IAPSM's Textbook of COMMUNITY MEDICINE
IAPSM's Textbook of COMMUNITY MEDICINE
Editor-in-Chief
AM Kadri
Department of Community Medicine PDU Government Medical College Rajkot, Gujarat, India
Editors
Rashmi Kundapur
Department of Community Medicine KS Hegde Medical Academy Mangaluru, Karnataka, India
Amir Maroof Khan
Department of Community Medicine UCMS and GTB Hospital Delhi, India
Rakesh Kakkar
Department of Community and Family Medicine All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
Associate Editors
Ankit Sheth
Department of Community Medicine PDU Government Medical College Rajkot, Gujarat, India
Nidhi Mangrola
Department of Community Medicine PDU Government Medical College Rajkot, Gujarat, India
Foreword
Anil J Purty
Jaypee Brothers Medical Publishers (P) Ltd
Headquarters
Jaypee Brothers Medical Publishers (P) Ltd
4838/24, Ansari Road, Daryaganj
New Delhi 110 002, India
Phone: +91-11-43574357
Fax: +91-11-43574314
Email: jaypee@jaypeebrothers.com
Overseas Offices
J.P. Medical Ltd
83 Victoria Street, London
SW1H 0HW (UK)
Phone: +44 20 3170 8910
Fax: +44 (0)20 3008 6180
Email: info@jpmedpub.com
Jaypee Brothers Medical Publishers (P) Ltd
Bhotahity, Kathmandu, Nepal
Phone: +977-9741283608
Email: kathmandu@jaypeebrothers.com
Jaypee-Highlights Medical Publishers Inc
City of Knowledge, Bld. 235, 2nd Floor
Clayton, Panama City, Panama
Phone: +1 507-301-0496
Fax: +1 507-301-0499
Email: cservice@jphmedical.com
Jaypee Brothers Medical Publishers (P) Ltd
Bhotahity, Kathmandu, Nepal
Phone: +977-9741283608
Email: kathmandu@jaypeebrothers.com
Website: www.jaypeebrothers.com
Website: www.jaypeedigital.com
© 2019, Jaypee Brothers Medical Publishers
The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book.
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers.
All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.
Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought.
Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity. The CD/DVD-ROM (if any) provided in the sealed envelope with this book is complimentary and free of cost. Not meant for sale.
Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com
IAPSM's Textbook of Community Medicine
First Edition: 2019
9789352709946
Printed at
REVIEWERS
- A Bhagyalaxmi
- BJ Medical College
- Ahmedabad, Gujarat, India
- Anand Krishnan
- All India Institute of Medical Sciences
- New Delhi, India
- Anjali Mall
- BJ Medical College
- Ahmedabad, Gujarat, India
- AP Kulkarni
- Government Medical College
- Aurangabad, Maharashtra, India
- Ashwatha Narayan
- Kempegowda Institute of
- Medical Sciences
- Bengaluru, Karnataka, India
- Bishan S Garg
- Dr Sushila Nayar School of Public Health
- Mahatma Gandhi Institute
- of Medical Sciences
- Wardha, Maharashtra, India
- Deepak Saxena
- Indian Institute of Public Health
- Gandhinagar, Gujarat, India
- Devendra Gaur
- Gandhi Medical College
- Bhopal, Madhya Pradesh, India
- Dhrubajyoti Debnath
- All India Institute of Medical Sciences
- Mangalagiri, Andhra Pradesh, India
- Harivansh Chopra
- LLRM Medical College
- Meerut, Uttar Pradesh, India
- Lalit Sankhe
- Grant Medical College
- Mumbai, Maharashtra, India
- Manju Toppo
- Gandhi Medical College
- Bhopal, Madhya Pradesh, India
- Najam Khalique
- JN Medical College
- Aligarh Muslim University
- Aligarh, Uttar Pradesh, India
- Narayan Gaonkar
- United Nations International Children's Emergency Fund (UNICEF)
- India
- Niraj Pandit
- SBKS Medical Institute and Research Center
- Sumandeep Vidyapeeth
- Vadodara, Gujarat, India
- PV Kotecha
- Asian Pacific Community in Action
- Phoenix, Arizona, USA
- Rajesh Kumar
