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• •

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o

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▪
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❖
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𝑆𝐴𝑅
#𝑛𝑒𝑤 𝑐𝑎𝑠𝑒𝑠 𝑖𝑛 𝑔𝑟𝑜𝑢𝑝 − 𝑖𝑛𝑖𝑡𝑖𝑎𝑙 𝑐𝑎𝑠𝑒𝑠 •
=
#𝑠𝑢𝑠𝑐𝑒𝑝𝑡𝑖𝑏𝑙𝑒 𝑝𝑒𝑟𝑠𝑜𝑛𝑠 𝑖𝑛 𝑔𝑟𝑜𝑢𝑝 − 𝑖𝑛𝑖𝑡𝑖𝑎𝑙 𝑐𝑎𝑠𝑒𝑠

•
#𝑝𝑒𝑟𝑠𝑜𝑛𝑠 𝑤𝑖𝑡ℎ 𝑎𝑛𝑡𝑖𝑏𝑜𝑑𝑦 𝑟𝑒𝑠𝑝𝑜𝑛𝑠𝑒
𝐼𝑅 =
𝑡𝑜𝑡𝑎𝑙 𝑛𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑒𝑥𝑝𝑜𝑠𝑒𝑑
•

o
o
o
❖ o
o
❖
❖ o
•
o

#𝑖𝑛𝑓𝑒𝑐𝑡𝑒𝑑 𝑝𝑒𝑟𝑠𝑜𝑛𝑠 𝑤𝑖𝑡ℎ 𝑑𝑖𝑠𝑒𝑎𝑠𝑒

𝑃𝑎𝑡ℎ𝑜𝑔𝑒𝑛𝑖𝑐𝑖𝑡𝑦 =
𝑡𝑜𝑡𝑎𝑙 𝑛𝑢𝑚𝑏𝑒𝑟 𝑖𝑛𝑓𝑒𝑐𝑡𝑒𝑑 𝑝𝑒𝑟𝑠𝑜𝑛𝑠
 o

•
•
•
•
•
• •
• •
•
• o
• •

• ▪
o

•
o

❖
 o

o →

•
•

o
o
o

Single necessary agent No single necessary agent

Agent-disease
Seldom agent-disease specificity
specificity
Causes are unknown
Causes are known Intervention often based on risk
factors
Short incubation period Long Latency period

Single exposure usually May require multiple exposure to

•
sufficient same or multiple agents
•
Usually produce acute Most often produce chronic
disease disease
•
Acquired immunity
o Acquired immunity unlikely
disease
Diagnosis based on
Diagnosis often dependent on
• tests specific to disease
non-specific symptoms or tests
agent
•
•
• •
•

•
 •
Epidemiologic Measures

Ratio Count

Rate (Crude, Specific,

Proportion
Adjusted)
•
o
𝑇𝑟𝑢𝑒 𝑃𝑜𝑠𝑖𝑡𝑖𝑣𝑒 Prevalence Incidence Rate (attack Rate)
𝑥 100
𝑇𝑟𝑢𝑒 𝑃𝑜𝑠𝑖𝑡𝑖𝑣𝑒 + 𝐹𝑎𝑙𝑠𝑒 𝑁𝑒𝑔𝑎𝑡𝑖𝑣𝑒
o Point Period
Prevalence Prevalence
𝑇𝑟𝑢𝑒 𝑁𝑒𝑔𝑎𝑡𝑖𝑣𝑒
𝑥 100
𝑇𝑟𝑢𝑒 𝑁𝑒𝑔𝑎𝑡𝑖𝑣𝑒 + 𝐹𝑎𝑙𝑠𝑒 𝑃𝑜𝑠𝑖𝑡𝑖𝑣𝑒
•
•
o •

o
o
o
𝑇𝑟𝑢𝑒 𝑃𝑜𝑠𝑖𝑡𝑖𝑣𝑒
𝑃𝑃𝑉 = 𝑥 100 •
𝑇𝑟𝑢𝑒 𝑃𝑜𝑠𝑖𝑡𝑖𝑣𝑒 + 𝐹𝑎𝑙𝑠𝑒 𝑝𝑜𝑠𝑖𝑡𝑖𝑣𝑒
𝑇𝑟𝑢𝑒 𝑁𝑒𝑔𝑎𝑡𝑖𝑣𝑒
𝑁𝑃𝑉 = 𝑥 100
𝑇𝑟𝑢𝑒 𝑁𝑒𝑔𝑎𝑡𝑖𝑣𝑒 + 𝐹𝑎𝑙𝑠𝑒 𝑁𝑒𝑔𝑎𝑡𝑖𝑣𝑒

