INTRODUCTION TO COMMUNITY HEALTH

AND ENVIRONMENTAL SANITATION

WORKSHEET AND STUDY GUIDE

FOR THE EXCLUSIVE USE OF UNIVERSITY OF ST. LA SALLE STUDENTS

Compiled by BIEN ELI NILLOS, MD

NATURAL SCIENCES DEPARTMENT
COLLEGE OF ARTS AND SCIENCES
Academic Year 2011-2012
 FOREWORD

This Worksheet is designed to supplement the lectures for Community Health and
Environmental Sanitation, an elective class for USLS College students, particularly those
taking Bachelor of Science Major in Biology. It shall also serve as one of the major references
for the course. To better appreciate and learn the principles in Community Health and
Environmental Sanitation, classroom instruction must be complemented with a large amount of
community exposure. Therefore, during field work and community exposure, this worksheet
will come in handy for the student in reviewing the basic principles of Community Health and
Environmental Sanitation.

Public Health, or sometimes referred to as Community Health, is defined as “the

science and art of preventing disease, prolonging life, and promoting physical health and
efficiency through organized community efforts for the sanitation of the environment, the
control of community infections, the education of the individual in principles of personal
hygiene, the organization of medical and nursing service for the early diagnosis and
preventive treatment of disease, and the development of the social machinery which will
ensure to every individual in the community a standard of living adequate for the
maintenance of health.”(Winslow, 1920).

Its major elements therefore include: Prevention and Control of Community Infections,
(through) Sanitation, Education, Health Care Service Delivery and Social Structures.
Throughout the course, the students will be expected to learn and apply these elements of
Community health and Environmental Sanitation.
 Worksheet No. 1
INTRODUCTION TO HEALTH

The World Health Organization defines Health as a state of complete physical, mental, and
social well-being and not merely the absence of disease or infirmity.

How would you define Health? Make your own definition of Health.

HEALTH is _________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

If you are having a hard time trying to make STUDY GUIDE

your own definition of health, read some of • According to Buddha, “Every
the definitions of health according to various human being is the author of
individuals and/or groups: his own health or disease”.
What does this imply?
Health is “a resource for everyday life, not the • Research on the LaLonde
objective of living. Health is a positive Report. What do you think
concept emphasizing social and personal was the significant
resources, as well as physical capacities.” contribution of Marc
(Ottawa Charter for Health Promotion, 1986) LaLonde’s report for his
community/country?
Health is “maintained and improved not only • Read up on the functions of
through the advancement and application WHO.
of health science, but also through the efforts
and intelligent lifestyle choices of the
individual and society” (LaLonde Report, 1974)

By this time, you must already have some understanding about Health. The WHO definition
mentions the term “Disease”. It can be said that Disease is exactly the opposite of Health.

DISEASE is _________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
What is the difference between DISEASE and ILLNESS?
DISEASE ILLNESS

Throughout the history of mankind, there have been many interpretations as to what would
cause a disease or illness. In the early days, disease is due to an “evil spirit”, a “curse” or a
“spell”. It was only logical therefore for early people to refer to their priests and shamans for
treatments since the cause of their diseases was perceived to be due to something “spiritual”.
Treatments of diseases were incorporated into religious ceremonies such as the offering of an
animal to appease the spirits.

From your own observations and experiences, what can be the many general causes of a
DISEASE? Write down as many as you can think of:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

According to historians, Public Health began when human beings started living together
(communal living). From small tribes, human beings began to build towns and cities; thus the
development of rural to urban living. In order support urban living, people started building
infrastructures that would make life easier and more comfortable. For example, to make clean
water more accessible, aqueducts were built. To dispose human waste and dirty water, sewage
systems were built. The motivation therefore of doing “environmental engineering” was not
because of some health concerns but due to the demands of urban living. After all, when it
came to health and disease, they were all due to “spiritual causes”.