- Gandhi Medical College
- Bhopal, Madhya Pradesh, India
- RB Jain
- Postgraduate Institute of Medical Sciences
- Rohtak, Haryana, India
- Sairu Philip
- Government TD Medical College
- Alappuzha, Kerala, India
- Sanjiv Kumar
- International Institute of
- Health Management Research
- New Delhi, India
- Sheetal Vyas
- AMC MET Medical College
- Ahmedabad, Gujarat, India
- Sonal Shah Parikh
- Smt. NHL Municipal Medical College
- Ahmedabad, Gujarat, India
- Sonu Goel
- School of Public Health
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Suneela Garg
- Maulana Azad Medical College and Associated Hospitals
- New Delhi, India
- Uday Shankar Singh
- Pramukhswami Medical College
- Karamsad, Gujarat, India
EDITORIAL SUPPORT TEAM
- Bharat Desai
- PDU Government Medical College
- Rajkot, Gujarat, India
- Bhargav Dave
- PDU Government Medical College
- Rajkot, Gujarat, India
- Dixit Chauhan
- PDU Government Medical College
- Rajkot, Gujarat, India
- Nikita Savani
- PDU Government Medical College
- Rajkot, Gujarat, India
- Pravin Raj
- PDU Government Medical College
- Rajkot, Gujarat, India
- AM Kadri
- PDU Government Medical College
- Rajkot, Gujarat, India
- Abhay Srivastava
- Himalayan Institute of Medical Sciences
- Dehradun, Uttarakhand, India
- Abhik Sinha
- Indian Council of Medical Research
- National Institute of Cholera
- and Enteric Diseases
- Kolkata, West Bengal, India
- Abhimanyu Singh Chauhan
- Institute of Tropical Medicine
- Antwerp, Belgium
- Abhishek Mishra
- All India Institute of Medical Sciences
- Patna, Bihar, India
- Abhishek Singh
- SHKM Government Medical College
- Gurugram, Haryana, India
- Abu Hasan Sarkar
- Oxford University and Shrimanta Shankaradeva University of
- Health Sciences
- Guwahati, Assam, India
- Afraz Jahan
- Kempegowda Institute of Medical Sciences
- Bengaluru, Karnataka, India
- Akhil Dhanesh Goel
- All India Institute of Medical Sciences
- Jodhpur, Rajasthan, India
- Alka Kaware
- Seth GS Medical College and KEM Hospital
- Mumbai, Maharashtra, India
- Amir Maroof Khan
- UCMS and GTB Hospital
- Delhi, India
- Amit Kumar Mishra
- Pondicherry Institute of Medical Sciences
- Puducherry, India
- Amit Sachdeva
- Indira Gandhi Medical College
- Shimla, Himachal Pradesh, India
- Anand Krishnan
- All India Institute of Medical Sciences
- New Delhi, India
- Anil J Purty
- Pondicherry Institute of Medical Sciences
- Puducherry, India
- Animesh Jain
- Kasturba Medical College
- Mangaluru, Karnataka, India
- Anjali Modi
- Government Medical College
- Surat, Gujarat, India
- Ankit Sheth
- PDU Government Medical College
- Rajkot, Gujarat, India
- Ankeeta Menona Jacob
- KS Hegde Medical Academy
- Mangaluru, Karnataka, India
- Anku Moni Saikia
- Gauhati Medical College
- Guwahati, Assam, India
- Anmol Gupta
- Indira Gandhi Medical College
- Shimla, Himachal Pradesh, India
- Anupam Banerjee
- PDU Government Medical College
- Rajkot, Gujarat, India
- Anupam Parashar
- Indira Gandhi Medical College
- Shimla, Himachal Pradesh, India
- Anusha Rashmi
- AJ Institute of Medical Sciences
- and Research Center
- Mangaluru, Karnataka, India
- Arpit Prajapati
- GCS Medical College
- Ahmedabad, Gujarat, India
- Arundhathi B
- Osmania Medical College
- Hyderabad, Telangana, India
- Ashok Mishra
- Gajra Raja Medical College
- Gwalior, Madhya Pradesh, India
- Ashwin Kumar
- SS Institute of Medical Sciences and
- Research Centre
- Davangere, Karnataka, India
- Atul Trivedi
- Government Medical College
- Bhavnagar, Gujarat, India
- Ayesha Siddiqua Nawaz
- Navodaya Medical College
- Raichur, Karnataka, India
- Bishan S Garg
- Dr Sushila Nayar School of Public Health
