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Epidemiologic Triad

Disease - result of forces within a dynamic system

Agent
An element or a substance animate or inanimate, the presence or absence of which may initiate or perpetuate a disease process

Biological
Infectivity Pathogenicity Virulence

Physical Chemical
Exogenous Endogenous

Mechanical

Agents
Nutrients Poisons Allergens Radiation Physical trauma Microbes Psychological experiences

Characteristics of Agent
1. 2. 3. 4. 5. 6. Infectivity Pathogenicity Virulence Toxigenicity Resistance Antigenicity

Epidemiologic Triad-Related Concepts


Infectivity (ability to infect) (number infected / number susceptible) x 100 Pathogenicity (ability to cause disease) (number with clinical disease / number infected) x 100 Virulence (ability to cause death) (number of deaths / number with disease) x 100

All are dependent on host factors

Predisposition to Infections
(Host Factors) Gender

Genetics
Climate and Weather

Nutrition, Stress, Sleep


Smoking

Stomach Acidity
Hygiene

Chain of Infection

Nutritive Element
Physical agents
1 3

Chemical agents 2 7 6

Others factors
(Genetic/ immunological

Agents of Disease (etiological Factors)


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Mechanical agents

Social agents

Biological agents
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HOST
A person or another living animal including birds and arthropods that affords subsistence and lodgment to an infectious agent under natural conditions.

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Host Factors (Influence Exposure, Susceptibility, response to agents


Genetic Occupation
Human behavior
Intercurrent or Preexisting disease

Age Sex

Marital status

Ethnic group Physiologic


state

Prior immunologic experience


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Host Factor
Factors which make the person susceptible to a disease.
Demographic Characteristics Biological Characteristics Life Style Factors

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Host susceptibility
A person or animal presumably not possessing sufficient resistance against a particular pathogenic agent to prevent contracting infection or disease if or when exposed to the agent.

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TYPES OF HOST
Definitive Host
Hosts in which parasite attains maturity or passes its sexual stage, are primary or definitive hosts.

Intermediate Host
Hosts in which the parasite is in larval or asexual stage, are secondary or intermediate Hosts.

Propagative Host
A transport or Propagative host, is the one in which, the organism remains but does not undergo development.

Cyclo - Propagative
The agent changes in form and number, e.g. malaria 15 parasites in mosquito.

Host Factors
Genetic endowment
Immunologic state Age Personal behavior

The Environment
Domain in which the disease-causing agent may exist, survive or originate. Acts as a reservoir or niche that fosters the survival of infectious disease agents. The reservoir may be a part of the physical environment or may reside in animals or insects (vectors) or other human beings (human reservoir host) External Environment: physical, biologic, social, economic components

Physical environment

Biologic environment

Environmental factors (influence existence of the agent)

Socioeconomic environment
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Environmental Factor
(aggregate of all external conditions and influences affecting the life and development of an organism, human behavior or society)

Biological Environment Psycho-social Environment Physical Environment

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Environment
Crowding Atmosphere Modes of communication phenomena in the environment that bring host and agent together, such as:
Vector Vehicle Reservoir

Epidemiological Triad
Environment

Agent

Host

Agent
Biological
Infectivitiy Pathogenicity Virulence

Nutrient Physical Chemical Mechanical Absence or insufficiency or excess of a factor necessary to health Social

Host
Demographic Biological Social and economic Lifestyle

Environment
Physical
Biological Psycho-social

Factors Influencing Disease Transmission


Agent
Infectivity

Weather Housing

Environment

Pathogenicity Virulence Immunogenicity Antigenic stability Survival Age Sex

Geography

Occupational setting
Air quality

Food Host Genotype Behaviour Nutritional status

Health status