EPIDEMIOLOGY

• DEFINITION
“The study of distribution and determinants of
health-related states of events in specified
populations, and the application of this study
to the control of health problems.”
(John M.Last in 1988)
• Frequency of disease
Rates, Ratios and Proportions
Health-related events and states (Health
needs, demands, activities, tasks, health care
utilization)
Domain of biostatistics (Basic tool of
Epidemiology)
• Distribution of disease
Time
Place
Person
Formulation of etiological hypothesis
Descriptive Epidemiology
• Determinants of disease
Real substance of epidemiology
Analytical epidemiology
Identify the underlying causes(risk factors)
Help in developing scientifically sound health
programmes
• Aims of epidemiology
To describe the distribution and magnitude of
health and disease
To identify etiological factors
To provide the data
• Ultimate Aim
To eliminate the health problem
To promote the health and well-being
 MEASUREMENTS IN EPIDEMIOLOGY
• Mortality
• Morbidity
• Disability
• Natality
• Presence, absence or distribution of characteristic or attribute
of the disease
• Medical needs, health care facilities, utilization of health
services
• Presence, absence or distribution of the environmental and
other factors suspected of causing disease
• Demographic variables
 TOOLS OF MEASUREMENTS

• Rates
• Ratios
• Proportions
 Rate
• Numerator part of denominator
• Time specification
• Multiplier
• Death rate= No. of deaths in one year × 1000
Mid-year population
Crude Rates
Specific Rates
Standardized Rates
 Ratio
• Numerator not a part of denominator
• May involve an interval of time or may be
instantaneous in time
• Sex-ratio
• Doctor-population ratio
• Child-woman ratio
• Maternal mortality ratio
 Proportion
• Numerator part of denominator
• Expressed as percentage
• No. of children with scabies at a certain time × 100
Total no. of children in the village at the same time
 MEASUREMENT OF MORBIDITY

• Any departure subjective or objective from a

state of physiological well-being

• Incidence – the no. of new cases occurring in a

defined population during a specified period
of time
• No. of new cases of specific disease during a given time period × 1000
Population at risk during that period
• Attack rate= No. of new cases of a
specified disease during a
specified time interval × 1000

Total population at
risk during the same interval
• Secondary attack rate : No. of exposed
persons developing the disease within the
range of incubation period following exposure
to a primary case.
 PREVALENCE
• All current cases (old and new) existing at a
given point in time
• Point Prevalence: No. of all current cases of a
disease at one point of time, in relation to a
defined population
• Point may be a day, several days, a few weeks
• Period Prevalence: All current cases existing
during a defined period of time expressed in
relation to a defined population
• P=I×D
 MEASUREMENT OF MORTALITY

• Crude death rate

• Specific death rate ( cause or disease specific, age
specific, sex specific)
• Case fatality rate- killing power of a disease (for
acute infectious diseases)
• Proportional mortality rate- deaths from a specific
disease, under-5 proportional mortality rate
• Survival rate- proportion of survivors in a group
studied and followed over a period of time
EPIDEMIOLOGIC METHODS