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应急时期与水和卫生关联的疾病 Introduction to WASH-related diseases in Emergencies 模块1-第2节 健康 Health
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什么是健康 What is health? 世界卫生组织将健康定义为: 健康不仅是身体没有病或身体虚弱,还要有完整的生理、心理状态和 社会适应能力 World Health Organization defines health as: “ Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity ” 世界卫生组织还提出: 获得高度健康的幸福感是每个人最基本的权利,这种权利不应因个人 种族、宗教信仰、政治信念、经济或社会地位的不同而不同 。 ” WHO constitution also mentions: “ The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition ”
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应急时期的卫生 Health in Emergencyy.应急时期的公共卫生也可以成为一种自然灾难,其可以引起高概 率的人员伤亡。 “Public Health in Emergency ”, is a natural disaster that poses a high probability of a large number of deaths or harm to a population -应急时期的卫生(处理灾难中与卫生有关的事宜) Health in Emergencies (deals with health in disasters) -紧急卫生事件(流行病) Health Emergencies (epidemics)
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灾难产生的后果 Consequences of Disasters 人员、牲畜伤亡Severe injuries, deaths 房屋损坏或损毁Loss/damage to shelters 财产损失Loss of properties 爆发疾病Disease outbreaks 食物短缺Food Shortages 大量人员转移Large population displacement 与健康有关的基础设施需求超负荷Load on health infrastructure 水、卫生设施需求超负荷Load on water sanitation 营养需求超负荷Load on nutrition
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各种灾难对人类健康造成的后果 Health Impact of different disasters 受伤 Injuries 疾病传播(水生疾病、食物传播的疾病、虫媒传播的疾病)腹泻、霍乱 、伤寒、疟疾、结核病 Disease epidemics (water-borne, food-borne, vector-borne) – Diarrhea, Cholera, Typhoid Fever, Malaria, Tuberculosis … 应急时期,与特定人群有关的具体健康问题 Population specific health issues in emergencies 小于5岁的孩子、老年人、残疾人 < 5 y/o children; elderly; physically challenged 急性呼吸道感染、麻疹、缺乏维生素A、营养不良、生殖健康、艾滋病毒 /艾滋病 ARI, Measles, Vit.A deficiency, malnutrition, reproductive health, HIV/AIDS 精神压力 Psychological stress 其他 —— 蛇咬伤,狗咬伤、皮肤疾病 Others-snake-bites, dog bites, skin diseases
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可增加疾病严重性的要素 Factors contributing to Disaster Severity 贫穷和社会不平等造成了人们的易受灾性 Human vulnerability due to poverty and social inequality 环境恶化 Environmental degradation 快速的人口增长,尤其是贫困家庭人口的快速增长 Rapid population growth especially among the poor 人口密度增加 Increasing population density 更多的人定居在高风险区域 Increased settlement in high-risks areas 增加的技术性灾害和依赖性 Increased technological hazards and dependency
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可使疾病增多的要素 Factors that can increases to Diseases 水质差 Poor water -用于卫生方面的水的数量非常有限 Limited quantity of water for hygiene purposes -水质差 Poor quality water 卫生设施差 Poor sanitation -排泄物处置设施的设立和维护不足或不当 Lack/absence of sufficient or appropriate and well-maintained excreta disposal facilities -缺少垃圾收集体系,排水不畅,有死水 Lack of refuse collection, blocked drainage, standing water -虫媒控制不足(如:蚊、蝇、跳蚤、虫、鼠) Inadequate control of vectors (e.g. mosquitoes, flies, fleas, insects & rodents
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可使疾病增多的要素 Factors that can increases to Diseases 房屋质量和排水设施差 Poor Housing and Drainage 房屋条件差,拥挤-Poor, over-crowded housing -排水设施不足 Inadequate drainage systems 缺少有关的知识、习惯差 Poor knowledge and practice -卫生知识不足 Poor level of hygiene understanding -卫生习惯差(脏手导致食物污染) Poor hygiene practice (food contamination from soiled hands)
