ARBOLEDA, Abbiegail E.

2B-BSMT

RSA # 2
Measures of Disease Occurrence

I. Introduction of the Study

Defining disease occurrence in epidemiology, it refers to the number of new incident cases of disease or
injury in a population that have happened over a specified time period. There are different measures used to
delineate how frequent a particular disease or health event occurs in a population. Commonly, when dealing
with the number of new cases in a community, epidemiologists use incidence rate to determine the etiology
and risk factors associated with the disease. With this, epidemiologists may measure the probability of
developing disease as well as the ratio of the number of new cases to the time at risk for disease. In this
paper, it discusses why it is preferable to use incidence rate in terms of describing and interpreting the
occurrence of a disease. Using number of examples taken from nephrology literature, it will also discuss the
different measures of disease occurrence which are the concept of incidence and prevalence.

II. Objectives of the Study

This section includes the specified objectives of this paper to describe and determine measure of disease
occurrence:
1. To describe how often disease or health event occurs in a population
2. To determine which is the best measure to calculate disease occurrence
3. To assess the etiology of a disease or event and its risk factors by utilizing the types of measures

III. Significance of the Study

The current findings of this study will provide supplementary basis for future epidemiological studies in
measuring and identifying disease frequency and health outcome in a population. Moreover, it will significantly
help the following sectors to discover the potential causes and risk of a disease and determine the most
effective preventive measure for the disease outcome.

 Epidemiologists and Infectious Disease Experts

The study is mostly beneficial to them because they are the one who assess where the disease is
coming from, and identify those who are vulnerable and at risk in the community. Considering the abundancy
of newly occurring disease nowadays, this will be of great help to our epidemiologists and disease experts to
 find new ways on how to control the spread of a disease and develop remarkable preventive measures on
possible future outbreaks.

 Community and Public Health Safety

As with a good and effective measures of disease occurrence, it will help the entire healthcare system
and different areas of the community to be prepared of the possible disease outbreaks. Thus lessen the
burden of healthcare professionals in terms of taking care overcrowding number of patients. It can also
improve both health and economic stability by promoting disease prevention programs, ensuring both
community and public health safety.

IV. Methodology
How to Calculate Measure
of Disease Occurrence

Decide which type of

First, analyze and describe the measure is suitable and
time, place and population to applicable
which a disease or event occur

Incidence Prevalence

Incidence Point Period

Risk Rate Prevalence Prevalence

𝑁𝑜. 𝑜𝑓 𝑠𝑢𝑏𝑗𝑒𝑐𝑡𝑠 𝑑𝑒𝑣𝑒𝑙𝑜𝑝𝑖𝑛𝑔 𝑁𝑜. 𝑜𝑓 𝑠𝑢𝑏𝑗𝑒𝑐𝑡𝑠 ℎ𝑎𝑣𝑖𝑛𝑔 𝑑𝑖𝑠𝑒𝑎𝑠𝑒

𝑑𝑖𝑠𝑒𝑎𝑠𝑒 𝑑𝑢𝑟𝑖𝑛𝑔 𝑎 𝑡𝑖𝑚𝑒 𝑝𝑒𝑟𝑖𝑜𝑑 𝑎𝑡 𝑎 𝑝𝑎𝑟𝑡𝑖𝑐𝑢𝑙𝑎𝑟 𝑝𝑜𝑖𝑛𝑡 𝑖𝑛 𝑡𝑖𝑚𝑒
𝑁𝑜. 𝑜𝑓 𝑠𝑢𝑏𝑗𝑒𝑐𝑡𝑠 𝑓𝑜𝑙𝑙𝑜𝑤𝑒𝑑 𝑇𝑜𝑡𝑎𝑙 𝑛𝑜. 𝑜𝑓 𝑠𝑢𝑏𝑗𝑒𝑐𝑡𝑠 𝑖𝑛 𝑡ℎ𝑒
𝑓𝑜𝑟 𝑡ℎ𝑒 𝑡𝑖𝑚𝑒 𝑝𝑒𝑟𝑖𝑜𝑑 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛

