EPIDEMIOLOGY

The word Epidemiology is derived from the Greek epi upon , desmos people , logos- discourse or science. The scope of this branch of science was originally confined to the origin , development and distribution of communicable disease or epidemic infections . Nowadays , it is defined as orderly study of diseases and other conditions in the human population where the group rather than the individual is the unit of interest.

 It is the study of the distribution and determinants of disease. Its primary tool is the systemic observation of human beings as they relate to their environment. Objectives of Epidemiology : * Investigation of the disease and other conditions in population , to ascertain the public health needs . *To conduct research into factors that may influence the occurrence of the disease or conditions , with a view to their ultimate prevention or control.

FACTORS OF DISEASE CAUSATION AND BEHAVIOR

1. Agent 2. Host 3. Environment

Biologic Laws For Communicable and Noncommunicable Diseases

1. Disease result from an imbalance between a disease agent and man 2. The nature and extent of the imbalance depends on the nature and characteristics of the host and agent. 3. The characteristics of the two are influenced considerably by the conditions of their environment.

FACTORS INFLUENCING HEALTH EQUILIBRIUM Agents Human Host

Biologic, nutrient , Chemical , physical, And mechanical Age, sex, race , habits

Physical, Social, Economic, Biologic

The Agent Factor of Disease

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. 1. Could be non-living , living or borderline 2. Could be physical and mechanical in nature : light , electricity , temperature, and physical trauma. 3. Agents exhibit characteristics of both lifeless and living agents combined. ( rickettsiae and viruses.

Characteristics of Agents of Diseases

1. Physical features 2. Biologic requirements 3. Chemical make-up 4. Viability 5. Resistance

Characteristics of Disease in Relation to the Host

1. Infectivity ability to gain access and adapt to the human host to the extent of finding lodgement and multiplying. 2. Pathogenicity refers to the ability of an agent when lodged in the body to set up a specific reaction , local general, clinical and subclinical. 3. Virulence refers to the severity of the reaction produced and usually measured in terms of fatality. 4. Antigenicity ability to stimulate the host to produce antibodies.

Characteristics of Disease in Relation to Environment

Refers to reservoir , sources of infection and modes of transmission : 1. Reservoir of infections are man, animal, plants, soil or inanimate organic matter in which an infectious agent lives and multiplies and depends primarily for survival, reproducing itself in such a manner that it can be transmitted to a susceptible host. 2. Source of infection defined as the thing, person, object or substance, from which an infectious agent passes immediately to a host .

3. Modes of transmission are the mechanisms by which an infectious agent is transported from reservoir to a susceptible human host. - Airborne spread could be through the respiratory inhalation of residue of droplets from humans or from sources such as the laboratory. 4. Vehicle of infection refers to inanimate objects soiled or contaminated by an infectious agent; water, food, milk, instruments, utensils, blood, etc. 5. Vectors are arthropods or other invertebrates which transmit infection by inoculation or by depositing infective materials on the skin or objects.

The Host Factor of the Disease

Age Sex Race Habits , Customs and Religion Exposure to agent Defense mechanism of the Host

Defense Mechanism of the Host

A. Specific anatomical defenses B. Immunity defined as the resistance usually associated with possession of antibodies having a specific action on the microorganism concerned with a particular infectious disease. C. Inherent susceptibility ability to resist disease independently of antibodies or specifically developed tissue responses. D. Resistance is the sum total of body mechanism which interpose barriers to progress of invasion of infectious agents. Includes both immunity and inherent susceptibility . E. Tolerance applied to the conditions whereby the infectious agent can be demonstrated from the individual and yet the person does not show clinical manifestation as should be expected. F. Premonition applied to condition of refractoriness to further infection in an individual already sick or harboring the infectious agent due to a previous infection. G. Allergy is the untoward reaction of the body towards certain specific substances which stimulate the formation of histamine responsible for the allergic phenomenon. H. State of nutrition.

The Environmental Factors of Disease

Environment - is the sum total of an organisms, external surrounding conditions and influences that affect its life and development. Physical environment : 1. climate 2. humidity 3. geography Biologic environment: Socioeconomic environment

Three Divisions of Epidemiology

DESCRIPTIVE EPIDEMIOLOGY ANALYTICAL EPIDEMIOLOGY EXPERIMENTAL EPIDEMIOLOGY

DESCRIPTIVE EPIDEMIOLOGY
- Used to aid in the conceptualization and quantification of the disease status of the community * MAJOR PARAMETERS * INCIDENCE - # of cases that will occur within a population during a specified time period cases/person-time PREVALENCE is the term used to indicate what proportion of a given population is affected by a condition at a given point in time. It is expressed in percentage of the population, its range is 0% to 100%. Cases/population x 100%

ANALYTICAL EPIDEMIOLOGY

Used in studies to determine the etiology of the disease A researcher may attempt to establish that a casual relationship exists between a factor and a disease 3 Common study designs : 1. Prospective cohort study- conducted on general population that is followed through time to see which member develop the disease or outcomes in question . 2. Case control study conducted using a population that has a disease and a matching population that does not. In this study the researcher thinks back from effect to cause. Relatively inexpensive and requires a fairly short period of time to obtain results. 3. Retrospective follow-up study used to evaluate the effect that a specific exposure has had on a population. Most commonly used in the area of occupational health hazards. This study starts with an exposure in time past and evaluate the histories of those exposed through to time present.

EXPERIMENTAL EPIDEMIOLOGY
Used primarily in intervention studies Used to judge the cause and effect relationship of the risk factors ( preventive factors and development of disease ). The experimental population is divided into 2 groups , one will receive the preventive treatment and one that will not. Studies are done to assess the value of a particular intervention or treatment such as antimicrobial therapy. Also in artificial fluoridation of water supplies.

Uses of Epidemiological Studies

Collecting of data to describe normal biological processes. Understanding the natural history of diseases Measurement of distribution of diseases in populations. Identification of determinants of diseases. Testing hypotheses for prevention and control of diseases through special studies in populations. Planning and evaluating health care services.