EPIDEMIOLOGY

BY: NOSHEEN MUSTAFA

 Basic Terminology
• The term epidemiology is derived from the Greek word

 Epi Among, upon,

 Demos study population or people and
 Logos scientific study.
 Definitions
Health: A state of complete physical, mental and social well-
being (WHO,1948)

Disease: A physiological or psychological dysfunction

Illness: A subjective state of not being well

Sickness: A state of social dysfunction

OR
The role negotiated with society
• Endemic: a disease that exists permanently in a particular
region or population. E.g. Chicken pox and Malaria which is
endemic to Africa.

• Epidemic: An outbreak of disease that attacks many peoples

at about the same time and may spread through one or
several communities.

• Pandemic: When an epidemic spreads throughout the world.

•  Morbidity: Refers to the presence of disease
in a population

• Mortality: Refers to the occurrence of death in

a population
 Prevalence
The number of existing cases in the population
during a given time period.
PR = # existing cases during time period /population at same point in time

Prevalence rates are often expressed as a

percentage.
 Incidence
The number of new cases of disease that develop
in the population during a defined period
IR = # new cases during time period X 100 / specified
population at risk
IR = Incidence rate
Example Of IR:
• During a six-month time period, a total of 53
fungal infections were recorded by an infection
control nurse at a hospital. During this time,
there were 832 patients with a total of 1,290
population of that specified area which at risk.
What is the rate of fungal infections rate?
• IR = 53 X 100/1,290
= 4.1
 Epidemiology

It is the study of frequency, distribution, and determinants of

diseases and other health-related conditions in a human
population

Application of this study to the prevention of disease and

promotion of health

Epidemiological thought emerged in 460 BC

Epidemiology flourished as a discipline in 1940
 Components of the Definition
•Study: Systematic collection, analysis and interpretation of data

•Frequency: the number of times an event occurs

•Distribution: Circulation of an event by person, place and time

•Determinants: Factors the presence/absence of which affect

the occurrence and level of an event

•Diseases & other health related events

•Human population

•Application
 Scope of Epidemiology
•Originally, Epidemiology was concerned with investigation &
management of epidemics of communicable diseases.

•Lately, Epidemiology was extended to endemic communicable

diseases and non-communicable infectious diseases.

•Recently, Epidemiology can be applied to all diseases and other

health related events.
 Purpose of Epidemiology
•The ultimate purpose of Epidemiology is prevention of diseases
and promotion of health

•How?
1. Elucidation of natural history of diseases
2. Description of health status of population
3. Establishing determinants of diseases
4. Evaluation of intervention effectiveness
 Types of Epidemiology
•Two major categories of Epidemiology

1.Descriptive Epidemiology

• Defines frequency and distribution of diseases and other

health related events (4 questions: how many, who, where, and
when?)
Observation on population or individual.

• Time distribution- When disease occurring?

• Place distribution- Where ?
• Person –Who is getting it
2. Analytic Epidemiology

• Analyses determinants of health problems

• Answers two other major questions: how?

and why?
 Basic Features of Epidemiology
1. Studies are conducted on human population
2. It examines patterns of events in people
3. Can establish cause-effect relationship without the
knowledge of biological mechanism
4. It covers a wide range of conditions
5. It is an advancing science
 Theories of Disease Causality
•What causes a disease?

•19-20th century theories

Contagion theory (crowd)
Supernatural theory
Personal behavior theory
Miasma theory (pollution)
Germ theory
Lifestyle theory
Environmental theory
Multi-causal theory
 Levels of Disease Prevention
•Three major levels of disease prevention

•Primary prevention
Targeted at healthy people (Objectives are Promotion of health,
Prevention of exposure and Prevention of disease).

•Secondary prevention
Targeted at patients (Objective is to stop or slow the
progression of disease and to prevent or limit permanent
damage through early detection & treatment).

•Tertiary prevention
Targeted at people with chronic diseases & disabilities that
can’t be cured (Objective is to prevent further disability or death
and to limit impacts of disability through rehabilitation)
 Comparison Between Clinical Medicine and
Epidemiology
Area Epidemiology Clinical Medicine
OBJECTIVES To identify the source, Mode of transmission, To cure the patient.
etiological factors,
EXAMINATION Group of people or community Individual case
CONCERN WITH Sick and healthy Sick
DIAGNOSIS By survey, research Individual test done
WHERE TO GO? Experts goes to community Patient goes to hospital
AREA CONCERN Mainly concern to prevention and promotion Mainly in curative field
through intervention
CONCEPT Bio-statistical Bio-medical
PRESENTATION OF By tables, charts and diagrams By laboratory and others
RESULT reports
TIME Long process Short time sometimes long
time
OUTCOME Planning, implementation and health Cured or disability or death
promotion
Example – Typhoid Fever

S. Typhi

Young Age,
more in males,
Polluted
Low immunity
water, open
power, Lack of
defecation
personal
hygiene
 Dynamic Of Diseases
Transmission
• Reservoir (Case, Carrier, Animals, Reservoir of non- living Things – Soil etc)

• Mode Of Diseases Transmission (direct – indirect)

• Susceptible Host (low immunity person, high risk person)

 Diseases Prevention And
Control
• Prevention of source or reservoir
Early diagnosis
Notification
Epidemiological Investigation
Isolation
Treatment
Quarantine
• Interruption of the disease transmission
• Prevention of susceptible host
• Immunization
• Health education