- Mahatma Gandhi Institute of Medical Sciences
- Wardha, Madhya Pradesh, India
- Baridalyne Nongkynrih
- All India Institute of Medical Sciences
- New Delhi, India
- Bhanu M
- Grassroots Research and Advocacy Movement
- Mysuru, Karnataka, India
- Bharatkumar M Gohel
- PDU Government Medical College
- Rajkot, Gujarat, India
- Bhavana Laxmi Surity
- Osmania Medical College
- Hyderabad, Telangana, India
- Bhavani Kenche
- Osmania Medical College
- Hyderabad, Telangana, India
- Bhavani Nivetha
- Mysore Medical College and Research Institute
- Mysuru, Karnataka, India
- Bhavesh Modi
- GMERS Medical College
- Gandhinagar, Gujarat, India
- Bhavik Rana
- GCS Medical College
- Ahmedabad, Gujarat, India
- Bhavna Seth
- Harvard Medical School
- Boston, USA
- Bratati Banerjee
- Maulana Azad Medical College
- New Delhi, India
- Chandresh Pandya
- GMERS Medical College
- Vadodara, Gujarat, India
- Charu Kohli
- North Delhi Municipal Corporation Medical College and Hindu Rao Hospital
- New Delhi, India
- Cherian Varghese
- World Health Organization
- Avenue Appia, Geneva, Switzerland
- DS Dhadwal
- Indira Gandhi Medical College
- Shimla, Himachal Pradesh, India
- DV Bala
- NHL Medical College
- Ahmedabad, Gujarat, India
- Darshan Mahyavanshi
- GMERS Medical College
- Valsad, Gujarat, India
- Deepshikha
- Himalayan Institute of Medical Sciences
- Swami Rama Himalayan University
- Dehradun, Uttarakhand, India
- Deepthi Kiran
- ESICMC and ESI – Post Graduate Institute of Medical Science and Research
- Bengaluru, Karnataka, India
- Deepthi N Shanbhag
- St John's Medical College
- Bengaluru, Karnataka, India
- Devraj R
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Dhiraj Kumar Srivastava
- University of Medical Sciences
- Etawah, Uttar Pradesh, India
- Dibakar Haldar
- Bankura Sammilani Medical College
- Kolkata, West Bengal, India
- Dinesh Kumar
- Pramukhswami Medical College
- Karamsad, Gujarat, India
- Dipesh Zalavadiya
- GMERS Medical College
- Junagadh, Gujarat, India
- E Venkata Rao
- IMS and SUM Hospital
- Bhubaneswar, Odisha, India
- Ekta Gupta
- ESIC Medical College and Hospital
- Faridabad, Haryana, India
- G Rakesh Maiya
- KS Hegde Medical Academy
- Mangaluru, Karnataka, India
- G Shiny Chrism Queen Nesan
- KS Hegde Medical Academy
- Mangaluru, Karnataka, India
- Gneyaa Bhatt
- GMERS Medical College
- Ahmedabad, Gujarat, India
- Gouri Sen Gupta
- Himalayan Institute of Medical Sciences
- Swami Rama Himalayan University
- Dehradun, Uttarakhand, India
- Gurmeet Kaur
- Army College of Medical Sciences
- New Delhi, India
- Harsh Bakshi
- GMERS Medical College
- Ahmedabad, Gujarat, India
- Harshal R Salve
- All India Institute of Medical Sciences
- New Delhi, India
- Harshitha HN
- KS Hegde Medical Academy
- Mangaluru, Karnataka, India
- Himanshu Negandhi
- Indian Institute of Public Health
- New Delhi, India
- Hitesh M Shah
- GMERS Medical College
- Valsad, Gujarat, India
- Ipsa Mohapatra
- Kalinga Institute of Medical Sciences
- KIIT University
- Bhubaneswar, Odisha, India
- Jay K Sheth
- AMC MET Medical College
- Ahmedabad, Gujarat, India
- Jayanthi Srikanth
- Kempegowda Institute of
- Medical Sciences
- Bengaluru, Karnataka, India
- Jithin Daniel J
- KS Hegde Medical Academy
- Mangaluru, Karnataka, India
- Jyotiranjan Sahoo
- Institute of Medical Sciences and
- SUM Hospital
- Bhubaneswar, Odisha, India
- Jyothi Lakshmi Naga Vemuri
- Osmania Medical College
- Hyderabad, Telangana, India
- Kalaiselvi
- Pondicherry Institute of Medical Sciences
- Puducherry, India
- Kalpita Shringarpure
- Government Medical College
- Vadodara, Gujarat, India
- Kapil Gandha
