Introduction to Epidemiology

Presented by:
Roofen Julious
Subject : Community Health Nursing
15/04/2020
Aligarh College of Nursing

1
Learning Objectives
Upon completion of this Unit, the students will
be well introduced to the Epidemiology and will
be able to:

 Define Epidemiology;
 Discuss the Determinants of Epidemiology;
 State the Uses of Epidemiology; and
 Explain the Scope of Epidemiology.
Introduction
Epidemiology is very old word dating back 3 rd
century BC. The word epidemiology is derived
from epidemic which literally means “ Upon the
population”.
The word epidemiology is derived from three
Greek words,
1. “Epi” means “ upon or among”
2. “Demos” means “People”
3. “Logos” means “ Science”
Introduction
Thus the epidemiology is a science that
concerned with the study of events that occurs in
a community.
Epidemiology is one of the most important
investigative technique in the study of health and
disease. It is a discipline that evolved specialized
method for investigating health problem. The
primary focus of the epidemiologist is not on the
individual, but on the health problem of the
group of people.
Introduction
Epidemiology: the most widely accepted
definition is that given by international
epidemiological association.
“Epidemiology is the study of frequency,
distribution and determinants of disease”
Frequency: intervals between exposure to
inciting factor and onset of disease.
Introduction
Distribution of disease: it means selection of people
for attack by disease in relation to;
Age
Sex
Race
Geography
Occupational and social characteristics
Place of residence
Susceptibility
Exposure to specific agent
Introduction
Determinants of disease: it involves the possible
factor that influence the disease distribution.
Primary Determinants : Causative agents of disease
or disorder:
Bacteria
Virus
Parasites
Nutrients
Accidents, etc.
Introduction
Secondary Determinants : Multitude of factors that
influence the disease:
Socio-economic factors
Physical environment
Life style, etc.
Uses of Epidemiology
 The epidemiology completes the natural history of

disease by providing information about the behavior

of the disease in early stages.
 It helps identify the precursors of disease.
 It helps identify syndromes.
Uses of Epidemiology
 Epidemiology helps identify the spectrum of

disease. Diseases of heart, kidney and brain can all

follow hypertension.
 It helps elucidate the risk factors of diseases where

they are not known.

Uses of Epidemiology
 It helps determine the effective methods of control

of diseases where they are not known.

 Epidemiology helps in community diagnosis.
 Epidemiology helps predict the future behavior of

the disease.
Uses of Epidemiology
 It helps identify the factors that block the ongoing

programs.
 It provides guidelines for revising medical education

syllabus in the country.

 It helps identify the priority areas for medical

research.
Scope of Epidemiology
Historically, epidemiology was concerned with studying
infectious diseases such as cholera, plague, smallpox,
yellow fever and typhoid, which until the 20th century
were the most important threats to human life and
health. In the past, the term epidemic was used to
describe an acute outbreak of infectious disease.
Scope of Epidemiology

The scope of epidemiology can further be classified as:

Clinical epidemiology
Occupational epidemiology
Clinical Epidemiology

Deals with clinical symptoms of the patients and

compare its recording with patients having similar

symptoms in groups so as to predict a probable
diagnosis.
Offers a scope by clinical trial.
Clinical Epidemiology

Most of the studies are based on epidemiological

methods like cohort, case control, cross sectional etc.

Disease control priorities with the health transition

will largely necessitate the use of clinical

epidemiology.
Occupational Epidemiology

It involves a study of health effects on workers with

factors to which they are exposed.

