why are r factors important in the treatment of infectious diseases

R 0 can be used to measure any contagious disease that may spread in a susceptible population. Some of the most highly contagious conditions are measles and the common flu. More serious conditions, such as Ebola and HIV, spread less easily between people.

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What are the environmental factors influencing infectious disease response?

The analysis results on the factors influencing infectious disease response were as follows. Legislation, sociocultural factors and disaster characteristics were identified as the environmental factors influencing disaster response.

What determines success and failure of infectious disease response?

Despite the growing interest in and the need for further research, there are only few studies on the factors that determine the success and failure of infectious disease response and the responses to administrative and policy aspects.

What is the relationship between infectious period and r 0 value?

The longer the infectious period of a disease, the more likely a person who has it can transmit the disease to other people. A long period of infectiousness will contribute to a higher R 0 value.

Why is it important to study the factors underlying disease emergence?

Knowledge of the factors underlying disease emergence can help focus resources on the key situations and areas worldwide ( 3, 4) and develop more effective prevention strategies.

Why are R factors important in the treatment of infectious diseases quizlet?

Why are R factors important in the treatment of infectious diseases? R factors represent a very serious problem when it comes to the treatment of infectious diseases with antibiotics. R factors can spread resistance to not only one enteric specie, but to multiple.

What are R plasmids and how do they contribute to the problem of antibiotic resistance?

Plasmids are small DNA circles outside the bacterial chromosome. Several antibiotic resistance genes can be present on the same plasmid. In this example, they are called res A, res B and res C. Res A gives resistance to antibiotic A, res B to antibiotic B and so on.

What is the role of R plasmids in the spread of multi drug resistance in bacteria?

Multidrug resistance in bacteria occurs by the accumulation, on resistance (R) plasmids or transposons, of genes, with each coding for resistance to a specific agent, and/or by the action of multidrug efflux pumps, each of which can pump out more than one drug type.

What is an R-factor in bacterial conjugation?

R-factor, or resistance factor, are plasmids that allow specific bacteria to gain resistance against antibiotics. They are mostly available in a set of genetic codes which can transfer themselves from one cell to another of a bacterium via means of conjugation or non-conjugation.

What is an R-factor and why is it important?

R -factor is a formula for estimating errors in a data set. It is usually the sum of the absolute difference between observed (Fo) and calculated (Fc) over the sum of the observed: (3.2) If two random data sets are scaled together, then the R-factor for acentric data is 0.59 and for centric data it is 0.83.

What is an R-factor and why are they important bacteria?

What is R-Factor? R-Factor is also called as the resistance factors or resistance plasmids. They are a group of conjugative plasmids which promotes the bacterial host resistance to specific antibiotics and to some metal ions, including sulphonamide, streptomycin, tetracycline, arsenic, cadmium, mercury, etc.

How do multi drug resistance R factors come about?

Multidrug-resistant organisms develop when antibiotics are taken longer than necessary or when they are not needed. At first, only a few bacteria may survive treatment with an antibiotic. The more often the antibiotics are used, the more likely it is that resistant bacteria will develop.

What do R plasmids contain?

R-factors are pieces of DNA, usually plasmids, that contain antibiotic resistance genes.

Why is it significant that many antibiotic resistance genes are found on the loops of DNA mini chromosomes called plasmids?

Why is it significant that many antibiotic resistance genes are found on the loops of DNA (mini-chromosomes) called plasmids? Plasmids can be passed among cells—allowing rapid spread, even between species of bacteria.

What is the meaning of R factor?

Definition of R factor : a group of genes present in some bacteria that provide a basis for resistance to antibiotics and can be transferred from cell to cell by conjugation.

What is the function of R plasmids in bacteria?

The genes on R plasmids confer resistance to antibiotics or other bacterial growth inhibitors. A bacterium with an R plasmid for penicillin resistance is able to survive treatment by that antibiotic. R plasmids can also carry the tra genes that allow the plasmid to be spread from cell to cell.

What are R determinants?

determinant is a generic function that returns separately the modulus of the determinant, optionally on the logarithm scale, and the sign of the determinant.

How to stop transmission of infection?

For example, wash your hands regularly with soap and water, especially before you prepare or eat food.

What happens if you have an R 0 of 18?

For example, if a disease has an R 0 of 18, a person who has the disease will transmit it to an average of 18 other people. That replication will continue if no one has been vaccinated against the disease or is already immune to it in their community.

