Community Health and Hygiene: Disease Prevention, Water and Immunisation
This domain tests health concepts, communicable disease control, safe water, sanitation, personal hygiene, immunisation and first aid. Answers should name the causative agent or mode of transmission and then give a feasible preventive measure.
Core rules
- WHO (1948) defines health as complete physical, mental and social well-being, not merely the absence of disease.
- The disease triad is agent, host and environment. Modes of transmission include air, water, food, vectors, contact and blood.
- Safe water: boiling, filtration, chlorination. Sanitation: safe excreta disposal, refuse disposal, food hygiene and handwashing with soap at critical times.
- Under India's Universal Immunisation Programme: BCG, OPV-0 and hepatitis B at birth; pentavalent and OPV at 6, 10 and 14 weeks; measles–rubella at 9–12 months and 16–24 months; DPT booster at 16–24 months; TT at 10 and 16 years.
- Acute diarrhoea: ORS and zinc, continued breastfeeding and feeding. Zinc is given for 14 days (10 mg/day under 6 months; 20 mg/day older).
Worked example
A 1-year-old has acute watery diarrhoea with no signs of dehydration. Reasoning: the priority is preventing fluid loss, so give ORS after each loose stool, add zinc for 14 days, and continue breastfeeding and soft food. Antibiotics are not routine because most acute watery diarrhoea is viral. Refer urgently if there is blood, persistent vomiting, sunken eyes, lethargy or poor intake. This combines nutrition, child care and community health.
Traps
Calling homemade sugar–salt water equivalent to standard ORS; giving antibiotics for viral colds; claiming vaccines cause autism; omitting the second measles–rubella dose; describing handwashing without soap or without naming critical times.
Exam focus
Mode of transmission, prevention, immunisation schedule and first-aid sequencing.