Introduction to Epidemiology

Prof. Dr. Azmina Hussain

Professor and Head-Oral Pathology Dept.
DIDC-DUHS
Learning Objectives

By the end of this session, we will be able to:

Define what Epidemiology is?
Discuss the two broad types of Epidemiology
& their components.
Define Endemic, Epidemic, Pandemic &
Sporadic states.
What is Disease Prevention and what are its
four stages.

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Definitions..

I hate definitions..
Benjamin Disraeli
Former British Prime Minister

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What does Epidemiology mean?

Greek English
epi (among)

demos (people)

logy (study)

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Definitions of Epidemiology
Oxford English Dictionary
THE BRANCH OF MEDICAL SCIENCE WHICH
TREATS EPIDEMICS
Kuller LH: Am J Epid 1991;134:1051
EPIDEMIOLOGY IS THE STUDY OF
"EPIDEMICS" AND THEIR PREVENTION

Anderson G,quoted in Rothman KJ: Modern

Epidemiology
THE STUDY OF THE OCCURRENCE OF ILLNESS

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Definitions of Epidemiology

Lilienfeld A: in Foundations of Epidemiology

THE STUDY OF THE DISTRIBUTION OF A DISEASE

OR A PHYSIOLOGICAL CONDITION IN HUMAN
POPULATIONS AND OF THE FACTORS THAT
INFLUENCE THIS DISTRIBUTION

Last JM: A Dictionary of Epidemiology

THE STUDY OF THE DISTRIBUTION AND

DETERMINANTS OF HEALTH RELATED STATES AND
EVENTS IN POPULATIONS AND THE APPLICATION
OF THIS STUDY TO CONTROL OF HEALTH
PROBLEMS

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In Short
Epidemiology . . .

is a Greek word that

means to put people to
sleep with charts and
graphs.

- Dr. Mark JohnsonIntroduction to Epidemiology- Nov

In testimony before the 17, 2016
Objectives of Epidemiology
To identify the etiology or cause of a disease
and the relevant risk factors
To determine the extent of the disease found
in the community
To study the natural history and prognosis of
disease
To evaluate both existing and newly
developed preventive and therapeutic
measures and modes of healthcare delivery
To provide the foundation for public health
policies to prevent disease and promote
health
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 Two Broad Types of
Epidemiology

OBSERVATIONAL EXPERIMENTAL
EPIDEMIOLOGY EPIDEMIOLOGY
NO Interventions Interventions
Typical study Typical
design: study designs:
Observational & Analytic RCT, Field Trials, Community
Trials

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 Two Broad Types of
Observational Epidemiology

ANALYTIC
DESCRIPTIVE
EPIDEMIOLOGY
EPIDEMIOLOGY
Examining the distribution of Testing a specific
a disease in a population, and hypothesis about the
observing the basic features relationship of a disease to
of its distribution in terms of a putative cause, by
time, place, and person. conducting an
Typical study epidemiologic study that
design: relates the exposure of
interest to the disease of
community health survey interest.
(approximate synonyms -
cross-sectional study, Typical
descriptive study) study designs: cohort, case-
control
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Epidemiologic approaches
DESCRIPTIVE
Health and disease in the community
What? Who? When? Where?
What are the How many people Over what Where do the
health problems are affected? period of time? affected people
of the live, work or
community? What are the spend leisure
attributes of time?
What are the affected persons?
attributes of
these illnesses?

Etiology, prognosis and program evaluation

ANALYTIC
Why? How?
What are the By what mechanism
causal agents? do they operate?

What factors
affect outcome? Introduction to Epidemiology- Nov
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 A COMMON ERROR IN EPIDEMIOLOGY IS
MOVING TO ANALYTIC EPIDEMIOLOGY
WITHOUT HAVING A SOLID BASE IN THE
DESCRIPTIVE EPIDEMIOLOGY OF THE
CONDITION.

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 The Basic Triad Of Descriptive
Epidemiology

THE THREE ESSENTIAL CHARACTERISTICS

OF DISEASE WE LOOK FOR IN DESCRIPTIVE
EPIDEMIOLOGY:
TIME
PLACE
PERSON

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Time
Changing or stable?
Seasonal variation.
Clustered (epidemic) or evenly distributed
(endemic)?
Point source or propagated.

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Place
Geographically restricted or widespread
(pandemic)?
Relation to water or food supply.
Multiple clusters or one?

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Person
Age
Socio-economic status
Gender
Ethnicity/Race
Behavior

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 The Basic Triad Of
Analytic Epidemiology

THE THREE PHENOMENA ASSESSED IN

ANALYTIC EPIDEMIOLOGY ARE:
HOST

AGENT ENVIRONMENT
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 The Basic Triad Of
Analytic Epidemiology

In case of Malaria label the followings..

HOST ?

AGENT ? ENVIRONMENT?
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Agents

Poisons
Allergens
Radiation
Physical trauma
Microbes
Psycho-Social experiences

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Host Factors

Genetic makeup
Immunologic state
Age
Personal behavior

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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

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 Epidemiologists are required to have some
knowledge of the disciplines of public health,
clinical medicine, pathophysiology, statistics,
and the social sciences.

public health, because of the emphasis on disease

prevention.
clinical medicine, because of the emphasis on disease
classification and diagnosis.
pathophysiology, because of the need to understand
basic biological mechanisms in disease.
statistics, because of the need to quantify disease
frequency and its relationships to antecedents.
social sciences, because of the need to understand the
social context in which disease occurs and presents.

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IN SHORT
Epidemiology is the branch of Science which
deals with the study of all aspects of
disease(s) except for PRACTICALLY TREATING
the disease(s).

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 EVERY HEALTH OUTCOME HAS SOME
INTERESTING AND USEFUL EPIDEMIOLOGIC
CHARACTERISTIC
DEATH RATES BY SOCIAL CLASS FROM A
CERTAIN CAUSE AMONG 1,316 PEOPLE

Men Women Children Total

1st class 67% 3% 0 38%

2nd class 92% 14% 0 59%

3rd class 84% 54% 66% 62%

WHAT CAUSE OF DEATH IS

THIS?
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The previous slide shows death
rates by class of ticket on the
Titanic, a large ocean liner that
sank after colliding with an
iceberg in 1912

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Disease status based on trend
Endemic: disease occuring at normally
expected frequency (habitually present)
Epidemic: sudden rise in disease frequency
Pandemic: a global epidemic. An outbreak of
a disease affecting large geographic area
usually many countries
Sporadic: off and on, un related cases
Exotic: Imported disease (Rabies in UK)

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Epidemiology & Disease Prevention
Disease prevention includes measures not
only to prevent the occurrence of disease,
such as risk factor reduction, but also to arrest
its progress and reduce its consequences once
established.

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Levels of prevention (I)

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Levels of prevention (II)

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Thank you for your
attention

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