PROBLEMS

1. The population of TamilNadu was 60 million in 1999. The birth rate, death rate, infant
mortality rate, maternal mortality rate in that year was 19.5,8.6,5.4& 2.8 respectively,
estimate the birth rate, death rate, infant death, maternal death that had occurred in
TamilNadu in the year 1999.

BR ×total population
No. of births =
1000
6
19.5× 60 ×10
=
1000

=1170000

DR ×total population
No. of deaths =
1000

6
8.6 ×60 ×10
=
1000

=516000

IMR × no . of live births

No. of infant deaths =
1000

5.4 ×1170000
=
1000

=6318

MMR × no . of live births

No. of maternal deaths =
1000
2.8× 1170000
=
1000

=3276
2. The population in India in 1991 was 843 million & in 2001 was 1028 million. Estimate
the 2010 population & the 2010 midyear population.

Midyear= 1stjuly.

P1= population in 1991= 843 million.

P2= population in 2001= 1028 million.

P3= population in the year 2010 = ???

2−P
P
1

P3= P2+ ×d
n

=1028+ [ 1028−843
10
×9
]
=1028+[18.5×9]

=1194.5 million.

[ ( )]
1

P2 1 P

Midyear population= P2+ × d+

n 3

[
= 1028+18.5 × 9+ ( 13 )]
=1028=172.66

=1200.67 million.
3. A town having population of 1.2 lakh, had 1800 TB patients on 31/12/97. During the
year 1998, 100 TB died, 500 new cases were diagnosed & 600 patients were cured.
Calculate the prevalence rate as on 31/12/97 & as on 31/12/98. Estimate the incidence of
the diseases for the year 1998 & specific death rate due to TB & case fatality rate.

total cases
Prevalence as on 31/12/97= ×1000
population

1800
= 5 ×1000
1.2× 10

180
=
12

=15/1000 population

total cases
Prevalence as on 31/12/98= ×1000
population

[ ( 1800−100 ) +500 ]−600

= ×1000
1.2 ×105

1600
= 5 ×1000
1.2× 10

160
= 12

=13.33/1000 population.

no . ofcases
Incidence in TB in 1998= ×1000
total population

500
= ×1000
120000

=4.16/1000 population.
 ¿
Specific death rate= total number of death due ¿ past disease total population ×1000

100
= ×1000
120000

=0.83/1000 population.

¿
Case fatality rate= death due ¿ particular disease no . of attacks /detected ×100

100
= ×100
( 1800+500 )

10000
=
2300

=4.35%.

4. The age of MI patients were 47,55,58,60,62,42,53,57,55,65. Find out the mean, median,
mode.

total amount of all ages

Mean=
no . of observations

554
=
10

=55.4

Median= arrange in ascending order & mean value of the 2 or 1 in the center.

=42,47,53,55,|55 , 57|,58,60,62,65

55+57
= = 56.
2

Mode= most frequently occurring value

= 55.
5. The diameter of a circular well is 2m. The height of the water column is 7m. Calculate the
quantity of water in the well. In the Horrock test, the second cup showed to distinct blue colour.
Calculate the quantity of bleaching power to chlorinate the water.

R=1m
h=7m
Volume = π r 2h
=22/7 (1)2 (7)

=22m3

Volume=22000L (1m3=1000L)

Horrock’s Appartus: Second cup=4 g required

Standard volume=455 L

Bleaching powder required = 4/455 * 22000

=193.4 g

Therefore, the volume of water in the well is 22000 L and 193.4 g of bleaching powder is required to

chlorinate the water.

6. There was a epidemic of acute gastroenteritis(AGE) in a village having 1750 population, 65

people had attack of AGE, out of whom 4 persons died. Calculate attack rate and case fertility

rate

Total population=1750

AGE affected people = 65

No. of persons died =4

Attack rate= No. of persons died of AGE * 100

Total population

= 65 * 100

1750
 = 3.71%

Case fertility rate= No. of persons died of AGE * 100

No. of persons affected

= 4 * 100

65

=6.15%

7. A town having the population of 1.2 lakhs and 1700 TB patient as on 2004, during the year

2005, 100 TB patients died , 500 new case are diagnosed and 600 patients cured. Calculate the

prevalence rate as on 2004 and 2005. Estimate the incidence of the disease for the year 2005 and

specific death rate to TB.

