Descriptive Epidemiology

Practical session 2

Question 1
Comment on, and interpret, the following graphs/curves. Explain the variation in disease occurrence by different variables presented.

Question 1
The curve shows that the incidence of whooping cough in relation to age in years. It shows that the highest incidence of whooping cough is in infants and preschool children and later it decreases rapidly

Question 1
This could be explained by long lasting immunity following infection .

Question 2
What is the name of this curve?
Bimodal age incidence curve

Question 2
Explain reasons of these two age-incidence peaks)?
The first peak could be explained by ovarian dysfunction The second is due to adrenal estrogen imbalances

Question 2
Give an example of another disease having a similar curve?
Hodgkins lymphoma

Question 3

What is the age group having the highest rate of gonorrhea?

Males 20-24 & 25- 29 Females 20 - 24

Question 3
What could be the possible explanation(s) for age and sex variation in incidence of gonorrhoea?
The age group being the age of active sexual life and hence the greater incidence of highly risky behavior

Question 3
What could be the possible explanation(s) for age and sex variation in incidence of gonorrhoea?
Sex variation could point to the greater tendency of males to engaged in risky sexual behaviors more than females. Gonorrhoea is more difficult to be diagnosed in females

Question 4
Define ethnic group?
A group of persons who lived together for a sufficient length of time to have acquired common characteristics whether by biological or social mechanism

Question 4
Comment on these bar charts?
Higher prevalence rates of hypertension among Blacks (both males & females) as compared to whites. Within each ethnic group, males show greater prevalence of hypertension as compared to females

Question 4
Explain the ethnic differences?
Genetic susceptibility Poorer socioeconomic situations Stressful life style Poor coverage by health services

Question 4
Explain the sex differences?
Less exposure to smoking and stress among females

Question 5
Comment on the following graph?
This graph illustrates incidence rate of TB among different districts in a city. District C has the highest incidence among all 5 districts and district D has the lowest rate.

Question 5
Suggest the characteristics of the population of the district that has the highest rate?
TB is an example of social diseases: Low socioeconomic class Living in slums(squatter areas) High crowding index Malnutrition Poor housing conditions, badly ventilated

Question 6
What are the age and sex variations of lung cancer that may be concluded from the tabulated figures?
Lung cancer is more common in males than females Incidence increase in both sexes by age The highest incidence is in the age group of 60-85 in both males and females

Question 6
Interpret the sex variations?
Higher exposure to risk factors: Smoking Occupational hazards Environmental pollution

Question 6
Interpret the age variations?
Cumulative effect of the risk factor (smoking , occupational hazards & environmental pollution)

Question 7
The peak of the curve is in the . season.
Winter season

Question 7
Why most cases of pneumonia occur in this season?
Over crowding Bad ventilation Characteristics of the organism

Question 7
Name other diseases that may show the same seasonality?
Meningitis, influenza, measles, German measles, mumps

Question 8
What is the season of the highest number of cases? Explain why?
Summer More multiplication of the organism Season of breeding of disease vector(flies) More out door feeding

Question 9
Describe and interpret the following curve.
This curve shows the cyclic trend of measles which occurs every 2 to 3 years ( In the pre vaccination era )

Question 9
Could this type of curve be seen in developed countries? Yes No
NO

Question 9
Explain your answer.
Due to accumulation of susceptible ( under five children). What do you expect the shape of the curve after launching of compulsory measles vaccine ?
It will be eliminated

Question 10
Distinguish between an epidemic and an outbreak?
Epidemic is occurrence of a disease in a community or a region in clear excess of normal expectancy Outbreak is a localized epidemic within a closed community e.g. school

Question 10
This curve suggests that the type of this epidemic is .
Point source epidemic

Question 10
State the main features of this type of epidemic?
The epidemic curve rises and falls rapidly with no secondary waves. The epidemic tend to be explosive, there is clustering of cases within a short period of time. All cases develop within one incubation period of disease

Question 10
Name the other type of epidemic, and mention its characteristics?
Propagated or contagious epidemic and its main features are:
Epidemic curve rises and falls gradually. Cases occur over a much longer period. Cases occur within more than one incubation period of the disease

Question 11
What is meant by the secular trend of a disease?
Implies changes in the occurrence of disease (i.e. progressive increase or decrease) over a long period of time, generally several years or decades

Question 11
What is the difference between the secular trends of X and Y diseases?
Disease X shows a progressive decline while Disease Y is showing progressive rise across years

Question 11
Give two examples for diseases having (X) pattern of secular trend, and give possible explanation(s)?
Infectious diseases in general due to:
Environmental sanitation Medical advances as ; vaccination, diagnostic technology, better reporting and treatment.

E.g. Puerperal sepsis, poliomyelitis, diphtheria,.....

Question 11
Give two examples for diseases having (Y) pattern of secular trend, and give possible explanation(s)?
Chronic diseases due to:
Changing life styles Accumulation of risks Increasing life expectancies Advances in diagnosis & reporting. e.g. Coronary heart diseases, cancer,.......

Question 12
Choose the best answer: This drastic decline in cases of typhoid fever, in the United States, could be MOSTLY attributed to:
Vaccination of high risk groups Implementation of disinfection methods of drinking water Administration of appropriate antibiotics Identification and treatment of typhoid carriers

Question 12
Choose the best answer: This drastic decline in cases of typhoid fever, in the United States, could be MOSTLY attributed to:
Vaccination of high risk groups Implementation of disinfection methods of drinking water Administration of appropriate antibiotics Identification and treatment of typhoid carriers

Question 13
What are the general characteristics peculiar to place in relation to cancer breast?
High frequency rates in all ethnic groups. High frequency rates are not observed in persons not living in this area. Healthy persons entering the area become ill with the same rates. Inhabitants leaving the area do not show high rates
Continent Rate

Europe North America Australia South America

62.4 99.4 84.6 46.0

Asia
Africa

33.3
16.8

Question 13
Comment on the data in the above table, and give the possible explanation(s) of the place differences in relation to cancer breast?
North America has the highest rate, Africa has the lowest rate. This may be due to : Better diagnosis Better reporting Increased life expectancy lower fertility rate Lower breast feeding Obesity Lack of physical activity Hormonal contraceptives / hormone replacement therapy.
Continent Rate

Europe North America Australia South America

62.4 99.4 84.6 46.0

Asia
Africa

33.3
16.8