It was not until Hippocrates came and noted the

STUDY GUIDE
• Research on Hippocrates’ De
aëre, aquis et locis.
• Read about Hippocrates.
What were his biggest
contributions to the field of
Medicine?
• How did the Romans accept
the concepts proposed by
Hippocrates?
your observation or experience.
effect of food, of occupation, and especially of
climate in causing disease. Hippocrates was said to
be the Father of Medicine and because of his
revolutionary concept of health and causes of
diseases, the idea of “environmental factor” as a
cause of health or illness came to establish the field
of Public Health.
Following the Hippocratic Thinking of the causes
of diseases, fill up the table below by listing
specific illnesses or diseases and their
corresponding environmental causes according to

DISEASE/ILLNESS ENVIRONMENTAL FACTORS

e.g. Diarrhea/Dysentery drinking dirty or infected water

Since then, other concepts regarding the causes of diseases or illnesses came to focus
such as the concept of bodily fluids not in equilibrium (Humors) and the existence of
microorganisms that cause specific diseases. The idea therefore of supernatural causes of
illnesses has been replaced by scientifically-based concepts on health and disease.

Research on the development of Public Health and cite 3 examples of successful milestones in
the history of Public Health. A classic example would be the eradication of smallpox through
vaccination.

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

STUDY GUIDE
• Research about the Salerno Medical School. What was this historical school’s
innovation and contribution to the history of Health and Medicine
• What was the Regimen Sanitatis Salernitanum? Why was it called the first “health
guide” of the masses?
• Who was Girolamo Fracastoro? What was the central theme of his “On Contagions
and the Cure of Contagious Diseases?”
• During the Age of Expansion, when Europeans traveled to the New World in search
of new lands, they brought with them not only their culture but also their diseases.
Read up on examples of Diseases brought to the New World and vice versa. Read
up on the concept of Global Health.
 WORKSHEET NO. 2
INTRODUCTION TO PRIMARY HEALTH CARE

Below is a true-to-life story of Rosario1.

“The village of Tanyong lies beside the river of Malabon in Metro Manila. The village has a
land area of 5 hectares and a population of 12,400 or 1,850 families. To reach the houses of
Tanyong, one has to cross unsteady makeshift wooden bridges, and it is not uncommon to hear
of children falling into the murky black waters of the river. The river serves as the sewer and
main garbage disposal system of the village. A
STUDY GUIDE survey done in the village revealed that only
• Highlight the pertinent details that 10% of the households had toilets, while 90%
describe the living conditions of used the river to dispose of human wastes. Only
Rosario’s family. 10% availed of water piped into their houses;
• Highlight the pertinent details that 90% had to buy water from entrepreneurs who
describe Jaime’s family as a unit. fetched water from 2 deep wells in the village. 5
• Considering their living gallons of water cost between P15-30,
conditions and their situation as a depending on the distance of the house from the
family, do you think Rosario’s well. None of the families living in the village
family can cope up when an owned the house nor the land they lived on.
illness beset them?
A small room rented out for P500-P1000 per
month; while a bigger room rented out for
P1500-2000 a month. Jaime and his family
lived in the village of Tanyong. Jaime was 24
years old, while his wife Lucy was 27. They had four children: Jocelyn, 5 years old; Marites, 4
years old; Antonio, 2 ½ years old; and Rosario, 1 year and 4 months old.

Jaime was among the 70% of the population who migrated to Metro Manila from the provinces
looking for a better life. Jaime, like his father, was a poor peasant, but the land did not produce
enough to support Jaime’s family and so they migrated to Manila. In Manila, Jaime worked as
a laborer in a construction site. He earned P165 a day, and this was hardly enough to support
his family. He and Lucy were chronically in debt. Lucy usually strove to fit 3 meals a day
within a budget of P50, and often skipped meals in order to feed her children. In these times,
Lucy found her strength in her faith, and repeated in her mind what she had heard the Bishop
say in a sermon: “Blessed are they who suffer, for they shall inherit the kingdom of God.”

