Epidemiology

Dr. Furqan K. Hashmi

Assistant Professor
Punjab University College of Pharmacy
 Basic Terminology

• The term epidemiology is derived from the Greek word

epidemic.

 Epi means-Among, upon,

 Demos means study population or people and
 Logos means scientific study.
 Definitions

Health: A state of complete physical, mental and social well-being

and not merely the absence of disease or infirmity
(WHO,1948)

Disease: A physiological or psychological dysfunction

Illness: A subjective state of not being well

Sickness: A state of social dysfunction

 Definitions

Endemic: a disease that exists permanently in a particular region

or population.

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.

 Definitions

Epidemiology

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

diseases and other health-related conditions in a human
population
and

the 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
 History of Epidemiology

1. Hippocrates (460BC): Environment & human behaviors

affects health
2. John Graunt (1662): Quantified births, deaths and diseases
3. Lind (1747): Scurvy could be treated with fresh fruit
4. William Farr (1839): Established application of vital statistics
for the evaluation of health problems
5. John Snow (1854): tested a hypothesis on the origin of
epidemic of cholera
6. Alexander Louis (1872): Systematized application of
numerical thinking (quantitative reasoning)
7. Bradford Hill (1937): Suggested criteria for establishing
causation
 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
 Field Of Epidemiology

• Epidemiology covers the various types of field in different types

of activities. It is applied in every field as agricultural,
economics, statistics etc.

 Clinical epidemiology
 Geographical epidemiology
 Social epidemiology
 Statistical epidemiology
 Descriptive epidemiology
 Analytical epidemiology
 Experimental epidemiology
 Infectious diseases epidemiology etc.
 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?)

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 sick individuals (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 preventive and promotive 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
Disease

Young Age,
Polluted more in males,
Low immunity
water, open power, Lack of
defecation personal
hygiene
 Latest Scandal
Recently published research has found that
about half of the authors of Harrison’s
Principles of Internal Medicine, which is
nothing short of a Bible in medicine, have
received payments from 17 pharmaceutical
and device companies and about a quarter
hold patents. Some of these payments
were considerable: authors in total had
received more than $11m over four years,
and one author had been paid $560 021
over a 17 month period, 90% of it for
consulting. But none of these conflicts of
interest were declared in the textbook. The
research found that other textbooks had
authors with financial conflicts of interest
that were not declared, confirming earlier
research.
 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
Thank You