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A Presentation

**EPIDEMIOLOGY is the study
**

of frequency, distributions and determinants of health related states and events in human populations, and the application of this study to control health problems.

**Frequency is the measurement
**

of disease, disability, or death and converting this information into rates or ratios. [ Incidence, Prevalance and Death rates. This yields magnitude of the problem.

**To investigate distributions and determinants of disease, it is necessary to know:
**

The

size of the source population from which time period during which the data were

**affected individuals were derived
**

The

collected.

RATIO

The most basic measure Obtained by simply dividing one quantity by another without implying any specific relationship between the numerator and denominator, such as the number of stillbirths per thousand live births. In ratio, the numerator & denominator are mutually exclusive.

PROPORTION

A

proportion is a type of ratio in which those who are included in the numerator must also be included in the denominator. example: the proportion of women over the age of 50 who have had a hysterectomy, or the number of fetal deaths out of the total number of births (live births plus fetal deaths).

For

RATE

A

rate is a proportion with specifications of time. It is a ratio in which there is a distinct relationship between the numerator and denominator with a measure of time being an intrinsic part of the denominator. example, the number of newly diagnosed cases of breast cancer per 100,000 women during a given year.

For

IMPORTANT POINT

It is necessary to be very specific about what constitutes both the numerator and the denominator. In some circumstances, it is important to make clear whether the measure represents the number of events or the number of individuals.

For example, the frequency of myopia among a population of school children could represent the number of affected eyes in relation to total eyes, or the number of children affected in one or both eyes relative to all students.

PREVALENCE

Prevalence quantifies the proportion of individuals in a population who have the disease at a specific instant and provides an estimate of the probability (risk) that an individual will be ill at a point in time

It is a measure of current status of the disease.

PREVALENCE

The formula for calculating the prevalence P = number of existing cases of a disease divided by total population (at a given point in time)

POINT PREVALENCE

Prevalence

can be thought of as the status of the disease in a population at a point in time and as such is also referred to as point prevalence. This "point" can refer to a specific point in calendar time or to a fixed point in the course of events that varies in real time from person to person, such as the onset of menopause or puberty or the third postoperative day.

PERIOD PREVALENCE

It

represents the proportion of cases that exist within a population at any point during a specified period of time. The numerator thus includes cases that were present at the start of the period plus new cases that developed during this time

INCIDENCE:

Incidence

quantifies the number of new events or cases of disease that develop in a population of individuals at risk during a specified time interval.

INCIDENCE:

The

number of new events or cases of a specific disease during a given time divided by Population at risk [during a specified time interval.]

Cumulative incidence (CI)

is

the proportion of people who become diseased during a specified period of time. It provides an estimate of the probability, or risk, that an individual will develop a disease during a specified period of' time

**Mid Interval Population
**

Means

the population in the middle of that specified period e.g. for a whole year, 1st July is mid interval.

**Issues in the Calculation of Measures of Incidence
**

For

any measure of disease frequency, precise definition of the denominator is essential for both accuracy and clarity. This is a particular concern in the calculation of incidence. The denominator of a measure of incidence should include only those who are considered "at risk" of developing the disease.

Contd.

That

is, the total population from which the new cases could arise. Consequently, those who currently have or have already had the disease under study or persons who cannot develop the disease for reasons such as age, immunization, or prior removal of the involved organ should be excluded from the denominator.

MORBIDITY RATE

**is the number of nonfatal cases in the total population at risk during a specified period of time.
**

For

example, the morbidity rate of tuberculosis (TB) in the U.S.

in 1982 can be calculated by dividing the number of nonfatal cases newly reported during that year by the total U.S. midyear population

Morbidity rate of TB = 25,5201231,534,000/year = 11.01101/Year

Thus,

in 1982, the morbidity rate or incidence rate of nonfatal TB in the United States was 1 1.0 per 100,000 population.

MORTALITY RATE

It

expresses the number of deaths in a particular population during a period of time. It is calculated the number of fatalities divided by the total population. during that period.

**Proportionate Mortality Rate
**

It

measures the proportions of deaths from a specified cause relative to all deaths in a particular population during a period of time. It is calculated the number of fatalities due to a specified disease divided by the total number of deaths reported during that period.

**Case Fatality Rate
**

It

measures the number of deaths from a specified disease divided by the total number of case of that disease reported during that period.

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