Lucy grew up in a rural community and graduated from high school, unlike Jaime who
completed only 3 years of elementary education. She did not learn the proper ways of caring
for children. When her oldest child was still a baby, she was told by a physician that she should
not breastfeed because she had a heart ailment. She was told instead to buy an infant formula
from a nearby pharmacy that was owned by the same physician. Lucy, however, had no heart
ailment according to another physician who had examined her a few years later.

1
Story presented by Christian Gomez, MD of the UP College of Medicine during the 2010 Global health Course
at the University of Tampere, Finland.
But since she was forbidden to breastfeed, she raised all her children on condensed milk
because this was more affordable than formula milk. She did not know the importance of
sterilizing her children’s feeding bottles and rubber nipples, nor could she afford to do it
regularly. She was also not aware of what food was nutritious for her children. As a result, all
her children were malnourished. They were prone to respiratory tract infections, and frequently
had fever and diarrhea. Their abdomens were large and protruding. They frequently passed out
worms (parasites) in their feces, which Lucy believed to be good. She believed that intestinal
parasites aided in the proper digestion of food.

The 2 youngest children, Antonio and Rosario, were not vaccinated because Lucy was
frightened when Jocelyn and Marites developed fever after receiving their vaccinations. Jaime
scolded her when this happened. Besides, the village health center did not have enough
vaccines for all the children in the village. Rosario, the youngest, was the most sickly among
Lucy and Jaime’s children. She was very thin, STUDY GUIDE
pale and invariably suffered from diarrhea.
• Read about breastfeeding. Was
the doctor correct on his advice
One day, Rosario contracted measles. Lucy on Rosario and her breastfeeding?
brought her to the nearest public health center,
• Read about immunization. Was it
where medical consultation was free. The nurse
a correct decision on Jaime’s part
in the center, however, informed Lucy that the
not to immunize Antonio and
center had run out of medicines, and that the
Rosario? Why?
budget for medicines for the year had been used
up. The request for additional budget for • What is measles? How can one
get measles? What are the signs
medicines was turned down by the City Council
and symptoms of measles?
because they suspected the City Health Officer
and the Mayor of misappropriating funds
intended for medicines. Lucy decided to buy the
medicines prescribed for Rosario: Carbocisteine for the cough (P109), a preparation for the
diarrhea (P243), and an antibiotic (P150). Though Rosario was still sick after a bottle of each
of these meds were consumed, Lucy could not buy additional medicines because she did not
have money left.

Rosario continued to have diarrhea and was soon dehydrated. Lucy then brought Rosario back
to the village health center, but the nurse in the health center advised Lucy to bring Rosario to a
larger facility, a private hospital nearby. In the hospital, Lucy was required to give a deposit of
PhP1200 before Rosario could be admitted. It was a good thing that Jaime was able to borrow
PhP1500 from the village leader at usurious rates. Because Rosario was so anemic, Jaime
needed to donate blood that was transfused to Rosario. After only one night in the hospital,
Lucy and Jaime’s bill piled up to Php 4,125 and was increasing fast. Every item used in the
treatment of Rosario like cotton balls, alcohol, gauze and tape, was charged and added to their
bill. Jaime and Lucy finally decided that it was best to take Rosario home against the doctors’
advice. They had to sign a document absolving the hospital and the doctors of any legal
liability, should Rosario’s condition deteriorate. Jaime and Lucy were told to bring Rosario
back to the hospital when they had enough money to pay for the hospital services or to bring
Rosario to a government (public) hospital.
After one week of continuous fever and diarrhea, Rosario further weakened and eventually
died.”

Question: Why did Rosario die? Discuss with classmates and be ready to participate during
the open forum in class.

In the story of Rosario, one can observe that inadequate health care was given to Rosario and
may have contributed to her demise. There was therefore some form of inaccessibility to the
different levels of health care.

