EPI DEMIOLOGI

Dr Djaka handaja MPH

01/12/23
 PUBLIC HEALTH (WINSLOW, 1920)
Is THE SCIENCE AND ART of
PREVENTING DESEASE, PROLONGING LIFE AND
PROMOTING PHYSICAL ANDA MENTAL HEALTH
AND EFFICIENCY
through ORGANIZED COMMUNITY EFFORT for the:
• SANITATION OF ENVIRONMENT,
• CONTROL OF COMMUNICABLE INFECTIONS,
• EDUCATION OF THE INDIVIDUAL IN PRINCIPLES OF
PERSONAL HYGIENE,
• ORGANIZATION OF MEDICAL AND NURSING SERVICES for
THE EARLY DIAGNOSIS AND PREVENTIVE TREATMENT OF
DESEASE, and
• THE DEVELOPMENT OF SOCIAL MACHINERY WHICH WILL
ENSURE TO EVERY INDIVIDUAL IN THE COMMUNITY A
STANDARD OF LIVING ADEQUATE FOR THE MAINTANANCE
OF HEALTH

01/12/23
 EPIDEMIOLOGI, Untuk Apa ?
• Misi Public Health :
– Mencegah penyakit
– Mencegah kematian dini.
– Membudayakan perilaku sehat
• Mencegah penyakit dan kematian dini, dibutuhkan:
– Kemampuan Identifikasi Penyakit , Faktor Penyebab,
Populasi Ber Resiko.
– Kemampuan Pengembangan Kebijakan, Strategi,
Sistem, Program, Fasilitas Pelayanan, Research dll
• Jadi Epidemiologi adalah “Tools dan Metoda”

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 GENERAL OBJECTIVES
• Memahami peran epidemiologi dlm bidang
kedokteran dan kesehatan.
• Mampu menerapkan KONSEP DAN METODA
epidemiologi untuk :
– Mengidentifikasi permasalahan kesehatan
– Menetapkan indikator permasalahan kesehatan
– Memilih alternatip desain studi epidemiologi yang
sesuai permasalahan kesehatan komunitas
– Menyusun alternatip strategi pencegahan dan
pengendaliannya

01/12/23
 POKOK BAHASAN
• Penyakit , Penyebab Penyakit dan
Penyebaran Penyakit.
• Disease Measurement
• Studi epidemiologi deskriptip
• Studi epidemiologi analitik
• Screening
• Surveilan epidemiologi
• Investigasi epidemi.

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 LINGKUP BAHASAN

• Konsep Dasar / Pengertian

• Prinsip Dasar
• Tehnik Dan Metoda
• Fungsi-Kegunaan
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 PENGERTIAN/DEFINISI EPIDEMIOLOGI
1. Ilmu tentang Epidemi atau Wabah (Lama)
2. Ilmu yang mempelajari Frekuensi dan Distribusi penyakit dan faktor-
faktor yang menentukan terjadinya penyakit tersebut pada manusia
(Mac Mahon & Pugh, 1970)
3. “Study of disease and other health related phenomena” in group of
persons (Kramer MS, 1988)
4. The study of the distribution and determinants of diseases and injuries
in human populations (Mausner JS, 1985)
5. Epidemiology is concerned with the patterns of disease occurrence in
human populations and of the factors that influence these patterns
(Lilienfeld AM, 1980)
6. Study distribusi dan faktor determinant kejadian yang berkaitan dengan
kesehatan dalam populasi manusia (CDC, 1992)
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Prinsip Dasar Epidemologi/Karakteristik

• Fokus Studi pada Populasi

• Studi Distribusi (Penyebaran)
• Studi Faktor Determinant/Causa

Studi Epidemiologi Deskriptip

Studi Epidemiologi Analitik

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 HEALTH PROBLEMS
•
APPROACH
WHAT is the health problem,disease or event and what are its
manifestations and characteristics ?
• WHO is affected with reference to age,sex, social class, ethnic,
occupation, heredity and personal habits ?
• WHERE does the problem occur, in relation to place of residence,
geographical distribution and place of exposure ?
• WHEN does it happen, in terms of days,months,seasons or years ?
• HOW does the health problem, disease or event occur,and what is its
association with spesific conditions,agents, vectors, sources of infection,
susceptible groups and other contributing factors ?
• WHY does it occur, in terms of the reasons for its persistence or
occurrence ?
• SO WHAT interventions have been implemented as a result of the
information gained and what was their effectiveness ? Have there been
any improvements in health status ?