• o

• •
o

o •

• •
𝑎
• 𝑅𝑖𝑠𝑘 𝑜𝑓 𝑑𝑖𝑠𝑒𝑎𝑠𝑒 𝑖𝑛 exposed
= 𝑎+
𝑐
𝑏
𝑅𝑖𝑠𝑘 𝑜𝑓 𝑑𝑖𝑠𝑒𝑎𝑠𝑒 𝑖𝑛 𝑢𝑛𝑒𝑥𝑝𝑜𝑠𝑒𝑑
𝑐+𝑑
• o
•

•
 •
o

•
o

𝑁𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑀𝑎𝑙𝑒 𝑐𝑎𝑠𝑒𝑠 950

= = 19: 1 𝑚𝑎𝑙𝑒 𝑡𝑜 𝑓𝑒𝑚𝑎𝑙𝑒
𝑁𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝐹𝑒𝑚𝑎𝑙𝑒 𝑐𝑎𝑠𝑒𝑠 50
o

𝑁𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑀𝑎𝑙𝑒𝑠 151, 781, 326

𝑥 100 = 𝑥 100 = 96.7
𝑁𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝐹𝑒𝑚𝑎𝑙𝑒𝑠 16, 964, 212
o o
# 𝑜𝑓 𝑑𝑒𝑎𝑡ℎ𝑠 𝑖𝑛 𝑎 𝑔𝑖𝑣𝑒𝑛 𝑦𝑒𝑎𝑟
𝐶𝐷𝑅 = 𝑥 100,000
𝑅𝑒𝑓𝑒𝑟𝑒𝑛𝑐𝑒 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 (𝑑𝑢𝑟𝑖𝑛𝑔 𝑚𝑖𝑑𝑝𝑜𝑖𝑛𝑡 𝑜𝑓 𝑦𝑒𝑎𝑟)

𝑁𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑀𝑎𝑙𝑒 𝑏𝑖𝑟𝑡ℎ𝑠

𝑆𝑒𝑥 𝑟𝑎𝑡𝑖𝑜 𝑎𝑡 𝑏𝑖𝑟𝑡ℎ = 𝑥 1,000
𝑁𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝐹𝑒𝑚𝑎𝑙𝑒 𝑏𝑖𝑟𝑡ℎ𝑠

• 2,423,712
𝐶𝐷𝑅 = 𝑥 100,000 = 803.6 𝑝𝑒𝑟 100,000
301,621,157

𝐴 •
𝑃𝑟𝑜𝑝𝑜𝑟𝑡𝑖𝑜𝑛 (𝑃) =
𝐴+𝐵
• •
o

o •

o
𝐴 1,400 •
𝑃 = = = 0.127 𝑜𝑟 12.7%
𝐴+𝐵 11,050

• •
o
•

o
𝑁𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑒𝑣𝑒𝑛𝑡𝑠 𝑖𝑛 𝑡𝑖𝑚𝑒 𝑝𝑒𝑟𝑖𝑜𝑑
𝑅𝑎𝑡𝑒𝑠 =
𝑁𝑢𝑚𝑏𝑒𝑟 𝑎𝑡 𝑟𝑖𝑠𝑘 𝑓𝑜𝑟 𝑡ℎ𝑒 𝑒𝑣𝑒𝑛𝑡 𝑖𝑛 𝑝𝑒𝑟𝑖𝑜𝑑
 o
•

