TOS: CHAPTERS 2, 3, 4, & 6

EPIDEMIOLOGY OF HUMAN DISEASES

 Disease is an impairment of the normal function of the body

o Signs and symptoms take time to manifest because of the incubation period
o Infection starts when infectious agents enter the body
 Global burden
o Quantified in quality-adjusted life years or disability-adjusted life years
o Length of time humans exist

DEFINITIONS

 Window period – term referring to the timeframe where the person is infected but the person is
serologically inactive, the antibodies are slowly developing where it is not enough for detection,
leading to false negative.

EPIDEMIOLOGIC TRIANGLE (communicable diseases)

 THE ENVIRONMENT – contribute to the conduciveness of the organism to grow

o Providing for the survival of the organism
o Reservoir
 Zoonotic infection
 Carrier – asymptomatic
 THE INFECTIOUS AGENTS – bacteria, virus, fungi, parasite
o Intrinsic properties
 Morphology – culture, staining procedures
 Chemical composition
 Antigenic property
 Antibiotic resistance
 Antigenic variation – viruses (changes in spikes), difficulty in making vaccines
o Host-agent interactions
 Infectivity – infective dose
► Example: Giardia lamblia where 10 cysts is required to have an infection
► Measure by SAR and IR (infection rate)
 Immunogenicity – person’s ability of develop antibodies to the organism
► IgM – first antibodies formed, primary response to acute infection
► IgG – chronic infections, found in secretions
 Pathogenicity
 Virulence – every organism has a virulent factor, help the organism to build
infection
 Toxigenicity – not all organisms are capable of making toxin
 Resistance – capability of organism to protect itself.
 THE HOST – protection
o EDIT: Low pH of gastric juice – HCl
o Cell-mediated – provided by T-cells, special lymphocytes
 o Humoral immunity – provided by B-cells (transform themselves to antibody “plasma
cells”), special lymphocytes
o 3rd line of defense – antibody production
 Memory cells for secondary attack of infection
o Generation time – incubation period
o Herd immunity - community
o Host Agent Spread:
 Sporadic – pasulpot-sulpot sa community, mawawala din after (intermittent)
 Endemic – may certain time frame na nandoon siya, nagtagal na siya sa isang
place
 Epidemic – excess number
 Pandemic – worldwide

EPIDEMIOLOGY OF NON-COMMUNICABLE DISEASES

 Burden of NCDs – 43% (chronic)

 Group of NCDs
o Genetic disorders – non modifiable risk (wala nang magagawa pa)

NATURAL HISTORY

 Retrospective study – going backward

o Knowing the risk factors
 Time frame
o Years or decades
o Risk factors are cumulative over a long time-frame
 Chronicity

REASONS FOR THE PROMINENCE OF NCD

 Impact of automobiles – pollution

 Social and behavioral factors – the most difficult to handle, challenges we need to address to

PART 2

NON-COMMUNNICAABLE DISESASES

 Make a decision matrix for modifiable risks

 Chronic (except chemical poisoning – acute)
 Top 1: cardiovascular diseases
o Because of lifestyle
CARDIOVASCULAR DISEASES

 Risk factors
o High cholesterol – cholesterol deposits in the heart valves, leading to constrictions

DIABETES MELLITUS

 Insulin - lowers glucose

 One will die due to complications of diabetes
o Stroke
o Kidney failure
o Amputations
 Type 1 – childhood onset, insulin-dependent
o Deficient insulin production
 Type 2 – adult onset, non-insulin
o Lead to increase body weight
 Gestational diabetes mellitus
o Cause premature delivery
 Signs and symptoms
o Polyuria – urinating frequently
o Polydipsia – drinking water frequently
o Polyphagia – eating frequently

CANCER

 Earlier detected due to tumor markers (early detectors), associated to neoplastic conditions
 Physical – carcinogenesis
 Chemical
 Biological - genetics
 Oncovirus – agent associated to cancer
o HPV – Pap’s smear
o Mammography – lumps on breast if benign or malignant
 Consumption moderately

CHRONIC RESPIRATORY DISEASES

 Non curable
 Shortness of breath due to lack of oxygen supply, in the exchange of gases
 Types:
o Asthma – given medications to dilate blood vessels
o Occupational lung disease – exposed to chemical agents (e.g asbestosis)
o COPD – chronic smokers (irreversible, can lead to lung canacer)
 Emphysema or bronchitis
 Second hand smoking
o Pulmonary hypertension
MENTAL DISORDERS

 Referred to psychologists
 Triggered by depression
 Types:
o Depression
 Suicide
o Bipolar disorder
o Schizophrenia
 Severe
o Dementia
 Chronic progressive
o Developmental disorders

PART 3

MODIFIABLE RISK FACTORS

 Physical inactivity
 Tobacco use
o Through strong policy
 Alcohol use
 Unhealthy diets

NON-MODIFIABLE RISK FACTORS

 Age
 Gender
 Race
 Family history (genetics)

There are many factors overlapping