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Introduction To Epidemiology

The document provides an introduction to epidemiology, defining it as the study of disease distribution and determinants in populations, and outlines its scope, including infectious and non-infectious diseases, environmental health, and health behaviors. It discusses the classification of epidemiology into descriptive and analytic types, detailing their purposes and methods, as well as the core functions of epidemiology in public health practice. Additionally, it highlights emerging trends, technological advancements, and the importance of a systematic approach in epidemiological research.
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0% found this document useful (0 votes)
12 views31 pages

Introduction To Epidemiology

The document provides an introduction to epidemiology, defining it as the study of disease distribution and determinants in populations, and outlines its scope, including infectious and non-infectious diseases, environmental health, and health behaviors. It discusses the classification of epidemiology into descriptive and analytic types, detailing their purposes and methods, as well as the core functions of epidemiology in public health practice. Additionally, it highlights emerging trends, technological advancements, and the importance of a systematic approach in epidemiological research.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Introduction to

Epidemiology
Professor Anthony Adofo Ofosu
Objectives
• At the end of the lecture, the student will be able to :
1. Define Epidemiology and understand the scope of
Epidemiology
2. Know the classification of epidemiology,
3. The purpose and methods used in the different
classification
4. Understand the use of epidemiology,
5. Understand what the Core functions of epidemiology
are.
6. Understand what the epidemiologic approach is
What is
epidemiology?
• It is the study of the distribution
and determinants of disease
frequency in human population. Hennekens 1987
CH et al
The components
• Distribution,
• Determinants
• Frequency
encompass all epidemiologic principles
and methods.
What is Epidemiology?

• The classical definition has evolved over the years.

Epidemiology is the study of the distribution and determinants of


health-related states or events (including disease), and the
application of this study to the control of diseases and other health
problems. Various methods can be used to carry out epidemiological
investigations: surveillance and descriptive studies can be used to
study distribution; analytical studies are used to study determinants
(WHO 2017)
The Evolution of Epidemiology

• Circa 400 B.C.:The roots of Epidemiology can be traced back 20 centuries,


when Hippocrates, often referred to as the father of Medicine, noted that
environmental factors played a role in the prevalence of diseases.
• 16th Century: John Graunt systematically analyzed and published data on the
incidence of disease and mortality.
• 17th Century: During the 1700s, Scottish naval surgeon James Lind recognized
that more soldiers succumbed to illnesses than to combat, leading him to design
an intervention study.
• 18th Century: Edward Jenner, in the early 1800s, discovered that individuals
who had contracted cowpox were immune to smallpox. Additionally, John Snow,
an English physician famous for his connections to the royal family, conducted
studies on Cholera outbreaks.
• 19th Century: This era saw a significant advancement in measuring the
The Scope of Epidemiology

Infectious and Non-Infectious Diseases


The field encompasses both infectious diseases, like viruses,
and non-infectious diseases, such as chronic illnesses.
Environmental Health
Epidemiology also studies environmental health, examining
how environmental factors impact public health.
Health Behaviors
Health behaviors such as diet, exercise, and smoking are key
components in understanding disease epidemiology.
Key Principles and Concepts
Incidence and Prevalence
Incidence refers to the number of new cases in
a population over a specific time,
while Prevalence indicates the total cases at
a given time.

Risk Factors
Risk factors are characteristics or conditions
that increase the likelihood of developing a
disease or health issue.

Causality in Epidemiology
Causality refers to the relationship between a
cause and its effect, crucial for establishing
links between risk factors and health outcomes.
This Photo by Unknown Author is licensed under CC BY-SA
Classification of Epidemiology

Descriptive
Analytic
Epidemiolo
Epidemiolo
gy
gy
Descriptive Epidemiology
• Descriptive Epidemiology is concerned with the
distribution of diseases, including consideration of what
populations or subgroups do or do not develop a
disease, in which geographic locations is it most or least
common, and how the frequency of occurrence varies
over time.

