Descriptive Epidemiology

Dr Paul T Francis, MD
Prof. Com Med
College of Medicine, Zawia
Contents
Definition
Time distribution
Place distribution
Person distribution

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How do you describe a disease?
Symptoms and Signs
Symptoms - High grade fever, Redness
of eyes and Rash
Signs - Rash, Koplicks spots

Measles
We can describe the disease in a
community in a scientific way
Descriptive epidemiology

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Epidemiology
Epidemiology is the study of the
distribution( )and determinants
of health-related states
( ) or events in specified
populations and the application of this
study to the control of health
problems.

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Descriptive Epidemiology
Is the method by which
Epidemiologists describe an
epidemiological / health related
event.
Descriptive Epidemiology describes
the distribution of cases/events in
Time
Place
Person

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What purpose does it serve?
1. Epidemiologist becomes familiar( )
with the data and thereby the problem
2. Epidemiologist learns the extent/size of the
problem
3. Epidemiologist creates a detailed
description which can be communicated
4. Identify high risk group(s) and get a clue
(, ) into the causation of
disease (Hypothesis)

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Time distribution
The occurrence of disease changes
over time.
In Time distribution epidemiologist
tries to describe the changes in the
disease occurrence

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Time distribution
There are three kinds of time trends
or fluctuation
Short-term fluctuations
Periodic fluctuations
Long-term or secular trends

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Short-term fluctuations
These are called epidemics/outbreaks
There are three types of epidemics
Common-source epidemic
Single exposure or point source epidemic
Continuous or multiple exposure epidemic
Propagated epidemics
Person to person
Arthropod vector
Animal reservoir
Slow (modern) epidemics
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Epidemic curve
A graph of the time distribution of
epidemic cases is called the epidemic
curve.
The shape and size of the epidemic
curve will help us know the type of
epidemic

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Common-source: Single exposure
epidemic (point source epidemic)
Number of

Exposure
cases

Time

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Common-source: Single exposure
epidemic (point source epidemic)
The main features of a point-source
epidemic are
The epidemic curve rises and falls rapidly
No secondary curves
All cases occur in ONE incubation period
Commonly seen in food poisoning,
industrial pollution

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Common-source: Continuous or
repeated exposure
Exposure from the same source may
be continuous or repeated.
The cases occur for more than one
incubation period
The epidemic curve will have more
than one peak

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Single source continuous exposure
epidemic
Number of
cases

Time

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Propagated epidemics
Propagated epidemic is mainly due to
person-to-person transmission
E.g. Hepatitis
Transmission continues till susceptible
individuals are depleted

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Periodic fluctuation
Seasonal trend
Some occur more during certain
seasons. E.g. respiratory diseases are
more common during winter months
Cyclic trend
Some diseases show an increase every
few years. E.g. measles show an
increase every 2-3 years

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Time distribution-seasonal trend

Seasonal pattern of Influenza

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Cyclic trend
Number of cases

1 2 3 4 5 6 7 8 9 10 11 12 13

Year 18
Long term or Secular trend
Secular trend means changes in the
occurrence of disease over a long
period of time, generally several
years or decades.

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Tuberculosis and Leprosy cases, Libya 1972-2005

TB

Leprosy

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Health indicators of Libya 1964-2004

NNMR IMR
U5MR

U5MR Under 5 Mortality Rate; NN NeoNatal; I - Infant 21

Time distribution

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Time distribution - Uses
Take appropriate action
Know whether interventions are
effective
Develop hypothesis regarding the
source or cause of outbreak

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Place distribution
Describes the distribution of cases in a
geographic area
The distribution can be based on place of
residence, place of work, place of
recreation, place of travel etc depending on
the disease
We may have to try more than one
distribution to learn more about the disease
Two types of maps - Spot map and Area
map
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Place distribution (Area map)

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Spot map vs Area map
Spot map gives an idea of the
number and distribution of cases in
an area
Area map describes the rate of
occurrence of cases by taking into
account the population of the area

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Place distribution - uses
Know the geographical extent of
disease
Identify the source of infection or
causative agent
To plan control or preventive
measures

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Person distribution
Personal characteristics like age, sex
etc. almost invariably affect disease
occurrence
So distribution of disease or health
event among these categories help
the epidemiologist in knowing more
about the disease

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Person distribution - age
Almost every health related event
vary with age
Measles
Cancer
Hypertension

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Person distribution (age)

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Person distribution (sex)
Distribution of disease varies between
males and females

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Person distribution other
attributes
Race
Ethnicity
Nationality
Behaviour
Socioeconomic groups

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Summary
Epidemiologist has to describe data
on diseases on three important
characteristics - Time, Place and
Person
Describing the distribution of disease
in Time, Place and Person helps in
understanding the problem in all
dimensions

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Summary
Study of these distributions will give
the epidemiologist clues regarding
the cause of disease Hypothesis
It is also important for
Implementing health interventions
Evaluation of health services

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