EPIDEMIOLOGY

PRESENTED BY
POONAM KOL
PBBSC 2nd year
 INTRODUCTION
• The term epidemiology is derived from the Greek word
• Epi means-Among, upon,
• Demos means study population or people and
• Logos mean scientific study
• it is the scientific study of the disease pattern in human.
• In broad sense, it is the study of effects of multiple factors on.
• It is multidisciplinary subject involving those of the physician,
Biologists, Public Health experts, Health educators etc.s scientific
study.
 DEFINITION

• ,The science of infective diseases, their prime causes,

propagation and prevention. (Stallbrass 1931.)

• Epidemiology is the study and analysis of the distribution,

patterns and determinants of health and disease conditions in a
defined population.
 Epidemiology is the study of the distribution and determinants of
health-related states or events in specified populations, and the
application of this study to the control of health problems.
 AIMS
.According to the International Epidemiological Association (IEA)
Epidemiology has three main aims.
• To describe and analyze diseases occurrence and distribution human
populations;
• To identify etiological factors in the pathogenesis of diseases
• To provide the data essential to the planning, implementation and
evaluation of services for the prevention, control and treatment of
diseases and to the setting up of priorities among those services
The ultimate aims of epidemiology can be concluded in to two
followings points.
• –To eliminate or reduce the health problem or consequences and
• –To promote the health and wellbeing of as a whole.
 PRINCIPALS

• To study historically the rise and fall of disease in the population.
•  Community diagnosis.
•  Planning and evaluation
• . Evaluation of individuals risks and chances.
•  Completing the natural history of disease
• . Searching for causes and risk factors
 OBJECTIVE
• to identify the etiology, or cause, of a disease and its relevant risk
factors (i.e., factors that increase a person’s risk for a disease).
• to intervene to reduce morbidity and mortality from the disease
• to develop a rational basis for prevention programs based on
identified etiologic or causal factors
• to work on to reduce or eliminate exposure to those factors
• to determine the extent of disease found in the community.
• to help plan health services and facilities for effective health care
facilities
• to study the natural history and prognosis of the disease.
 CONCEPT OFEPIDEMIOLOGY
• The concept of epidemiology compasses three components
• DISEASE FREQUENCY
• Measurement of frequency of disease disability or death,and
summarizing this information in the from of rates and ratios (e,g
prevalence rate including rate death rate etc) thus the basic measure
of disease frequency is rates or ratio.
DISEASE FREQUENCY
 2.DISTRIBUTION OF DISEASES

• An important function of epidemiology is to study the

distribution pattern various sub group of the population time,
place,and person.that is the epidemiology examines whether there
has been an increase or decrease of disease over time span.
•
 3.DETERMINANTS OF DISEASES
• A unique feature of epidemiology is to test etiological hypotheses
and the underlying causes or risk factor of diseases
•
 USES OF EPIDEMIOLOGY
• To determine, describe, and report on the natural course of disease,
disability, injury and death
• To aid in the planning and development of health services and
programs
• To study the cause of disease, conditions, disorders, disability, etc
• To determine the primary agent responsible or ascertain causative
factors
• To determine the characteristics of the agent
 BROAD TYPES OF EPIDEMIOLOGY