Define the three levels of care and give an example for each:

PRIMARY CARE SECONDARY CARE TERTIARY CARE

Community Health is largely dependent on a strong Primary health care system. The
World Health Organization, through the Alma Ata Declaration of 1978, defined Primary
Health Care as “essential health care based on practical, scientifically sound and socially
acceptable methods and technology made universally accessible to individuals and families in
the community through their full participation and at a cost that the community and country
can afford to maintain at every stage of their development in the spirit of self reliance and self-
determination.”

Get a copy and read the Alma Ata Declaration of 1978. Be ready to share your insights in
the class during the open forum. From the Alma Ata Declaration, pick out a statement
that struck you the most and comment. Write your essay in not more than 15 sentences to
be submitted in class.

One can analyze the cause of death of Rosario using what we call a Problem Tree. Below is an
example of a Problem Tree. Base on your own analysis, make your own Problem tree for
Rosario’s case focusing only on three direct causes of Rosario’s death.

DEATH OF ROSARIO

DEHYDRATION/DIARRHEA

NO MEDICINES DIRTY WATER LIVING IN SLUM AREA

HEALTH CLINIC WITH NO DRUGS LIVING IN POVERTY

Submit your Problem Tree Analysis on the case of Rosario. Be ready to discuss your
problem tree in front of the class.
 WORKSHEET NO. 3
COMMUNICABLE DISEASES

Fill up the table below citing as many causative agents/diseases as you can. Diseases may not
necessarily be endemic in the Philippines
.

CAUSATIVE AGRNT DISEASE TYPE OF ORGANISM MODE OF DISTRIBUTION

TRANSMISSION
CAUSATIVE AGRNT DISEASE TYPE OF ORGANISM MODE OF DISTRIBUTION
TRANSMISSION
 Cite the Differences between a Bacterium, Virus and a Parasite. Consider its cellular
structure, size and behavior when comparing.

BACTERIA VIRUS PARASITE

Define the “Germ” Theory

______________________________________ STUDY GUIDE
______________________________________ • Read up on the following persons
______________________________________ and know their contributions to
______________________________________ the development of Medicine and
______________________________________ Public Health:
______________________________________ o Louis Pasteur
______________________________________ o Robert Koch
______________________________________

Write the Koch’s Postulates:

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
 WORKSHEET NO. 4
IMMUNIZATION

The body is constantly exposed to pathogens such as bacteria, viruses, parasites and even
fungi. However, our body is equipped with a mechanism that would protect itself against these
harmful and disease-causing pathogens.

Define LEUKOCYTES: ________________________________________________________

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Draw and describe the functions of the six types of Leukocytes in the human body.

Name: Name: Name:

Name: Name: Name:

Differentiate Innate Immunity from Acquired

STUDY GUIDE
Immunity: ____________________________
• Know the Definition of the _____________________________________
following: _____________________________________
o Diapedesis _____________________________________
o Chemotaxis _____________________________________
o Phagocytosis _____________________________________
_____________________________________
• What are Macrophages? _____________________________________
• What is Active versus Passive _____________________________________
Immunity? ____________________________________.

Write down the recommended schedule of

 Immunization according to the WHO’s Expanded Program of Immunization as implemented in
The Philippines:

Name of Vaccine Type of Vaccine Number of Doses Time Interval Minimum

age in
months

BCG

Hepatitis B

DPT(diphtheria,
Pertussis, tetanus)

Oral Polio Virus

Measles

There are other vaccines available that are not actually included in the Expanded Program of
Immunization (EPI) implemented in the Philippines. Examples of which are Pneumococcal
Vaccine, Hemophilus Influenza B Vaccine or MMR (Measles, Mumps, Rubella) Vaccine.
Read up on the other vaccines. If you are to add another vaccine in the EPI Program, what
would this vaccine be and why? Read up on facts about the disease addressed by this vaccine.
Cite data that would justify your choice. Be ready to submit your paper and discuss it during
the open forum with the class.