Prevalence rate on 2004 = Total no. of cases in 2004 * 1000

Total population

=1700 * 1000

120000

= 14.16/ 1000 population

Prevalence rate on 2005 = Total no. of cases in 2005 * 1000

Total population

= 1700-(100+600) + 500 * 1000

120000

= 1000 + 500

120

= 12.5/ 1000 population

Incidence rate on 2005 = No. of new cases * 100

 Total population

= 500 * 1000

120000

=4.16/ 1000 population

Specific death rate=No. of death * 1000

Total population

= 100 * 1000

100000

= 0.83 / 1000 population

8. The data related to case control study is given below:

With lung cancer Without lung cancer

Smokers 33(a) 55(b)

Non smokers 2(c) 27(d)

Calculate the exposure rates for smokers for case and control.

Exposure rates for case = a * 100

a+c

=33 * 100

33+2

=33 * 100

35

=94.28%

Exposure rate for control = b * 100

b+d
 = 55 *100

55+27

=55 *100

82

=67.07%

9. The data on cohort study are as follows:

Smoking Developed Lung Cancer Not developed

Yes 70(a) 6930 (b)

No 3(c) 2997 (d)

Calculate the relevant incidence rate

Estimate the relative risk and attributable risk

Incidence among exposed(smokers) = a __ * 1000

a+b

= 70 * 1000

70+6930

= 70 * 1000

7000

= 10/ 1000 population

Incidence among non exposed( non smokers) = c____ * 1000

c+d

= 3 * 1000

3=2997
 = 3 * 1000

3000

= 1/ 1000 population

Relative risk = Incidence of disease among exposed

Incidence of disease among non exposed

= 10

= 10

Risk of smokers developing lung cancer is 10 times more than the non smokers

Attributable risk = Incidence among exposed – Incidence among non exposed * 100

Incidence among exposed

= 10-1 * 100

10

= 9 * 100

10

= 90%

Smokers atttibute to 90% risk of lung cancer.

10 The population of PHC in the year 2005 vital events recorded 54000.

no. of births = 650

no.of death = 290

no.of dead babies in 1 month = 15

death of babies between 1 year = 16

maternal death = 2

calculate relevent rate?

 Birth rate= (no.of births/total population)*1000

= (650/54000)*1000

=12.03/1000 population

Death rate=(no.of death/total population)*1000

=(290/54000)*1000

=5.37/1000 population

Neonatal mortality rate=(no. death in 1 month/

live birth)*1000

=(15/650)*1000

=23.07/1000 live birth

postneonatal mortality rate=(no.of.death after 1

month-1year/live

birth)*1000

=(16/650)*1000

=24.62/1000 live birth

Infant mortality =neonatal mortality rate +

postneonatal mortality rate

= 23.07+24.62

=47.69/1000 population.

maternal mortality rate=(no.maternal death/

live birth)*1000

= (2/650)*1000

=3.07/1000 population

growth rate =[(birth rate-death rate)/1000]*100

=[(12.03-5.37)/1000]*100

=0.67%
11. The population of TamilNadu was 52million in the year 2000. Birth rate=18.5/1000
population, death rate= 8.6/1000 population, infant mortality rate =40, maternal mortality = 1.6.
Calculate births, deaths, infant death, and maternal death.

Birth rate= (no.of births/total population)*1000

18.5 = (x/52*106)*1000
x = 18.5*52000
no.of birth = 962000
Death rate=(no.of death/total population)*1000
8.6 =(x/52*106 )*1000
x = 8.6*52000
no.of death =447200
Infant mortality rate =neonatal mortality rate +

postneonatal mortality rate

= (x/total no.of live birth)*1000

40 =(x/962000)*1000
x=40*962
x= 38480
maternal mortality rate=(no.maternal death/

live birth)*1000

1.6 = (x/962000)*1000
x = 962*1.6
x= 1539.2
12. The population of India in 2001 was 1028 million and in 2011 it was 1210 million,
estimate the 2013 population? 2013 mid year population.
P3 = p2+{[(p2-p1)/n] *x}
p1 = population on given year
p2 = population of subsequent year
p3 = population to be calculated
n = interval between cencus
x = no.of years between 2nd and last cencus
p1 = 1028 million
p2 = 1210 million
p3 =?
n =p2 - p3 =10
x = p3 - p2 =2
P3 = p2+{[(p2-p1)/n] *x}
= 1210+{(182/10)*2}
= 1210+36.4
= 1246.4 million
mid year population = p2 + [{(p2-p1)/n}*{x+1/3}]
= 1210 +[{182/10}*{2+1/3}]
= 1210 +[18.2*2.33]
= 1210 +42.42
= 1252.42 million

13) The population of a primary health centre in 2012 is 30500.1950 blood slides were
collected by active surveillance and 750 blood slides were collected by passive surveillance
the malaria cases detected were 120 .Calculate the API and ABER?