• •

•
# 𝑜𝑓 𝑑𝑒𝑎𝑡ℎ𝑠 𝑟𝑒𝑙𝑎𝑡𝑒𝑑 𝑡𝑜 𝑐ℎ𝑖𝑙𝑑𝑏𝑖𝑟𝑡ℎ
𝑥 100,000 𝑙𝑖𝑣𝑒 𝑏𝑖𝑟𝑡ℎ𝑠
# 𝑜𝑓 𝑙𝑖𝑣𝑒 𝑏𝑖𝑟𝑡ℎ𝑠 𝑤/𝑖𝑛 𝑝𝑒𝑟𝑖𝑜𝑑 # 𝑜𝑓 𝑖𝑛𝑓𝑎𝑛𝑡 𝑏𝑖𝑟𝑡ℎ𝑠
𝐶𝑟𝑢𝑑𝑒 𝑏𝑖𝑟𝑡ℎ 𝑑𝑎𝑡𝑒 = 𝑥 1,000 𝑝𝑜𝑝
𝑃𝑜𝑝 𝑠𝑖𝑧𝑒 𝑎𝑡 𝑡ℎ𝑒 𝑚𝑖𝑑𝑑𝑙𝑒 𝑜𝑓 𝑝𝑒𝑟𝑖𝑜𝑑
• •
o

o •

•
203,694
𝐶𝑟𝑢𝑑𝑒 𝑏𝑖𝑟𝑡ℎ 𝑑𝑎𝑡𝑒 = x 1,000 = 𝟐. 𝟖𝟒
71,723,373
𝟐. 𝟖𝟒 𝐫𝐞𝐠𝐢𝐬𝐭𝐞𝐫𝐞𝐝 𝐥𝐢𝐯𝐞 𝐛𝐢𝐫𝐭𝐡𝐬 𝐩𝐞𝐫 𝟏, 𝟎𝟎𝟎 𝐩𝐨𝐩𝐮𝐥𝐚𝐭𝐢𝐨𝐧

•
•

• •

• •

•
# 𝑜𝑓 𝑖𝑛𝑓𝑎𝑛𝑡 𝑑𝑒𝑎𝑡ℎ𝑠 𝑑𝑢𝑟𝑖𝑛𝑔 𝑡ℎ𝑒 𝑦𝑒𝑎𝑟
𝑥 1,000 𝑙𝑖𝑣𝑒 𝑏𝑖𝑟𝑡ℎ𝑠
# 𝑜𝑓 𝑖𝑛𝑓𝑎𝑛𝑡 𝑙𝑖𝑣𝑒 𝑏𝑖𝑟𝑡ℎ𝑠 𝑑𝑢𝑟𝑖𝑛𝑔 𝑡ℎ𝑒 𝑦𝑒𝑎𝑟
# 𝑜𝑓 𝑑𝑒𝑎𝑡ℎ𝑠 𝑎𝑚𝑜𝑛𝑔 𝑝𝑒𝑟𝑠𝑜𝑛𝑠 𝑤𝑖𝑡ℎ 𝑑𝑖𝑠𝑒𝑎𝑠𝑒
# 𝑜𝑓 𝑝𝑒𝑟𝑠𝑜𝑛𝑠 𝑤𝑖𝑡ℎ 𝑑𝑖𝑠𝑒𝑎𝑠𝑒

# 𝑜𝑓 𝑖𝑛𝑓𝑎𝑛𝑡 𝑑𝑒𝑎𝑡ℎ𝑠
𝑥 1,000 𝑙𝑖𝑣𝑒 𝑏𝑖𝑟𝑡ℎ𝑠 𝑑𝑢𝑟𝑖𝑛𝑔 𝑎 𝑦𝑒𝑎𝑟
# 𝑜𝑓 𝑖𝑛𝑓𝑎𝑛𝑡 𝑙𝑖𝑣𝑒 𝑏𝑖𝑟𝑡ℎ𝑠

# 𝑜𝑓 𝑖𝑛𝑓𝑎𝑛𝑡 𝑑𝑒𝑎𝑡ℎ𝑠
𝑥 1,000 𝑙𝑖𝑣𝑒 𝑏𝑖𝑟𝑡ℎ𝑠
# 𝑜𝑓 𝑖𝑛𝑓𝑎𝑛𝑡 𝑙𝑖𝑣𝑒 𝑏𝑖𝑟𝑡ℎ𝑠 − 𝑛𝑒𝑜𝑛𝑎𝑡𝑎𝑙 𝑑𝑒𝑎𝑡ℎ𝑠
•
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• → One case of unusual

findings
• → Multiple cases of findings
•
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o

