Basic Epidemiologic

concept
 Definition of epidemiology
• Epidemiology is the study of the distribution and
determinants of health related states and events in population
and application of this study to control health problem.

- Distribution: includes description of disease by place,

time and person

- Determinants: the factors that determine the probability

of occurrence of disease (risk factors)

 Two Broad Types of Epidemiology

DESCRIPTIVE EPIDEMIOLOGY
ANALYTIC EPIDEMIOLOGY
 Examining the distribution of a
disease in a population, and • Testing a specific hypothesis about the
observing the basic features of relationship of a disease to a putative
its distribution in terms of time, cause, by conducting an epidemiologic
place, and person. study that relates the exposure of
interest to the disease of interest.
 Typical study design:
 Typical study designs:
community health survey
(approximate synonyms - cross- cohort, case-control
sectional study, descriptive
study)
The Basic Triad Of Descriptive
Epidemiology

THE THREE ESSENTIAL

CHARACTERISTICS OF DISEASE WE
LOOK FOR IN DESCRIPTIVE
:EPIDEMIOLOGY
• TIME
• PLACE
• PERSON
Time
• Changing or stable?
• Seasonal variation.
• Clustered (epidemic) or evenly
distributed (endemic)?
Place

Geographically restricted or widespread •

  ?(pandemic)
• Relation to water or food supply.  
Person
• Age
• Socio-economic status
• Gender
• Ethnicity/Race
• Behavior
 Descriptive Epidemiology Is A
Necessary Antecedent Of Analytic
Epidemiology
To undertake an analytic epidemiologic study
you must first:
• Know where to look
• Know what to control for
• Be able to formulate hypotheses compatible
with laboratory evidence
The Basic Triad Of
Analytic Epidemiology

• the three phenomena assessed in

analytic epidemiology are:

HOST

AGENT ENVIRONMENT
Agents

• Nutrients
• Poisons
• Allergens
• Radiation
• Physical trauma
• Microbes
• Psychological experiences
Host Factors

• Genetic endowment
• Immunologic state
• Age
• Personal behavior
Environment

• physical: media (air, water, soil),

and pollutants (heat,
radiation ,chemicals).
• Biological: reservoirs of infection( man,
animal, plant), and vectors.
• psycho-social: lifestyle, food habits, stressors.
Purposes Of Epidemiology

1. Identify causes and risk factors for

disease.
2. Determine the extent of disease in the
community.
3. Study natural history and prognosis of
disease.
4. Evaluate preventive and therapeutic
measures
5. Provide foundation for public policy
Epidemiologic triad

Host
• Demographic
• Biological
Agent • Socio-economic
Biological Environment
Physical
Chemical • Physical
Mechinical • Biological
Social • Social
Definition of communicable disease

• A communicable disease is an illness due to a

specific infectious agent or its toxic products
capable of being directly or indirectly transmitted
from man to man, from animal to man ,from animal
to animal or from the environment
Chain of infection (infectious
cycle)

• Source or reservoir

• Mode of transmission

• Susceptible host
(1) Source or reservoir:

• The source of infection: the person, animal, object

or substance from which an infectious agent passes

• Reservoir: any person, animal, arthropod, plants,

soil in which infectious agent normally lives and
multiplies
(2) Mode of transmission

Mode of transmission

Direct Indirect

Direct contact Vehicle-borne

Vector-borne
Droplet infection - Mechanical
- biological
Vertical transmission Air-borne
a. Direct:
1- Direct contact:
- Sexually transmitted diseases ( AIDS, syphilis, gonorrhea)
- Tetanus (contact with contaminated soil)
- Schistomiasis (contact with contaminated water)
- Rabies (contact with saliva of rabid animals)

2- Droplet infection:
- Pertussis and Meningitis

3- Vertical transmission (intrauterine, natal or breast-feeding)

- Rubella, Syphilis, Herpes simplex, CMV
b. Indirect:
1- Vector borne: (mechanical or biological)
- Malaria, Plague, Filaria

2- Vehicle-borne (non-living contaminated objects)

- food borne diseases: typhoid fever, Hepatitis A
- water borne diseases: Cholera
- Blood borne diseases: Hepatitis B, C
- Fomite borne diseases: transmitted by contaminated
surgical instruments, utensils, bedding, clothes

3- Air- borne: (droplet nuclei, dust)

- meningitis, streptococcus, TB
Susceptible host )3(
An infectious agent seeks a susceptible host
aiming “successful parasitism”.

Four stages are required for successful

parasitism:
1- Portal of entry
2- Site of election inside the body
3- Portal of exit
4- Survival in external environment
• Epidemic: Occurrence of a disease at rates clearly
exceeding the normal expected levels in a
community.

• Endemic: Habitual presence of a disease within a

certain geographic area.

• Pandemic: Worldwide epidemic.

• Measures of morbidity and
mortality
Prevalence
• Prevalence is the number of new and existing cases divided
by the total population (can be during a period of time or at
a given point) presenting in place
• Prevalence =
(New cases + existing cases)/Total population
- Can be expressed as a percent
- Can give a picture of disease burden within a population
Prevalence rates can be calculated at a certain point in time
“point prevalence" or during period of many
days,months,years”period prevalence”
Incidence
• Number of new events occurring in a defined
population during a specified period of time
• Incidence =
New cases/population at risk/time
• Used to measure current disease activity
• Allows comparison between areas with different
populations
 Comparison between incidence and prevalence
INCIDENCE PREVALENCE

MEANING risk of getting the disease Burden of

disease in
population
NUMERATOR Recent new cases New+ old cases
DENOMINATOR Population at risk Total population

FACTORS Number of new cases Number of new

AFFECTING affected by prevention cases affected
by prevention
Number of old
cases affected
by duration
Natural history of disease
-:Definition
The progress of a disease in an
individual over time, in the
absence of medical intervention.
Importance of natural history of
-: disease
Provides crucial insights into
disease occurrence-
.disease severity-
.clinical services*
.public health programs*
.disease treatment-
.disease prevention-
Four stages of the natural history of
:disease
1)susceptibility-precedes exposure to the causal
agent

(2)subclinical(preclinical)disease-the stage of
disease that follows exposure to the agent but is
before symptoms are apparent (incubation period)..
(3)clinical disease-the stage of disease associated
with signs and symptoms .
(4) recovery, disability, or death -the stage at which
disease resolution occurs
Thank you