Which disease is transmitted the fastest and easiest?

The diseases that are transmitted the fastest and easiest are the ones that can travel through the air, such as the flu or measles.

Which has a higher R 0?

Airborne illnesses tend to have a higher R 0 value than those spread through direct contact.

Is it rare to have a combination of diseases?

This combination of conditions is rare nowadays thanks to advances in medicine. Many diseases that were deadly in the past can now be contained and sometimes cured.

How to get rid of infectious diseases?

Many infectious diseases, such as colds, will resolve on their own. Drink plenty of fluids and get lots of rest.

Why are antibiotics so hard to treat?

The overuse of antibiotics has resulted in several types of bacteria developing resistance to one or more varieties of antibiotics. This makes these bacteria much more difficult to treat.

What are the causes of malaria?

Some diseases, including malaria, are caused by tiny parasites. While there are drugs to treat these diseases, some varieties of parasites have developed resistance to the drugs.

What doctor treats lung infections?

For example, a dermatologist specializes in skin conditions, and a pulmonologist treats lung disorders.

Can antibiotics be used on certain bacteria?

Certain types of bacteria are especially susceptible to particular classes of antibiotics. Treatment can be targeted more precisely if your doctor knows what type of bacteria you're infected with.

Can you take antifungal medication for a fungal infection?

Some fungal infections, such as those affecting the lungs or the mucous membranes, can be treated with an oral antifungal. More-severe internal organ fungal infections, especially in people with weakened immune systems, may require intravenous antifungal medications.

What are the factors that determine the causation of an infectious disease?

A classic model of infectious disease causation, the epidemiological triad (Snieszko, 1974), envisions that an infectious disease results from a combination of agent (pathogen), host, and environmental factors (Figure 1). Infectious agents may be living parasites (helminths or protozoa), fungi, or bacteria, or nonliving viruses or prions. Environmental factors determine if a host will become exposed to one of these agents, and subsequent interactions between the agent and host will determine the exposureoutcome. Agent and host interactions occur in a cascade of stages that include infection, disease, and recovery or death (Figure 2(a)). Following exposure, the first step is often colonization, the adherence and initial multiplication of a disease agent at a portal of entry such as the skin or the mucous membranes of the respiratory, digestive, or urogenital tract. Colonization, for example, with methicillin-resistant Staphylococcus aureusin the nasal mucosa, does not cause disease in itself. For disease to occur, a pathogen must infect(invade and establish within) host tissues. Infectionwill always cause some disruption within a host, but it does not always result in disease. Diseaseindicates a level of disruption and damage to a host that results in subjective symptomsand objective signsof illness. For example, latent TB infection is only infection – evidenced by a positive tuberculin skin test or interferon gamma release assay – but with a lack of symptoms (e.g., cough or night sweats) or signs (e.g., rales on auscultation of the chest) of disease. This is in contrast to active pulmonary TB (disease), which is accompanied by disease symptoms and signs.

What are the principles of infectious disease?

Principles of Infectious Diseases: Transmission, Diagnosis, Prevention, and Control

What is an infectious disease?

An infectious diseasecan be defined as an illness due to a pathogen or its toxic product, which arises through transmission from an infected person, an infected animal, or a contaminated inanimate object to a susceptible host. Infectious diseases are responsible for an immense global burden of disease that impacts public health systems and economies worldwide, disproportionately affecting vulnerable populations. In 2013, infectious diseases resulted in over 45 million years lost due to disability and over 9 million deaths (Naghavi et al., 2015). Lower respiratory tract infections, diarrheal diseases, HIV/AIDS, malaria, and tuberculosis (TB) are among the top causes of overall global mortality (Vos et al., 2015). Infectious diseases also include emerging infectious diseases; diseases that have newly appeared (e.g., Middle East Respiratory Syndrome) or have existed but are rapidly increasing in incidence or geographic range (e.g., extensively drug-resistant tuberculosis (XDR TB) and Zika virus (Morse, 1995). Infectious disease control and prevention relies on a thorough understanding of the factors determining transmission. This article summarizes some of the fundamental principles of infectious disease transmission while highlighting many of the agent, host, and environmental determinants of these diseases that are of particular import to public health professionals.

What are the potential outcomes of host exposure to an infectious agent?

(a) Following an exposure, the agent and host interact in a cascade of stages the can result in infection, disease, and recovery or death. (b) Progression from one stage to the next is dependent upon both agent properties of infectivity, pathogenicity, and virulence, and host susceptibility to infection and disease, which is in large part due to both protective and adverse effects of the host immune response.