What is a Fully Immunized Child as defined under WHO’s EPI?

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Given the list below, mark the children who are considered as FIC.

1. Andres – 10 months old – Received HepB x 3 doses, OPV x 3 doses, DPT x 3 doses
2. Bogart – 7.5 months old – Received HepB x 2 doses, OPV x 2 doses, DPT x 2 doses
3. Charo – 11 months old – Received BCG, HepB x 3 doses, OPV x 3 doses, DPT x 3
doses, Measles x 1 dose
4. Denise – 9 months old – Received BCG, HepB x 3 doses, OPV x 3 doses, DPT x 3
doses, Measles x 1 dose
5. Edgar – 12 months old – Received BCG, HepB x 3 doses, OPV x 3 doses, DPT x 3
doses, MMR x 1 dose
6. Ferdinand – 15 months old – Received HepB x 2 doses, OPV x 3 doses, DPT x 3 doses,
Measles x 1 dose
7. Gary – 3 months old – Received HepB x 1 dose, OPV x 1 dose, DPT x 1 dose.
8. Holly – 6 months old – Received BCG, HepB x 1 dose, OPV x 2 doses, DPT x 2 doses.
9. Irene – 15 months old – Received HepB x 1 dose, OPV x 2 doses, DPT x 2 doses
10. Jackie – 8 months old – Received OPV x 3 doses, DPT x 3 doses, Measles x 1 dose

What are the possible side effects of a vaccine and what are the contraindications?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
 WORKSHEET NO. 5
VECTOR-BORNE DISEASES

Malaria is taken from the words mal aria which means bad air since it was previously
believed that Malaria was inhaled from polluted air. Malaria, which is endemic in some parts
of the Philippines, is an example of a vector-borne disease. The vector is an Anopheles
Mosquito which carries the parasite.

There are three types of Anopheles mosquito. Describe and compare the three types of
Anopheles.

A. flavirostris A. litoralis A. maculates

As of November 2007, 22 of the 57 provinces STUDY GUIDE

endemic for malaria have been cleared, the • What is endemic? What is
more recent ones being Marinduque, Sorsogon, epidemic? What is pandemic?
Albay in Luzon; Eastern and Western Samar in • What is a vector?
the Visayas; and Surigao del Norte. • What are the signs and
symptoms of a patient who has
Malaria?
List down the ways one can prevent the spread of Malaria:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

What are other vector-borne diseases? List down the disease, the causative agent and the vector
 WORKSHEET NO. 6
DENGUE

Dengue Fever/Dengue Hemorrhagic Fever is another example of a vector-borne disease. It is

endemic in the Philippine and other Asian and African countries. The mosquito that carries the
Dengue Virus is the Aedes aegypti.

Read up on the Aedes mosquito and describe the behavioral characteristics of the Aedes
aegypti.

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

STUDY GUIDE Dengue Fever, if left untreated, can lead to

Be ready to know the definitions of the a hemorrhagic phase. The virus affects
following words: platelet production in the body. The platelet
ensures clotting of blood, thus, if the
• Incubation Period
platelets are low in number, a person
• Asymptomatic versus
affected with the Dengue Virus can bleed
Symptomatic
spontaneously. Sites of bleeding can be in
• Carrier the gums, underneath the skin (purpuric
• Subclinical rash) or even internally such as
• Prodromal Gastrointestinal bleed (hematochezia or
• Latency hematemesis), or bleeding along the urinary
tract (hematuria).

Read up on the 4S Program of the Philippine Department of Health regarding Dengue

Outbreak Prevention. Give examples on how you can implement the 4S program in the school
or in the community. Be ready to discuss it with the class.
 WORKSHEET NO. 7
DIARRHEAL DISEASES

Review the list of causative agents in Worksheet No. 3 and identify how many of those
organisms can cause diarrheal diseases in humans. Write them down in this table and identify
how they can be transmitted (water-borne, food borne, etc).

