PBH 541 : Concepts of

Epidemiology and Biostatistics

Lecture No. 1 – Introduction to Epidemiology

08.10.2020

Dr. AKM Nazmul Islam

Master of Public Health (MPH) Program
UNIVERSITY OF
School of Public Health & Life Sciences
SOUTH ASIA University of South Asia
 Introduction
# Course objectives # Definition:
1. Public Health
2. Epidemiology:
- WHO
Outline for
today
Given that we have some knowledge on (do we? 2nd semester)
• Basics of Epidemiology (definition, types, objectives and use)
• Dynamics of disease transmission

We will learn more on ( course objectives)

• Dynamics of disease transmission
• Some epidemiologic terms
• Indices of morbidity and mortality
Endemic, Epidemic &
Pandemic
• The habitual presence of a disease within a given geographic area
• May also refer to the usual prevalence of a given disease within such
an area (Malaria in CHT)

• The occurrence in a community or region of a group of illnesses of

similar nature, clearly in excess of normal expectancy (Cholera in
august every year in Dhaka)

• A worldwide epidemic (CoVID-19)

Epidemic
Curve
Prevention of Disease
transmission
• Primary preventing the initial development of disease
• Secondary early detection of disease and reduction of severity
• Tertiary reducing the impact of the disease
Herd
Immunity
It is the resistance of a group to attack from a disease to which a large
portion of members are immune.
The entire group is likely to be protected, not just those who are
immune

Group = Community, Population, Cohort etc.

Important points to remember = Immunization, Solid immunity, Host
species
Incubation period
• Defined as the interval from receipt of infection to the time of onset
of clinical illness

• Importance is quarantining the infected person

Attack
Rate
Number of people at risk in whom a certain illness develops
Total number of people at risk

• The attack rate is useful for comparing the risk of disease in groups
with different exposures
• Primary case = First person attacked by exposure
• Secondary case = A person who acquires the disease from exposure to a
primary case
Surveillanc
e
Ongoing systematic collection, analysis, and interpretation of health
data essential to the planning, implementation, and evaluation of
public health practice closely integrated with the timely dissemination
of these data to those who need to know

Types
• Active
• Passive
Indices of
Morbidity
Total Population

Sick

Seek Care
Hospitalized
DIE
Indices of
Morbidity
Incidence
# of NEW cases of disease occurring in the population during a
specified period of time
# of persons at risk of developing the disease during that period of
time

Prevalence
# of cases of a disease present in the population at a specified time
# of persons in the population at that specified time
Relationship between incidence and prevalence
Indices of
Morbidity
Incidence rate
• Incidence expressed per XXX

Types of Prevalence measures

• Point Prevalence (Do you currently have Chicken Pox?)
• Period Prevalence (Have you had Chicken Pox during the last year?)
•Cumulative (life-time) Incidence (Have you ever had Chicken Pox?)
(Prevalence = Incidence × Duration)
Indices of
Mortality
Mortality rate
Total # of deaths from all causes in a time period
# of persons in the population at midyear

Age Specific Mortality Rate:

• change the denominator to only that age-group

Cause-Specific Mortality Rate:

• change the numerator to # of deaths from the cause
Indices of
Mortality
Case Fatality rate
# of individuals dying during a specified period of time after disease
onset or diagnosis

# of individuals with the specified disease

Proportionate Mortality (not a rate)

# of deaths from specific disease
Total # of deaths
Indices of measuring disease burden
• Diseases that may not be lethal may be associated with considerable
physical and emotional suffering resulting from disability associated
with the illness affecting Quality of life

• DALY – Disability Adjusted Life Year

• QALY – Quality Adjusted Life Years
• YHL – Healthy Life Years