Such factors may be related to physical, chemical and

biological environment.
Eras of epidemiology
Epidemiology divided into four eras:
Sanitary era
Infectious disease era
Chronic disease era
Era of eco-epidemiology
Sanitary era: the first era was the sanitary era of the
early 19th century. The focus of epidemiological work
was largely on sewage and drainage system and the
major preventive measure was the introduction of
sanitation programs.
Eras of epidemiology
Infectious disease era: the second era was the
infectious disease era that occur between the late 19th
and mid twentieth centuries. The principal preventive
approach was to break the chain of transmission
between the agent and host.
Chronic disease era: the third era is the chronic disease
era taking place in the last half of the twentieth century.
Here the focus is on controlling risk factor by
modifying life style, agents and environment.
Eras of epidemiology
Era of eco-epidemiology: according to the Susser and
Susser the new era of 21st century is that of eco-
epidemiology. In this era preventive measure are
multidisciplinary and scientist from different fields are
involved in epidemiological work, such as sociologists,
physicians, public health worker, biologists,
demographics etc.
These scientists use their techniques to deal with health
problem at different level such as molecular level,
population level and global level.
Aims of epidemiology
According to international epidemiological association,
there are three main goal of epidemiology;
1. To decrease the distribution and size of health
problem in the community
2. To identify causative factors in the pathogenesis of
disease
3. To provide data essential to the planning,
implementation and evaluation of services for the
prevention, control and treatment of disease.
Terminologies
Carrier: a carrier is a person or animal that
harbours a specific infectious agent, in the
absence of clinical feature and who serve as the
potential source of infection for others. In
meningitis and diphtheria the organisms are
hurboured in upper respiratory track.
Incubatory carrier: An individual who is
capable of transmitting a disease-causing agent to
others during the incubation period of the disease.
Terminologies
Healthy carrier: is a person or other organism
that has become infected with a pathogen, but
that displays no signs or symptoms.  can transmit
it to others or develop symptoms in later stages
of the disease.
Suspect: a suspect is an individual whose
medical history suggests that he may have or be
developing a particular disease.
Terminologies
Contact: a contact is a person who has been in association
with an infected person or animal or contaminated
environment that might provide an opportunity to acquire
the infective agent.
Contamination: it means the presence of an infectious
agent on a body surface; also on clothes, bedding, toys,
surgical instrument or substance including water, milk and
food.
Infection: it is defined as the invasion and multiplication of
pathogenic organisms in the body. The infecting agent may
be bacteria, viruses, protozoa or fungi.
Terminologies
Infectious agent: infectious agent is an organisms
that is capable of producing an infection. There are
four main classes of infectious agents: bacteria,
viruses, fungi, and parasites.
Fomites: objects or materials which are likely to
carry infection, such as clothes, utensils, and
furniture. These have been contaminated with
pathogenic agent. Disease transmit via fomites are
diphtheria, typhoid fever.
Terminologies
Transmission: it means transfer of an infectious
agent, directly or indirectly from a reservoir to a
susceptible host.
Vector: vector is any agent who carries and
transmits an infectious pathogen into another
living organism; most agents regarded as
vectors are organisms, such as intermediate
parasites or microbes, but it could be an inanimate
medium of infection such as dust particles.
Terminologies
Virulence: it is a degree of pathogenicity of a
microorganism.
Infestation: the presence of an unusually large
number of insects or animals in a place, typically
so as to cause damage or disease.
Zoonosis: a infectious disease which can be
transmitted under natural condition to humans
from animals
Terminologies
Epidemic disease: it is the rapid spread of
infectious disease to a large number of people in a
given population within a short period of time, usually
two weeks or less. Examples of epidemic
diseases include typhus, influenza, the Black Death,
malaria, and smallpox.
Endemic disease: An endemic disease is a disease that
is always present in a certain population or region. One
of the most talked about endemic diseases is malaria.
Terminologies
Sporadic disease: it is defined as a disease which is
constantly present intermittently in a area. The case
occur irregularly, from time to time and generally
infrequently Examples of sporadic diseases include
tetanus, rabies, and plague.
Pandemic: a pandemic defined as an epidemic affecting
a large proportion of the population and occurring over a
wide geographical area such as section of country, entire
country or the world e.g. influenza pandemic of 1918
and 1957.
Terminologies
Prodromal symptoms: Prodromal symptoms, also
known as premonitory symptoms, are symptoms
indicating an impending attack of a disease.
Communicable: communicable mean capable of being
transmitted directly or indirectly, from an infected
person to a susceptible host.
Communicable disease: it is a disease that is
transmitted from a patient to a healthy person either
directly or indirectly e.g. cholera, scabies.
Terminologies
Communicable period: it is a period during
which an infectious agent may be transferred,
directly or indirectly, from an infected person to
health one.
Non-communicable disease: it is a disease that
can not be transmitted from a patient to a healthy
person e.g. hypertension, diabetes mellitus,
cancer.
Terminologies
Incubation period: it is the time interval between the
entry of an infectious agent into the body and
appearance of first sign and symptoms of the disease.
The incubation period depends on disease to disease.
Prophylaxis: prophylaxis refer to treatment given or
action taken to prevent disease.
Isolation: it is a process of separation of a person,
suffering from an infectious disease, in special in a
special unit.
Terminologies
Quarantine: it is the process of separation of an
individual, who has been in contact with a communicable
disease, in a special hospital unit.
Disinfection: it is process of destruction of pathogenic
micro organisms outside the body by direct exposure to
chemical or physical agents.
Sterilization: it is the process of complete elimination of
microorganisms that may cause certain disease. In this
process there is destruction of all the microorganisms
including spores.
Terminologies
Incidence: incidence refer to number of new cases
of a specific disease occurring in a given
population during a specific period of time.
Incidence rate: a rate with the number of new
cases of a specified disease reported during a
defined period of time and the number of persons
in the population in which they occurred as
denominator. This is usually expressed as cases
per 1000 or 100000 population.
Terminologies
Prevalence: prevalence refer to the number of cases of a
disease existing at a particular time within a given
population. Prevalence would include new cases as well
as all previously existing case.
Prevalence rate: a rate obtained by using as the
numerator the number of diseased persons in a given
population at a particular time, regardless of when that
illness began as the denominator the number of person
in the population in which they occurred, expressed as
number of cases per 1000, or 100000 population.
Terminologies
Epidemiologist: an epidemiologist is an
individual who applies epidemiological
principles and methods for prevention and
control of disease.
Fatality rate: fatality rate is expressed as a
percentage of the number of persons diagnosed
as having a specified disease and the number
who die as a result of that illness.
Terminologies
Mortality rate: it is a measure of the frequently
of death in a defined population during a
specified time and expressed as the number of
deaths per 1000 and 100000 population.
Thank you!