EPIDEMIOLOGY

Is the study of the occurrences and

distribution of diseases as well as
the distribution and determinants of
health states or events in specified
population, and the application of
this study to the control of health
problems

EPIDEMIOLOGY
Study the history of health population and
the rise and fall of diseases and changes
in the character
Diagnose the health of the community
and the condition of people

Study the work of health services with a

view of improving them.

USES OF EPIDEMIOLOGY
Estimate the risk of the disease, accident,
defects and the chances of avoiding them

Identify syndromes by describing the

distribution and association of clinical
phenomena in the population

USES OF EPIDEMIOLOGY
Complete the clinical picture of chronic
disease and describe their natural history

Searchfor causes of health and disease by

comparing the experience of groups

USES OF EPIDEMIOLOGY
EPIDEMIOLOGIC TRIANGLE

HOST

AGENT ENV’T
• The model implies that each must be
analyzed and understood for
comprehensions and prediction of patterns
of a disease
• A change in any of the component will
alter an existing equilibrium to increase or
decrease the frequency of the disease

EPIDEMIOLOGIC TRIANGLE
HOST
Any organism that harbors and
provides nourishment for
another organism
AGENT
Is the intrinsic property of microorganism
to surivive and multiply in the
environment to produce disease
CAUSATIVE AGENT
◦ Is the infectious agent or its toxic component
that is transmitted from the source of infection
to the susceptible body
ENVIRONMENT
Is the sum total of all external condition
and influences that affects the
development of an organism which can be
biological, social and physical

Affects both agent and the host

PHYSICAL ENVIRONMENT
◦ Is composed of the inanimate sorroundings
such as the geophysical conditions of the
climate
BIOLOGICAL ENVIRONMENT
◦ Makes up the living things around us such as
plants and animal life
SOCIO-ECONOMIC ENVIRONMENT
◦ Which maybe in the form of level of economic
development of the community, presence of
social disruptions and the like

3 COMPONENTS of ENVIRONMENT
Nutritive elements
◦ Excess and deficiencies of elements

Chemical agents
◦ Poisons and allergens

Physical agents
◦ Heat, light, radiation

Infectious agents
◦ Protozoa, bacteria, fungi

CLASSIFICATIONS OF AGENTS
Host factors (intrinsic) influences
exposure, susceptibility or response to
agents

◦ Genetic ◦ Experience
◦ Age ◦ Current/pre-exisiting
◦ Sex disease
◦ Ethnic group ◦ Human behavior
◦ Physiologic
◦ immunologic

CLASSIFICATION OF HOST
Environmental Factors – influences
existence of the agent, exposure or
susceptibility to agent
◦ Physical environment
◦ Biologic environment
 Human population
◦ Socio-economic
 Occupation
 Urbanization
 disruption

CLASSIFICATION OF ENVIRONMENT
TIME
◦ Refers both to the period during which the
cases of the disease being studied were
exposed to the source of infection and the
period during which the illness occurred
EPIDEMIC PERIOD
a period during which the reported number of
cases of a disease exceed the expected or usual
number for that period

DISEASE DISTRIBUTION
PERSONS
◦ Refers to the characteristics of the
individual who were exposed and
who contacted the infection or the
disease in question
PLACE
◦ Refers to the features, factors or conditions
which existed in or described the environment
in which the disease occurred.
 URBAN/RURAL DIFFERENNCES
◦ Dse spread most rapidly in urban than rural areas
because of the greater population density
 SOCIO-ECONOMIC AREAS
PATTERNS OF OCCURRENCE
AND DISTRIBUTION
SPORADIC

◦ Is the intermittent occurrence of a few isolated

and unrelated cases in a given locality

◦ The cases are few and scattered

ENDEMIC
◦ Is the continuous occurrence throughout a
period of time, of the usual number of cases in
a given locality

◦ The dse therefore is always occuring in the

locality and the level of occurrence is more or
less constant through a period of time
EPIDEMIC
◦ Is of unusually large number of cases in a
relatively short period of time.
◦ Eg. Dengue cases in Pigcawayan in 2011

PANDEMIC
◦ Is the simultaneous occurrence of epidemic of
the same disease in several countries
◦ Eg. AIDS is globally increasing worldwide
 Public

Summaries, Health care Reports

Interpretations providers
recommendations

Heath
agencies
IMPORTANCE OF AN OUTBREAK
INVESTIGATION
◦ Control and prevention measure
◦ Severity and risk to others
◦ Research opportunities
◦ Public, political or legal concerns
◦ Program consideration
◦ training

WHY IS THERE A NEED TO

INVESTIGATE AN OUTBREAK?
VITAL STATISTICS
Statistics
◦ Refers to a systematic approach to obtaining,
organizing and analyzing numerical facts so
that conclusion may be drawn from them
Vital statistics
◦ Refers to the systematic study of vital events
such as births, illnesses, marriages, divorce,
separation and death
Statisticsof disease (morbidity) and death
(mortality) indicate the state of health of a
community and the success or failure of
health work
NSO (National Statistics Office)
◦ Keeps records of the statistics on population
and other data such as age and sex

