PENGANTAR

EPIDMIOLOGI PENYKIT
MENULAR

Epidemiologi
Definisi

Studi yg mempelajari distribusi dan

determinant status atau kejadian yg
berhubungan dengan kesehatan pada
sekelompok populasi, dan aplikasi
studi ini adalah untuk mengkontrol /
mengendalikan masalah kesehatan
Last ed. Dictionary of Epidemiology

Epidemiologi Penyakitamenular
Definisi

Epidemiologi penyakit menular

terfokus dalam mempelajari distribusi
dan determinan penyakit menular
dalam populasi.

Epidemiologi Penyakitamenular
Klasifikasi Penyakit Berdasarkan etiologi
(kausa)
Penyakit infeksi
Penyakit

non infeksi

Etiologi (organism) : Tuberkulosis, Campak,

Malaria, dsb
Manifestasi klinik : Meningitis, Encefalitis,
Rinitis, Diare ??, dsb

Epidemiologi Penyakitamenular
Berdasarkan Durasi :
Penyakit

akut

Penyakit

kronik

Peak symptoms within 3 months (acute) or

longer than 3 months (chronic)

Epidemiologi Penyakitamenular
Acute

infection vs. chronic infection

Acute

Infection

An

infection characterized by sudden

onset, rapid progression, and often with
severe symptoms

Chronic
An

Infection

infection characterized by delayed onset

and slow progression

Types of Diseases

Examples

Acute Diseases
MENULAR

Common cold, pneumonia,

mumps, measles, pertussis,
typhoid fever, cholera

TIDAK MENULAR

Appendicitis, poisoning, trauma

Chronic
Diseases
MENULAR

Tuberculosis, AIDS, Lyme disease,

syphilis, rheumatic fever

Diabetes, coronary heart disease,

TIDAK MENULAR osteoarthritis, cirrhosis of the liver
03/14/15

Definition of communicable diseases

A

communicable disease is an illness due

to a specific infectious (biological) agent
or its toxic products capable of being
directly or indirectly transmitted:
from man to man, from animal to man,
from animal to animal, or
from the environment (through air,
water, food, etc..) to man.

Definition of communicable diseases

Epidemiology
The

study of the transmission of disease

Communicable Disease
A

disease that can be transmitted from one

individual to another

Contagious Disease
A

communicable disease that is easily spread from

one individual to another

Noncommunicable Disease
A

disease that is not transmitted from one

individual to another

Definition of communicable diseases

Communicable

Diseases-biological agents

Biological agents = microorganism

- Virus
- Fungus

-Bacteria
- Protozoa
- Helminthes - Others form of microorganism

Non

Communicable Diseases-Non
biological Agents
-

Physics

- Nutrition - Chemical -etc

Definition of disease & infectious

disease
Disease
Any

deviation from a condition of good

health and well-being

Infectious

Disease

A disease condition caused by the presence

or growth of infectious microorganisms or
parasites

Etiologi
Infeksi

Non Infeksi

Durasi
Akut
Common cold
Pneumonia
Campak
Gondongan
Pertusis
Typhoid
Kolera
Keracunan
(intoksikasi
insektisida dan
logam, dsb)
Trauma

Kronis
Kusta
TBC
AIDS
Demam rheumatik
Hepatitis B

Penyakit Jantung Koroner

Diabetes Mellitus
Kanker
Stroke
12

Classification of Diseases &

Health Problems
Organ or Organ System
i.e., heart disease, kidney disease, respiratory
infection

Causative Agent
Biological Agents
Chemical Agents
Physical Agents

Communicable vs Non communicable

Acute vs Chronic

Peak symptoms within 3 months (acute) or

longer than 3 months (chronic)

Chap 4: Prevention and Control

Causative Agents for

Diseases & Injuries
Biological
Agents

Viruses
Rickettsiae
Bacteria
Fungi
Protozoa
Metazoa

Chemical
Agents

Pesticides
Food additives
Pharmacologics
Industrial chemicals
Air pollutants
Cigarette smoke

Physical
Agents

Heat
Light
Radiation
Noise
Vibration
Speeding
objects

DEFINITIONS
INFECTION
- The entry, development or multiplication of an
infectious agent in the body tissues of man or animals
INFECTIOUS DISEASE
- A clinically manifest disease of man/animal resulting
from an infection
COMMUNICABLE DISEASE
- An illness due to a specific infectious agent OR its toxic
products that arises through transmission from a
reservoir to a susceptible host either directly or
indirectly

 Some communicable diseases may not be

infectious BUT all infectious diseases are
communicable.
communicable but not infectious:
-tetanus
- botulism
- staphylococcal food poisoning
INCUBATION PERIOD
- time interval between initial contact with an
infectious agent and the first appearance of
symptoms associated with the infection
COMMUNICABLE PERIOD
- time during an infectious agent may be
transferred from an infected host/reservoir to
another susceptible host

Ep
ide
mi

gle
ian
Tr

olo
gic

Communicable Disease Model

Model

Communicable Disease Model

Agent

The element that

must be present in order
for the diseases to occur

Communicable Disease Model

Host

Agent

Any susceptible
organism invaded
by an infectious agent

Communicable Disease Model

Host

Agent

Environment
All other factors that inhibit
or promote disease
transmission

Chain of Infection

A model to conceptualize the transmission of a

communicable disease from its source to a susceptible host

Chain of Infection

Pathogen
- The disease-causing agent

Chain of Infection

Pathogen Reservoir
The habitat in which an infectious agent normally
lives and grows
Human: Anthroponoses, symptomatic or asymptomatic
Animal: Zoonoses
Environmental: Plants, soil, and water

