Epidemiologicalmethods 150922085550 Lva1 App6892

Epidemiological
Methods
Study of distribution and determinants of health related events and its

application to control health problems.
IMS BANGALORE
At the end of the session, you

will be able to
Enumerate two different types of epidemiological

methods .
To define descriptive epidemiology and describe
importance of time, place and person distribution.
Enumerate three kinds of time fluctuations in
disease occurrence.
To describe disease load in terms of prevalence and
incidence.
To differentiate cross sectional and longitudinal
studies.
To enumerate two used of descriptive epidemiology.
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Epidemiology: Definition
Dynamic study of the
Determinants
Occurrence
Distribution
Of health and disease in a population
Control
Pattern
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So, Epidemiology
Is the basic science of public health
Provides insight regarding the nature,

causes, and extent of health and disease
Provides information needed to plan and

target resources appropriately
IMS BANGALORE
Epidemiology is a Quantitative
Discipline
Measures of frequency
Counts and rates
Measures of association
Relative risk
Odds ratio
Statistical inference
P-value
Confidence limits
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To Study disease
occurrence
Observational studies- Investigator only
measures. Does not interfere.
--Descriptive studies.
--Analytical studies .
Experimental studies. Also called
Interventional studies. Active attempt by
investigator.
IMS BANGALORE
Kinds of Epidemiology
Descriptive
Analytic
Study of the occurrence and

distribution of disease
Further studies to determine the

validity of a hypothesis concerning
the occurrence of disease.
Experimental
Deliberate manipulation of the
cause is predictably followed
by an alteration in the effect
not due to chance
IMS BANGALORE
Descriptive vs.Analytic
Epidemiology
Analytic
Descriptive
Used when little is

known about the
disease
Rely on
preexisting data
Who, where, when
Illustrates
potential
associations
Used when insight

about various
aspects of disease is
available
Rely on development
of new data
Why
Evaluates the
causality of
associations
Both are
IMS BANGALORE
Observational studiesdescriptive
Observation on population or individual.
(dengue in gokula ).
Time distribution- When disease
occurring?
Place distribution- Where ?
Person Who is getting it ?
IMS BANGALORE
Descriptive Epidemiology
1. Defining population-Whole population in a

geographic area, or representative
population. Should be large enough. Age,
sex, occupation and other information. Also
called Population at Risk. Framingham
study !
IMS BANGALORE
10
Descriptive Epidemiology
2. Disease under study-Precise with validity.

Well defined diagnostic method acceptable
to the population. If not defined precisely, it
leads to errors.
Operational definition of the disease. Once
accepted, it cannot be changed.
Example- Dengue.
IMS BANGALORE
11
Descriptive -Time
distribution
Disease is seasonal, ? Periodic fluctuation ?
Short term fluctuation
EPIDEMIC .-Occurrence in a community of
illness or event clearly in excess of normal
expectancy.
Periodic fluctuation
Long term trends
IMS BANGALORE
12
Endemic, Epidemic and Pandemic
Endemic - The habitual presence (or usual occurrence) of a

disease within a given geographic area
Epidemic - The occurrence of an infectious disease clearly
in excess of normal expectancy, and generated from a
common or propagated source
Pandemic - A worldwide epidemic affecting an
exceptionally high proportion of the global population
Number
of Cases
of
Disease
Time
IMS BANGALORE
13
Types of epidemics
Common source epidemic- 1.Point

source- brief exposure, epidemic is severe,
all case in one incubation period. Food
poisoning.
2. Continuous or repeated
exposure- Gonorrhea, respiratory infection,
water contamination.
IMS BANGALORE
14
Types of epidemics- Propagated

epidemics
Infectious, Person to person.
Gradual rise, fall over a long period.
Long term transmission. Herd immunity ?
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15
Periodic fluctuations
Seasonal trend, -Measles, URTI, Diarrhea,.
Cyclic trend- Influenza (H1N1).
Long term trends- CVD, Tuberculosis,

