In the Name of ALLAH, The

most Beneficent, The

most Merciful
 EXERCISES OF
MORBIDITY
EPIDEMIOLOGY
PART 2
 Exercise

You are a health officer at BHU. You are going through

monthly reports of Health management information

system for the past six months. You find an increase in

the number of clients from ages 0 to 10 years attending

Health facility in the months of June & July.

Answer the following Questions:
What is your probable diagnosis?
 Gastroenteritis

What are the reasons for the above condition.

 Hot weather
 Vector increase
 Bad sanitation
 Bad personal hygiene
 Low socio economic status
 Lack of education
 Place of residence
 EXERCISE
Of the 75 Persons who Attended the Picnic, 46
Subsequently Developed Gastroenteritis.
a. What is the Attack Rate?
b. Is this Primary or Secondary Attack Rate?
 Exercise
7 Cases of Hepatitis A occurred among 70
children attending a child day care centre. Each
infected child came from a different family. The
total number of persons in the 7 affected families
was 32. one incubation period later, 5 family
members of the 7 infected children also
Developed Hepatitis
a. Calculate the Secondary Attack Rate.
 Exercise
In a bulk of hundred children out of whom 28
are immunized 2 of them get measles
simultaneously. Subsequently 14 get measles.
Assume the efficacy of the vaccine to be 100%.
What is the Secondary Attack Rate?
1. 5%
2. 10%
3. 20%
4. 21.5%
5. 19.4%
 Exercise
A village has total of 100 under-five children. The
coverage with measles vaccine in this age group is
60%. Following the occurrence of a measles case in a
child after a visit outside, twenty- six children
developed measles. The Secondary Attack Rate of
measles is:
1. 25%
2. 40%
3. 50%
4. 65%
5. 66%
 Exercise
In a population of 1000, measles coverage is 60%, one
child goes out of station and comes back with measles
from whom 20 more children get measles. Secondary
attack rate of measles is:
1. 0.65%
2. 5%
3. 6%
4. 6.5%
5. 7%
 Answer
Total No. of children = 1000

No. of immunized = 600

No. of un-immunized = 400

Primary case = 01
Secondary Attack Rate = 20/(400-1) X 100
= 20/399 X100
= 05%
In a Stable Situation:

1. Prevalence

= Incidence X Duration

2. Incidence

= Prevalence / Duration

3. Duration

= Prevalence / Incidence
 Answer

Prevalence 1 year = 100/5000

= 20/1000
Prevalence 2 year= 20/1000 X 2

= 40/1000
 Exercise
Which of the following measures is used frequently
as a denominator to calculate the incidence rate of
disease?
1. Number of cases observed

2. Number of new cases observed

3. Number of asymptomatic cases

4. Person-years of observation

5. Persons lost to follow-up

 Answer

4. Person-years of Observation

19
 Exercise
The results of a study of the incidence of pulmonary
tuberculosis in a village in India are given in the table
below. All persons in the village are examined during
two surveys made 2 years apart, and the number of
new cases was used to determine the incidence rate.
What is the incidence of new cases per 1000 persons
years in households that had a culture positive case
during the first survey?

Category of Household at Number of Number of new cases

First survey Persons
With culture positive case 500 10
Without culture positive 10,000 10
 Answer
Incidence =
Number of new cases of specific disease during a given period /
Population at Risk During that Period

= 10 new cases X 10n

500 persons x 2 years

=10 cases/1000 persons years

 Exercise
What is the incidence of new cases per 1000 persons
years in households that did not have a culture
positive case during the first survey?

Category of Household at Number of Number of new cases

First survey Persons

With culture positive case 500 10

Without culture positive 10,000 10

case
 Answer
Incidence =
Number of new cases of specific disease during a given
period / Population at Risk During that Period

= 10 new cases X 10n

10,000 persons x 2 years

= 0.5 cases/1000 persons years

23
 Exercise

Among the in- patients of RGH Hospital during the

month of June, a total of 12 were admitted with a
primary diagnosis of UTI (urinary tract infection).
For the same month, the hospital had total of 2400
patients. The Incidence Rate of UTI for the month of
June per 1000 patients is :
 Answer
Incidence Rate =
Number of new cases of specific disease
during a given period X 1000 / Population at
Risk During that Period

= 12 X 1000 / 2400
= 05
= 5 per 1000 patients
 Exercise

During the month of April, a total of 32 patients in

RGH Hospital were found to have diabetes mellitus,

and the hospital had a total of 6400 patients. The

prevalence rate of diabetes for the month of April

per 1000 patients is:

 Answer
Prevalence Rate =
Number of New and Old Cases of specific
disease during a given period X 1000 /
Population at Risk During that Period
= 32 X 1000/ 6400
= 5
= 5 per 1000 patients
 Exercise
The Incidence of bronchogenic carcinoma in a country
was found to be three times higher for men than for
women, but the prevalence rates were almost the same in
both sexes. This can be explained by :
1. The duration of the disease is shorter for women

2. The incidence rate is higher for women

3. The recovery rate from the disease is higher for women
4. The duration of the disease is becoming shorter for men

5. The duration of the disease is becoming longer for men

 Answer

4. The duration of the disease is becoming

shorter for men.

29
THE END
30