Chain of Infection

Pathogen Reservoir Portal

of exit
The path by which an agent leaves the
source host

Chain of Infection

Pathogen Reservoir Portal

of exit

Modes of Transmission

How pathogens
Transare passed
mission

Direct: Immediate transfer

- Direct contact
- Droplet spread
Indirect
- Airborne
- Vehicleborne
- Vectorborne

Modes of Transmission
of
the Agent to a New
:Host is
A mode of transmission
essential for the infectious agent
to bridge the gap between the
portal of exit from the reservoir
. and the portal of entry of the host
Modes of transmission can be
. classified as direct or indirect

Routes of transmission
Direct

Indirect

Skin-skin
Herpes type 1
Mucous-mucous

Food-borne

STI

Across placenta
toxoplasmosis

Through breast milk

HIV

Sneeze-cough
Influenza

Salmonella

Water-borne
Hepatitis A

Vector-borne
Malaria

Air-borne
Chickenpox

Ting-borne
Scarlatina

Exposure
A relevant contact depends on the agent
Skin, sexual intercourse, water contact, etc
(www)

Chain of Infection

Pathogen Reservoir Portal

of exit

Portal
Transmission of entry

- Agent enters

susceptible host

Respiratory
Oral
Skin
Intravenous
Gastrointestinal

Chain of Infection

Pathogen Reservoir Portal

of exit

Portal
Transmission of entry

New
host

- Final link is
a susceptible host

Levels of Prevention

Primary Prevention
The forestalling of the onset of illness or injury
during the pre-pathogenesis period (before the
disease process begins)
Secondary Prevention
The early diagnosis and prompt treatment of
diseases before the disease becomes advanced
and disability becomes severe
Tertiary Prevention
The retraining, reeducation, and rehabilitation of
the patient who has already incurred disability

Pencegahan primer
Adl

Upaya pencegahan yg dilakukan

saat proses penyakit belum mulai (pd
periode pre-patogenesis) dengan
tujuan agar tidak terjadi proses
penyakit
T.a: 1. Promosi kesehatan
2. Perlindungan khusus

Riwayat Alamiah Penyakit

31

Pencegahan sekunder
Adl

Upaya pencegahan yg dilakukan saat

proses penyakit sudah berlangsung
namun belum timbul tanda/gejala sakit
(patogenesis awal) dengan tujuan proses
penyakit tidak berlanjut
T.a:
1. Early diagnosis & prompt treatment
2. Disability limitation
Riwayat Alamiah Penyakit

32

Tingkat pencegahan
tertier
Bila telah terjadi defect /kerusakan struktural
ataupun disabilitas:

maka untuk mencegah semakin buruknya

kondisi atau menetapnya disabilitas
dilakukan usaha preventif tertier
dengan rehabilitasi

Riwayat Alamiah Penyakit

33

Prevention of Communicable
Diseases
Pathogen
Pasteurization
Chlorination
Antibiotics
Antivirals
Disinfectants

Prevention of Communicable
Diseases
Human Reservoir
Isolation
Surveillance
Quarantine
Drug treatment

Prevention of Communicable
Diseases
Portal of Exit
Gowns
Masks
Condoms
Hair nets
Insect repellents

Prevention of Communicable
Diseases
Transmission
Isolation
Hand washing
Vector control
Sanitary engineering
Sneeze glass
Sexual abstinence
Safer sex

Prevention of Communicable
Diseases
Portal of Entry
Masks
Condoms
Safety glasses
Insect repellents

Prevention of Communicable
Diseases
Establishment of Disease in New Host
Immunizations
Health education
Nutrition promotion
Sexual abstinence

Noncommunicable Disease
Model

Your genetic
endowment

Noncommunicable Disease Model

Your genetic
endowment
Behavioral
choices
Air
Pollution

Wa
te r
Qu
al i
ty

Eco
nom
ics

y
t
i
l
a
n
o
s
Per

re
Ca
h
alt tem
He ys
S
fs
li e
Be

Environment

Diseases of the Heart and Blood

Coronary heart disease (CHD):
Characterized by damage to the coronary
arteries.
Atherosclerosis: Narrowing of the blood
vessels resulting from the build-up of fatty
deposits on the walls of the blood vessel.
Cerebrovascular disease (stroke): Blood
supply to the brain is disrupted.

Cancer
Malignant neoplasm: Occurs when cells
lose control over their growth and division.
As these cells continue to grow they
eventually develop a new growtha
tumor
Metastasis: Parts of the tumor break off
and travel to the rest of the bodys organs
and continue their growth.

Other Top Noncommunicable

Diseases
1. Chronic obstructive pulmonary disease
2. Diabetes mellitus
3. Chronic liver disease and cirrhosis

Prevention of Noncommunicable
Diseases
Primary Prevention
Adequate food intake
Good opportunities for education, employment, and
housing
Efficient community services
Health promotion
Access to medical services
Protection from the environment
Protection from occupational hazards
Empowerment for ones own health

Prevention of Noncommunicable
Diseases
Secondary Prevention
Mass screenings
Case-finding measures
Adequate health personnel, equipment, and
facilities
Personal screening (self breast or testes
exams)
Hemoccult tests
Pap tests

Prevention of Noncommunicable
Diseases
Tertiary Prevention
Adequate emergency medical personnel,
services, and facilities
Understand unmodifiable risk factors
Significant behavioral or lifestyle changes
(Modifiable risk factors)
Support groups
Counseling