- MP Shah Government Medical College
- Jamnagar, Gujarat, India
- Kathiresan Jeyashree
- Velammal Medical College Hospital and Research Institute
- Madurai, Tamil Nadu, India
- Kaushik Lodhiya
- GMERS Medical College
- Junagadh, Gujarat, India
- Kaushik Mitra
- Burdwan Medical College
- West Bengal, India
- Kedar Mehta
- GMERS Medical College
- Vadodara, Gujarat, India
- Kumaril Goswami
- Gauhati Medical College
- Guwahati, Assam, India
- Liaquat Roopesh Johnson
- Azeezia Institute of Medical Sciences
- and Research
- Kollam, Kerala, India
- Madhur Verma
- Kalpana Chawla Government
- Medical College
- Karnal, Haryana, India
- Madhurjya Baruah
- Tezpur Medical College and Hospital
- Tezpur, Assam, India
- Malatesh Undi
- Karwar Institute of Medical Sciences
- Uttar Kannada, Karnataka, India
- Manasa AR
- Kempegowda Institute of Medical Sciences
- Bengaluru, Karnataka, India
- Manish Rana
- GMERS Medical College
- Ahmedabad, Gujarat, India
- Manish Kumar Singh
- Dr Ram Manohar Lohia Institute of Medical Sciences
- Lucknow, Uttar Pradesh, India
- Manisha Gohel
- Pramukhswami Medical College
- Karamsad, Gujarat, India
- Manjit Boruah
- Assam Medical College and Hospital
- Dibrugarh, Assam, India
- Manju Toppo
- Gandhi Medical College
- Bhopal, Madhya Pradesh, India
- Manjula R
- Sri Nijalingappa Medical College
- Bagalkot, Karnataka, India
- Manoj Bansal
- GR Medical College
- Gwalior, Madhya Pradesh, India
- Manoj Gupta
- All India Institute of Medical Sciences
- Jodhpur, Rajasthan, India
- Manoj Talapalliwar
- Government Medical College
- Gondia, Maharashtra, India
- Manya Prasad
- All India Institute of Medical Sciences
- New Delhi, India
- Mausumi Basu
- Institute of Post-Graduate Medical Education and Research
- Kolkata, West Bengal, India
- Mihir Rupani
- Government Medical College
- Bhavnagar, Gujarat, India
- Mitasha Singh
- ESIC Medical College and Hospital
- Faridabad, Haryana, India
- Mohua Moitra
- Government Medical College
- Surat, Gujarat, India
- Muthukumar R
- Sri Ramachandra Medical College
- Chennai, Tamil Nadu, India
- NR Ramesh Masthi
- Kempegowda Institute of
- Medical Sciences
- Bengaluru, Karnataka, India
- Narayanan Namboothiri G
- AJ Institute of Medical Sciences and
- Research Center
- Mangaluru, Karnataka, India
- Neeraj Agrawal
- All India Institute of Medical Sciences
- Patna, Bihar, India
- Nidhi Mangrola
- PDU Government Medical College
- Rajkot, Gujarat, India
- Nilesh Fichadiya
- PDU Government Medical College
- Rajkot, Gujarat, India
- Niravkumar Joshi
- PDU Government Medical College
- Rajkot, Gujarat, India
- Nirmal Kumar Mandal
- Malda Medical College
- Malda, West Bengal, India
- Nishanth Krishna K
- Father Mullers Medical College and
- Research Center
- Mangaluru, Karnataka, India
- Nitu Kumari
- Kempegowda Institute of
- Medical Sciences
- Bengaluru, Karnataka, India
- Niyati Parmar
- Government Medical College
- Vadodara, Gujarat, India
- P Amritha Krishna
- AJ Institute of Medical Sciences and
- Research Center
- Mangaluru, Karnataka, India
- PV Kotecha
- Asian Pacific Community in Action
- Phoenix
- Arizona, USA
- Palash Das
- College of Medicine and
- Sagore Dutta Hospital
- Kolkata, West Bengal, India
- Pankaj Bhardwaj
- All India Institute of
- Medical Sciences
- Jodhpur, Rajasthan, India
- Pankaja Raghav
- All India Institute of Medical Sciences
- Jodhpur, Rajasthan, India
- Paragkumar Chavda
- GMERS Medical College
- Vadodara, Gujarat, India
- Paramita Sengupta
- Christian Medical College
- Ludhiana, Punjab, India
- Paras Agarawal
- Diabetologist and Wellness Consultant
- Gurugram, Haryana, India
- Pooja Goyal