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水 传 疾病 Water-borne diseases- 通过饮用含有病原体的水而进行传播:如:霍乱、伤寒、腹泻、 痢疾、传染性肝炎 transmitted through drinking water which contains pathogen e.g. cholera, typhoid, diarrheas, dysenteries and infectious hepatitis
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用水带来的疾病 Water-washed diseases 其由病原体引起,可以通过改善个人卫生(主要指水的数量而非 水的质量)来预防其传播 caused by pathogens whose transmission can be prevented by improving personal hygiene-water quantity rather than water quality 类型:-该疾病与某些媒介物引起的皮肤或眼睛传染病的粪便至口感 染路径有关 Types diseases associated with the faecal-oral route-infections of the skin or eyes-infections caused by some vectors
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水媒疾病 Water-based diseases 病原体部分生命周期在水中完成 pathogen spends parts of its lifecycle in the water 通常在蜗牛或其他水生动物中,都是由寄生虫引起的。病原体通 常从感染者的尿液和粪便进入水中 usually in a snail or other aquatic animal. -all caused by parasitic worms-pathogens usually enter the water from faeces and urine of infected persons
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食物引发的疾病 Food-borne illnesses 当可导致疾病发生的介质通过食物进入身体时则会引发 有关的疾病 result when disease-causing agents enter the body through food;
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水媒昆虫疾病 Vector Borne 由昆虫传播的疾病。虫类在脏水中或其附近繁殖,通过载体(如 蚊子,苍蝇,虱子)传播疾病 diseases carried by insects that breed in or near dirty water-transmitted through vectors (e.g. mosquito, fly, lice)
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腹泻 Diarrhea 通常出现肠胃感染的症状 It is usually a symptom of gastrointestinal infection. 严重腹泻会导致体内液体流失,并可能危及生命,尤其是对儿童和营 养不良或免疫功能受损的人更是如此。 Severe diarrhea leads to fluid loss, and may be life-threatening, particularly in young children and people who are malnourished or have impaired immunity. 1. 感染:大多数细菌、病毒和寄生生物的寄主散布在被粪便污染的水 中。一旦缺乏洁净的水饮用、烹饪、清洗,感染腹泻的病例则更多 Infection:a host of bacterial, viral and parasitic organisms, most of which are spread by feces- contaminated water. Infection is more common when there is a shortage of clean water for drinking, cooking and cleaning. 在发展中国家,轮状病毒和大肠杆菌是引起腹泻最常见的原因。 Rotavirus and Escherichia coli-two most common causes of diarrhea in developing countries. 2..营养不良:那些死于腹泻的孩子常常存在营养不良的问题。营养不 良使得他们更容易感染腹泻 Malnutrition:Children who die from diarrhea often suffer from underlying malnutrition, which makes them more vulnerable to diarrhea
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腹泻 Diarrhea 传播模式 Mode of transmission 摄入了受污染的食物或水,或由于不良卫生习惯导致的人与人之 间的疾病传播 Ingestion of contaminated food and water, or from person to person as a result of poor hygiene. 症状 Signs and symptoms .腹泻至少每天3次,或根据个人情况超过正常范围的次数 Passage of loose or liquid stools at least 3x a day, or more frequently than is normal for the individua l 过度口渴 Excessive thirst 囟门凹陷 Sunken fontanels
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腹泻 Diarrhea 即时处置 Immediate Treatment 口服补液、米汤,以补充流失的水分 Give Oral Rehydration Solution (ORESOL), rice soup (am) to replace lost body fluid 继续进食 Continue feeding 咨询健康员有关脱水的迹 象 Consult a health worker for signs of dehydration 预防和控制 Prevention and control 改善饮用水质量 Improve access to safe drinking water 改善卫生设施的条件 Improve sanitary conditions 养成个人良好的卫生习惯和食品卫生习惯 Good personal and food hygiene 开展有关疾病传播的健康教育 Health Education on how infections spread
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减少腹泻发病率( % ) Reduction in diarrhoea morbidity (%)