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 SCHEME FOR AN EPIDEMIOLOGICAL
STUDY CYCLE

DESCRIPTIVE
STUDIES

ANALYSIS OF RESULTS,
Profile ?
SUGGEST FURTHER- MODEL BUILDING
DESCRIPTIVE AND NEW FORMULATION
HYPOTHESIS OF HYPOTHESIS

TEST HYPOTHESIS

ANALYTICAL STUDIES EXPERIMENTAL STUDIES

- X - SECTIONAL - CLINICAL TRIALS
- CASE-CONTROL STUDY - FIELD TRIALS
- COHORT
01/12/23
 5 CRITERIA CAUSAL ASSOCIATION
1 TEMPORAL RELATIONSHIP --> means exposure to the
causal factor (risk factor) must precede development of
the disease (effect)
2 STRENGHT OF ASSOCIATION (RR/OR/PR > 4) -->
Strength refers to the size/magnitude of RR (not the
p value or degree of statistically significance which
can be increased by increasing the sample size).
3 CONSISTENCY (C) AND REPLICATION (R)
C -> means different studies resulted in the same
association
R--> means repetition of the same study resulted in
the same association.
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4 SPECIFICITY/DOSE-RESPONSE
RELATIONSHIP
Measures the degree to which one
particular exposure produces one specific
disease.
5 COHERENCE WITH EXISTING KNOWLEDGE
(BIOLOGICAL PLAUSIBILITY)
Support for the causal of an association exist
if a causal interpretation is plausible in term
of current knowledge about the factor and the
disease.
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 PENGGUNAAN EPIDEMIOLOGI
1. SEARCH FOR CAUSES OR RISK FACTORS:

PSYCHOBIOLOGIC/
HEREDITER

LINGKUNGAN
• FISIK
PELA
• BIOLOGIS DERAJAT YANAN
• KIMIA
KESEHATAN KESE
• SOSEKBUD HATAN
• ERGONOMI

LIFE STYLE
(PERILAKU)
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 2. RIWAYAT PENYAKIT
STATUS KES -) SUBCLINICAL CHANGE -) CLINICLE CHANGE

RECOVERY OR DEATH

3. DESKRIPSI STATUS KESEHATAN PENDUDUK

(POPULATION OR COMMUNITY HEALTH ASSESSMENT)

4. EVALUASI DARI INTERVENSI

STATUS KESEHATAN SEHAT-SAKIT

CARING/PERAWATAN :
CURING/PENYEMBUHAN
• PROMOTIVE
• PREVENTIF (PENGOBATAN)
• PELAYANAN KES
01/12/23 5. INDIVIDUAL DESCISION
 HEALTH PROBLEMS APPROACH

CLINICAL HEALTH EPIDEMIOLOGIC

APPROACH PROBLEMS APPROACH
IN CO
DI M
VI M
U
D
NI
U TY

HOW TO * WHY THE DISEASE EXISTS

CURE * HOW IT CAN BE PREVENTED

CURING
CARING
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 RESEARCH DESIGN IN EPIDEMIOLOGY
THE EPIDEMIOLOGY STUDY

OBSERVATIONAL STUDIES EXPERIMENTAL STUDIES

(NO CONTROL OVER EXPOSURE) (INFESTIGATOR DETERMINE) WHO
EXPOSED OR NOT EXPOSED

NO COMPARISON GROUP COMPARISAN GROUP

DESCRIPTIVE ANALYTIC

• CASE REVIEW • CROS SEC TIONAL STUDY

• SURVEILLANCE • CASE CONTROL STUDY
• SURVEY
01/12/23 • COHORT STUDY
 TERIMA KASIH !!!

01/12/23
 Tugas !
1. Bagaimana alur proses penemuan kasus
Flue Burung ?
2. Bagaimana alur penemuan kasus Acute
Flaccid Paralysis (AFP) sehingga diputus
kan untuk melakukan ERAPO (Eradikasi
Polio) dengan pelaksanaan PIN ?
3. Bagaimana alur ditemukannya kasus
HIV-AIDS pada manusia ?

01/12/23