EPIDEMIOLOGY :

(Pengukuran Frekuensi Penyakit)

Prof.Dr.Suharyo Hadisaputro, dr.Sp.PD-KPTI, FISPH

 SUMBER DATA
EPIDEMIOLOGIK
 DATA PRIMER,
Kegunaan :
1. Membimbing perencanaan/penilaian
program yg sedang berjalan;
2. Menafsir kebutuhan pelayanan;
3. Mengadakan tes hipotesis;
4. Melengkapi informasi yang relevan;
 SUMBER DATA
EPIDEMIOLOGIK
 DATA PRIMER,
Berbagai cara :
(a) Survai interview kesehatan;
(b) Survai pemeriksaan kesehatan;
(c) Survai catatan kesehatan;
(d) Survai penyakit tertentu;
(e) Observasional & Eksperimental.
 SUMBER DATA
EPIDEMIOLOGIK
 DATA SEKUNDER,
(tidak menggambarkan morbiditas sesuatu golongan penduduk)

Macam Sumber Data :

1. RS/Poliklinik/Puskesmas/Dokter Swasta;
2. Asuransi Kesehatan;
3. Asuransi kecelakaan;
4. Organisasi yang mengurus orang miskin;
5. Absensi sekolah-kantor oleh karena sakit;
6. Pre employment (Periodic Physical Examination)
 RATE = Frekuensi distribusi penyakit / peristiwa yang
terjadi di masyarakat
a
(proporsi dengan masukan waktu
(a+b) x waktu pengamatan)

RATIO = Dibandingkan dengan (a/b).

Membandingkan frekuensi penyakit pada
dua kelompok individu/lebih)

PROPORSI = Membandingkan numerator dan denumerator

yang mengandung numerator  (a/a+b)
FREQUENCY IN EPIDEMIOLOGY
1. INCIDENCE RATE ;
2. ATTACK RATE ;
3. PROPORTIONAL DISTRIBUTION ;
4. MORTALITY RATE ;
5. RATIO.

FORMULA :
RATE (atau RATIO atau PROPORSI)
= (X/Y) X (K)
X = angka kejadian penyakit / kematian
Y : jumlah populasi
K : ukuran, biasanya 100.000
Note :
X = the number of people in a defined population (defined
in terms of time, place and person) who become ill
from specified cause during a specified interval of
time.
Y = the number of people in a defined population during the same
spceified interval within the cases occurred. Usually the size of
the population at the middle of time interval is taken as the
size of the defined population.

K = an assigned value of 100.000, usually. However, values of

100, 1,000, or even 1,000,000 are often assigned.
DEFINITION OF EPIDEMIOLOGIC MEASURE

1. ‘Time of onset’-
Waktu mulai sakit - pasti ?

2. ‘Period of observation’
Biasanya IR - dilakukan pada periode
waktu tertentu
Penyakit secara mendadak sering
digunakan ‘Attack Rate’
 orang yang sakit
AR =
Pop. At risk
3. Numerator :
Apakah betul-betul kasus baru  karena
dapat berulang kali timbul.

4. Denominator
Jumlah populasi yang mempunyai
risiko (pop. At risk), tidak selalu
konstan.

5. Denominator - ‘person year’

 orang yang mempunyai risiko yang
diobservasi dalam waktu tertentu.
 MORBIDITY MORTALITY

- INCIDENCE RATE - CRUDE DEATH R

- PREV. RATE - SPECIFIC D.R
* Point - CASE FATALITY R
* Interval - INFANT M R
- PROPOTIONAL MR
- MATERNAL MR
- NEONATAL MR
- POST NEONAT MR
- PERINATAL MR
- STILL BIRTH R
 INCIDENCE RATE =

 Pdrt penyakit tertentu / Kasus baru

‘ Population at risk’

X 1000
  Pdrt (kasus lama/baru) / saat / period
= X 1000
‘ Population at risk’

Kegunaan :
Incidence : Etiologi
Morbiditas
Risiko sakit

Prevalence : Penyakit Kronik

Perencanaan fasilitas dan
SDM
 CHARACTERITIC OF INCIDENCE ROLES
AND PREVALENCE

INCIDENCE PREVALENCE
New cases occuring All cases commited
NUMERATOR during the follow up on a single survey
period in a group or examination of a
initially free of the group
disease
DENOMINATOR All susceptible in All individuals
dividuals present at examinated incluiding
the beginning of the cases and new cases
follow up period
(often called the
Population at Risk)

TIME Duration of the Single point in time

follow up period

HOW MEASURE Cohort study Prevalence or Cross

sectional study
 FACTORS INFLUENCE OF
PREVALENCE RATE
 The severity of illness (if many people
who develop a disease die its prevalence
rate is depressed).
 The duration of illness (if a disease last a
short time its prevalence rate is lower
than if last a long time).
 The number of new cases (if many people
develop a disease its prevalence rate is
higher than if few people do so).
 Increased by :
Longer duration time disease
Prolongation of life of
patients without cure
Increase in new cases
(increase in incidence)
In-migration of cases
(susceptible people)
Out-migration of healthy
people
Improved diagnostic facilities
(better reporting)
Decreased by :
Shorter duration of disease
High case-fatality rate from
disease
Decrease in new cases
(decrease in incidence)
In-migration of healthy
people
Out-migration of cases
Improved cure rate of cases