Causative Agent Type of Organism Mode of Transmission

Define Diarrhea: ____________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
STUDY GUIDE
Prevalence of Diarrheal Diseases
correlates with the standard of living
conditions in a population. Poor housing
for example can contribute to the
development of diarrheal diseases.
What are other social factors that can
lead to the high prevalence of
diarrheal diseases in a community?
Review the story of Rosario. From the story of Rosario in Worksheet No. 2 you can identify
some measures that can prevent the occurrence of diarrheal disease. Based on the information
and your readings regarding causative agents of Diarrhea, write down five major disease
prevention strategies for diarrhea.

STRATEGY NO. 1
STRATEGY NO. 2

STRATEGY NO. 3
STRATEGY NO. 4

STRATEGY NO. 5

Review the attached Integrated Management of Childhood Illnesses Guidelines for managing
cases of diarrhea in children.
 WORKSHEET NO. 8
ANIMAL BITES

Diseases can be transmitted to humans by animals. In your Worksheet No. 3, you may
have listed down some causative agents that are transmitted by animals such as rodents, cats
and any other animal. Fill in the table below with diseases transmitted by animals and their
corresponding causative agents. They don’t have to be endemic in the Philippines:

Causative Agent Animal Carrier Name of Disease Type of Organism

One common disease a person can get from an animal is rabies. Rabies is caused by a
rhabdiriform virus and is a deadly disease. Once a person has shown signs and symptoms of
rabies, it is always 100% fatal.

Read up on Rabies and list down the signs and symptoms of this disease:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
_______________________________________________________________________

In Public Health, Rabies is one of the notifiable diseases, which means, if a person in your
community has been diagnosed with Rabies, you have to report it to the health authorities. In
the Philippines, the most common source of animal bites that lead to deaths due to Rabies is
the canine animal (dogs). Other animals include cats and bats.

There are three categories of Animal Bites/Contact that would guide the health worker in
managing and preventing Rabies. Fill up the table below and differentiate the categories based
on level of exposure to animal and the appropriate treatment.

CATEGORY ONE CATEGORY TWO CATEGORY THREE

 WORKSHEET NO. 9
SEXUALLY TRANSMITTED DISEASES

Sexually Transmitted Disease is a disease that is transmitted through sexual contact. STD’s are
highly contagious and sexually active individuals are prone to developing these illnesses,
especially when engaged in unprotected sex. Read on the various types of STD’s and based on
your readings, complete the table below:

Type of STD Causative Agent Type of Organism

Some STD’s are easily detected because they would show obvious signs and symptoms. In
some cases, STD’s are very hard to detect because they would not usually show obvious signs
and symptoms. People who have these kinds of STD’s and would continue to be sexually
active are known to be carriers of the disease and would help spread the disease. A classic
example would be the Human Immunodeficiency Virus (HIV).

HIV is transmitted not only through sexual intercourse but through other means as well. List
down the other ways a person can get infected with HIV:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
__________________________________________________________________________

Read up on HIV, especially on how the virus would “sabotage” the immune system of the
human body. Draw a diagram depicting the step by step process of how an HIV can do this.
STUDY GUIDE
What are other STD’s that can HIV is a huge burden especially among
manifest without signs and many African countries. If untreated, HIV
symptoms? can cause AIDS which is Acquired
Immunodeficiency Syndrome. What is
Discuss among your friends how a happening in the body of a person that has
person can avoid getting an STD. full-blown AIDS? _____________________
____________________________________
Debate: Are Filipino students ____________________________________
ready for Sex Education Today? ____________________________________
____________________________________
____________________________________
____________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

MINI-SURVEY. With a group of four friends/classmates, randomly ask fellow students in

campus the following questions:
1. Are you aware about HIV or AIDS? Count how many said Yes and No.
2. What do the letters H-I-V or A-I-D-S stand for? Count how many answered correctly
3. How do you get infected with HIV? Record their answers and tally.
4. Can HIV kill a person? Count how many said Yes and No and I don’t know.