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霍乱 Cholera 病原体 Causativeagent 细菌(霍乱弧菌 ) Bacteria(VibrioCholera) 传播模式 Modeoftransmission 摄入了被粪便污染的食物或水 Eatingoffoodordrinkingwatercontaminatedbyfeacalwastes 症状 Signsandsymptoms 突然发起的频繁的无痛性腹泻,一天至少3次 Sudden on set of frequent painless watery stool at least 3xaday 呕吐 Vomiting 快速脱水(眼球凹陷,皮肤干燥、皱巴巴的) Rapid dehydration (sunken eyeballs, wrinkled dry skin)
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霍乱 Cholera 即时治疗 Immediate Treatment: 通过口服补液补充水分 Replace lost body fluid by giving Oral Rehydration Solution (ORESOL) 如果症状持续,应送病人就近医治 If symptoms persist, bring the patient to a nearest health facility 预防和控制 Prevention and control- 改善饮用水,如果在水源或水处理方面没有保障,应将水煮沸后使用 Improve access to safe drinking water. Practice boiling of water if unsure of the source and handling 水加氯 Do water chlorination 剩余食物加盖保存 Practice food safety by covering left over foods for future consumption 正确的清洗和烹饪食物 Wash and cook food properly 卫生处理人类排泄物 Sanitary disposal of human wastes -正确使用厕所Use toilet properly 保持周围环境卫生,防止垃圾成堆,蚊蝇虫鼠繁殖 Keep surroundings free from rubbish to prevent flies and other insects and rodents from breeding 多洗手 Practice Hand-Washing
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伤寒 Typhoid fever 病原体 Causative Agent 细菌(伤寒沙门氏菌 ) Bacteria (Salmonella Typhi) 传播模式 Mode of transmission 摄入了受污染的食物或水 Ingesting contaminated food and/or water 症状 Signs and symptoms 持续高烧 Sustained high fever 头痛 Headache 精神萎靡不振 Malaise 厌食 Anorexia 腹泻或便秘,腹部不适 Diarrhea or constipation and abdominal discomfort
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伤寒 Typhoid 预防和控制 Prevention and Control 改善饮用水。如果在水源或水处理方面没有保障,应将水煮沸饮 用 Improve access to safe drinking water. Practice boiling of water if unsure of the source and handling 水加氯处理 Do water chlorination 注意食品安全。剩下的食物应加盖保存,以便再次食用 Practice food safety by covering left over foods for future consumption 正确的清洗和烹饪食物 Wash and cook food properly
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螺旋体病 Leptospirosis 病原体 Causative Agent -细菌(钩端螺旋体 ) Bacteria (Leptospira interogans) 传播模式 Mode of transmission -接触了被携带传染源的尿液污染的水 Contact with water contaminated with bacteria-infected urine 症状 Signs and symptoms 早期 Early Stages - 严重头疼Severe headache -发高烧High Fever -眼红Redness in the eyes -肌肉痛(腿部肌肉和背部肌肉痛)Muscle Pains (calf and back muscles) -易疲劳Fatigue -恶心-Nausea -腹痛Abdominal pain -黄疸高Jaundice
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螺旋体病 Leptospirosis 管理和治疗 Management and treatment 大量抗生素,如青霉素、盘尼西林、链霉素,应由医生合理开处方 Wide range of antibiotic e.g. doxycycline, penicillin or streptomycin duly prescribed by a physician 早期识别和治疗前两天的病情,可防止出现钩端螺旋体病的病发 症 Early recognition and treatment within last 2 days of illness to prevent complications of leptospirosis 预防和控制 Prevention and Control 避免直接或间接接触动物尿液(如:发洪水时,避免从水中趟过)Avoidance to direct and indirect contact with animal urine (e.g. wading in flood water) 使用橡胶防水鞋和手套Use of rubber boots and gloves 下肢受刀伤或擦伤时,应在伤口使用抗菌软膏或聚合碘In cases of cuts and abrasions on lower extremities, antiseptic ointment or betadine should be applied before and after exposure 正确排放污水Drain potentially contaminated water 控制啮齿动物 Control of rodents 保持环境卫生 Maintain cleanliness of surroundings
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