• Descriptive epidemiology –
• Analytic epidemiology
 Descriptive epidemiology

examining the distribution of disease in a population, and observing

the basic features of its distribution.in term of time place and person
Typical study design
 Analytic epidemiology
–investigating a hypothesis about the cause of disease by studying
how exposures relate to disease .
 HISTORY OF EPIDEMIOLOGY
• The history of epidemiology has its origin in the idea, goes back to
(400BC) Hippocrates through John Graunt (1662), William to Farr,
John Snow and others that environmental factors can influences the
occurrences of diseases in stead of supernatural viewpoint of
diseases.
• John Graunt analysis and published the mortality data in 1662.He
was the first quantify pattern of death, birth and diseases
occurances.
• No one built upon Graunt’s work until 1800’s.when William Farr
began to systematically collect and analyst the Britain’s mortality
statistics. Farr considered as the father of vital statistics and diseases
 SCOPE OF EPIDEMIOLOGY
For many years epidemiology was considered to be restricted to the
infectious diseases, epidemics, and endemics which were the major
health problem in the past. With changing pattern of population
morbidity and mortality, the scope of epidemiology has been
enlarging.
• Disease causation
• Disease transmission
• Outbreak investigation
• Disease surveillance
• Screening, bio-monitoring, and comparisons of treatment effects
such as in clinical trials.
 .Aging epidemiology
Examines the public health impact of aging societies, and the
multi factorial changes associated with aging that make health
issues for older persons important and unique.
 2.Applied public health epidemiology:
Areas of focus include population health status assessment;
infectious and chronic disease surveillance and control; maternal
and child health epidemiology; and environmental health
epidemiology.
 3.Cancer Epidemiology
Cancer epidemiology is the study of the distribution and
determinants of the likelihood of cancer development. Cancer
epidemiology can be used to identify events that increase or
decrease cancer incidence in specific populations.
 Cardiovascular and diabetes epidemiology
It is the study of the distribution and determinants of the likelihood of
cardiovascular disease and diabetes development.cardiovascular disease
is a major cause of death and disability in people with diabetes
.this is because diabetes can damage the heart and blood vassels
 5.Clinical trials and methods:
The activities of the epidemiologic methods group contribute to all
areas of emphasis, specializing in design and conduct of studies
including adaptive trials, survey sampling, and statistical methods
 Environmental epidemiology
Environmental epidemiology is a branch of epidemiology concerned
with determining how environmental exposures impact human
health.concerned . This field seeks to understand how various external
risk factors may predispose to or protect against disease, illness, injury,
developmental abnormalities, or death.
 7.Global health epidemiology
Global health epidemiology addresses the causes and consequences of
morbidity and mortality that cross-regional or national boundaries,
with emphasis on research in resource-poor countries and application
of research findings to the implementation of programs to promote
health in those area
 Infectious disease epidemiology
The study of the incidence and spread of infectious diseases in
populations over time. Host, pathogen and environmental factors are
monitored to determine the dynamics of infection, the ultimate goal of
which is to devise intervention strategies .
 9Injury prevention epidemiology:
Emphasis on the application of epidemiological methods in population
and clinical settings to understand key risk and prognostic factors for
primary and secondary prevention of injury
 EPIDEMIOLOGICAL APPROACH
• As with all scientific endeavors, the practice of epidemiology relies
on a systematic approach.epidemiological studies fall into 2
categories;
• Asking questions
• Making comparison
 Asking question
• The key information can be approached through a series of
questions.
• Related to health events-
• What are the actual and potential health problems its manifestation
&characteristics?
• Where are they occur in terms of place?
• Which problems are increasing or have the risk to increase?
• Related to health action-
• What can be done to reduce the problems and its consequences?
• How can it be prevented in the future
 Making comparision
• This approach is to make comparisons and draw inferences.
Comparision may be made between different population at a given
time. Eg – rural with urban population
• between subgroup of population. Eg- male & female population
• between various periods of observation. Eg- different seasons
 EPIDEMIOLOGY METHOD
• Epidemiological investigations can be grouped into 4broad
categories:
• observational epidemiology
• experimental epidemiology
• natural experiments
• theoretical epidemiology
 Observational Epidemiology
• This method begins with surveillance of populations, using vital and
health statistics including analysis of death rates arranged by age,
sex, locality, and cause of death.other information is derived from
notified cases of infectious diseases of public health importance,
from registries of cancer or other diseases, and from hospital
discharge statistics.
 Descriptive epidemiology
• the statement emphasizes the best use of observation on individuals
or populations exposed to suspected factors of disease. These studies
are concerned with observing the distribution of disease or health
related characteristics in human populations and identifying the
characteristics with which the disease in question seems to be
associated.
 Analytic observational studies-