Bring the results to class and be ready to share your insights during the open forum. This mini-
survey can also be done in your own adopted community.
 WORKSHEET NO. 10
INTRODUCTION TO EPIDEMIOLOGY

Define Epidemiology __________________________________________________________

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
__________________________________________________________________________

Cite 3 importance of Epidemiology in relation to Community health

1. ______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
_____________________________________________________________________
2. ______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
____________________________________________________________________
3. ______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

In epidemiology, it is important to know how data are gathered and most of all interpreted so
that conclusions that are derived from the interpretation can lead to sound recommendations
that would influence people in authority to regulate laws and policies and strategies that would
benefit the over-all health of the population. Below are some data an epidemiologist must need
to gather and interpret. Read up on their definitions and write the formula on how to calculate
for these important indicators.

1. Prevalence –

2. Incidence –

3. Crude Birth Rate –

4. Crude Death Rate

5. Cumulative Incidence –

6. Attack Rate –

7. Fertility rate –

8. Mortality rate (versus mortality ratio) -

9. Population Density

10. Literacy Rate –

11. Maternal Mortality Ratio

12. Infant Mortality Rate

The Epidemiological Triad is the traditional model for infectious disease causation. Draw the
epidemiological triad and identify its three components:

There is another form or version of the epidemiological triad as shown below. Label properly
the three components of the triad based on this new version.
 WORKSHEET NO. 11
LIFESTYLE-RELATED DISEASES

Lifestyle Disease is a disease associated with the way a person or a group of person lives.
According to latest data, Lifestyle Diseases are increasing. Unlike infectious diseases, lifestyle
or non-communicable diseases are not contagious however genetics to some extent can come
into play.

Read up on examples of these Lifestyle Diseases and based on your readings, fill up the table
below:

LIFESTYLE DISEASES POSSIBLE CAUSE/HUMAN ACTIVITY

Life communicable diseases, Lifestyle-Related diseases are also preventable. Go back to your
list of Lifestyle-related diseases and list the ways you can prevent the occurrence of these
diseases or prevent the progression of these diseases to their irreversible complications.

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

One lifestyle or human activity that has a direct link with a particular lifestyle disease is
smoking. Smoking can cause lung cancer and other forms of diseases. Read up on data and
studies regarding smoking and its effects on both the individual and the entire population as a
whole. If you are to propose an anti-smoking program in your school or in your adopted
community, how will you implement it? Write your proposal or plan of activities in the
following format:

Name of Description People Budget/Resources Outcomes

Activity responsible

Suggested strategies before you lay-out your

proposal or plan of activities:
STUDY GUIDE
a. Visit your Pulmonologist and
In the Philippines, the number of
interview him/her regarding the
women who smoke are on the
effects of smoking
rise.
b. Visit your Health Officers (City,
Provincial, etc) and ask about data
According to estimates, 250
regarding the effects of smoking
Filipinos die every day due to
c. Make a rapid survey in your
smoking-related illnesses.
community or school and measure
how many are active smokers vs.
According to the WHO, in every 8
non-smokers
seconds, a person dies due to
d. Interview random smokers and ask
smoking-related illnesses.
about their smoking habits (how
young they started, how many sticks
a day, willingness to quit, etc.)
 WORKSHEET NO. 12
WASTE DISPOSAL

Waste management is the collection, transport, processing, recycling or disposal, and

monitoring of waste materials. The term usually relates to materials produced by human
activity, and is generally undertaken to reduce their effect on health, the environment or
aesthetics. Waste management is also carried out to recover resources from it. Waste
management can involve solid, liquid, gaseous or radioactive substances, with different
methods and fields of expertise for each.

Describe each method of solid waste disposal and focus on the advantages and
disadvantages of each method.

