Fourth EditionAH Suryakantha MD DHA Professor, Department of Community Medicine Basaveshwara Medical College and Hospital Chitradurga, Karnataka, India Formerly, Professor and Head Department of Community Medicine JJM Medical College Davangere, Karnataka, India Formerly, Professor Department of Community SS Institute of Medical Sciences and Research Center Davangere, Karnataka, India
Jaypee Brothers Medical Publishers (P) Ltd.
4838/24, Ansari Road, Daryaganj
New Delhi 110 002, India
J.P. Medical Ltd.
83, Victoria Street, London
SW1H 0HW (UK)
Phone: +44-20 3170 8910
Fax: +44(0) 20 3008 6180
Jaypee-Highlights Medical Publishers Inc.
City of Knowledge, Building 235, 2nd floor
Clayton, Panama City, Panama
Fax: +1 507-301-0499
Jaypee Medical Inc.
325, Chestnut Street
Suite 412, Philadelphia, PA 19106, USA
Phone: +1 267-519-9789
Jaypee Brothers Medical Publishers (P) Ltd.
17/1-B, Babar Road, Block-B
Jaypee Brothers Medical Publishers (P) Ltd.
Bhotahity, Kathmandu, Nepal
© 2017, 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.
Inquiries for bulk sales may be solicited at: firstname.lastname@example.org
Community Medicine with Recent Advances
First Edition: 2009; Second Edition: 2010; Third Edition: 2014
Fourth Edition: 2017
Printed atDedicated to
The Revered Memory of Public Health Stalwarts, My Parents and TeachersPreface to the Fourth Edition
It gives me immense pleasure with professional satisfaction to bring forth the fourth edition, with the same elegant cover page.
As the field in this subject is growing, so is the transition in the book. As per the title, recent advances in community medicine have been incorporated. The chapter on Communicable Diseases, now contains revised case definitions of tuberculosis and their treatment outcomes; benefits of directly observed treatment short-course (DOTS); Revised National Tuberculosis Control Program (RNTCP) laboratory network; childhood tuberculosis; global multidrug-resistant tuberculosis (MDR-TB) crisis; antiretroviral treatment in HIV; revised WHO clinical staging of HIV disease in infants and children; cotrimoxazole prophylaxis for HIV-related infections among children, adolescents and adults; prevention of parent-to-child transmission of HIV; revised guidelines for postexposure prophylaxis for HIV; epidemiology of hepatitis C; commitment of measles elimination by 2020; maternal and neonatal tetanus elimination; diagnosis and treatment of malaria; malaria control strategies; malaria vaccine; dengue vaccine; revised National and Indian Academy of Pediatrics (IAP) immunization schedule.
The chapter on Preventive Obstetrics and Pediatrics, now contains revised guidelines on antenatal care; National Health Mission with all its components such as Reproductive, Maternal, Newborn, Child Health and Adolescent (RMNCH+A) strategy India, Newborn Action Plan, Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakram (JSSK), Navajatha Shishu Suraksha Karyakram, Rashtriya Bal Swasthya Karyakram, Rashtriya Kishor Swasthya Karyakram, Rogi Kalyan Samiti, National Rural Health Mission (NRHM) and new scheme of National Urban Health Mission. Other minor topics are National Family Planning Indemnity Scheme and Preconception and Prenatal Diagnostic Technique Act, 1994. Millennium development goals (MDGs) and sustainable development goals for 2015–2030 have been described in detail.
The chapter on National Health Programs now includes control programs on fluorosis, viral hepatitis, health care of the elderly and Global Polio Eradication Initiative and End Game Strategic Plan.
The National AIDS Control Program, Tobacco Control Program and guidelines for the control of iron deficiency anemia have been revised. Some topics of the National Programs have been integrated with the respective chapters to avoid fragmentation and enhance learning. The international public health problems, such as middle-east respiratory syndrome, Ebola virus disease and Zika disease, have been added to the chapter on Emerging Diseases.
Other small topics incorporated are e-toilet, Mission Indradhanush, national iron plus initiative, demographics of India, adverse events following immunization, modified BG Prasad's classification of socioeconomic status and many others.
Almost all the typographical errors happened in third edition have been taken care of. All this was possible because of the feedback I received from my colleagues from various parts of the country. It is indeed a pleasure to receive both positive and negative feedback from the readers to effect improvement in the subsequent editions.
My special thanks to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Mr Tarun Duneja (Director-Publishing) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for the encouragement given to me and to make the book popular both at the national and international levels. I am grateful to all undergraduate and postgraduate students, who have helped me to keep the book up-to-date.
I sincerely thank Mr Venugopal V, Associate Director of Jaypee Brothers Medical Publishers (P) Ltd., South India Zone, who inspired me to take up the task and go ahead.
I also thank to Dr Nagendra Gowda, Professor and Head, Department of Community Medicine, Basaveshwara Medical College and Hospital, Chitradurga, Karnataka, India, for his kind cooperation extended in completion of the book.
I sincerely thank Late Dr Suresh Babu, Ex. Dean of Basaveshwara Medical College and Hospital, Chitradurga, for providing me an opportunity to write the fourth edition.
I also thank Mrs Usha Suryakantha for her cooperation throughout the period of my work.
I will be failing in my duty, if I do not thank Mr Sanjeev Kumar GP, M/s Gundal Compu Center, Davangere, Karnataka, India, for his valuable help in preparing the manuscript.Preface to the First Edition
The publication of this book is the end result of teaching community medicine to undergraduate and postgraduate students for more than three decades. Though the book is written primarily for undergraduates, it would also be useful for postgraduate students of community medicine. Considering an ever-increasing demand for a comprehensive book on community medicine, an attempt has been made to make the book, student-friendly, teacher-friendly, examiner-friendly and doctor-friendly.
The book is student-friendly because it is written in an understandable way, covering the entire syllabus prescribed by the Medical Council of India (MCI), including the recent advances. The matter is presented in such a way as to avoid confusion and to make the reading of the book a pleasurable experience. Topics like Biostatistics would encourage the students to take up the research activities. The lucid language of the book would facilitate quick revision.
The book is teacher-friendly because they may appreciate the presentation of the subject matter exhaustively and clearly, having tentacles attached to various other branches of medicine such as obstetrics, pediatrics, dermatology, psychiatry and general medicine, in order to conform to the changing profile of community medicine.
The book is examiner-friendly because it covers the vast areas of the subject to enable asking questions vertically, horizontally and tangentially.
The book is doctor-friendly because it would help the general practitioners and the rural medical officers in providing not only curative services, but also preventive and promotive services to the community at large, motivating them to a healthier, and happier life.
In spite of sincere attempt to make the book a comprehensive one, there may be some gaps, imperfections and mistakes. Readers are requested to give the feedback in the form of remarks and suggestions, which will be accepted sportively for the improvement of the next edition.
I sincerely thank Mrs Jyothi and staff members of Zen Computers for their excellent typing work and helpful services.
I would like to express my appreciation of the patient forbearance borne by my wife Smt Usha during the entire period of preparation.
Lastly, I am grateful to Mr Venugopal, Branch Manager, Bengaluru, Karnataka, India and the entire team of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for making my dream a reality.