Universidade Católica de Moçambique

Faculty of Heath Sciences

Medine, year 1

Concept of Epidemiology

Arlinda Basílio Zango

azango@ucm.ac.mz
846312653

Beira, 22/09/2021
Introduction

Objectives

At the end of this lecture students should be able to:

 Define Public Health,

 Define Epidemiology

 Describe usages of epidemiology

 Describe the core functions of epidemiology

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Public Health concept

What is Public Health?

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 Public Health concept

 Public Health: “Referees to all organized measures (whether

public or private) to prevent disease, promote health, and prolong
life among the population as a whole”.
Or
 Public health “is the art of applying science in the context of
politics so as to reduce inequalities in health while ensuring the
best health for the greatest number”

 Health “is a state of complete physical, mental and social well-

4
being and not merely the absence of disease or infirmity”. 03/02/2023
 Public Health concept

As a multidisciplinary field, public health:

 Promote the health of population through organized community efforts.

 Protects people against threats to health.

 Empowers people lives.

 Improves the quality of health services.

 Prepares leaders to advance health. 03/02/2023 5

Epidemiology concept

What is Epidemiology?

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 Epidemiology concept

Epidemiology EPI =ON; DEMOS = POPULATION; LOGOS =

STUDY

Epidemiology is the study of:

• the distribution of health outcomes or disease within populations;

• factors that determine spread of health outcomes and disease (risk

factors)

• the specific populations affected by a health outcome 03/02/2023 7

 Epidemiology concept (Cont.)

 Epidemiology is a scientific discipline with sound methods.

 Uses a systematic and unbiased approach to the collection,
analysis, and interpretation of data.
 Is the basic science of Public Health.

 Epidemiology is concerned with the frequency and pattern

of health events in a population.
 What is frequency and what is pattern?
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Epidemiology concept (Cont.)

 Frequency (Absolute/relative)
 Number of health events such as the number of cases of
tuberculosis or HIV in a population,
 Relationship of the number to the size of the population.
 Rate that allows epidemiologists to compare disease
occurrence across different populations.

 Pattern refers to the occurrence of health-related events

by time, place and person.
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Epidemiology concept (Cont.)

 Epidemiology is also used to search for determinants of

heath.
 causes that lead to physiological changes of the body;
 factors that influence the occurrence of diseases and other
health-related events (outcomes)

 Epidemiology is the study of the distribution and

determinants of the diseases or health-related event in
specified populations including the application of this results
to control health problem (CDC, 2012). 10
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 Evolution of Epidemiology

Time period Events

1850 -1873 Communicable diseases and epidemics

1900 - 1927 Infectious diseases

1927 - 1951 Conditions associated with infectious diseases

1951 - 1962 Distribution of diseases

1962 - 1988 Control of health problems 03/02/2023 11

 Epidemiologic transition

1. Infectious and nutritional diseases linked to agriculture and

food production

Zoonotic diseases and nutrient deficiencies

2. Immune systems and disease-causing organisms

changed; Shift from major epidemics to endemic disease

Humans developed genetic changes

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Epidemiologic transition

3. Change to chronic and degenerative diseases; Nutrition,

public health, clinical medicine

Long lifespan, sedentary lifestyle

4. End of 20th century, New diseases; Re-emergence of

infectious diseases.

Rapid spread through globalization

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 Pioneers of Epidemiology

Hippocrates (c. 460-377 BCE)

• Environmental and behavioral issues associated with

disease.

• Rational explanations on disease and disease effects to

population.

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Pioneers of Epidemiology

Girolamo Fracastoro (c. 1478-1553)

• Identified ways by which infections can be transmitted –direct contact,

air transmission and clothing

• Disease caused by rapidly multiplying seed

Captain John Graunt (c. 1620-1674)

• Population and mortality statistics survivorship chart

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• Modern demography
Pioneers of Epidemiology

James Lind (c. 1716-1794)

• Benefit to the field of preventive medicine; Improved nutrition
and helped leading to modern clinical trials

Percivall Pott (c. 1714-1788)

• Association between dust and scrotal cancer, environmental
factor noted as cancer-causing for the first time