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o

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o
o
 ❖

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o
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•
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o

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o

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o
•

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o
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•

•
• # 𝑜𝑓 𝑝𝑟𝑒 − 𝑒𝑥𝑖𝑠𝑡𝑖𝑛𝑔 𝑐𝑎𝑠𝑒𝑠 𝑖𝑛 𝑎 𝑡𝑖𝑚𝑒 𝑝𝑒𝑟𝑖𝑜𝑑
o 𝑥 10𝑛
𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝑑𝑢𝑟𝑖𝑛𝑔 𝑠𝑎𝑚𝑒 𝑡𝑖𝑚𝑒 𝑝𝑒𝑟𝑖𝑜𝑑
•
o

219,000,000
𝑥 1000 = 𝟐𝟗. 𝟏𝟐𝟐𝟑𝟒𝟎𝟒𝟑 𝑝𝑒𝑟 1000 𝑝𝑜𝑝.
7,520,000,000

•
o
𝑃𝑒𝑟𝑠𝑜𝑛𝑠 ℎ𝑎𝑣𝑖𝑛𝑔 𝑎𝑡𝑡𝑟𝑖𝑏𝑢𝑡𝑒 𝑑𝑢𝑟𝑖𝑛𝑔 𝑡𝑖𝑚𝑒 𝑝𝑒𝑟𝑖𝑜𝑑
𝑥 10𝑛
𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝑑𝑢𝑟𝑖𝑛𝑔 𝑠𝑎𝑚𝑒 𝑡𝑖𝑚𝑒 𝑝𝑒𝑟𝑖𝑜𝑑
•
o

2,049
𝑃𝑟𝑒𝑣𝑎𝑙𝑒𝑛𝑐𝑒 = 𝑥 100,000 = 𝟏. 𝟗𝟓
104,921,600
o

171,731
𝑃𝑟𝑒𝑣𝑎𝑙𝑒𝑛𝑐𝑒 = 𝑥 100,000 = 𝟏𝟔𝟑. 𝟔𝟖
104,921,600
 o

219,000,000
𝑥 1000 = 𝟓𝟗. 𝟏𝟎𝟎𝟎𝟎𝟎𝟎𝟎𝟏 𝐜𝐚𝐬𝐞𝐬 𝐢𝐧 𝟐𝟎𝟏𝟕
3,705,583,756
o

247
𝑃𝑟𝑒𝑣𝑎𝑙𝑒𝑛𝑐𝑒 = 𝑥 100 = 41.2%
600

•
10,000,000
𝑥 1000 = 𝟏. 𝟑𝟐𝟗𝟕𝟖𝟕𝟐𝟑𝟒
# 𝑜𝑓 𝑛𝑒𝑤 𝑐𝑎𝑠𝑒𝑠 𝑜𝑓 𝑑𝑖𝑠𝑒𝑎𝑠𝑒 𝑑𝑢𝑟𝑖𝑛𝑔 𝑔𝑖𝑣𝑒𝑛 𝑡𝑖𝑚𝑒 𝑝𝑒𝑟𝑖𝑜𝑑 7,520,000,000
𝑥 10𝑛
𝑇𝑜𝑡𝑎𝑙 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝑎𝑡 𝑟𝑖𝑠𝑘 o
•
o

