3 Epidemiology 3

Epidemiology
EPIDEMIOLOGY
The science that studies when
and where diseases occur and
how they are transmitted in
population.
From the Greek word epidemic
or upon the population.
Also includes non-infectious diseases
NUTRITIONAL DISEASE
OCCUPATIONAL DISEASE
CHRONIC AND DEGENERATIVE DISEASE
MENTAL ILLNESS
NUTRITIONAL DISORDER
CONGENITAL DEFECTS
ACCIDENTS
SOCIAL PATHOLOGY
THREE DIVISIONS
Measurement of health and
disease
General Epidemiology
Epidemiology of infections
EPIDEMIOLOGIST
An individual who studies
disease in population.
Determines the etiology of
disease
EPIDEMIOLOGIST
Can provide physician with
information that is important in
determining the prognosis and
treatment of a disease
Can provide data to help in
evaluating and planning overall
health care in community
DETERMINANT OF DISEASE
1. Those that which
determines the susceptibility
of the individual or host
factors.
DETERMINANT OF DISEASE
2. Those which determine his
exposure to the specific
agent (environmental or
exposure factors)
Measurement of Health
Status
Illness (how many and what
kind)
Deaths (how many and from
what cause)
Population (growing, declining,
or staying about the same)
TYPES AND USES OF EPIDEMIOLOGIC
STUDIES
1. DESCRIPTIVE
EPIDEMIOLOGY
Entails collecting all data that
describe the occurrence of the
disease under study.
STUDIES
2. ANALYTICAL
EPIDEMIOLOGY
Analyzes a particular
disease to determine its
probable cause.
STUDIES
Case-Controlled Method a group of
people who have the disease is
compared with another group of
people who are free of the disease.
Cohort Method a population that has
had contact with the agent before or
after the outcome occurs
STUDIES
3. EXPERIMENTAL EPIDEMIOLOGY
Begins with a hypothesis about a particular
disease, experiments to test the hypothesis
are then conducted with the group of
people.
A group of infected individuals is selected
and divided randomly so that some receive
the drug and others received placebo.
PATHOLOGY
The scientific study of disease
pathos suffering; logos
science
INFECTION
Invasion or colonization
of the body by pathogenic
microorganism
CLASSIFICATION OF INFECTIOUS
DISEASE
COMMUNICABLE DISEASE
CONTAGIOUS DISEASE
NON-COMMUNICABLE DISEASE
COMMUNICABLE DISEASE
Any disease that spreads
from one host to another
either directly or indirectly
CONTAGIOUS
DISEASE
Disease that is easily spread
from one person to another
NON-COMMUNICABLE
DISEASE
Is not spread from one

host to another
THE OCCURRENCE OF A
DISEASE
Incidence - the fraction of a
population that contracts it
during a particular period.
Prevalence the fraction of the
population having the disease
at a specified time
Sporadic Disease
If a particular disease occurs

only occasionally
Endemic Disease
A disease constantly
present in a population
Epidemic Disease
If many people in a given
area acquire a certain
disease in a relatively
short period
Pandemic Disease
An epidemic disease that

occurs worldwide
THE SEVERITY OR DURATION OF A
DISEASE
ACUTE DISEASE
CHRONIC DISEASE
SUB-ACUTE DISEASE
LATENT DISEASE
ACUTE DISEASE
Develops rapidly but lasts only in a short
time
Influenza
CHRONIC DISEASE
Develops more slowly, and the bodys
reaction may be less severe but the
disease is likely to be continual or recurrent
for long periods.
TB
SUB-ACUTE DISEASE
A disease that is intermediate between acute and
chronic.
Panecephalitis rare brain disease
LATENT DISEASE
The causative agent remains inactive for a time
but then becomes active to produce symptoms of
the disease.
Shingles caused by varicella-zoster virus
RESERVOIRS OF INFECTION
HUMAN RESERVOIR
ANIMAL RESERVOIR
NON-LIVING RESERVOIR
HUMAN RESERVOIR
The principal living reservoir of human
disease is the human body itself
These people called CARRIERS are living
reservoir of infections
AIDS, diphtheria, typhoid fever, hepatitis,
gonorrhea
ANIMAL RESERVOIR
Both wild and domestic animals
ZOONOSES disease that occur primarily
in wild and domestic animals and can be
transmitted to humans.
Influenza birds
Rabies dogs and cats
Lyme disease ticks
Malaria mosquitoes
Routes of transmission:
Direct contact with infected animals
Direct contact with domestic waste
Contamination of food and water
Contact with contaminated hides, furs,
and feathers
Consuming infected animal products
Insect vectors
NON-LIVING RESERVOIR
The 2 major non-living reservoirs of
infections are soil and water.
Soil harbors such pathogens as fungi
(ringworms), Clostridium botulinum
(botulism), Clostridium tetani (tetanus)
Water harbors such pathogens as Vibrio
cholerae (cholera), Salmonella typhi
(typhoid fever)
THE TRANSMISSION OF DISEASE
The causative agents of disease can
be transmitted from the reservoir of
infection to a susceptible host by the
principal routes: contact, vehicles,
vectors.
A. CONTACT TRANSMISSION
B. VEHICLE TRANSMISSION
C. VECTORS
CONTACT TRANSMISSION
Spread of an agent of disease by
direct contact, indirect contact, or
droplet transmission.
Direct Contact
Indirect Contact
Droplet Transmission
Direct Contact person to
person transmission
Touching
Kissing
Diseases: common
cold, influenza, AIDS
Indirect Contact when the agent of the
disease is transmitted from its reservoir to a
susceptible host by means of a non-living
object.
Handkerchief
Towels
Tissues
Money
Toys
Syringes
Diseases: AIDS, Hepa-B, tetanus
Droplet Transmission microbes are spread in
droplet nuclei that travel only short distances
Coughing
Sneezing
Laughing
Talking
Disease: influenza, pneumonia, whooping
cough
VEHICLE TRANSMISSION
Medium: water, food, air, blood, body fluids, IV fluids
VECTORS
Animals that carry pathogens from one host to another (ex.
Arthropods)
Methods of Transmission:
Mechanical Transmission passive transport of pathogens