What is the epidemiological triad model?

The epidemiological triad model of infectious disease causation . The triad consists of an agent (pathogen), a susceptible host, and an environment (physical, social, behavioral, cultural, political, and economic factors) that brings the agent and host together, causing infection and disease to occur in the host.

What are the environmental factors that affect vulnerability?

Environmental determinants of vulnerability to infectious diseases include physical, social, behavioral, cultural, political, and economic factors. In some cases, environmental influences increase risk of exposure to an infectious agent. For example, following an earthquake, environmental disruption can increase the risk of exposure to Clostridium tetaniand result in host traumatic injuries that provide portals of entry for the bacterium. Environmental factors promoting vulnerability can also lead to an increase in susceptibility to infection by inducing physiological changes in an individual. For example, a child living in a resource-poor setting and vulnerable to malnutrition may be at increased risk of infection due to malnutrition-induced immunosuppression. Table 2provides examples of some of the many environmental factors that can facilitate the emergence and/or spread of specific infectious diseases.

What are the components of an innate immune response?

The innate immune response is an immediate, nonspecific response to broad groups of pathogens. By contrast, the adaptive immune response is initially generated over a period of 3–4 days, it recognizes specific pathogens, and it consists of two main branches: (1) T cell-mediated immunity (a.k.a. cell-mediated immunity) and (2) B cell-mediated immunity (a.k.a. humoral or antibody-mediated immunity). The innate and adaptive responses also differ in that the latter has memory, whereas the former does not. As a consequence of adaptive immune memory, if an infectious agent makes a second attempt to infect a host, pathogen-specific memory T cells, memory B cells, and antibodies will mount a secondary immune response that is much more rapid and intense than the initial, primary response and, thus, better able to inhibit infection and disease. Immune memory is the basis for the use of vaccinesthat are given in an attempt to stimulate an individual's adaptive immune system to generate pathogen-specific immune memory. Of note, in some cases the response of the immune system to an infectious agent can contribute to disease progress. For example, immunopathology is thought to be responsible for the severe acute disease that can occur following infection with a dengue virus that is serotypically distinct from that causing initial dengue infection (Screaton et al., 2015).

How to prevent bacterial infection?

Wash your hands often. Washing with regular soap and rinsing with running water, followed by thorough drying, is considered the most important way to prevent disease transmission. Routine consumer use of residue-producing antibacterial products, such as those containing the chemical triclosan, have not been proven to confer health benefits and may actually contribute to antibiotic resistance.

How do antibiotics help with infections?

They either kill bacteria or stop them from reproducing, allowing the body’s natural defenses to eliminate the pathogens. Used properly, antibiotics can save lives. But growing antibiotic resistance is curbing the effectiveness of these drugs. Taking an antibiotic as directed, even after symptoms disappear, is key to curing an infection and preventing the development of resistant bacteria.

Why are antiviral drugs so difficult to develop?

These medicines have been much more difficult to develop than antibacterial drugs because antivirals can damage host cells where the viruses reside. Today, there are more antiviral drugs for HIV than for any other viral disease, transforming an infection that was once considered a death sentence into a manageable chronic condition. But novel drugs are needed to combat other epidemic viral infections, such as influenza and hepatitis B and C.

What is the purpose of the Cures Acceleration Network?

Department of Health and Human Services recently formed the Biomedical Advanced Research and Development Authority, which provides an integrated, systematic approach to the development and purchase of the vaccines, drugs, therapies, and diagnostic tools necessary for public health medical emergencies. The Cures Acceleration Network provision of the Patient Protection and Affordable Care Act, signed into law by President Obama in March 2010, is designed to move research discoveries through to safe and effective therapies by awarding grants through the National Institutes of Health to biotech companies, universities, and patient advocacy groups. And nonprofit organizations dedicated to accelerating the discovery and clinical development of new therapies to treat infectious diseases are bringing together philanthropists, medical research foundations, industry leaders, and other key stakeholders to forge effective collaborations.

Why are antibiotics not profitable?

Major pharmaceutical companies have limited interest in dedicating resources to the antibiotics market because these short-course drugs are not as profitable as drugs that treat chronic conditions and lifestyle-related ailments, such as high blood pressure or high cholesterol. Antibiotic research and development is also expensive, risky, and time consuming. Return on that investment can be unpredictable, considering that resistance to antibiotics develops over time, eventually making them less effective.

