EPIDEMIOLOGY

 It is defined as the science concerned with the

various factors and conditions which influence
the occurrence and distribution of health,
disease, defect, disability and death among
groups of individuals.
 It is the study of interrelationships of factors in
particular areas in the field of health, and the
application of the results of such studies to
influence such factors to achieve a given
outcome.
 It is the study of the ecology of health and
disease, and the application of the knowledge
gained to promote health and control diseases.

THE THEORY OF DISEASE CAUSATION

Factors that contribute to the disease causation:

1. agent
2. host
3. environmental influences

THE AGENT FACTOR OF DISEASE:

Definition of AGENT.
 An agent is any element, substance or force
whether living or non-living, the presence or absence
of which can initiate or perpetuate a disease process.

Types of Agent

 These could be living, non living, and

borderline.
 Agents could be physical or mechanical in
nature such as extreme of temperatures, light,
electricity, physical trauma etc.
 They could be chemicals.
 They could be exogenous (i.e. common poison)
or endogenous such the accumulation of toxic
products of metabolism like in renal failure.
 These could be nutrients, of which we have two
kinds, the deficiency agents and the excess
agents.
Example:
1. Beriberi results from deficiency of
Vitamin B, Anemia from iron deficiency
and night blindness from lack of Vitamin
A.
2. Obesity results from over eating, flourosis
from excess fluoride, Gigantism from
defective pituitary gland secretion.
 The living agents are plants and animals.
 Example:
Plants- bacteria, fungi, molds and yeasts
Animals – may be big ones such as animals
of prey and arthropods. They maybe smaller
ones such as multicellular types and the
unicellular types.
Example of Multicellular types of agent
are:
flatworms (Flukes)
round worms (ascaris, hookworm,
pinworm)
Examples of unicellular types of agents:
 amoeboid protozoa (entamoeba
histolytica)
ciliated protozoa (Balantidium coli)
flagellated protozoa
( Trichomonas)
blood parasites (plasmodia)
 There are agents which exhibit characteristics of
lifeless and living agents combined or known as
the borderline.
Example of these agents are viruses.

Characteristics of Agents of diseases:

1. Inherent Characteristics:
 • physical feature- this include the
morphology, motility, presence or
absence of capsules.
• Biologic requirements-refers to the
things needed by the agent to survive.
Some are aerobic, some are anaerobic.
• viability- ability to live when introduced
to the host
• resistance- organism with capsule have
stronger resistance to the effects of
drying, heat and sunlight
2. Characteristics directly related to human
 Infectivity- is the ability to gain
access and adapt to the human host
to the extent of finding lodgement
and multiplication.
Factors affecting infectivity:
o viability
o portal of entry
o susceptibility of the host
o susceptible tissues
o body defenses of the host
 Pathogenicity- measures the ability of
an agent when lodged in the body to set
up a specific reaction, local or general.
Factors affecting pathogenicity:
1. dosage
 2. presence or absence of a capsule
3. degree of toxigenicity
4. condition of the host
5. types of cell affected
 Virulence- refers to the severity of the
reaction produced and is usually
measured in terms of fatality.
 Antigenicity- is the abilityu to stimulate
the host to produce antibodies.
Examples are the immunizing effects of
smallpox,dengue, whooping cough,
measles, chicken pox, etc
3. Characteristics in relation to the
environment. This refers to the :
 Reservoir of infections- man,
animals, plants, soil in which
infectious agents live and
multiplies and depends primarily
for survival, reproducing itself in
such a manner that it can be
transmitted to a susceptible host.
Examples are :
a. Man- intestinal parasites, scabies,
cholera
b. Animals- rabies from dogs
c. Soil- tetanus and fungi
  Sources of Infection- is
defined as the thing, person,
object or substances, from
which an infectious agent
passes immediately to a host

( Transfer is often direct from the reservoir to the

host in which case the reservoir is also the source
of infection.)

 Modes of Transmission are the mechanisms by

which an infectious agent is transported from
the reservoir to a susceptible host. The mode
could either be direct or indirect.
Direct transmission could be by direct contact
such as kissing, touching or sexual intercourse,
or by passage of spray directly from one person
who is close to another through coughing,
sneezing, or talking.
Indirect transmission include vehicle, vector
and air.
Vehicle of infection- refers to inanimate
objects soiled or contaminated by infectious
agent like food, milk, blood or instruments.
Vectors – are arthropods or other
invertebrates which transmit infection by
inoculation or by depositing infective materials
on the skin or objects. Example are mosquitoes.
 Airborrne- spread through respiratory
inhalation of residue of droplets from human like
chicken pox virus.

THE HOST FACTOR OF DISEASE

Characteristics of the Host:
1. Age- certain disease have predilection for
specific age groups like measles, they occur
frequently in children because of the absence of
immunity among them.
2. Sex- certain disease are sex linked. Like
Hemophilia is carried by women but the disease
is only manifested in male offspring.
3. Race-Sunburn is more common among whites by
reason of difference in skin pigmentation.
4. Habits, custom and tradition
5. Exposure to the agents- important factor to
consider is the occupation
Example: Farmers – their most common
complains are backache, rheumatism and
pneumonia.
6. Defense mechanism of the host
Examples:
a. Specific anatomical defenses- example the
presence of hair in the nostrils.
b. Immunity- example are vaccine
c. Resistance
d. Tolerance
 e. State of Nutrition

The Environmental Factors of Disease

Environment- is the sum total of an organism’s

external conditions and influences that affect its life
and development.

Three Categories
A. Physical environment:
1. Climate-this includes temperature, altitude,
rainfall and wind.
Example: Broncho-pulmonary diseases are
common in cold months.
Diarrhea- are frequent during summer,
especially in areas where there is poor water
supply.
2. Geography- the location and character of the
terrain. It affects the habits of the people and
customs.
Example: In areas where rice production is
not suitable, problem of vitamin deficiency
can be rampant.
 In areas where mode of transportation
is difficult, it can affect the frequency of
visits to centrally located health centers and
hospitals.

B. Biological Environment:
The living environment of man is consists of
plants, animals and fellow human being.
Example: Plants and animals can be a source of
medicine but they can also be a source or vector of a
disease.

C. Socio-economic environment: