NLE Community Health Nursing — Communicable Disease Control & ImmunizationConcept Map

Concept

Levels of Prevention

Sub Concepts

• Primary Prevention: Health education, immunization, sanitation, safe water, nutrition, vector control
• Secondary Prevention: Case-finding, screening, contact tracing, early diagnosis and treatment
• Tertiary Prevention: Management of complications, disability limitation, rehabilitation

Relationship To Central

Framework for disease control strategy

Concept

Immunity & Immunization

Sub Concepts

• Active Immunity: Natural (disease), Artificial (vaccines/toxoids)
• Passive Immunity: Natural (maternal antibodies), Artificial (immunoglobulins/antisera)
• Herd Immunity: Population-level protection when high proportion is immune
• Vaccine Types: Live attenuated, inactivated, toxoids, recombinant

Relationship To Central

Core mechanism of primary prevention

Concept

Expanded Program on Immunization (EPI)

Sub Concepts

• Launch: 1976 by DOH
• Legal Basis: PD 996 (compulsory), RA 10152 (2011 Mandatory Infants and Children Health Immunization Act)
• Target Diseases: TB, diphtheria, pertussis, tetanus, polio, measles (expanded to include Hep B, Hib, PCV)
• Routine Infant Schedule: BCG (birth), Hep B (birth), Pentavalent/OPV/PCV (6-10-14 weeks), IPV (14 weeks & 9 months), Measles (9 months), MMR (12 months)
• Immunization Coverage Milestones: FIC (Fully Immunized Child), CIC (Completely Immunized Child), CPAB (Child Protected at Birth)

Relationship To Central

Flagship DOH immunization program

Concept

Vaccine Administration & Cold Chain

Sub Concepts

• Routes: Intradermal (BCG-0.05mL), Intramuscular (DPT, Hep B, PCV, IPV-0.5mL), Subcutaneous (Measles/MMR), Oral (OPV 2-3 drops)
• Cold Chain Storage: Health center/RHU (+2°C to +8°C), Regional/provincial freezer (−15°C to −25°C)
• Heat-Sensitive Vaccines: OPV (most sensitive), Measles, BCG
• Freeze-Sensitive Vaccines: DPT, Hep B, Td, Pentavalent (shake test detects freezing)
• Stock Management: FEFO (First Expiry First Out), VVM (Vaccine Vial Monitor), proper documentation

Relationship To Central

Technical implementation of immunization

Concept

Notifiable Diseases & Surveillance

Sub Concepts

• Philippine Integrated Disease Surveillance and Response (PIDSR)
• Immediately Notifiable (24 hours): Acute flaccid paralysis, measles, neonatal tetanus, cholera, meningococcal disease, rabies
• Weekly Notifiable: Dengue, typhoid, TB
• Nurse Role: Prompt reporting, investigation initiation, outbreak response

Relationship To Central

Secondary prevention through early detection

Concept

National TB Control Program (NTP) & DOTS

Sub Concepts

• DOTS Strategy: 5 elements (political commitment, case detection, standardized treatment with DOT, drug supply, recording/reporting)
• Diagnosis: GeneXpert-Xpert MTB/RIF (primary), Direct Sputum Smear Microscopy (DSSM) for follow-up
• Anti-TB Drugs (1st-line): H (isoniazid), R (rifampicin), Z (pyrazinamide), E (ethambutol), S (streptomycin)
• Treatment Regimens: Category I (new TB-2HRZE/4HR), Category II (previously treated-longer regimen), MDR-TB (PMDT)
• Nursing Responsibilities: DOT observation, treatment partner identification, adherence education, contact tracing, side effect monitoring, cough etiquette teaching

Relationship To Central

Major communicable disease control program

Concept

Dengue Control

Sub Concepts

• Vector: Aedes aegypti (day-biting mosquito), breeds in clean stagnant water
• Disease Characteristics: 4 serotypes (DENV 1-4), secondary dengue infection can be severe
• DOH 4-S Strategy: Search and destroy breeding sites, Self-protection measures, Seek early consultation, Support fogging in hotspots
• Nursing Role: Community education, warning sign recognition, early care promotion, hydration management