• Beginning of modern non-infectious disease

 Epidemiology the study of outcomes in population.
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Pioneers of Epidemiology

William Far (c. 1807-1883)

• Used statistical data to test social hypotheses

• Classified causes of death

• Relationship: population density and mortality rates

• Mapped deaths, monitored outbreaks, developed

categorization system

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 Pioneers of Epidemiology

Sir Edwin Chadwick (c. 1800-1890)

• Proposed public health and social reform;

• Proposed clean water, water closets and sewer systems

Johon Snow (c. 1813-1858)

• First person to count and map cases geographically;

• Cholera spread by water

• Beginning of epidemiology
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Uses of Epidemiology

Epidemiology is used to develop, target population and evaluate

prevention strategies.
Primary prevention: before the person gets the health outcome
(disease) . Example Vaccines.

Secondary prevention: after health outcome (or disease), but before

symptoms. Example checking for HBP.

Tertiary prevention: The symptoms of the diseases (or health outcome)

are already present. Example: dietary advice to manage diabetes or salt
reduce to control Hypertension.
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Example of research area using
epidemiology

 Infectious disease/health
outcome • Health policy
• Health behavior
 Chronic disease/health • Etiology
outcome • Outbreak investigation
 Maternal/child health • Disease surveillance
• Screening
 Injury and accidents
• Bio-monitoring
 Environmental • Molecular biology
 Occupational • Comparisons of treatment effects
• Pharmacy/Medicine
 Nutrition
 Social
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Core functions of epidemiology

What are the core functions of epidemiology?

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Core functions of epidemiology

 Public health surveillance,

 Field investigation,

 Analytic studies,

 Evaluation, and linkages

 Policy development

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Core functions of epidemiology
(Cont.)

Public health surveillance

 Public health surveillance is the ongoing, systematic collection,
analysis, interpretation, and dissemination of health data to help
and guide public health decision making actions.

 The purpose of public health surveillance “information for

action,” is to portray the ongoing patterns of disease occurrence
and disease potential so that investigation, control, and
prevention measures can be applied efficiently and effectively.
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Core functions of epidemiology
(Cont.)

 Morbidity and mortality reports are

common sources of surveillance data
for local and state health departments.

 The reports generally are submitted by

health-care providers, infection control
practitioners, or laboratories that are
required to notify the health department
of any patient with a reportable disease
such as cholerae, Measles, Covid-19,
Tuberculosis…
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Core functions of epidemiology
(Cont.)

Field investigation
 Field investigation = coordinated efforts of dozens
of people to characterize the extent of an epidemic
and to identify its cause.

 The propose is to identify the additional unreported

or unrecognized ill persons who might otherwise
continue to spread infection to others.

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Core functions of epidemiology
(Cont.)

Analytic studies
 Analytic studies are used to evaluate/test the credibility of hypotheses
started through surveillance and field investigations.

Linkages
The epidemiologists need to maintain relationships with staff of other
agencies and institutions.
 Official memoranda of understanding,
 Sharing of published or on-line information
 Informal networks.
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Core functions of epidemiology
(Cont.)

Policy development
Epidemiologists working in public health regularly provide
input, testimony, and recommendations regarding disease
control strategies, reportable disease regulations, and
health-care policy.

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 The Epidemiologic Approach

As with all scientific endeavors, the practice of epidemiology relies

on a systematic approach to:

 Counts cases or health events, and describes them in terms of

time, place, and person;

 Divides the number of cases by an appropriate denominator to

calculate rates;

 Compares the rates over time or for different groups 28

of people.
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Bibliography

 CDC. Principles of Epidemiology in Public Health Practice. 3ª ed. Atlanta, GA

30333. Available at
https://www.cdc.gov/ophss/csels/dsepd/ss1978/ss1978.pdf
 Carr, S., Unwin, N. e Pless-Mulloli, T. (2007) An Introduction to Public Health
and Epidemiology. 2ª. Ed. McGraw-Hill Companies, England.

 Walley, J. e Wright J. (2010). Public Health an action guide to improving

health, 2ª. Ed. Oxiford. New York.

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Thank you!
?
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