- ESIC Medical College and Hospital
- Faridabad, Haryana, India
- Poonam Sancheti
- Dr Vaishampayan Memorial Government Medical College
- Solapur, Maharashtra, India
- Pracheth R
- Yenepoya Medical College
- Mangaluru, Karnataka, India
- Pradeep Kumar
- Dr MK Shah Medical College
- Ahmedabad, Gujarat, India
- Pradeep Agrawal
- Himalayan Institute of Medical Sciences
- Dehradun, Uttarakhand, India
- Pragti Chhabra
- UCMS and GTB Hospital
- Delhi, India
- Prakash Patel
- Surat Municipal Institute of Medical
- Education and Research
- Surat, Gujarat, India
- Pranab Chatterjee
- Indian Council of Medical Research
- National Institute of Cholera and
- Enteric Diseases
- Kolkata, West Bengal, India
- Pranay Jadav
- GMERS Medical College
- Gandhinagar, Gujarat, India
- Praveen Kulkarni
- JSS Medical College
- JSS Academy of Higher Education and Research
- Mysuru, Karnataka, India
- Preetam Mahajan
- Pondicherry Institute of Medical Sciences
- Puducherry, India
- Prince Alex Abhraham
- Mount Zion Medical College
- Adoor, Kerala, India
- Priscilla Kayina
- Jawaharlal Nehru Institute of Medical Sciences
- Imphal, Manipur, India
- Priya Arora
- Army College of Medical Sciences
- New Delhi, India
- Priyesh Marskole
- Gajra Raja Medical College
- Gwalior, Madhya Pradesh, India
- RB Jain
- Post Graduate Institute of Medical Sciences
- Rohtak, Haryana, India
- Rachana AR
- Karwar Institute of Medical Sciences
- Karwar, Karnataka, India
- Radha Valaulikar
- National Program for Prevention and Control of Cancer Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)
- Goa, India
- Rahul Hegde
- KS Hegde Medical Academy
- Mangaluru, Karnataka, India
- Rajesh Chudasama
- PDU Government Medical College
- Rajkot, Gujarat, India
- Rajesh Kumar Konduru
- Pondicherry Institute of Medical Sciences
- Puducherry, India
- Rakesh Kakkar
- All India Institute of Medical Sciences
- Mangalagiri, Andhra Pradesh, India
- Ramya MP
- Kempegowda Institute of Medical Sciences
- Bengaluru, Karnataka, India
- Rashmi Kundapur
- KS Hegde Medical Academy
- Mangaluru, Karnataka, India
- Rashmi Sharma
- GMERS Medical College
- Ahmedabad, Gujarat, India
- Ravikumar
- MR Medical College
- Kalaburagi, Karnataka, India
- Ravish HS
- Kempegowda Institute of Medical Sciences
- Bengaluru, Karnataka, India
- Ravneet Kaur
- All India Institute of Medical Sciences
- New Delhi, India
- Ritesh Singh
- College of Medicine and JNM Hospital
- West Bengal University of
- Health Sciences
- Kalyani, West Bengal, India
- Ritika Tiwari
- Public Health Foundation of India
- New Delhi, India
- Rivu Basu
- RG Kar Medical College
- Kolkata, West Bengal, India
- Rizwan Suliankatchi Abdulkader
- Saudi Board of Preventive Medicine
- Ministry of Health
- Kingdom of Saudi Arabia
- Rohit Ram
- MP Shah Medical College
- Jamnagar, Gujarat, India
- Roopa Shivashankar
- Centre for Chronic Disease Control (CCDC)
- New Delhi, India
- Ruchi Juyal
- Himalayan Institute of Medical Sciences
- Dehradun, Uttarakhand, India
- Rupsa Banerjee
- Vardhaman Mahavir Medical College
- New Delhi, India
- Saikat Bhattacharya
- Calcutta Medical College
- Kolkata, West Bengal, India
- Sandeep Kumar Panigrahi
- IMS and SUM Hospital
- Bhubaneswar, Odisha, India
- Sanjana SN
- JJM Medical College
- Davangere, Karnataka, India
- Sanjay Zodpey
- Public Health Foundation of
- India and Indian Institute of
- Public Health-Delhi
- New Delhi, India
- Sanjib Bandyopadhyay
- Calcutta National Medical College
- Kolkata, West Bengal, India
- Santosh K Yatnatti
- Yenepoya Medical College
- Mangaluru, Karnataka, India
- Sarmila Mallik
- Murshidabad Medical College
- Berhampore, West Bengal, India