API
 No of cases(during one year )
= ×1000
population under surveillance

120
= ×1000
30500

1200
=
305

=3.93/1000 population

API=3.93/1000 population

ABER

No of blood slides examined

= ×100
total population

1950+750
= ×100
30500

2700
=
305

=8.85%
ABER=8.85%

API

 API is a measure of malaria incidence in a community

 It is based on intense active and passive surveillance and cases are confirmed by blood
examination
 Areas with API≥2 per 1000 population/year are classified as high risk area and need a
prompt vector control.
 This area is an endemic area as API>2 and needs immediate vector control measures

ABER

 ABER is an index of operational efficiency it depends on annual blood collection and

examination rates
 Aim is to screen 10 percent of the population, here it is less than 10 percent so needs
improvement and surveillance activities

14. A filarial survey was conducted in a town having 55000 populations. 4200 persons were
examined on a random sampling basis .The results of the survey were

a)those who had mf in blood only =185

b) those who had clinical manifestations of filaria only=68

c) those who had both clinical manifestations and mf in blood=5

Calculate the mf rate disease rate and endemicity rate?

mf rate

no of total people having mf

= ×100
total sampling population

185+5
= ×100
4200

190
=
42

=4.52%

mf rate=4.52%

Disease rate

total no of people having clinical manifestation

= ×100
sampling population

68+5
= ×100
4200

73
=
42
=1.73%

Disease rate=1.73%
Endemicity rate

total number of people having microfilaria∧clinical manifestation∨both

= ×100
sampling population

185+68+5
= ×100
4200

=6.14 %

Endemicity rate =6.14%

15. There was an endemic of acute gastro enteritis in a village having 750 population .
65 people have had an attack of AGER and out of whom 4 people died . calculate attack rate
and case fatality rate?

Attack rate

population withdisease
= ×100
total population

65
= ×100
1750

650
=
175

=3.71%

Attack rate =3.17%

Case fatality rate

no of deaths
= ×100
no of cases

4
= ×100
65
 400
=
65

=6.15%

Case fatality rate =6.15%

16. Population of a primary health centre in the year 2005 was 54000,the following
vital events were recorded in that year

Births=650

Deaths =290

Death of babies in the first month after birth =15

Death of babies after 1month and before 1 year=16

Maternal death =1

Birth rate

no of births
= ×1000
total population

650
= ×1000
54000

650
=
54

=12.03/1000 population

Birth rate = 12.03/1000 population

Death rate

no of deaths
= ×1000
total population

290
= ×1000
54000

290
=
54
=5.370

Death rate =5.370/1000 population

no of deaths during neonatal period

Neonatal mortality rate= ×1000
total no of live births

15
= ×1000
650

= 23.07/1000 live births

Neonatal mortality rate =23.07/1000 live births

Post neonatal mortality rate

no of deaths during post neonatal period

= ×1000
total no of live births

16
= 650 ×1000

=24.62/1000 live births

Post neonatal mortality rate=24.62/1000 live births

Infant mortality rate

=neonatal mortality rate+post neonatal mortality rate

=23.07+24.62

=47.69/1000 live births

Infant mortality rate=47.69/1000 live births

Maternal mortality rate

no of maternal deaths
= × 1000
no of live b irths
 2
= 650 ×1000

=3.07/1000 population

Maternal mortality rate =3.07 /1000 population

birth rate−deathrate
Growth rate = ×100
1000

12.03−5.37
= ×100
1000

=6.66÷10

=0.66

17. Diastolic BP of 10 individuals are :

o 90, 84, 76, 80, 72, 88, 96, 100, 78, 84

Find the measures of dispersion of arithmetic averages. Measures of dispersion are

o Range
o Mean deviation
o Standard deviation

 72, 76, 78, 80, 84, 84, 88, 90, 96, 100. Range is 72-100
 Mean deviation (MD) ¿ ∑ ¿ ¿ ¿ , ~x is mean, n is no of observer
72+ 76+78+80+ 84+84 +90+ 96+100
o ~x=
10
848
= = 84.8
10

X ~
x x-~x ¿¿
90 84.8 5.2 27.04
84 84.8 -0.8 0.64
76 84.8 -8.8 77.64
80 84.8 -4.8 23.04
72 84.8 -12.8 163.84
88 84.8 3.2 10.24
 96 84.8 11.2 125.44
100 84.8 15.2 231.04
78 84.8 -6.8 46.24
84 84.8 -0.8 0.64

696
 Mean deviation ¿ ∑ ¿ ¿ ¿ = = 69.6
10

 Standard deviation ¿ √ ∑ ¿ ¿ ¿ ¿ ¿ ¿
√ 705.6 ¿ 8.8
9