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Intro To Epidemiology - Bap2024 - A

Epidemiology

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35 views35 pages

Intro To Epidemiology - Bap2024 - A

Epidemiology

Uploaded by

ncubeziyanda984
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Edgewood Howard College Nelson R Pietermaritzburg Westville

Campus Campus Mandela Campus Campus Campus

Introduction to Epidemiology (1)


BAP
PROFESSOR SALOSHNI NAIDOO
[email protected]
2024
LEARNING OBJECTIVES

1. To understand the definition of Epidemiology


2. To have an understanding of the history of
Epidemiology
3. To learn about the basic concepts in Epidemiology
4. To understand the objectives of Epidemiology
WHAT IS EPIDEMIOLOGY?
The study of the distribution and determinants
of health-related state or events in specified
populations and the application of study to the
control of health problems (Last, 1995)
DISTRIBUTION

https://covid19.who.int/
EPIDEMIC CURVE OF GLOBAL CASES OF MONKEY POX
DETERMINANT OF HEALTH ?
•A factor which affects human
health
•Biological
•Behavioural
•Social
•Structural

factors that influence the


occurrence of disease and other
health-related events
SPECIFIED POPULATIONS
THE WORD............
• Directly from “epidemic,” which originally referred to
communicable disease outbreaks in humans
• Derived from the Greek roots
• Epi (upon)
• demos (people).
• Logos (study)

“Study of what is on the people”


James Lind ( 1716-1794)
• Documented scurvy in sailors – “A
Treatise on Scurvy” (1754)
• Sailors took ill a month after being at
sea – bleeding gums, bleeding under
the skin
• Took 12 sick sailors, divided them into
groups of 2 and gave different food
types. The 2 who ate the lemons and
oranges improved in 6 days
• Not only did he observe clinical
disease in terms of symptoms, place,
person and time – tested an
experimental intervention
ADMIRALTY LIBRARY, NAVAL HISTORIC BRANCH :
https://www.bbc.com/news/uk-england-37320399
Cholera outbreak in England (1854)

https://www.lshtm.ac.uk/aboutus/i
ntroducing/history/frieze/william-
farr

WILLIAM FARR (1807-1833) JOHN SNOW (1813-1858)


“Miasmic theory” of disease- Cholera spread through
disease was transmitted by a contaminated water
“miasm” / low hanging cloud
Only people at low altitude
will get ill
John Snow (1813-1858)
• Cholera outbreak in London
• Risk of cholera was related to drinking water supplied by the Southwark
company
• Located the home of every patient died between 1848-49, 1853-54

Company Population Deaths Death


rate/1000
Southwark 167 654 844 5.0
Lambeth 19 133 18 0.9
SPOT MAP: DISTRIBUTION
PUMP HANDLE REMOVED
Doll (1912-2005): Smoking
• Long term follow up study of
British Doctors and their smoking
habits (1951-2001)
• Association between smoking and lung
cancer and cardiac disease
• smoking decreases life span up to 10
years
• more than 50% of all smokers die of a
disease known to be smoking-related
• smoking until 30: no excess mortality
• smoking until 40: lose 1 year
• smoking until 50: lose 4 years
• smoking until 60: lose 7 years
RECAP: WHAT IS EPIDEMIOLOGY?
The study of the distribution and determinants
of health-related state or events in specified
populations and the application of study to the
control of health problems (Last, 1995)
HEALTH & DISEASE
Health is a state of complete physical, mental and
social well-being and not merely the absence of
disease or infirmity (WHO,1977)

• Symptoms
• Signs
Disease
• Lab tests
• Chest X-rays
Epidemiology Matters – Chapter 2

Diseased Non-diseased
(CASES) Controls

17
Epidemiology Matters – Chapter 2

Set of 100 individuals


individuals 20 diseased individuals

18
Epidemiology Matters – Chapter 2

Multiple
sets of
individuals

19
Epidemiology Matters – Chapter 2

Defining a population of interest

• A population is a collection of individuals, at moments in time,


defined by at least one organizing characteristic
• The definition of a population has implications for analysis,
interpretation, and generalizability of results from
epidemiologic studies

.
20
Two axes of population definitions

1. Populations are defined by eligibility criteria


2. Populations are defined by whether individuals move in
and out of eligibility; i.e., populations can be dynamic or
stationary

.
Epidemiology Matters – Chapter 2 21
What could be eligibility criteria?

1. Geographic area and time period of interest


2. Characteristics of persons, events, or exposures for which
health-related factors are of interest
3. Factors that promote successful study completion

Epidemiology Matters – Chapter 2 22


Dynamic population of Pholela
over 1 year

Epidemiology Matters – Chapter 2 23


POPULATION AT RISK
• Loss of weight
• Night sweats
TB • Loss of appetite
• Cough

• Loss of taste
• Fever
COVID • Cough
HEALTH CARE WORKERS • Body pain
OBJECTIVES / USES OF EPIDEMIOLOGY
1. Causation
2. Burden of disease (description of health)
3. Natural history of disease
4. Evaluation of preventative / therapeutic
measures
5. Policy and interventions
1: Causation
BIOLOGICAL/
SOCIO-ECONOMIC
GENETIC

GOOD HEALTH ILL HEALTH

BEHAVIOURAL ENVIRONMENT
Disease
Sex HOST immunity
Age
Genetics
Nutritional
Behaviour
status
Stress
Disease status

AGENT ENVIRONMENT

Population
Density
Dose Urban /rural
Strain Climate
Exposure method Habitation
2: Burden of disease
• Impact of a health
problem.
• It is measured by financial
cost, morbidity and
mortality.
• Expressed as quality-
adjusted life years or
disability-adjusted life
years
3: Natural history of disease

DEATH

SUB-CLINICAL CLINICAL
GOOD HEALTH
CHANGES DISEASE

RECOVERY
4: Evaluation of preventative /
therapeutic measures
Treatment /
Medical Care

GOOD
HEALTH DISEASE

Health promotion / Preventive


measures / Public health services
5: Policy and Interventions

• Provides a foundation for developing public policy


and health interventions
• Provides evidence for regulatory decisions including
environmental exposures
EXAMPLES OF QUESTIONS EPIDEMIOLOGISTS ASK

• What is the incidence of hypertension between


2010-2020 among women KwaZulu-Natal?
• What are the causes of hypertension in this
population?
• If we were to change population dietary habits,
what improvement in hypertension incidence
could we affect?
Adapted from EPI Matters- Chapter 1
EPIDEMIOLOGY
“I keep six honest men,
(they taught me all I know),
Their names are What and Why and
When, and How and Where and Who”

Rudyard Kipling (from: Just So Stories 1902)


LEARNING OBJECTIVES
At the end of this lecture you should be able to

1.Define Epidemiology
2.Relate important contributing events to
Epidemiology
3.Explain the basic concepts in Epidemiology
4.Explain the objectives of Epidemiology
REFERENCES
1. Principles of Epidemiology in Public Health Practice – Centers
for Disease Control
2. EPI Matters - Katherine M. Keyes and Sandro Galea
3. Epidemiology: A Research Manual for South Africa.
Occupational Epidemiology – R Ehrlich and G Joubert
4. Basic Epidemiology – R Beaglehole, R Bonita, T Kjellstrom

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