INTRODUCTION TO EPIDEMIOLOGY

PREPARED BY: MS. RITZEL ROSE TABUJARA-GERBOLINGA

TOPIC OUTLINE
Definition of Epidemiology

Aims & Principles of Epidemiology

Use of Epidemiology &

Epidemiological Approach

Historical Developments in
Epidemiology

Tools of Epidemiological
Measurements & Levels of Disease
 SESSION
OBJECTIVES
• Define epidemiology and its related
terms
• Explain the aims and principles of
epidemiology
• Describe the uses & approaches of
epidemiology
• Identify the important figures and
events in the historical development
of epidemiology
• Identify the tools in epidemiology
and levels of disease
DEFINITION OF
EPIDEMIOLOGY

• The word “epidemiology” is derived

from the Greek words:
epi “upon”, demos “people” and
logos “study”.

Adapted from John Last “A Dictionary

of Epidemiology”
 • the study of the distribution and
determinants of health-related states or
DEFINITION OF events in specified populations and the
EPIDEMIOLOGY application of this study to the prevention
and control of health problems
STUDY

includes:
surveillance,
observation,
hypothesis testing,
analytic research and
experiments
 Distribution
(Descriptive
Epidemiology
refers to analysis of:
times, persons, places
and classes of people
affected

Epidemiology is
concerned with the
frequency and pattern
of health events in a
population
Determinants (Analytic
Epidemiology)
Provide the “Why” and “How” of such events
Health-related states and
events

• Refer to diseases, causes

of death, behaviours
such as use of tobacco,
positive health states,
reactions to preventive
regimes and provision
and use of health
services.
Specified populations
include those
with
identifiable
characteristics
, such as
occupational
groups.
Application to prevention and control
the aims of public health—to promote, protect, and restore health.
Ultimate AIM
Aims of epidemiology

• To describe the distribution and

magnitude of health and disease
problems in human populations
• To identify risk factors of disease
• To provide the data essential to
the planning , implementation
and evaluation of services for the
prevention , control and
treatment of disease and to the
setting up of priorities among
those services.
Epidemiological Principles
• Diseases (or other health
events) don’t occur at random

• Diseases (or other health

events) have causal and
preventive factors which can be
identified
Uses of epidemiology:

• Investigation of causation of disease

Genetic factors

Good health Disease

Environmental factors
USES OF EPIDEMIOLOGY

• Epidemiology is the cornerstone of public health, and

informs policy decisions and evidence-based practice by
identifying risk factors for disease and targets for preventive
healthcare.
Uses of epidemiology:
• Study of the natural history and prognosis of disease

Good Subclinical Clinical

Death Recovery
health changes diseases
 Uses of epidemiology:
Describe the health status of populations
Uses of epidemiology:
Investigate diseases outbreak
Uses of •Evaluate intervention
epidemiology:
Uses of epidemiology:

•Planning and evaluation

Uses of
epidemiology:

•Explain
mechanism of
disease
transmission
Epidemiological Approach

Foundations

Asking questions

Making Comparisons
Asking Questions

Related to Health Events Related to health action

What is the problem? What can be done to
reduce this problem?
What is its magnitude? How can it be prevented
in the future?
Where did it happen? What difficulties may
arise?
When did it happen
What types of questions can epidemiology answer?
Is it an epidemiological
Type of question
question? (Y/N) & why
How common is heart disease
in KSA?
Is heart disease more
common in the KSA compared
with Japan?
Why did Mr. X develop
breathlessness?
What types of questions can epidemiology answer?
Is it an epidemiological
Type of question
question? (Y/N) & why
How common is heart disease yes /Addresses frequency of disease
in KSA?
Is heart disease more Yes /Addresses frequency and
common in the KSA compared distribution of disease
with Japan?
Why did Mr. X develop NO /Addresses disease in an individual,
breathlessness? not population
Making Comparisons
• Between 2/more groups/ individuals
• With and without the disease
• Considerations: comparability between study
and control groups
• Similar with age, gender, other variables
• Randomization/random allocation- best
method
History of epidemiology