- Sasmita Mungi
- Gajra Raja Medical College
- Gwalior, Madhya Pradesh, India
- Saurabh Kumar
- Father Mullers Medical College and
- Research Center
- Mangaluru, Karnataka, India
- Saurabh Sharma
- National Institute of Medical Statistics
- Indian Council of Medical Research
- New Delhi, India
- Senkadhirdasan
- All India Institute of Medical Sciences
- Rishikesh, Uttarakhand, India
- Shailee Vyas
- Government Medical College
- Surat, Gujarat, India
- Shaili Vyas
- Himalayan Institute of Medical Sciences
- Swami Rama Himalayan University
- Dehradun, Uttarakhand, India
- Shalini Pradeep
- MS Ramaiah Medical College
- Bengaluru, Karnataka, India
- Sharon Baisal
- State Health Services
- Kerala, India
- Shashi Kumar M
- ESICMC and ESI – Post Graduate Institute of Medical Science and Research
- Bengaluru, Karnataka, India
- Shikha Jain
- BJ Medical College
- Ahmedabad, Gujarat, India
- Shobha Mishra
- Government Medical College
- Vadodara, Gujarat, India
- Shreyaswi Sathyanath M
- AJ Institute of Medical Sciences and
- Research Center
- Mangaluru, Karnataka, India
- Shubha Davalagi
- JJM Medical College
- Davangere, Karnataka, India
- Shveta Lukhmana
- Regional Labour Institute
- Faridabad, Haryana, India
- Swetha Rajeshwari
- Navodaya Medical College
- Raichur, Karnataka, India
- P Stalin
- Pondicherry Institute of
- Medical Sciences
- Puducherry, India
- Sudhir Prabhu H
- Father Mullers Medical College and
- Research Center
- Mangaluru, Karnataka, India
- Sukamal Bisoi
- RG Kar Medical College
- Kolkata, West Bengal, India
- Sumanth MM
- Mysore Medical College and
- Research Institute
- Mysuru, Karnataka, India
- Sumit Aggarwal
- Indian Council of Medical
- Research (Headquarters)
- New Delhi, India
- Sumit Malhotra
- Centre for Community Medicine
- All India Institute of Medical Sciences
- New Delhi, India
- Sunil Kumar
- JSS Medical College
- JSS Academy of Higher Education
- and Research
- Mysuru, Karnataka, India
- Teeku Sinha
- Late Baliram Kashyap Memorial
- Government Medical College
- Jagdalpur, Chhattisgarh, India
- Tulika Goswami
- Tezpur Medical College
- and Hospital
- Tezpur, Assam, India
- Tushar Manohar Rane
- UNICEF, Assam, India
- Umed Patel
- PDU Government Medical College
- Rajkot, Gujarat, India
- Vaidehi S Gohil
- GCS Medical College
- Ahmedabad, Gujarat, India
- Varghese Iybu Chacko
- AJ Institute of Medical Sciences and
- Research Center
- Mangaluru, Karnataka, India
- Vartika Saxena
- All India Institute of Medical Sciences
- Rishikesh, Uttarakhand, India
- Veena Kumari
- UNICEF, Assam, India
- Velavan A
- Pondicherry Institute of
- Medical Sciences
- Puducherry, India
- Venu Shah
- GCS, Medical College
- Ahmedabad, Gujarat, India
- Vidisha Vallabh
- Himalayan Institute of Medical Sciences
- Dehradun, Uttarakhand, India
- Vidya R
- Akash Institute of Medical Sciences and Research Centre
- Bengaluru, Karnataka, India
- Vikas Doshi
- Government Medical College
- Vadodara, Gujarat, India
- Vinayak J Kempaller
- SS Institute of Medical Sciences and
- Research Centre
- Davangere, Karnataka, India
- Viral Dave
- GCS Medical College
- Ahmedabad, Gujarat, India
- Yogita Bavaskar
- Government Medical College
- Jalgoan, Maharashtra, India
- (Brig) Zile Singh
- Pondicherry Institute of Medical Sciences
- Puducherry, India
- Zinia T Nujum
- Government Medical College
- Kollam, Kerala, India
The Indian Association of Preventive and Social Medicine (IAPSM) with a sense of professional satisfaction and responsibility, places in the hands of its readers the first edition of this textbook on community medicine for undergraduate students.
