and overcrowded living conditions
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How many cases in 2013?
nearly 9 million, with 1.5 million deaths
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What % of deaths occur in low and middle income countries?
95% - Africa has the most
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Non-communicable disease caused by a deficiency of insulin, a hormone secreted by the pancreas
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How many affected?
nearly 250 million people - responsible for nearly 4 million deaths annually
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Where is it most strongly concentrated?
North America, East and South Asia
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Difference between type-1 and type-2?
Type-1 develops in childhood and is genetic. Type-2 occurs in adulthood and is often linked to obesity, poor diet and physical inactivity
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Cardiovascular Disease (CVD)
Includes coronary heart disease, stroke, hypertension and angina. Incidence rises steeply with age so major cause of mortality in ageing populations and high-income countries
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When standardised by age, where is the highest CVD mortality rates?
Russia, sub-Saharan Africa and the Arabian peninsula
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How many deaths per year?
17 million - 80% in middle and low income countries
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What is the death linked to?
Lifestyle, particularly tobacco consumption, unhealthy diet and physical inactivity
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Influence of temperature
Many diseases e.g. malaria, whose epidemiology depends on warm, humid conditions, are endemic to the tropics and sub-tropics
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Why do diseases influenced by climate show seasonal patterns?
As temperature determines rates of vector development and viral replication
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Creates aquatic habitats such as ponds and stagnant pools, which allow insects and disease vectors to flourish e.g. cholera and worms caused by areas like slums having surface water contaminated by sewage
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Ethiopia for example has lots of disease in the lowlands but non in high altitude areas as relief changes the temperature - lower temp means less disease
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Seasonal variations in colder climates
In colder regions in the northern hemisphere, epidemics of influenza, a contagious respiratory illness, peak in the winter months as transmission is most effective at lower temps when humidity is low
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The probability of zoonotic diseases being transmitted to humans increases where:
Movement of wild animals unrestricted by physical or political barriers, controls on movement of disease domestic animals ineffective, urbanisation creates suitable habitats for foxes, raccoons and skunks, vaccination of pets and livestock sparse
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Zoonotic continued...
Limited control within urban areas, poor hygiene and sanitation (drinking water contaminated with faeces), prolonged contact between humans and animals e.g. poultry farms - avian flu, cattle farming - anthrax
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Abdel Omran's model
Describes the relationship between development and changing patterns of population age distribution, mortality, fertility, life expectancy and causes of death
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The age of Pestilence and Famine
In pre-industrial societies, mortality is high and fluctuates from year to year. Life expectancy averages around 30 years. Poor sanitation, contaminated drinking water and low standards of living make people susceptible to infectious diseases
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The age of Receding Pandemics
In industrial societies with advances in medical technology, diet and hygiene and improvements in living standards, epidemics causing large-scale mortality become rare - includes LIDCs and EDCs
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The age of Slackening Mortality (post-industrial)
Further improvements in living standards and hygiene means mortality related to infectious diseases is rare - mostly man-made
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Communicable diseases in LIDCs
Dominate mortality in world's poorest countries, undernutrition and malnutrition weakens the immune system, poor conditions like poor drainage create breeding sites (slum housing and overcrowding), geography affects prevalence - high temperature
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Non-communicable diseases in ACs
CVD and cancer dominate mortality, communicable mostly eliminated due to medical care and high standards of living, overnutrition and too much sugar increases CVD and type-2 diabetes - increasingly apparent in younger age groups
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WHO (World Health Organisation)
Established in 1948 and part of the UN system - works with organisations such as UNICEF, the World Bank and NGOs. Gather data, suggests priorities in critical health matters, researches health problems, monitors health situations, supports UN health
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The Influenza pandemic (swine flu)
In 2009, identified in Mexico and spread through North America though recorded in 74 countries. Spreads through coughing and sneezing.
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How many people were affected?
official figures state 18,000 (estimate). WHO estimates 284,500 deaths as an average. Half of all deaths were reported in Africa and the Southeast
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Physical barriers and disease
Isolate communities and restrict population movements - reduces risk of infection and the spread of disease, however may delay arrival of medical assistance and emergency aid.
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Amazon Basin Rainforest
Isolated hundreds of indigenous Indian tribes from the outside world until the mid-twentieth century world until mid-twentieth century. Contact with cattle ranchers, oil explorers and loggers pass on diseases such as influenza - fatal as no immunity
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Gorkha region of Nepal
Many settlements one or two days from main village. During 2015 earthquake settlements cut off by landslides and were without clean water and medical supplies
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When first appeared in 1980s, communities affected were so isolated in the Congo rainforest that disease was contained
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Maryland, USA
Chesapeake Bay divided state into two distinct regions which acted as a barrier to population movements, limited spread of measles in 1917-38
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Non-communicable and have a variety of causes e.g. nutritional deficiencies like rickets, lifestyle can cause heart disease, diabetes

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