• It can also help in formulation of epidemiological


hypothesis consistent with existing knowledge of
disease occurrence.
Descriptive Epidemiology

Distribution by Person
Analyzing disease patterns among
different demographic groups helps
identify at-risk populations.
Distribution by Place
Mapping disease occurrence
geographically reveals hotspots and
environmental influences on health.
Distribution by Time
Tracking changes in disease incidence
over time aids in recognizing trends and
outbreaks.
The main goal of descriptive epidemiology is to
identify patterns and trends that can guide public
health strategies and interventions.
Case Studies
Case studies provide in-depth analysis of
individual cases, offering insights into specific
Purpos health conditions or phenomena.
e and Cross-Sectional Studies
Metho Cross-sectional studies analyse data from a
ds population at a single point in time, helping
identify prevalence and associations.
Ecological Studies( Correlational
Studies)
Ecological studies evaluate health data at a
population level, examining relationships
between environmental factors and health
outcomes.
Analytical Epidemiology

• It focuses on the determinants of a disease by testing


the hypothesis formulated from descriptive studies with
the ultimate goal of judging whether a particular
exposure causes or prevents disease
Understanding Disease
Determinants
Analytic epidemiology focuses on
identifying factors that influence the
occurrence of diseases within
populations.
Assessing Relationships
Analytic Studies in analytic epidemiology
assess the relationships between
Epidemiolo various exposures and health
gy outcomes to uncover causal links.
Establishing Causation
By evaluating evidence, analytic
epidemiology helps in establishing
causation which is crucial for public
health interventions.
Objective of Analytical Epidemiology
The main aim of analytical epidemiology is to
Purpose and
identify risk factors and establish causal links that
influence health outcomes.
Methods OBSERVATIONAL STUDIES
Cohort Studies
Cohort studies track groups over time to evaluate the incidence of
outcomes in relation to their exposure status.
Case-Control Studies
Case-control studies examine individuals with a particular outcome
against those without, investigating previous exposure to possible
risk factors.
Cross-Sectional Studies
Cross-sectional studies evaluate data from a population at a specific
moment, uncovering relationships between exposures and
outcomes.

EXPERIMENTAL STUDIES/INTERVENTION STUDIES


Clinical Trials – Usually involving individuals
Community Trials usually involving a group of people
Descriptive versus
Analytic Epidemiology
Descriptive Epidemiology
Descriptive epidemiology
examines health issues
through the lens of who,
what, when, and where. It
provides foundational data
for further research.
Analytic Epidemiology
Analytic epidemiology
focuses on understanding
the causes and relationships
of health issues. It
Uses of Epidemiology
1. To study the disease trend
2. Community diagnosis
3. . Planning and evaluation of health services
4. Evaluation of a new therapy or a new health
measure
5. Determining the risk to an individual
6. Identification of syndromes
7. Filling in the gaps in the natural history of the
disease.
8. Searching for the cause of a disease
The core Epidemiological
Functions
This refers to the six major tasks of epidemiology in public
health practice. They are:

1. Public health surveillance.

2. Field investigation

3. Analytic studies

4. Evaluation

5. Linkages

6. Health policy development,


Public Health Surveillance
• Public health surveillance is the ongoing, systematic
collection, analysis, interpretation, and dissemination
of health data to help guide public health decision
making and action.
• Surveillance is equivalent to monitoring the pulse of
the community. The purpose of public health
surveillance, which is sometimes called “information
for action, is to portray the ongoing patterns of disease
occurrence and disease potential so that investigation,
control, and prevention measures can be applied
efficiently and effectively.
Field Confirming the Outbreak
Investigation-
The first step in managing an
Identifying cause
outbreak is confirming its
of a disease
occurrence through data analysis
outbreak
and epidemiological methods.
Defining and Identifying
Cases
Clearly defining and identifying
cases is essential for effective
outbreak investigation and
management, helping to track the
spread.
Implementing Control
Measures
Implementing effective control
measures is critical to controlling
the outbreak and preventing
further spread of the disease.
Analytic Studies
• Surveillance and field investigations are usually sufficient
to identify causes, modes of transmission, and appropriate
control and prevention measures.
• But sometimes analytic studies employing more rigorous
methods are needed. Often the methods are used in
combination — with surveillance and field investigations
providing clues or hypotheses about causes and modes of
transmission, and analytic studies evaluating the credibility
of those hypotheses using the appropriate study design.
• The hallmark of an analytic epidemiologic study is the use
of a valid comparison group.
Evaluation
• Evaluation is the process of determining, as
systematically and objectively as possible, the
relevance, effectiveness, efficiency, and impact of
activities with respect to established goals.
• Effectiveness refers to the ability of a program to
produce the intended or expected results in the field;
effectiveness differs from efficacy, which is the ability
to produce results under ideal conditions.