NIDDM.
IMS BANGALORE
16
Place distribution.
Geographical variation- environment, diet,
etc.
International variation- Ca stomach (Japan Vs
USA ) , Ca Oral cavity (India )
National variation Malaria Sabah ,
Sarawak. Filariasis- Perak, Sabah.
Migration studies- Tuberculosis among
migrants in Malaysia.
IMS BANGALORE
17
Person
Age
Hobbies
Sex
Pets
Occupation
Travel
Immunization status Personal Habits
Underlying disease
Stress
Medication
Family unit
Nutritional status
School
Socioeconomic factors Genetics
Crowding
Religion
IMS BANGALORE
18
Measurement of disease
Disease load in a population.
Mortality, Morbidity, Disability .
Morbidity- Incidence, Prevalence.
Prevalence- All current cases existing at a
given point of time in a given population.
Incidence- Number of NEW cases occurring
in a defined population during a specific
time.
How to measure ?
Hypothesis.
IMS BANGALORE
19
Measures
Morbidity: Refers to the presence of disease

in a population
Mortality: Refers to the occurrence of death

in a population
IMS BANGALORE
20
Prevalence vs. Incidence
Prevalence is the number of existing

cases of disease in the population during a
defined period.
Incidence is the number of new cases of

disease that develop in the population
during a defined period.
IMS BANGALORE
21
Prevalence
Prevalence: The number of existing cases in
the population during a given time period.
PR = # existing cases during time period
population at same point in time
Prevalence rates are often expressed as a
percentage.
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22
Incidence Rates
Population denominator:
IR = # new cases during time period X K
specified population at risk
IMS BANGALORE
23
Example (Incidence Rate)

During a six-month time period, a total of 53
nosocomial infections were recorded by an
infection control nurse at a community
hospital. During this time, there were 832
patients with a total of 1,290 patient days.
What is the rate of nosocomial infections
per 100 patient days?
53 X 100
4.1 infections per
IR =
=
100 pt. days
1,290 pt. days
IMS BANGALORE
24
What is a hypothesis?
An educated guess
an unproven idea
based on observation or reasoning, that can

be proven or disproven through
investigation.
IMS BANGALORE
25
Studies
Cross sectionalSingle examination

of a cross section
of population.
Prevalence study.
Longitudinal
Repeated
observation in the
same population.
IMS BANGALORE
26
Uses of Descriptive
Epidemiology
trends in health and disease and allow
comparisons among countries and
subgroups within countries
Provides clue to disease etiology.
provides a basis for planning, provision
and evaluation of services
identifies problems to be studied by
analytic methods (?)and to test
hypotheses related to those problems
IMS BANGALORE
27
IMS BANGALORE
28
. Circle the most appropriate explanation on Prevalence rate:

a. the number of patients who have the disease at a particular
time, divided by the population at risk of having the disease at
that time.
b. the number of new cases of a diseased in a population over a
period of time.
c. not useful for developing HIV/AIDS control programme.
d. useful for developing Avian flu control programme.
e. not useful for any disease control programme.
IMS BANGALORE
29
Questions
What is Epidemic ?
What is endemic ?
What is pandemic ?
IMS BANGALORE
30
Following are steps in

Descriptive studies
1.
2.
3.
4.
5.
Define population
Define the disease
Randomized trial
Measurement of a disease.
Formulate an hypothesis.
[email protected]
IMS BANGALORE
31

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Epidemiological

Study of distribution and determinants of health related events and its

At the end of the session, you

Enumerate two different types of epidemiological

Of health and disease in a population

Is the basic science of public health

Provides insight regarding the nature,

Provides information needed to plan and

Study of the occurrence and

Further studies to determine the

Used when little is

Who, where, when

Used when insight

1. Defining population-Whole population in a

2. Disease under study-Precise with validity.

Endemic, Epidemic and Pandemic

Endemic - The habitual presence (or usual occurrence) of a

Common source epidemic- 1.Point

Types of epidemics- Propagated

Long term trends- CVD, Tuberculosis,

Morbidity: Refers to the presence of disease

Mortality: Refers to the occurrence of death

Prevalence vs. Incidence

Prevalence is the number of existing

Incidence is the number of new cases of

Example (Incidence Rate)

based on observation or reasoning, that can

Cross sectionalSingle examination

. Circle the most appropriate explanation on Prevalence rate:

Following are steps in

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