Conventionally, doctors are concerned with the process of providing treatment to cure the affected individuals. However, this is only one part of their professional responsibility. To improve the health status and ensure that people are healthy and are protected against threat of various diseases, is also the responsibility of the medical doctors. The Indian medical graduates therefore need to also acquire knowledge and competencies to solve various health problems affecting the community and emphasize on health promotion and disease prevention. As a health leader, they need to know how to apply cost-effective preventive, promotive and curative interventions through effective community participation. The Medical Council of India's Medical Education Regulation envisages that, the subject community medicine also known as preventive and social medicine is responsible for imparting this training.
Community medicine is a relatively newer discipline in medical science. It has evolved from ‘hygiene’ to ‘health care’, ‘latrines’ to ‘leadership’ and ‘sanitation’ to ‘sustainable development’. Medical students on the one side are taught to look inside the human body—structures and functions from human system to cells, i.e. an internal journey from body surface to cells; and, on the other side, they need to take journey outwards—beyond human body surface, to study everything which surrounds it. All subjects teach, how to focus and acquire in-depth understanding in the respective discipline and community medicine teaches how to broaden the understanding and skills by taking along all the disciplines. Thus, learning in community medicine during undergraduate studies is complementary to all other medical disciplines and helps in developing a holistic approach in health and medical care.
Community medicine is an important branch of medical science for any country. While all other branches in medical sciences largely focus on managing the patients, community medicine focuses on managing health of all the members of community residing in the region. It includes identifying the factors prevailing in the region which are associated with the health outcomes, either directly or indirectly and managing them through healthcare delivery system (local or national) with intersect oral coordination.
A textbook of community medicine; written in lucid language, with logical explanations, giving clear understanding about the subject was the long-time felt need in medical education. I am happy to share that Indian Association of Preventive and Social Medicine, an apex professional body of subject has come forward to bridge this gap and has prepared a multi-authored textbook of community medicine.
When a textbook is prepared by the group of faculties involved in the teaching, it would address the challenges faced by students in their learning and will facilitate to improve the teaching-learning process of the subject.
I am sure that this textbook will make the subject more relevant to the country's needs and will be a game changer in teaching and training of community medicine discipline for faculties and learning for undergraduate students.
Anil J Purty
President, IAPSM (2018–2019)
Professor and Head
Department of Community Medicine
Pondicherry Institute of Medical Sciences
Puducherry, India
Preface
IAPSM's Textbook of Community Medicine is an attempt by the Indian Association of Preventive and Social Medicine (IAPSM) to reshape the discipline and give it a desired direction for teaching, learning and practices.
The goal and specific objectives as envisaged by the Medical Council of India (MCI) for Indian medical graduates, has placed a very important role and responsibility to the subject ‘Community Medicine’ in the undergraduate medical curriculum. A textbook for undergraduate students is an effective tool to realize these important roles.
This textbook of community medicine subject for undergraduate medical students is prepared with the aim to provide a comprehensive information about all topics relevant to undergraduate medical students with their expected roles as medical graduates.
Preparation of first edition of this book has gone through long period of three years. IAPSM has carried out wide consultations with students to stalwarts in the field of community medicine to understand the issues affecting the practice of teaching and training and its needs. We have reviewed published literature on issues and have included the suggestions received from the vast experience of IAPSM members in teaching the various topics in community medicine. The syllabus was prepared by the following guiding principles:
- The goals, objectives and specific objectives for community medicine as per the Graduate Medical Education Regulation, 1997, MCI are to be used to decide about topics and subtopics.
- Removing of unnecessary details in topics that are not relevant to MBBS graduates.
- Emphasis is to be given to the topics which are relevant to current need and role of medical graduates.
- Flow of the topics and subtopics are to be logical and progressive, i.e. from basic level to applied levels.