2,049
𝑥 1000 = 𝟎. 𝟐𝟑 𝒄𝒂𝒔𝒆𝒔 𝒑𝒆𝒓 𝟏𝟎𝟎𝟎 𝒑𝒆𝒐𝒑𝒍𝒆
8,899,070
o

65,538
𝑥 1000 = 𝟎. 𝟕𝟑 𝑻𝑩 𝒄𝒂𝒔𝒆𝒔 𝒑𝒆𝒓 𝟏𝟎𝟎𝟎 𝒑𝒆𝒐𝒑𝒍𝒆
90,262,246
o

357
𝑥 100 = 30%
1,200

• 59 new caes
𝑥 100 = 10.3 per 100 person − yrs
571 new person years

•
o
# 𝑜𝑓 𝑝𝑒𝑟𝑠𝑜𝑛𝑠 𝑑𝑒𝑣. 𝑎 𝑐𝑒𝑟𝑡𝑎𝑖𝑛 𝑑𝑖𝑠𝑒𝑎𝑠𝑒𝑠 𝑎𝑡 𝑡𝑖𝑚𝑒 𝑝𝑒𝑟𝑖𝑜𝑑
𝑥 10𝑛
𝐴𝑣𝑒. 𝑝𝑜𝑝 𝑎𝑡 𝑟𝑖𝑠𝑘 𝑑𝑢𝑟𝑖𝑛𝑔 𝑡𝑖𝑚𝑒 𝑖𝑛𝑡𝑒𝑟𝑣𝑎𝑙
•
o

44,232
𝑥 100,000 = 𝟏𝟓. 𝟐𝟏 𝐧𝐞𝐰 𝐜𝐚𝐬𝐞𝐬 𝐩𝐞𝐫 𝟏𝟎𝟎𝐤 𝐩𝐨𝐩𝐮𝐥𝐚𝐭𝐢𝐨𝐧
290,809,777
 •
o

(70,000 + 50,000) 1.5

Sex Ratio = =
80,000 1

• •

number of males
Sex Ratio = x 100
number of females
•
o

30,745,341 males 1 male

Sex Ratio = x 100 =
25,115,929 females 22 females

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𝑅𝑖𝑠𝑘 𝑜𝑓 𝑑𝑖𝑠𝑒𝑎𝑠𝑒 (𝐼𝑃, 𝑎𝑡𝑡𝑎𝑐𝑘 𝑟𝑎𝑡𝑒) 𝑖𝑛 𝑔𝑟𝑝 𝑜𝑓 𝑝𝑟𝑖𝑚𝑎𝑟𝑦 𝑖𝑛𝑡𝑒𝑟𝑒𝑠𝑡𝑠

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𝑅𝑖𝑠𝑘 𝑜𝑓 𝑑𝑖𝑠𝑒𝑎𝑠𝑒 (𝐼𝑃, 𝑎𝑡𝑡𝑎𝑐𝑘 𝑟𝑎𝑡𝑒) 𝑖𝑛 𝑐𝑜𝑚𝑝𝑎𝑟𝑖𝑠𝑜𝑛 𝑔𝑟𝑜𝑢𝑝
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𝑎/𝑐 𝑎𝑑
𝑂𝑅 = =
𝑏/𝑑 𝑏𝑐
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(1,141) (52,040,209)
𝑂𝑑𝑑𝑠 𝑅𝑎𝑡𝑖𝑜 = = 𝟏. 𝟐𝟒
(52,879,345) (905)
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(15,865) (12,906,083)
(1,881) (5,153,070) 𝑂𝑑𝑑𝑠 𝑅𝑎𝑡𝑖𝑜 = = 𝟒. 𝟎𝟗
𝑂𝑑𝑑𝑠 𝑅𝑎𝑡𝑖𝑜 = = 50.26 (12,984) (3,880,287)
(3,214,586) (60)
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(112,250)(51,981,633)
𝑂𝑑𝑑𝑠 𝑅𝑎𝑡𝑖𝑜 =
(52,768,36)(59,481)
Odds Ratio
(7,000) (104,332,987)
= 𝟏. 𝟖𝟔 𝒍𝒊𝒌𝒆𝒍𝒊𝒉𝒐𝒐𝒅 𝒐𝒇 𝒎𝒂𝒍𝒆𝒔 𝒕𝒉𝒂𝒏 𝒇𝒆𝒎𝒂𝒍𝒆𝒔 𝑂𝑑𝑑𝑠 𝑅𝑎𝑡𝑖𝑜 = = 𝟑𝟏𝟎. 𝟏𝟎
(4,103) (574,000)

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