Types of Solid Waste Advantages Disadvantages

Disposal
LANDFILL

Landfill – Trench method

Landfill - Area method

Sanitary Landfill
Incinerator

Recycling Plants

Composting

Another form of Solid waste is Human Excreta. Management of human excreta is essential in
public health because human waste carries germs that can cause diseases and can spread and
contaminate clean water and food source. There are many ways of disposing human excreta.
On the paper provided, draw the set-up for the following forms of Human excreta disposal:

a. Simple pit latrine

b. Ventilated Improved Pit (VIP)
c. Pour flush latrines
d. Composting latrines
e. Aquaprivies
f. Septic Tanks
g. Sewerage and sewage sanitation

For each method of waste sanitation there can be many variants. Be aware of these variants and
read up on them. Research on how many Filipino homes are practicing such methods of human
waste sanitation.
 WORKSHEET NO. 13
WATER SANITATION

Water is essential for life and for quality health. It is important therefore to ensure a potable
water supply for human consumption in order to preserve quality public health.

There are many ways to use water. Water can be utilized for direct human consumption
(drinking, bathing, washing of laundry, etc). Water can also be utilized for agricultural
purposes such as irrigation or as water source for cattle. It can also be utilized for industry such
as production of processed food or beverages. Water can also be used for recreational
activities.

There are two general types of water: salt and fresh water. Draw a diagram or picture of the
many sources of fresh water. Label.

There are three levels of water systems in the Philippines. According to data, only 63% of the
total population have access to potable water supply in 20002.
2
World Bank (December 2005). Philippines: Meeting Infrastructure Challenges. Retrieved
2008-04-09., p. 107
Describe the three levels of water systems in the Philippines and illustrate.

Levels of Water Supply Definition Examples

Illustration:
Review of the water Cycle:

Identify human activities that would create “water stress” or affect the water supplies in our
communities. Be ready to share insights during the open forum.

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
_________________________________________________________________________
Bacteriological Water testing is a method of analysing the presence of pathogenic bacteria in
water, measuring their count and if possible sorting their types. It is a microbiological
analytical procedure which uses samples of water and from these samples determines the
concentration of bacteria. It is then possible to draw inferences about the suitability of the
water for use from these concentrations. This process is used, for example, to routinely confirm
that water is safe for human consumption or that bathing and recreational waters are safe to
use.

There are many methodologies of Bacteriological water analysis. Read on them and describe
one method:

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

The presence of Microorganisms is just one of the factors you must consider in analysing water
sources. There are four other major factors you must also consider:

1. ____________________________________
2. ____________________________________
3. ____________________________________
4. ____________________________________

Presence of elements and minerals are relevant in the analysis of a water source. Outline at
least 4 of these elements and minerals and describe how the presence or absence of these
minerals and elements affect the suitability of a water source.
Elements/Minerals Relevance
Water Analysis may be performed by the class. A different set of instructions will be given by
your teacher.
 WORKSHEET NO. 14
THE GREEN IDEA

Incorporating every concept and principle learned, think of one Innovative and Creative Idea
that can propose a solution to a particular environmental or public health problem of a local
community, school or even the entire City.

It must be grounded on facts (data gathering) and must answer the question, “Why?” Why
focus on that particular problem? Why the urgency and attention?

The Green Idea can be a modification of an original concept already being applied elsewhere
and customized to fit the proposed recipients or beneficiaries. Original ideas however are
highly encouraged.

Experts will be invited to comment on the Green Idea based on the following criteria:
Innovation, Applicability (feasibility), Ability to Address Problem, Knowledge of Principles in
Environmental Sanitation and Community Health, Knowledge About the problem.

An exhibit of Green Ideas will be done by the end of the course. The exhibits will be judged as
well.

Suggested Areas to focus are:

1. Prevention of Dengue and other Mosquito-borne diseases
2. Solid waste management
3. Water sanitation
4. Reduction of air pollution
5. Reduction of Animal Bites
6. Efficient Waste Collection
7. Zero-Waste Strategies