Is infectious disease a fact of life?

Infectious disease may be an unavoidable fact of life, but there are many strategies available to help us protect ourselves from infection and to treat a disease once it has developed.

Can you use antibiotics for a virus?

Use antibiotics only for infections caused by bacteria. Viral infections cannot be treated with antibiotics. Your doctor may prescribe an antiviral medication if your condition warrants it.

What causes emerging infections?

Most emerging infections appear to be caused by pathogens already present in the environment , brought out of obscurity or given a selective advantage by changing conditions and afforded an opportunity to infect new host populations (on rare occasions, a new variant may also evolve and cause a new disease) ( 2, 4 ).

How can we protect ourselves from emerging diseases?

If we are to protect ourselves against emerging diseases, the essential first step is effective global disease surveillance to give early warning of emerging infections ( 3, 12, 13, 56 ). This must be tied to incentives, such as national development, and eventually be backed by a system for an appropriate rapid response. World surveillance capabilities are critically deficient ( 12, 56, 57 ). Efforts, such as the CDC plan (13), now under way in the United States and internationally to remedy this situation are the essential first steps and deserve strong support. Research, both basic and applied, will also be vital.

What are emerging infectious diseases?

"Emerging" infectious diseases can be defined as infections that have newly appeared in a population or have existed but are rapidly increasing in incidence or geographic range. Among recent examples are HIV/AIDS, hantavirus pulmonary syndrome, Lyme disease, and hemolytic uremic syndrome (a foodborne infection caused by certain strains of Escherichia coli ). Specific factors precipitating disease emergence can be identified in virtually all cases. These include ecological, environmental, or demographic factors that place people at increased contact with a previously unfamiliar microbe or its natural host or promote dissemination. These factors are increasing in prevalence; this increase, together with the ongoing evolution of viral and microbial variants and selection for drug resistance, suggests that infections will continue to emerge and probably increase and emphasizes the urgent need for effective surveillance and control. Dr. David Satcher's article#N#External Link#N#and this overview inaugurate Perspectives, a regular section in this journal intended to present and develop unifying concepts and strategies for considering emerging infections and their underlying factors. The editors welcome, as contributions to the Perspectives section, overviews, syntheses, and case studies that shed light on how and why infections emerge, and how they may be anticipated and prevented.

Why is water important for diseases?

Infections transmitted by mosquitoes or other arthropods, which include some of the most serious and widespread diseases ( 18, 19 ), are often stimulated by expansion of standing water, simply because many of the mosquito vectors breed in water . There are many cases of diseases transmitted by water-breeding vectors, most involving dams, water for irrigation, or stored drinking water in cities. (See Changes in Human Demographics and Behavior for a discussion of dengue.) The incidence of Japanese encephalitis, another mosquito-borne disease that accounts for almost 30,000 human cases and approximately 7,000 deaths annually in Asia, is closely associated with flooding of fields for rice growing. Outbreaks of Rift Valley fever in some parts of Africa have been associated with dam building as well as with periods of heavy rainfall (19). In the outbreaks of Rift Valley fever in Mauritania in 1987, the human cases occurred in villages near dams on the Senegal River. The same effect has been documented with other infections that have aquatic hosts, such as schistosomiasis.

What causes disease emergence?

Surprisingly often, disease emergence is caused by human actions, however inadvertently; natural causes, such as changes in climate, can also at times be responsible (6). Although this discussion is confined largely to human disease, similar considerations apply to emerging pathogens in other species.

What is the process by which infectious agents may transfer from animals to humans or disseminate from isolated groups into?

The process by which infectious agents may transfer from animals to humans or disseminate from isolated groups into new populations can be called microbial traffic ( 3, 4 ). A number of activities increase microbial traffic and as a result promote emergence and epidemics.

How does human behavior affect disease?

Human behavior can have important effects on disease dissemination . The best known examples are sexually transmitted diseases, and the ways in which such human behavior as sex or intravenous drug use have contributed to the emergence of HIV are now well known.

How to determine infectious disease?