Hippocrates 5th
Century BC

• Profound influence
• Association between external
environment (air, water, places)
and personal characteristics
(exercise, eating habits) and
health
History of epidemiology

• John Graunt,
Haberdasher, 1662
• 1st epidemiologist and
demographer
• Analyzed weekly
reports of births and
deaths in London
History of epidemiology

• John Snow ,Physician,

1854:Broad street Pump
• Founding father of
both epidemiology and
anesthesiology
• Cholera outbreak > 500
deaths in 10 days.
• Waterborne infection
• Pioneer of
epidemiologic study
design
Broad Street Pump
 Tools of measurement in
Epidemiology

• Rate
• A rate is a measure of the frequency with which an event occurs in a
defined population in a defined time
• e.g., number of deaths per 1000 population in one year.
• Ratios
• The value obtained by dividing one quantity by another
• E.g., the student to teacher ratio in a school.
• Proportion
• A proportion is the comparison of a part to the whole
• Percentage
Rate
RATIO
Proportion
Disease outbreak
• A disease outbreak happens when a disease occurs in greater
numbers than expected in a community or region or during a season.
• An outbreak may occur in one community or even extend to several
countries.
Level of disease

pandemic
epidemic

endemic

sporadic
 Level of disease
Sporadic refers to a disease
that occurs infrequently and
irregularly.

pandemic
epidemic

endemic

sporadic
 Level of disease
Endemic refers to the constant
presence and/or usual prevalence of
a disease or infectious agent in a
population within a geographic area.
pandemic
epidemic

endemic

sporadic
 Level of disease
Epidemic refers to an increase,
often sudden, in the number of
cases of a disease above what is
normally expected in that
population in that area pandemic
epidemic

endemic

sporadic
 Level of disease
Pandemic refers to an
epidemic that has spread
over several countries or
continents, usually
affecting a large number
pandemic
of people.
epidemic

endemic

sporadic
Thank you for
listening ☺
SELF ASSESSMENT ACTIVITY 1

1. In the definition of epidemiology,

“distribution” refers to:
a. Who
b.When
c. Where
d.Why
SELF ASSESSMENT ACTIVITY
•In the definition of epidemiology,
“determinants” generally includes:
A.Agents
B.Causes
C.Control measures
D.Risk factors
E. Sources
 Activity 2
• Below are three key terms taken from
the definition of epidemiology,
followed by a list of activities that an
epidemiologist might perform. Match
the term to the activity that best
describes it. You should match only
one term per activity.
• A. Distribution
• B. Determinants
• C. Application
• _______1.Compare food histories between persons with
Staphylococcus food poisoning and those without
• _______2. Compare frequency of brain cancer among anatomists
with frequency in general population
• ________3. Mark on a map the residences of all children born with
birth defects within 2 miles of a hazardous waste site
• ________4. Graph the number of cases of congenital syphilis by year
for the country
• _____ __5. Recommend that close contacts of a child recently
reported with meningococcal meningitis receive Rifampin
• _____ ___6. Tabulate the frequency of clinical signs, symptoms, and
laboratory findings among children with chickenpox in Cincinnati, Ohio
 Activity 3
• For each of the following
situations, identify whether
it reflects:
• A. Sporadic disease
• B. Endemic disease
• C. Pandemic disease
• D. Epidemic disease
_____ 1. 22 cases of legionellosis occurred
within 3 weeks among residents of a
particular neighborhood (usually 0 or 1 per
year)
_____ 2. Over 20 million people worldwide
died from influenza in 1918—1919
_____ 3. Single case of histoplasmosis was
diagnosed in a community
_____ 4. About 60 cases of gonorrhea are
usually reported in this region per week,
slightly
less than the national average