Disease Prevention: An Overview

Disease prevention can be defined as measures that seek to avert the occurrence of disease (including injury), arrest its progress, and reduce its consequences once it is established. Disease prevention can be classified into levels: primordial, primary, secondary, and tertiary prevention. Preventive interventions aim at interrupting the web of causality leading to one or more aspects of ill-health. They are directed at different phases in the development of disease, aiming at eradicating, eliminating, or minimizing its impact, or if none of this is feasible, retarding the progress of disease and disability. Building on the model of disease causation this article illustrates the different levels of disease prevention and describes core strategies toward prevention, juxtaposing the high-risk strategy and the population strategy of prevention as first outlined by Geoffrey Rose. It illustrates the challenges related to disease prevention using examples of noncommunicable diseases and injuries, drawing on both successes and failures of different preventive approaches. It then discusses some fundamental aspects of prevention as they relate to ethical considerations and the evidence base of preventive intervention. The article closes with a brief reminder that decisions made outside the health-care sector can have major consequences for population health and discusses its implications for disease prevention

Homicide of children in Dar Es Salaam, Tanzania

Background: Although data are sparse, it has been estimated that the highest rates of homicide death amongst children are in Africa. Little information is available on ages 0 . 14 years. No known quantitative surveillance of early neonaticide (killed at less than one week) has been conducted previously in Africa.Methods: A Violent Death Survey following WHO/CDC Guidelines was completed in Dar es Salaam region, Tanzania (population 2.845 million) in 2005. Qualitative and quantitative data were gathered and analyzed.Results:The overall age adjusted rate of discarded and killed children in DSM was 2.05 per 100,000. The rate of early neonaticide was 27.7 per 100,000 while the rate of homicide incidence for children older than one week was 0.54 per 100,000Discussion: The overall estimated homicide rate for Africa of children under age 15 was 4.53 per 100,000. The rate in DSM was closer to the estimated global rate of 1.7 per 100,000. The results in DSM show that broad age groupings such as