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Distribution

of Disease
Distribution of disease

Distribution is an essential component in


descriptive epidemiology and refers to the
study or summary of the frequencies of
disease ( or values of a
measurement ) according to groups defined
by factors such as age, time and place.
Segment Ⅰ the measurement values

of distribution of disease

Segment Ⅱ distribution of disease


Segment Ⅰ the
measurement values of
distribution of disease

 Concept of rate and ratio


 Incidence measurement
 Mortality measurement
1. Rate and Ratio
 rate
Number of existing
cases/population at risk x
100,000 per time period
1. The concept of rate and
ratio

Ratio, is also called relative


ratio, it is the quotient of two
values, which reflects the relative
level of two values and often
expressed by multiple or percent.
A
Rate = ( × 10 0 %)
B
 proportion
Proportion reflects the proportion
or distribution of parts of certain
entirety and often expressed by
percent.
the number of part
proportion = × 100 %
the number of entirety
(1) incidence rate
Within a certain time and a certain population
and estimated by counting the number of new
cases of disease.

IR = number of new cases in a certain population /


number at risk in the same time×k

k=100% , 1000‰ , 1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
Application of incidence rate

To descript the distribution of disease


To explore the pathogenesis
To put forward the hypothesis of pathogenesis
To evaluate the effect of the prevention and cure
measures.
1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
(2) attack rate

The proportion of persons within a


population who develop a particular outcome
within a specified period of time

a certain illness develops


AR = ×k
total number of people at risk

k=100% 或 1000‰
1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
(3) prevalence rate

The proportion of person in a given


population that has a particular disease at a
point or interval of time

PR = number of new or old cases /


persons at risk in the same time ×k

k=100%, 1000‰,
1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
(3) prevalence rate

The factors influence on prevalence rate :


incidence rate and course of disease

P = I×D

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
(3) prevalence rate

Application : prevalence rate often


represents occurence or epidemic
situation of chronic disease.

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
(4) infection rate
Is the proportion affected by a disease of a
investigated and often expressed by present.

IR = number of affected cases /investigated persons


×100%
Application : IR can research affected
situation of some infectious disease or
parasitic disease and effect of prevention
and curation.
(5)secondary attack rate , SAR

SAR = number of second-affected cases


/susceptible persons ×100%

Application : SAR can represent the


intensity of infectious power, analyze
epidemic factor and evaluate the effect of
prevention measurements.
1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
2.mortality measurement
(1)mortality rate

The proportion of persons within a given


population die from a particular disease.

MR = death number /average population ×k

k = 1000‰

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
 crude death rate
 Persons within a given population
die from a particular disease, without
adjustment for the underlying age
distribution of the population.

 specific death rate


 infant death rate
(1)mortality rate
Application Crude mortality rate represents
total death level, which is synthetical reflection
of culture and health level of country or area.

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
(2)fatality rate

Is the proportion of persons within a


population affected by a particular disease that
dies from the disease within a specified period
of time.
FR = number of deaths /number of diagnosed
patients ×100%

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
(3)survival rate
Is the proportion of persons affected by the
disease of interest that lives for at least a
specified period of time.

SR = number of deaths observed in a


specified period of time/number of diagnosed
patients under observation ×100%

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
(4)potential years of life lost, PYLL
e
PYLL = ∑ ai d i
i =1

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
Distribution of disease
sporadic

epidemic
A dramatic increase above the usual or
expected rate of occurrence of partical events
within a population.

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
outbreak
A sudden ,unexpected increase in the
occurrence of a disease within a
relatively limited geographic area

The affected patients have the same route of


transmission and source of infection

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
three primary Distribution of
disease
place distribution
time distribution
persons distribution

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
Time distribution
( 1 ) rapid fluctuation
( 2 ) seasonally
( 3 ) periodicity
( 4 ) secular trend
(secular change)

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
Person distribution of disease
 age  Social class
 sex  Marriage and family
 occupation
 behave
 race

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
(1) age
Age is perhaps the most important factor
because there is greater variation in age-
specific disease rates than in rates defined by
almost any other personal attribute. for
example, measles, mumps tend to occur
most commonly in childhood.

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
(2) sex
numerous epidemiologic studies have
shown sex differences in a wide scope
of health phenomena, males generally
have higher mortality rates than
females .

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
(3) occupation

Different occupation have different influence


on incidence rate mortality rate of disease
because different physical factor, medical
factor, biological factor and spirit factor can
lead to different diseases.

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
(4) race and ethnicity

Persons with different race and ethnicity


have different genetic factor, custom,natural
condition and religion, which can lead to
different diseases.

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S
(5)social stratum
(6)marriage and family situation

(7)behavior

1957

E P ID E M IO L O G Y A N D
H E A L T H S T A T IS T IC S