on the insects feet or other body parts. Ex. Houseflies
Biological Transmission active process. The arthropod
bites an infected host and ingests some of the infected
blood. The pathogens then reproduce in the vector and the
increase in the number of pathogens increases the
possibility that they will be transmitted to another host. Ex.
Mosquito
Transmission-Based Precaution:
1. Isolation
- Segregation of an infected person or animal until danger of
conveying infection has passed
2. Quarantine
- Detention of susceptible individuals who have been exposed to a
communicable disease
3. Reservoir Eradication
- The most permanent and the most desirable measure of
communicable disease control
4.Environmental Measures
Sanitation measures are directed toward the vehicle of
disease transfer. Ex. Application of sanitary control in water
supplies, milk processing, sewage disposal
5.Immunization
6.Personal hygiene and health behavior
7.Community education measures
Reverse Isolation
Applied among patients who are vulnerable to infection such
as patients with severe burns, with leukemia, patients who
received transplant, receiving radiation treatment, premature
babies.
Also called protective or neutropenic isolation
Source of Isolation
Infectious agents are isolated within a definite area and the
spread of pathogens to other patients is prevented.
The patient should be isolated in private air-conditioned
rooms with a private bath.
R.A. 9288 Newborn Screening
R.A. 9482 Control and Elimination of Human and Animal Rabies
R.A. 9165 Dangerous Drug Act of 2002
R.A. 9257 Expanded Senior Citizens Act of 2003
R.A. 9211 Tobacco Regulation Act of 2003
R.A. 7883 Barangay Health Workers Benefits and Incentive Acts of 1995
Rehabilitation, Self-development and self-reliance of disabled
R.A. 7277 person
R.A. 7183 Sale, Manufacture, distribution, and Use of Firecrackers
R.A. 8203 Special law on Counterfeit Drugs
R.A. 6675 Generics act of 1988
R.A. 4226 Hospital licensure act
R.A. 7876 Senior Citizens center act of the Philippines
R.A. 7305 Magna carta for public health workers
R.A. 7719 National blood services act of 1994
R.A. 7875 National health insurance act of 1995
R.A. 7170 Organ donation act
R.A. 8504 Prevention and control of HIV/AIDS
R.A. 8423 Traditional and Alternative Medicine Act
R.A. 8749 Clean Air Act
Prohibition of the demand of deposits or advance payments in
R.A. 8344 hospitals/medical clinics
R.A. 7394 Consumer act
R.A. 8976 Philippine food fortification act
R.A. 4688 Operation and maintenance of clinical laboratories
R.A. 9502 Cheaper and quality medicines
Basic Epidemiologic Elements
The human population (sick and well