An infectious disease diagnosis is reached by determining the site of infection, defining the host (eg, immunocompromised, diabetic, of advanced age), and establishing , when possible, a microbiological diagnosis. It is critical to isolate the specific pathogen in many serious, life-threatening infections, especially for situations that are likely to require prolonged therapy (eg, endocarditis, septic arthritis, disk space infection, and meningitis). Similarly, when a patient does not benefit from antimicrobial therapy chosen on the basis of clinical presentation, additional investigations are needed to determine the etiologic agent or exclude noninfectious diagnoses. To optimize an accurate microbiological diagnosis, clinicians should ensure that diagnostic specimens are properly obtained and promptly submitted to the microbiology laboratory, preferably before the institution of antimicrobial therapy. Infectious disease diagnoses also frequently rely on a detailed exposure history, as in the case of a patient with nonresolving pneumonia who has resided in or traveled to the southwestern United States where coccidioidomycosis is endemic. Although the microbiological diagnosis is ideally based on data such as bacterial or fungal culture or serologic testing, frequently the “most likely” microbiological etiology can be inferred from the clinical presentation. For example, cellulitis is most frequently assumed to be caused by streptococci or staphylococci, and antibacterial treatment can be administered in the absence of a positive culture. Similarly, community-acquired pneumonia that does not warrant hospitalization can also be treated empirically—with a macrolide or fluoroquinolone antibiotic—without performing specific diagnostic testing. 2 Finally, noninfectious conditions should be considered in the differential diagnosis for infections, especially when the diagnosis is not clear-cut.

Why is it important to know how well antimicrobials are working?

Renal and Hepatic Function. Because the kidney and the liver are the primary organs responsible for elimination of drugs from the body, it is important to determine how well they are functioning during antimicrobial administration. In most cases, one is concerned with dose reduction to prevent accumulation and toxicity in patients with reduced renal or hepatic function. However, sometimes doses might need to be increased to avoid underdosing young healthy patients with rapid renal elimination or those with rapid hepatic metabolism due to enzyme induction by concomitant use of drugs such as rifampin or phenytoin.

What is antimicrobial therapy?

Antimicrobial agents are some of the most widely, and often injudiciously, used therapeutic drugs worldwide. Important considerations when prescribing antimicrobial therapy include obtaining an accurate diagnosis of infection; understanding the difference between empiric and definitive therapy; identifying opportunities to switch ...

What is AST in microbiology?

When a pathogenic microorganism is identified in clinical cultures, the next step performed in most microbiology laboratories is antimicrobial susceptibility testing (AST). Antimicrobial susceptibility testing measures the ability of a specific organism to grow in the presence of a particular drug in vitro and is performed using guidelines established by the Clinical and Laboratory Standards Institute, 7 a nonprofit global organization that develops laboratory process standards through extensive testing and clinical correlation. The goal of AST is to predict the clinical success or failure of the antibiotic being tested against a particular organism. Data are reported in the form of minimum inhibitory concentration (MIC), which is the lowest concentration of an antibiotic that inhibits visible growth of a microorganism, and are interpreted by the laboratory as “susceptible,” “resistant,” or “intermediate,” according to Clinical and Laboratory Standards Institute criteria. A report of “susceptible” indicates that the isolate is likely to be inhibited by the usually achievable concentration of a particular antimicrobial agent when the recommended dosage is used for the particular site of infection. For this reason, MICs of different agents for a particular organism are not directly comparable. For example, MICs of 1 (susceptible) for ciprofloxacin and 2 (susceptible) for ceftriaxone against Escherichia coli do not imply that ciprofloxacin is twice as active as ceftriaxone. Instead, it indicates that concentrations achieved by giving recommended doses of both drugs are likely to be active against the organism. Although AST results are generally quite useful in narrowing the antibiotic regimen, AST has some limitations that should be kept in mind. First, it is important for both clinicians and laboratory personnel to be aware of the site of infection. For example, an isolate of S aureus could be reported as susceptible to cefazolin in vitro; however, if this particular isolate was obtained from the cerebrospinal fluid (CSF), cefazolin would not be an optimal therapeutic choice because it does not achieve therapeutic concentrations in the CSF. Clinical laboratories may provide different AST interpretations for different sites of infection (eg, meningitis and nonmeningitis AST results for S pneumoniae ). In addition, some organisms carry enzymes that, when expressed in vivo, can inactivate antimicrobial agents to which the organism shows in vitro susceptibility. Although their presence is not immediately apparent from AST results, certain AST “patterns” can provide a clue to their existence. For example, extended-spectrum β-lactamases (ESBLs) in Enterobacteriaceae are enzymes that mediate resistance to almost all β-lactam agents except carbapenems (eg, meropenem or imipenem). Extended-spectrum β-lactamases can be difficult to detect because they have different levels of in vitro activity against various cephalosporins. In clinical practice, susceptibility to cephamycins (cefoxitin, cefotetan) but resistance to a third-generation cephalosporin (eg, cefpodoxime, cefotaxime, ceftriaxone, ceftazidime) or aztreonam should alert one to the possibility of ESBL production. The production of ESBL should also be suspected when treatment with β-lactams fails despite apparent in vitro susceptibility. This should lead to additional testing, which usually involves growing the bacteria in the presence of a third-generation cephalosporin alone and in combination with clavulanic acid (a β-lactamase inhibitor); enhanced bacterial inhibition with the addition of clavulanic acid indicates ESBL. When detected by the laboratory, these bacteria should be considered resistant to all β-lactam agents except the carbapenem class.