Relationship To Central

Endemic disease control in Philippines

Concept

Other Endemic Diseases

Sub Concepts

• Malaria: Anopheles mosquito (night-biter), treated bed nets, endemic provinces
• Schistosomiasis: Schistosoma japonicum, Oncomelania snail, endemic in Visayas & Mindanao
• Filariasis, Leprosy (Hansen's disease), Rabies: Dedicated DOH elimination programs

Relationship To Central

Context-specific communicable disease control

Concept

Community Health Nursing Practice Standards

Sub Concepts

• RA 9173 (Philippine Nursing Act): Licensure and professional scope
• NCM Levels: I-IV competencies in community health nursing
• Nursing Process Application: Assessment, diagnosis, planning, implementation, evaluation in disease control
• NANDA Nursing Diagnoses: Health-seeking behaviors, risk for infection, knowledge deficit, non-compliance

Relationship To Central

Professional framework for implementation

To

Expanded Program on Immunization

From

Levels of Prevention

Strength

strong

Relationship

Immunization is the classic example of primary prevention-specific protection

To

Expanded Program on Immunization

From

Immunity Concepts

Strength

strong

Relationship

Understanding active immunity mechanisms is essential for understanding how vaccines work

To

Vaccine Administration & Cold Chain

From

Expanded Program on Immunization

Strength

strong

Relationship

EPI schedules must be implemented with proper vaccine handling and cold chain maintenance

To

Expanded Program on Immunization

From

Vaccine Administration & Cold Chain

Strength

strong

Relationship

Cold chain failures directly compromise EPI vaccine potency and program effectiveness

To

Levels of Prevention

From

Notifiable Diseases & Surveillance

Strength

strong

Relationship

Disease surveillance enables secondary prevention through early detection and outbreak response

To

Secondary Prevention

From

National TB Control Program (NTP) & DOTS

Strength

strong

Relationship

DOTS represents secondary prevention through case detection and early treatment

To

Notifiable Diseases & Surveillance

From

National TB Control Program (NTP) & DOTS

Strength

moderate

Relationship

TB is a weekly notifiable disease requiring PIDSR reporting and epidemiological follow-up

To

Levels of Prevention

From

Dengue Control

Strength

strong

Relationship

Dengue control integrates all three levels: primary (vector control), secondary (early care), tertiary (complication management)

To

Notifiable Diseases & Surveillance

From

Dengue Control

Strength

moderate

Relationship

Dengue is a weekly notifiable disease critical for outbreak surveillance in the Philippines

To

Community Health Nursing Practice Standards

From

Vaccine Administration & Cold Chain

Strength

strong

Relationship

Proper vaccine administration and cold chain management are NCM Level II-III competencies

To

Community Health Nursing Practice Standards

From

National TB Control Program (NTP) & DOTS

Strength

strong

Relationship

DOTS observation is a core NCM Level II community health nursing responsibility

To

Community Health Nursing Practice Standards

From

Dengue Control

Strength

moderate

Relationship

Community-based dengue prevention aligns with NCM Level I-II community health nursing roles

To

Community Health Nursing Practice Standards

From

Expanded Program on Immunization

Strength

strong

Relationship

EPI immunization delivery and advocacy are core NCM Level I competencies in community health nursing

To

Levels of Prevention

From

Other Endemic Diseases

Strength

moderate

Relationship

Endemic diseases like malaria and schistosomiasis require application of all three prevention levels

To

Community Health Nursing Practice Standards

From

Other Endemic Diseases

Strength

moderate

Relationship

Control programs for endemic diseases are context-specific implementations of community health nursing

To

Expanded Program on Immunization

From

Herd Immunity

Strength

strong

Relationship

High EPI coverage targets achieve herd immunity to break disease transmission chains

To

Levels of Prevention

From

Tetanus Protection

Strength

moderate

Relationship

Maternal tetanus immunization (Td) prevents neonatal tetanus—classic primary prevention targeting vulnerable population

To

National TB Control Program (NTP) & DOTS

From

Treatment Adherence

Strength

strong

Relationship

Poor adherence leads to drug resistance and treatment failure; DOT enforces adherence

To

Secondary Prevention

From

Case Detection

Strength

strong

Relationship

Early case detection through quality-assured diagnostics enables prompt treatment initiation

To

Dengue Control

From

Vector Control

Strength

strong

Relationship

Vector control (search and destroy) is the foundation of dengue prevention in endemic areas