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Fundamentals of epidemiology prof najeeb memon

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Fundamentals of epidemiology prof najeeb memon

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Fundamentals of epidemiology prof najeeb memon

  1. 1. Fundamentals of Epidemiology
  2. 2. PROF: NAJEEB MEMON MBBS, DFHC, MPH, (PhD) Community Medicine Deptt: BMC, LUMHS
  3. 3. Epidemiology
  4. 4. Epidemiology "The study of the distribution & determinants of health-related states or events in specified populations, and the application of this study to the control of health problems". Epidemiology (epi =upon ,demos = population)
  5. 5. How Distribution and Determinants are studied1) Disease Frequency: By Rates and Ratios. 2) Distribution of Disease: By Time, Place & Person. 3) Determinants of Disease: Identifying underlying cause.
  6. 6. Epidemiological studies Observational .S (Only measures not intervene) Experimental. S/ Interventions . S Descriptive or situ: analysis (occurrence of dis: ) Analytical / comparative (Analysis health status & variables) Randomize d clinical trials Field Trials Community Trials Cohort/ follow up Case control Cross sectional Ecological /correlation
  7. 7. USES OF DESCRIPTIVE EPID:  It helps to know the Extent / Magnitude of Dis: (Morbidity & Mortality Rates)  It helps to know distribution of a disease in the community (Person, Place & Time)  Helps to formulate an etiological hypothesis.  Helps to plan, organize & implement curative & preventive services.
  8. 8. Important Issues that Epidemiology can Address Disease Mortality Hospitalization Disability Quality of Life Health Status
  9. 9. Leading Causes of Death Worldwide, 2000 (Based on number of global deaths) 1. Ischemic Heart Disease 2.Cerebrovascular Disease 3.Lower Respiratory Infections 4. HIV/AIDS 5. COPD 6. Perinatal Conditions 7. Diarrhoeal Diseases 8. Tuberculosis 9. Road Traffic Injuries 10. Lung Cancers WHR 2001
  10. 10. Clinician Epidemiologist Patient’s diagnostician Investigations Diagnosis Therapy Cure  Community’s diagnostician  Investigations  Predict trend  Control  Prevention
  11. 11. Typical Study Design: Comm: Health Survey / Des.S Typical Study Design: Cohort & Case - control. S
  12. 12. • Simplest form of Observational study. Cross-sectional study Based on: • Single exam: of • Cross- section of population • at one point in time / specific point in time
  13. 13.  Collects data at one point in time  What exists today  More useful for Chronic Diseases. Cross-sectional study
  14. 14. Exposure and Disease Measures simultaneously
  15. 15. 3 essential characteristics of disease that we look for in descriptive studies are...
  16. 16. Person (Who) Age Sex Race/Ethnicity Socio-Economic Status Behaviors
  17. 17. Place (Where) presence of agents or vectors climate geology population density economic development nutritional practices medical practices
  18. 18. TimeTime distribution:-  Pattern of disease may be described by time of its occurrence by  Year  Month  season  Week  Day etc  Whether it shows periodic increase or decrease or it follows constant time trends.  Such clues show about the source or etiology of dis: Calendar time Time since an event Secular trend Seasonality Temporal trends
  19. 19. Emphasis on relationship of disease to the host, the agent and environmental factors. EPIDEMIOLOGICAL TRIAD3 essential characteristics that are examined to study the cause(s) for disease
  20. 20. Epidemics arise when host, agent, and environmental factors are not in balance
  21. 21. Age, Sex, Race, Religion, Customs, Occupation, Genetic profile, Marital status, Family background, Prior diseases, Immune status Temperature, Humidity, Altitude Crowding, Housing, Neighborhood, Water, Radiation, Noise, Air pollution Behavioral (malnutrition, physical exercise, smoking, alcohol), Biologic (bacteria, viruses), Chemical (poison, smoke), Physical (trauma, radiation, fire), ENVIRONME NT (Factors) AGENT (Type & Examples) HOST- Individual vulnerability Age, Sex, Race, Religion, Customs, Occupation, Genetic profile, Marital status, Family background, Prior diseases, Immune status The Epidemiologic Triangle Underlying the Outcome
  22. 22. Incidence Rate Prevalence Rate
  23. 23. Epidemiologic Activities  …are often framed under the mantle of descriptive and analytic epidemiology ◦Descriptive epidemiology (person, place & time)  Demographic distribution  Geographic distribution  Seasonal patterns etc.  Frequency of disease patterns ◦Useful for:  Allocating resources  Planning programs  Hypotheses development
  24. 24. Epidemiologic Activities Analytic epidemiology built around the analysis of the relationship between two items  Exposures  Effects (disease) ◦looking for determinants or possible causes of disease ◦useful for  hypothesis testing
  25. 25. Thank you

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