How to extend the antimicrobial spectrum?

To Extend the Antimicrobial Spectrum Beyond That Achieved by Use of a Single Agent for Treatment of Polymicrobial Infections. When infections are thought to be caused by more than one organism, a combination regimen may be preferred because it would extend the antimicrobial spectrum beyond that achieved by a single agent. For example, most intra-abdominal infections are usually caused by multiple organisms with a variety of gram-positive cocci, gram-negative bacilli, and anaerobes. Antimicrobial combinations, such as a third-generation cephalosporin or a fluoroquinolone plus metronidazole, can be used as a potential treatment option in these cases and can sometimes be more cost-effective than a comparable single agent (eg, a carbapenem).

Why are gram positive bacteria endemic?

They are commonly caused by drug-resistant organisms, both gram-positive (eg, methicillin-resistant Staphylococcus aureus[MRSA]) and gram-negative (eg, Pseudomonas aeruginosa) bacteria, which are often endemic in hospitals because of the selection pressure from antimicrobial use.

When critically ill patients require empiric therapy?

When Critically Ill Patients Require Empiric Therapy Before Microbiological Etiology and/or Antimicrobial Susceptibility Can Be Determined. As already discussed, antibiotic combinations are used in empiric therapy for health care–associated infections that are frequently caused by bacteria resistant to multiple antibiotics. Combination therapy is used in this setting to ensure that at least 1 of the administered antimicrobial agents will be active against the suspected organism (s). For example, when a patient who has been hospitalized for several weeks develops septic shock and blood cultures are reported to be growing gram-negative bacilli, it would be appropriate to provide initial therapy with 2 agents that have activity against gram-negative bacilli, particularly P aeruginosa, which is both a common nosocomial pathogen and frequently resistant to multiple agents—in this case, a combination of an antipseudomonal β-lactam with a fluoroquinolone or aminoglycoside could be used.

Who develops consensus on the priority and justification for the disease?

Consensus on the priority and justification for the disease must be developed by technical experts, the decision-makers, and the scientific community.

When did the Dahlem Workshop on the Eradication of Infectious Diseases take place?

With this background, the Dahlem Workshop on the Eradication of Infectious Diseases was held in March 1997 (2).

How are disease elimination and eradication programmes different from ongoing health or disease control programmes?

Disease elimination and eradication programmes can be distinguished from ongoing health or disease control programmes by the urgency of the elimination and eradication programmes and the requirement for targeted surveillance, rapid response capability, high standards of performance, and a dedicated focal point at the national level. Eradication and ongoing programmes constitute potentially complementary approaches to public health. There are areas of potential overlap, conflict and synergy that must be recognized and addressed. In many cases the problem is not that eradication activities function too well but that primary health care activities do not function well enough. Efforts are needed to identify and characterize those factors responsible for improved functioning of eradication campaigns, and then apply them to primary health.

What is the ultimate goal of public health?

Elimination and eradication are the ultimate goals of public health, evolving naturally from disease control. The basic question is whether these goals are to be achieved in the present or some future generation. Introduction.

What were the effects of the malaria, yellow fever, and yaws eradication programmes of earlier years?

Although the malaria, yellow fever, and yaws eradication programmes of earlier years were unsuccessful, they contributed greatly to a better understanding of the biological, social, political, and economic complexities of achieving the ultimate goal in disease control.

Why is eradication important?

There must be specific reasons for eradication. The demands for sustained support, high quality performance, and perseverance in an eradication programme increase the risks of failure, with a consequent significant loss of credibility, resources, and health workers' self-confidence.

Why is disease eradication so difficult?

At the same time, however, their implementation is extraordinarily difficult because of the unique global and time-driven operational challenges.

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