Introduction

to Epidemiology

Ms.Munerah Al Mulhem
What is epidemiology ?

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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

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 epidemiology

Epi = Upon/on

Ms.Munerah Al Mulhem
 epidemiology

Epi = Upon/on
Demos = People

Ms.Munerah Al Mulhem
 epidemiology

Epi = Upon/on
Demos = People
Logy=study of

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Definition of epidemiology

The study of the distribution and determinants of disease in human

populations and the application of this study to control health
problems
Adapted from John Last “A Dictionary of Epidemiology”

• Distribution of disease (descriptive epidemiology)

ØFrequency of disease :number, rate , risk
ØPattern of diseases :time ,place , person
• Determinants of diseases (analytic epidemiology)
ØCauses and influences :Risk factors or protective factors

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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.

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• 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.

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Uses of epidemiology:

• Investigation of causation of disease

Genetic factors

Good health Disease

Environmental factors

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Uses of epidemiology:

• Study of the natural history and prognosis of disease

Death

Good Subclinical Clinical

health changes diseases

Recovery

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Uses of epidemiology:

• Describe the health status of populations

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Uses of epidemiology:

• Investigate diseases outbreak

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Uses of epidemiology:

• Evaluate intervention

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 Uses of epidemiology:

• Planning and evaluation

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Uses of epidemiology:

• explain mechanism of disease transmission

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What types of questions can epidemiology answer?
Is it an epidemiological question?
type of question
(Y/N) & why
How common is heart disease in KSA? yes /Addresses frequency of disease

Is heart disease more common in the Yes /Addresses frequency and

KSA compared with Japan? distribution of disease
Why did Mr. X develop breathlessness? NO /Addresses disease in an individual,
not population
What are the risk factors for developing Yes /Addresses factors influencing
breast cancer? disease
Why does smoking cause lung cancer? NO /Addresses mechanism of disease
(pathology not epidemiology)
Does stopping smoking increase life
Yes / Addresses prognosis
expectancy in lung cancer?
(determinant of progression)

Ms.Munerah Al Mulhem
History of epidemiology

• Hippocrates 5th Century BC

• Association between external environment and personal characteristics and
health
• John Graunt, Haberdasher, 1662
• Analyzed weekly reports of births and deaths in London
• John snow ,Physician, 1854:Broad street Pump
• Cholera outbreak > 500 deaths in 10 days.
• Waterborne infection

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Broad street Pump

Ms.Munerah Al Mulhem
Measurements s in epidemiology

• Measurement of mortality
• Measurement of morbidity
• Measurement of disability
• Measurement of natality
• Measurement of the presence absence or distribution of disease
• Measurement of the presence or absence of environmental risk

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Tool of measurement

•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

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Ms.Munerah Al Mulhem
Disease outbreak

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• 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.

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Level of disease

pandemic
epidemic

endemic

sporadic

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

pandemic
epidemic

endemic

sporadic

Ms.Munerah Al Mulhem
 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

Ms.Munerah Al Mulhem
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

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 Level of disease

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

Ms.Munerah Al Mulhem
Ms.Munerah Al Mulhem
Ms.Munerah Al Mulhem