𝑁𝑜. 𝑜𝑓 𝑠𝑢𝑏𝑗𝑒𝑐𝑡𝑠 𝑑𝑒𝑣𝑒𝑙𝑜𝑝𝑖𝑛𝑔

𝑑𝑖𝑠𝑒𝑎𝑠𝑒 𝑁𝑜. 𝑜𝑓 𝑠𝑢𝑏𝑗𝑒𝑐𝑡𝑠 𝑤𝑖𝑡ℎ 𝑑𝑖𝑠𝑒𝑎𝑠𝑒 𝑎𝑡
𝑇𝑜𝑡𝑎𝑙 𝑡𝑖𝑚𝑒 𝑎𝑡 𝑟𝑖𝑠𝑘 𝑓𝑜𝑟 𝑡ℎ𝑒 𝑠𝑢𝑏𝑗𝑒𝑐𝑡𝑠 𝑡ℎ𝑒 𝑠𝑡𝑎𝑟𝑡 𝑜𝑓 𝑡ℎ𝑒 𝑝𝑒𝑟𝑖𝑜𝑑 + 𝑛𝑜. 𝑜𝑓
𝑓𝑜𝑙𝑙𝑜𝑤𝑒𝑑 𝑠𝑢𝑏𝑗𝑒𝑐𝑡𝑠 𝑑𝑒𝑣𝑒𝑙𝑜𝑝𝑖𝑛𝑔 𝑑𝑖𝑠𝑒𝑎𝑠𝑒 𝑜𝑣𝑒𝑟
𝑡ℎ𝑒 𝑡𝑖𝑚𝑒 𝑝𝑒𝑟𝑖𝑜𝑑
𝑇𝑜𝑡𝑎𝑙 𝑛𝑜. 𝑜𝑓 𝑠𝑢𝑏𝑗𝑒𝑐𝑡𝑠 𝑖𝑛 𝑡ℎ𝑒
𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛
V. Important Findings

The following findings are examples of measures of disease occurrence taken from different
epidemiological literature:

 Example 1 – Risk

It is a cohort study that aims to determine the risk of hospitalization for bacterial infection in the first 2-
years post-renal transplantation of 3,106 children. The researchers preferably used incident rate to
measure the disease occurrence in order to distinguish who among the 3,106 children considered at risk
has lost their grafts in the first 6 months after transplantation and were hospitalized for acquiring bacterial
infection. 687 or 22.1% of these children need to be hospitalized as they developed bacterial infection.
However, problem had appeared after it was identified that 164 of these children lost their graft for another
reason and not due to bacterial infection. For this reason, the researchers pointed out that such problems
will likely occur especially if the observation period is long enough in order for those persons at-risk with
particular disease outcome come to an end.

 Example 2 – Incidence Rate

In this example, the practical application of incidence rate was described based on different conditions.
In Austria, the registries divide annual transplant numbers by the number of country inhabitants in order
to compare the transplant activity within other countries. In addition, it was also mentioned that incidence
rate does not change with time under a steady state condition, and so it should be the reciprocal of the
waiting time which can be calculated using the average time. Meanwhile, the risk and incidence rate is
then considered similar with each other when measured over a short period of time. It is due to the fact
that there will be little loss to follow-up and competing risk will only play a minor role.

 Example 3 – Prevalence

In Spain, a cost analysis study was performed among 1,312 hemodialysis patients to evaluate the
economic burden of mineral regulating therapy in this patient group. It was found out that on a daily basis,
the average cost of this therapy was 1.68 Euro per patient. And so, it aims to represent almost 10% of all
hemodialysis patients in Spain if and only if it had been a representative sample. The estimated cost shall
be slightly more than 8 million Euro per year.
VI. Discussion on Incidence and Prevalence of the disease

In the study of epidemiology, incidence and prevalence are frequently used to measure the occurrence of
disease. Incidence deals with two measures which are risk and incidence rate. To distinguish them, risk is the
probability or likelihood of developing a disease while incidence rate refers to a ratio proportion of the number
of people developing a particular disease.