Based on the above principles, many obsolete topics and unnecessary details are removed. Newer topics as per the current needs are incorporated. Also, applications in community medicine practice is emphasized keeping focus on the Indian health situation and healthcare system. This will also keep the future health professional of India well informed about country's health conditions and the ongoing preventive and promotive efforts by the government. This will help in understanding their roles and responsibilities instead of practicing curative medicine in isolation.
In this textbook, the chapters and topics are grouped in five sections. The topics progress from the development of basic understanding of the individual health and disease to understanding the community health and dynamics of diseases/health problems in the community. It further provides the understanding of principles and methods to manage health of the community through healthcare delivery system. Lastly, it describes ‘How the health of people of India is being managed’.
This textbook is the result of collective efforts of IAPSM members who are experts in the field of community medicine. This is the first edition and there is a scope of improvement. While presenting the first edition of this textbook, we are committed to improve its quality further in the subsequent editions. This can be possible only, when we would receive feedback from respected teachers and importantly from the students.
The IAPSM is eager to have your valuable feedback/suggestions for improving this textbook. Please do give them through academia.iapsm@gmail.com.
AM Kadri
Editor - in - Chief and Secretary General
IAPSM (2016–2019)
Acknowledgments
SPECIAL ACKNOWLEDGMENTS
Ashok Mishra
Past IAPSM President
Gajra Raja Medical College
Gwalior, Madhya Pradesh, India
A Bhagyalaxmi
BJ Medical College
Ahmedabad, Gujarat, India
AK Bhardwaj
Dr Rajendra Prasad Government Medical College
Tanda, Himachal Pradesh, India
AP Kulkarni (Retired)
Government Medical College
Aurangabad, Maharashtra, India
Abraham Joseph
Christian Medical College
Vellore, Tamil Nadu, India
Anand Krishnan
All India Institute of Medical College
New Delhi, India
Ashok Kumar Jindal
Brigadier Medical and
Consultant Community Medicine
Assam, India
Bishan S Garg
Dr Sushila Nayar School of Public Health
Mahatma Gandhi Institute of
Medical Sciences
Wardha, Maharashtra, India
Chitranjan Roy
Darbhanga Medical College
Darbhanga, Bihar, India
Farooq Ahmed (Retired)
Assam Medical College
Dibrugarh and North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences
Shillong, Meghalaya, India
Mohan Doibale
Government Medical College
Aurangabad, Maharashtra, India
Pradeep Kumar
Chief Editor IJCM Journal
Dr MKS Medical College
Ahmedabad, Gujarat, India
PB Verma
GMERS Medical College
Himmatnagar, Gujarat, India
Rajesh Kumar
Post Graduate Institute of Medical,
Education and Research
Chandigarh, India
Ratan Srivastav
Past IAPSM President
Institute of Medical Sciences
Varanasi, Uttar Pradesh, India
Sanjiv Kumar
International Institute of Health
Management Research
New Delhi, India
Suneela Garg
Maulana Azad Medical College and Hospital
New Delhi, India
SK Rasania
Lady Hardinge Medical College
New Delhi, India
VK Srivastava
Prasad Institute of Medical Sciences
Lucknow, Uttar Pradesh, India
(Brig) Zile Singh
Pondicherry Institute of Medical Sciences
Puducherry, India
ACKNOWLEDGMENTS
Aarohi Mitra
BJ Medical College
Ahmedabad, Gujarat, India
Arjun Jakasania
Dr Sushila Nayar School of Public Health
Mahatma Gandhi Institute of Medical Sciences
Wardha, Maharashtra, India
Lakshmi N
BJ Medical College
Ahmedabad, Gujarat, India
Parimal Patel
BJ Medical College
Ahmedabad, Gujarat, India
Priyank Algotar
BJ Medical College
Ahmedabad, Gujarat, India
Saurabh Sahu
BJ Medical College
Ahmedabad, Gujarat, India
Trusha Kansagara
BJ Medical College
Ahmedabad, Gujarat, India
Yash Shah
Dr MK Shah Medical College and
Research Centre
Ahmedabad, Gujarat, India
We are very grateful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Dr Madhu Choudhary (Publishing Head–Education), Ms Pooja Bhandari (Production Head), Ms Sunita Katla (Executive Assistant to Group Chairman and Publishing Manager), Dr Sneha Kashyap (Development Editor), Ms Uma Adhikari (Typesetter), and team members of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for all their support to work in this project and make it a success.