• Efficiency: refers to the ability of the program to


produce the intended results with a minimum
expenditure of time and resources.
Linkages
• During an investigation an epidemiologist usually participates as
either a member or the leader of a multidisciplinary team. Other
team members may be laboratorians, sanitarians, infection control
personnel, nurses or other clinical staff, and, increasingly,
computer information specialists.
• Many outbreaks cross geographical and jurisdictional lines, so co-
investigators may be from local, state, or federal levels of
government, academic institutions, clinical facilities, or the private
sector.
• Mechanisms for sustaining such linkages include official
memoranda of understanding, sharing of published or on-line
information for public health audiences and outside partners, and
informal networking that takes place at professional meetings.
Policy Development
Data-Driven Insights
Epidemiologists analyze data to
provide insights that guide public
health policies and interventions.

Influencing Policy Design


The insights from epidemiological
studies help shape effective policies to
tackle public health challenges.

Addressing Health Challenges


Epidemiological data aids in identifying
and addressing significant public health
challenges.
Epidemiological Triangle
Components of the Triangle
Concept of Disease Occurrence
A critical premise of epidemiology A number of models of disease causation have been
is that disease and other health proposed. Among the simplest of these is the
events do not occur randomly in a epidemiologic triad
population,
The epidemiologic triangle is made up of three
critical components: the agent, the host, and the
environment.

Agent
The agent is the cause of the disease, which can be
biological, chemical, or physical in nature.

Host
The host is the organism that can be infected
by the agent. This includes humans, animals,
and plants.
Environment
The environment includes all external factors
Epidemiological approach
As with all scientific endeavors, the practice of
epidemiology relies on a systematic approach. In very
simple terms, the epidemiologist:
• Counts cases or health events, and describes them in
terms of time, place, and person;

• Divides the number of cases by an appropriate


denominator to calculate rates; and
• Compares these rates over time or for different groups
of people.
Epidemiological Approach
• Rates are measures that relate the numbers of cases during a
certain period of time (usually per year) to the size of the
population in which they occurred. For example, 42,745 new
cases of AIDS were reported in the United States in 2002.30 This
number, divided by the estimated 2002 population, results in a
rate of 15.3 cases per 100,000 population.
• Rates are particularly useful for comparing the frequency of
disease in different locations whose populations differ in size.
(Place)
• Rates are also useful for comparing disease occurrence during
different periods of time. For example, 19.5 cases of chickenpox
per 100,000 were reported in 2001 compared with 135.8 cases
per 100,000 in 1991. (Time)
• In addition, rates of disease among different subgroups can be
compared to identify those at increased risk of disease. (Person)
The epidemiological approach
• Before counting cases, however, the epidemiologist must decide
what a case is.
• This is done by developing a case definition.
• Then, using this case definition, the epidemiologist finds and
collects information about the case-patients.
• The epidemiologist then performs descriptive epidemiology by
characterizing the cases collectively according to time, place, and
person.
• To calculate the disease rate, the epidemiologist divides the
number of cases by the size of the population.
• Finally, to determine whether this rate is greater than what one
would normally expect, and if so to identify factors contributing to
this increase, the epidemiologist compares the rate from this
population to the rate in an appropriate comparison group, using
analytic epidemiology techniques.
Emerging Trends and Research Areas
Social Determinants of Health
There is an increasing focus on social
determinants of health, understanding how
social factors impact health outcomes.

Precision Public Health


Precision public health aims to tailor
interventions based on specific populations
and individual needs, improving health
outcomes.

Interdisciplinary Approaches
Addressing complex health issues requires
interdisciplinary approaches, combining
knowledge from various fields to create
effective solutions.
Technological Advancements
Big Data Analytics
Big data analytics allows researchers to
analyze vast datasets for better insights into
epidemiological trends and patterns.

Artificial Intelligence
Artificial intelligence enhances predictive
modeling and the identification of disease
outbreaks, improving responses to public
health challenges.

Mobile Health Applications


Mobile health applications enable real-time
data collection and patient engagement,
facilitating quicker responses in
epidemiology.

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