Office of Local Civil Registrar

◦ Registers the birth and death of a municipality
or city
◦ City Health Department
Indices of the health and illness status of
a community
Serves as bases for planning,
implementing, monitoring and evaluating
community health nursing programs and
services

USE OF VITAL STATISTICS

Population Census
Registration of vital data
Health Survey
Studies and researches

SOURCES OF DATA
RATES AND RATIOS
Rate
◦ Shows the relationship between a vital event
and those persons exposed to the occurrence of
said event, within a given area and during a
specified unit of time, it is evident that the
person experiencing the event (numerator)
must come from the total population exposed
to the risk of same event (denominator)
Ratio
◦ Is used to describe the relationship between
two (2) numerical quantities or measures of
events without taking particular considerations
to the time and place.
◦ These quantities need not necessarily represent
the same entities, although the unit of measure
must be the same for both numerator and
denominator of the relation
Crude or general rates
◦ Referred to the total living populations
◦ It must be presumed that the total population
was exposed to the risk of the occurrence of
the event

Specific rate
◦ The relationship is for a specific population
class or group. It limits the occurrence of the
event to the portion of the population definitely
exposed to it
FORMULAS
Crude Birth Rate (CBR)
◦ A measure of one characteristic of the natural
growth or increase of a population

number of live births

CBR =--------------------------------------- x 1000
Midyear population
Crude Death Rate
◦ A measure of one mortality from all causes
which may result in a decrease of population

number of deaths
CDR =------------------------------------- x 1000

midyear population
Infant Mortality Rate (IMR)
◦ Measures the risk of dying during the 1st year of
life. It is a good index of the general health
condition of a community since it reflects the
changes in the environment and medical
condition of a community

deaths under 1 yr of age

IMR = ---------------------------------------- x 1000
midyear population
Maternal Mortality Rate (MMR)
◦ Measures the risk of dying from causes related
to pregnancy, childbirth and puerperium. It is
an index of the obstetrical care needed and
received by women in a community

No. of deaths due to pregnancy,

delivery & puerpuerium
MMR =------------------------------------------------------ x 1000
number of live births
Neonatal Mortality Rate (NMR)
◦ Measures the risk of dying the 1st month of life.
It serves as an index of the effects of prenatal
care and obstetrical management of the
newborn

No. of Deaths under 28 days of age

NMR =------------------------------------------------------ x 1000
Midyear population
Proportionate Mortality Rate (PMR)

deaths from a particular cause

PMR = -------------------------------------------- x 100
total deaths
Swaroop’s Index

number of deaths among those

over 50 yrs and over
Swaroop’s Index = --------------------------------- x 100
total deaths
CAUSE-OF-DEATH RATE (CDR)

deaths from a specified cause

CDR = -------------------------------------------- x 1,000
midyear population
CASE FATALITY RATIO (CFR)

no. of deaths from a specified cause

CFR = -------------------------------------------- x 100
number of cases of the same dse
Incidence Rate (IR)
- Measures the frequency of occurrence of the
phenomenon during a given period of time

No. of new cases of a disease

IR = ---------------------------------------------- x 100,000
Population at Risk of developing the dse
Prevalence Rate (PR)
◦ Measures the proportion of the population
which exhibits a particular disease at a
particular time. This can only be determined
following a survey of the population concerned,
deals with total (new and old) number of cases

number of old + new cases of a dse

PR = ------------------------------------------------- -x 100
Total No. of persons examined
Attack Rate – a more accurate measure of
the risk of exposure

No. of persons acquiring a disease

AR = ---------------------------------------- x 100
No. of exposed
Specific Mortality Rate

No. of deaths in a specified group

SMR= ---------------------------------------- x 1000
Midyear population of the
same specified group
Observation of events in the community
are presented in the form of tablets,
charts and graphs

PRESENTATION OF DATA
LINE OR CURVED GRAPHS
◦ Shows peaks, valleys and season trends
◦ Also used to show the trends of birth and death
rates over a period of time

BAR GRAPHS
◦ Each bar represents or expresses a quantity in
terms of rates or percentages of a particular
observation like causes of illness and deaths

AREA DIAGRAM (PIE CHARTS)

◦ Shows the relative importance of parts to the
whole
To EASILY REMEMBER!
vital stat= NUMERATOR x f
DENOMINATOR

REMEMBER!
Vital stat= ____________ x 1000
total live births

Vital stat = _____________ x 1000

total midyear population

FORMULAS
 FORMULAS
total # of = MMR, NMR, IMR
live births (related to pregnancy)

total midyear = CBR, CDR, SMR

population
PAMPAGULO
Prevalence rate (PR)

PR = total # of old + new cases in a year x 1000

total # of people examined
 Attack rate (AR)

AR = total # of people acquiring the dse x 100

total # of people exposed to the dse

PAMPAGULO
 Case Fatality Ratio (CFR)

CFR = total # of death from a specific dse x 1000

Number of cases of the same disease

PAMPAGULO
Proportionate Mortality Rate (PMR)

PMR = total # of death from a specific cause x 1000

total # of death from ALL causes

PAMPAGULO