How to quantify risk?

In terms of quantifying risk, it is important to know the time in which the risk happens. For example,
humans’ risk of death within 150 years is 100% whereas the risk of death within 1 day is expected to be small.
Therefore, we can assume that in order to measure incidence, we need to follow the study subjects or
participants over a period of time. However, this can be kind of problematic as cases may vary depending on
several factors and occasions. In this case, it is preferable to use incidence rate instead. Because it is not
required for a study subject to fully complete the entire risk time. With this, it can be use in dynamic
populations.

Prevalence, on the other hand, deals with the current status of disease at a certain point in time. There are
two concepts to remember in prevalence and those are the number of incident cases plus the length of disease
time. An example of prevalence is the dependency between cases of aortic hemorrhage and ESRD. It was
mentioned that aortic hemorrhage leads to rapid death resulting to a short duration which makes the
prevalence extremely low. Meanwhile, ESRD has a relatively low incidence rate but it has a much higher
survival rate compare to aortic hemorrhage, hence, the disease duration is rather long.

Does the measure of prevalence better to use than incidence?

Usually, the prevalence rate can be determined more easily than the incidence rate because it can be
measured by using a single case-finding survey of a population group. In fact, point prevalence is the most
commonly used measure in dealing with existing cases. But nowadays, researchers preferably use period
prevalence to measure the existing cases at the start of a period and as well as the new cases that have
developed over the entire period.

VII. Conclusion

In conclusion, disease occurrence is the essence of epidemiology. It may be utilized to study some of the
most important aspects in studying epidemiology and those are the risk factors and causes of disease we are
ought to identify. The measure of incidence and prevalence will be of great help to know the probability of
 developing disease, ratio of the number of people exposed to a risk and proportion of people in the population
having a disease at a particular point or period of time. The difference between the two measure is that
prevalence refers to “proportion”, whereas incidence refers to the “rate”. Certain examples were mentioned in
order to classify, compare and express the size of their effects in terms of the type of disease occurrence
measure used. A risk represents the number of people vulnerable to a disease and is expressed in
percentage. Sometimes rates are measured as risks because it is more convenient. One thing to take note,
when using any type of measures, it is important to consider how these measures are used and whether they
are suitable for the effect we are ought to calculate. To express the size of such effects, one uses either
differences between measures of disease occurrence or ratios of those measures.

VIII. Recommendation

While there is much progress in terms of science and technological advancement globally,
epidemiologists and infectious disease experts still need to ensure that they are using the right tool to measure
the occurrence of diseases which remain timely and relevant in today’s world. Environment, for example, are
really one of our concern as it is one of the contributing factor why diseases spread and infectious agents are
transmitted. Host factor as well can be considered as one of the reasons why most agents mutate and became
powerful enough to fight certain medication and vaccine. If epidemiologists and other experts understand the
kind of environment and people we have, then they can also help in measure of disease occurrence, and they
might as well prevent transmission of infectious disease and impose infection control guidelines. Another thing
to consider is the risk. To properly interpret risk, it is extremely important for the researchers to know the time
period to which a disease applies. Because without the time period, the risk will be just an insignificant value.
To calculate the risk, the researchers must ensure that all subjects are free of disease during the start of the
time period. In addition, while the researchers decide which measure of disease occurrence to use, it is
important to understand the study population. Because in some cases, it can result to some drawbacks. Some
of the study participants may face a sudden death, loss to follow-up, or develop another disease of interest
during follow-up. The study population eventually becomes smaller over time. In this case, the researchers
should be ready and prepared so that the study will carry on.