members)
Natural history of diseases
The processes through which
deviations from health occur, the
course and outcome of the deviations.
This process involves the interactions of three
different kinds of factors
1. Causative agents
Biologic agents insects, worms, protozoa,
bacteria
Chemical agents gases, fumes, dusts
Nutritional agents lack or abundance of one or
many dietary elements
Physical agents extreme temperature,
radiation
2. Susceptible host
Biologic heredity or constitutional make-up
Chemical food habits
3. Environmental
Physical geography (climate, season),
topography (soil, water)
Biologic plants, animals
Economic standard of living
Social attitudes, beliefs, behaviors
APPLIED EPIDEMIOLOGY FOR
PHARMACISTS
Diseases do not occur by chance.
Diseases are not distributed randomly in the
population; thus their distribution indicates
something about how and why that disease
process occurred.
PHARMACOEPIDEMIOLOGY
PHARMACISTS use this method when conducting drug-
use reviews and evaluations.
It provides the best available evidence supporting or
refuting a hypothesis otherwise lacking data so that
health policy can be written.
Access to data coupled with epidemiological research
will permit the pharmacist to answer important questions
in drug therapy.
PHARMACOEPIDEMIOLOGIC STUDIES
A. EXPERIMENTAL
1. RANDOMIZED CLINICAL TRIALS study patients with
specific disease. (ex. Efficacy of a drug to prevent death
after a complication)
2. FIELD TRIALS study subjects to prevent disease. (ex.
Vaccination)
3. COMMUNITY INTERVENTION TRIALS study
communities to prevent diseases. (ex. Fluoridation of water
to prevent dental carries)
B. NON-EXPERIMENTAL
1. PROSPECTIVE COHORT observe group of patients
treated with the same drug.
2. RETROSPECTIVE COHORT extract data from an
existing repository to look at outcomes of exposed
group.
3. CASE CONTROL determine association between a
drug and a rare event.
4. CASE SERIES reveal common experience of a
number of patients following drug exposure.
B. NON-EXPERIMENTAL
5. CASE REPORT reveal the experience of a
single patient following drug exposure
6. CROSS-SECTIONAL determine the prevalence
of drug use in a patient population at a given time.
7. ECOLOGICAL determine the association
between drug use of a population or group and an
event.
EPIDEMIOLOGIC CONCEPTS:
Measurement of Health Outcomes
A. QUANTITATIVE MEASUREMENTS
1. COUNTS refer to the number of cases of a disease or
other health phenomenon under study.
- They have limited use in epidemiology if the size of the
source population is not interpreted.
A.QUANTITATIVE MEASUREMENTS
2. RATIO expression of the
relationship between two items.
RISK RATIO/ RELATIVE RISK incidence in the exposed
group divided by the incidence in the unexposed. It
addresses the number of times greater risk in exposed
than in unexposed.
ODDS RATIO probability of an outcome happening
divided by the probability of not happening.
RISK DIFFERENCE/ ATTRIBUTABLE RISK incidence in
the exposed group minus incidence in the unexposed. It
addresses the incidence of a disease attributed to an
exposure.
3. PROPORTION expression of the
relationship of one part to the whole. It is
usually expressed as percent.
4. RATE expression of the probability of
occurrence of a particular event in a defined
population during a specified period of time.
5. INDEX is used when the denominator or

population at risk cannot be determined.
B. SPECIFIC MEASUREMENTS
1.NATALITY RATES measure
the rate of birth.
a.Crude Birth Rate
b.Fertility Rate
2. MORBIDITY RATES measure the rate of
illness
a. Incidence Rate a high incidence rate means
high occurrence of disease
- It is a measure of the rate at which healthy
people develop disease during a specific time
- Frequency of new cases in a population over a
period
2. MORBIDITY RATES measure the rate of
illness
b. Prevalence Rate contains all known cases and
it is used to measure the amount of illness in the
community and thus, can be used to determine
the health care needs of the community.
*POINT PREVALENCE
frequency of cases at an
instant. It is often used in
cross-sectional studies.
*PERIOD PREVALENCE
frequency of cases within a
period such as one year.
2. MORBIDITY RATES measure
the rate of illness
c. Attack Rate
d. Secondary Attack Rate
3. MORTALITY RATES measure
the rate of death
a.Crude Death Rate
b.Cause-specific Death Rate
c. Maternal Mortality Rate
3. MORTALITY RATES measure the
rate of death
d. Case-fatality Rate it predicts the risk
of dying if the disease is contracted.
3. MORTALITY RATES measure the rate
of death
e. Years of Potential Life Lost (YPLL) is a
quantitative measure of premature
mortality (usually before 65 y/o)
- It reflects the mortality trends of younger-
age group by taking in account not only
the cause of death but also the age at
which it occurs.

3 Epidemiology 3

Diunggah oleh

Informasi Dokumen

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

3 Epidemiology 3

Diunggah oleh

Hak Cipta:

Format Tersedia

Epidemiology

Is not spread from one

If a particular disease occurs

An epidemic disease that

Mechanical Transmission passive transport of pathogens

The human population (sick and well

5. INDEX is used when the denominator or

Anda mungkin juga menyukai