• the possibilities of observational epidemiology are considerable,

but not limitless. They are powerfully reinforced by analytic studies
The two main analytic methods are the case-control study & the
cohort study.
• Case control study- is a systematic extension of routine medical
history taking, in which the past histories of patient suffering from
condition of interest are compared to the past histories of person
who do not have the condition of interest, but who otherwise
resemble the cases in such particular as age & sex
 Cohort study-
• is conducted by identifying individuals in a defined population who
are exposed to varying levels of known or suspected risk fr the
condition of interest, such as cancer of lung or coronary heart
disease. This study require large numbers, commonly many
thousand , and prolonged observation, commonly years or even
decades.
 Experimental Epidemiology
• it meant observing the passage of infectious pathogens in colonies
of rodent, but such experiments are rarely necessary, and the
meaning of the term has changed. Experiments in which the
investigator studies the effects of intentional alteration or
intervention in the course of a disease are now done on humans
rather than experimental animals, usually using a randomized
controlled trail design.
 Randomized controlled trail (RCT)
• is a form of human experimentation in which the subjects, usually
patients, are randomly allocated to receive either a standard accepted
therapeutic or preventive regimen, or an experimental regimen
 Field trails-
• - involves evaluation of whether an agent or procedure reducing the
risk of developing disease among those free from that condition at
enrollment.they are used as trails to test health education methods,
training procedures or other public health programs.
• Community trails – also called community intervention studies, are
experimental studies with whole communities as experimental
units; that is intervention are assigned to all members in each of
number of communities
 Natural Experiments
• refers to a fortuitous situation where a natural course of public
events closely approximate a planned control experiment. However,
these are basically observational studies. For instance, the welfare
reform in the United States has induced important differences in the
social conditions. Thus, the effect of changes in the social conditions
on the disease occurrence can studied through the patterns of disease
occurrence in the two periods, before and after the welfare reforms
were implemented
 Theoretical Epidemiology
• refers to development mathematical and statistical models to explain
the patterns of occurrence of diseases. Several models to explain the
outbreak and spread of infectious diseases have been developed.
Modern computing power enables numerical simulation to check and
refine these models. It is also possible to use the results from the
observational and planned or natural experiments to develop
mathematical models. These mathematical models can then used to
simulate “what-if" scenarios of disease patterns when the associated
factors are altered in some meaningful ways
 PROCESS OF EPIDEMIOLOGY
• 1. Identify investigation team and resources.
• 2. Establish existence of an outbreak.
• 3. Verify the diagnosis.
• 4.Construct case definition.
• 5. Find cases systematically and develop line listing.
• 6. Perform descriptive epidemiology/develop hypotheses
 ROLE OF A NURSE IN EPIDEMIOLOGY
• -Role of a nurse in epidemiology can be explained in 4 aspects. These
are:
•  Preventive role
•  Promotive role
•  Curative role
•  Rehabilitative role
 :PREVENTIVE ROLE-
• Epidemiology is one of the basic sciences applicable to nursing. The
nurses working in a community deal with people in various settings
and help them solve their health problems. They make the nursing
process. They identify and investigate the problem, formulate and test
the hypothesis regarding the causal factors, formulate alternative
interventions and implement to prevent and control the problem and
evaluate effectiveness of interventio
• They have an active role in the prevention and control of
communicable diseases which include:
• Identify sources of infection and methods of spread of infection.
• Health education of people in general.
• Having an important role in the prevention and control of chronic
and noninfectious problems, such as cardiovascular conditions,
accident, cancer, etc.
• Notification of certain diseases like measles, diphtheria, tetanus, etc.
to health authority.
They can also teach and supervise other workers in surveillance
activities
 :-ROLE IN PROMOTION OF HEALTH

• Using knowledge of epidemiology, the community health nurses can

set priorities for health programs according to the immediate health
needs.
• Using knowledge of epidemiology, they establish the health
resources more effectively, by giving more emphasis to urgent health
problems needing attention.
 -CURATIVE ROLE
• They may deal with the problem independently, especially when
these are the nursing problems, minor ailments or simply health
conditions and they are only the health workers in a healthcare
setting.
• They may participate as them members, especially when it is large
scale investigation, e.g. occurrence of any epidemic.
• They may participate in data collection, data analysis, planning,
implementation and evaluation.
• They may early diagnosis and treatment.
 -ROLE IN REHABILITATION
• They evaluate the effectiveness of measures used to control specific
disease or disorder.
• They can help people in the restoration of family and social life.
• They can also play a role in psychological rehabilitation by helping
in restoring personal dignity and confidence of a person.
• Conclusion-is the basic science of public health, epidemiology
includes the study of the frequency, patterns, and causes of health-
related states or events in populations, and the application of that
study to
• address public health issues. Two essential concepts of epidemiology
are population and comparison.
 NURSING RESPOSIBILITY
• STUDY HEALTH PROBLEMS ;
• Nurses study the occurrence and distribution of diseases in a
community.they also determine the risk factors for diseases.
• ANALYZE HEALTH DATA;
• Nurse collect and analyze data on health indicators such as rates of
chronic diseases.
• ADVOCATE FOR HEALTH SERVICES;
• Nurse help negotiate care management plans and facilitate the
provision of health services.
 CREATE COMMUNITY AWARENESS;
• Nurses help create community awareness on health matters
• CASE FINDING;
• Nurses carry out outreach programs targeting specific individual that
may need care services.
• COUNSILING;
• Nurses assist patient to cope with different health stressors
• EDUCATION;
• Nurses promote learning to facilitate positive health care outcomes.
 CONCLUSION:-

• Here I state my topic epidemiology branch of medicine which deals

with the incidence, distribution, and possible control of diseases and
other factors relating to health. Epidemiology is the study of how
often diseases occur in different groups of people and why.
Epidemiological information is used to plan and evaluate strategies
to prevent illness and as a guide to the management of patients in
whom disease has already developed.