 MEASUREMENTS IN EPIDEMIOLOGY

 The scope of measurements in epidemiology is

very broad and unlimited and includes the
following :
 Measurement of mortality
 Measurement of morbidity
 Measurement of disability
 Measurement of natality
 Measurement of the presence, absence or
distribution of the characteristic or
attributes of the disease
 Measurement of medical needs, health
care facilities, utilization of health
services and other health-related
events
 Measurement of the presence, absence
or distribution of the environmental
and other factors suspected of causing
the disease, and
 Measurement of demographic
variables.
 TOOLS OF MEASUREMENT
 The epidemiologist usually expresses disease magnitude
as a rate, ratio or proportion. A clear understanding of
the term is required for proper interpretation of
epidemiological data.

The basic tools of measurement in epidemiology are:

 Rates
 Ratios
 Proportions
 Rate
 A rate measures the occurrence of some particular event
development of disease or the occurrence of death in a
population during a given time of period.

 It indicates the change in some event that takes place in a

population over a period of time. The events can be deaths,
births, disease etc

 E.g- Death rate, Birth rate, Specific rate

ELEMENTS OF RATE
 Numerator
 Denominator
 Time specification
 Multiplier
 No. of deaths in one year
 Death rate =----------------------------------- X 1000
Mid year population

In above rate –
 Numerator is the number of deaths
 Denominator is mid –year population
 One year is time specification
 Multiplier is 1000, it can also be 10,000, 1,00,000
RATIO-
Ratio express a relation in size between two random
quantities.
 Ratio is the result of dividing one quantity by
another.
A:B OR A/B
ELEMENTS
 NUMERATOR

 DENOMINATOR
E.g-
 Sex-ratio
 Male: female OR No.of Males
No.of Females
Doctor –population ratio = No.of doctors
size of population
Other examples
 The number of children with scabies at a certain time

 The number of children with malnutrition at a certain

time
 3.Proportions
 A proportion is a ratio which indicates the relation in
magnitude of a part of the whole..
 The numerator is always included in the denominator.
 A proportion is usually expressed as a percentage.

 ELEMENTS
 Numerator
 Denominator
 Percentage as multiplier i.e-100
 Example :
 The number of children with scabies at a certain time
----------------------------------------------------------- X 100
The total number of children in the village at the same time
MORTALITY RATE(DEATH RATE)
 In this the numerator includes all the
deaths occurring in a defined geographical area
 ( community) in a particular year and denominator
includes the total population in the same area of the
same year.
 The mortality rate can be crude mortality and specific
mortality rate.
BIRTH RATE-
 the number of live births during a year per 1000
estimated mid year population
No. of live birth during the year
 BIRTH RATE=-------------------------------------- X 1000
Estimated mid year population
DEATH RATE
The number of deaths per 1,000 estimated mid-year
population in one year.
No. of death during the year
 DEATH RATE=-------------------------------------- X 1000
Estimated mid year population
SPECIFIC DEATH RATE
 The death rate is due to, specific causes eg:- cholera, in
specific groups –age, sex, occupation, social class and
specific periods- annual, weekly, monthly are called
specific death rates.
 SPECIFIC DEATH RATE=
No. of death from cholera during the year
----------------------------------------------- X 1000
Mid year population
INFANT MORATLITY RATE
 It is the number of infant deaths under one year of age
per 1,000 live births in one year.

No. of death under one year of age

 IMR =------------------------------------------ X 1000
Total live births in the year
NEONATAL MORTALITY RATE
 Deaths occurring within 4 weeks or 28 days of birth
are called neonatal deaths.

No. of death under 28 days of age

 NMR =------------------------------------------ X 1000
Total live births in the year
UNDER-FIVE MORTALITY RATE
 It is the annual number deaths of children aged under
5 years per 1,000 live births.

No. of death of children less than 5 years of age

in a given year
 UMR =------------------------------------------------ X 1000
Total live births in the year same year
MATERNAL MORTALITY RATE
 It is the number of deaths from puerperal causes per
1,000 live births.
No. of death directly due to pregnancy or
child birth or within 42 days of delivery
 MMR =----------------------------------------------- X 1000
Total live births in the year
PERINATAL MORTALITY RATE
 It is the mortality of infants occurring during the
period from 28 weeks of pregnancy to 7 days after
birth per 1000 total live births and still birth.
{ late foetal deaths + death under 1 week]
(28 weeks or more)
 PMR =------------------------------------------ X 1000
Total live births + still births
GENERAL FERTILITY RATE
 This is defined as the number of live births during a
year per 1,000 women in the reproductive age group 15-
45 years.

No. of live birth

 GFR=------------------------------------------ X 1000
No. of females in the age group
15- 45 years
MORTALITY RATE( DISEASE RATE)

 The incidence and prevalence rates are the two most

commonly used morbidity health.
INCIDENCE RATE
 It refers to the occurrence of new cases during a
particular period usually one year in a population
exposed to the risk in a particular area.
No. of new cases of a specific disease
occurring from time to time in a particular
place during the year.
Incidence rate =------------------------------------------ X 100o
Mid-year population of the same place
during the same year
PREVALENCE RATE
 It refers to the total number of all cases existing ( old &
new) in a particular community at a given time.

No. of existing (old & new cases) in a

place during a particular period
Incidence rate =---------------------------------------- X 100o
No. of people in a given place during
the same period