PENGANTAR
EPIDMIOLOGI PENYKIT
MENULAR
Epidemiologi
Definisi
Studi yg mempelajari distribusi dan
determinant status atau kejadian yg
berhubungan dengan kesehatan pada
sekelompok populasi, dan aplikasi
studi ini adalah untuk mengkontrol /
mengendalikan masalah kesehatan
Last ed. Dictionary of Epidemiology
Epidemiologi Penyakitamenular
Definisi
Epidemiologi penyakit menular
terfokus dalam mempelajari distribusi
dan determinan penyakit menular
dalam populasi.
Epidemiologi Penyakitamenular
Klasifikasi Penyakit Berdasarkan etiologi
(kausa)
Penyakit infeksi
Penyakit
non infeksi
Etiologi (organism) : Tuberkulosis, Campak,
Malaria, dsb
Manifestasi klinik : Meningitis, Encefalitis,
Rinitis, Diare ??, dsb
Epidemiologi Penyakitamenular
Berdasarkan Durasi :
Penyakit
akut
Penyakit
kronik
Peak symptoms within 3 months (acute) or
longer than 3 months (chronic)
Epidemiologi Penyakitamenular
Acute
infection vs. chronic infection
Acute
Infection
An
infection characterized by sudden
onset, rapid progression, and often with
severe symptoms
Chronic
An
Infection
infection characterized by delayed onset
and slow progression
Types of Diseases
Examples
Acute Diseases
MENULAR
Common cold, pneumonia,
mumps, measles, pertussis,
typhoid fever, cholera
TIDAK MENULAR
Appendicitis, poisoning, trauma
Chronic
Diseases
MENULAR
Tuberculosis, AIDS, Lyme disease,
syphilis, rheumatic fever
Diabetes, coronary heart disease,
TIDAK MENULAR osteoarthritis, cirrhosis of the liver
03/14/15
Definition of communicable diseases
A
communicable disease is an illness due
to a specific infectious (biological) agent
or its toxic products capable of being
directly or indirectly transmitted:
from man to man, from animal to man,
from animal to animal, or
from the environment (through air,
water, food, etc..) to man.
Definition of communicable diseases
Epidemiology
The
study of the transmission of disease
Communicable Disease
A
disease that can be transmitted from one
individual to another
Contagious Disease
A
communicable disease that is easily spread from
one individual to another
Noncommunicable Disease
A
disease that is not transmitted from one
individual to another
Definition of communicable diseases
Communicable
Diseases-biological agents
Biological agents = microorganism
- Virus
- Fungus
-Bacteria
- Protozoa
- Helminthes - Others form of microorganism
Non
Communicable Diseases-Non
biological Agents
-
Physics
- Nutrition - Chemical -etc
Definition of disease & infectious
disease
Disease
Any
deviation from a condition of good
health and well-being
Infectious
Disease
A disease condition caused by the presence
or growth of infectious microorganisms or
parasites
Etiologi
Infeksi
Non Infeksi
Durasi
Akut
Common cold
Pneumonia
Campak
Gondongan
Pertusis
Typhoid
Kolera
Keracunan
(intoksikasi
insektisida dan
logam, dsb)
Trauma
Kronis
Kusta
TBC
AIDS
Demam rheumatik
Hepatitis B
Penyakit Jantung Koroner
Diabetes Mellitus
Kanker
Stroke
12
Classification of Diseases &
Health Problems
Organ or Organ System
i.e., heart disease, kidney disease, respiratory
infection
Causative Agent
Biological Agents
Chemical Agents
Physical Agents
Communicable vs Non communicable
Acute vs Chronic
Peak symptoms within 3 months (acute) or
longer than 3 months (chronic)
Chap 4: Prevention and Control
Causative Agents for
Diseases & Injuries
Biological
Agents
Viruses
Rickettsiae
Bacteria
Fungi
Protozoa
Metazoa
Chemical
Agents
Pesticides
Food additives
Pharmacologics
Industrial chemicals
Air pollutants
Cigarette smoke
Physical
Agents
Heat
Light
Radiation
Noise
Vibration
Speeding
objects
DEFINITIONS
INFECTION
- The entry, development or multiplication of an
infectious agent in the body tissues of man or animals
INFECTIOUS DISEASE
- A clinically manifest disease of man/animal resulting
from an infection
COMMUNICABLE DISEASE
- An illness due to a specific infectious agent OR its toxic
products that arises through transmission from a
reservoir to a susceptible host either directly or
indirectly
Some communicable diseases may not be
infectious BUT all infectious diseases are
communicable.
communicable but not infectious:
-tetanus
- botulism
- staphylococcal food poisoning
INCUBATION PERIOD
- time interval between initial contact with an
infectious agent and the first appearance of
symptoms associated with the infection
COMMUNICABLE PERIOD
- time during an infectious agent may be
transferred from an infected host/reservoir to
another susceptible host
Ep
ide
mi
gle
ian
Tr
olo
gic
Communicable Disease Model
Model
Communicable Disease Model
Agent
The element that
must be present in order
for the diseases to occur
Communicable Disease Model
Host
Agent
Any susceptible
organism invaded
by an infectious agent
Communicable Disease Model
Host
Agent
Environment
All other factors that inhibit
or promote disease
transmission
Chain of Infection
A model to conceptualize the transmission of a
communicable disease from its source to a susceptible host
Chain of Infection
Pathogen
- The disease-causing agent
Chain of Infection
Pathogen Reservoir
The habitat in which an infectious agent normally
lives and grows
Human: Anthroponoses, symptomatic or asymptomatic
Animal: Zoonoses
Environmental: Plants, soil, and water
Chain of Infection
Pathogen Reservoir Portal
of exit
The path by which an agent leaves the
source host
Chain of Infection
Pathogen Reservoir Portal
of exit
Modes of Transmission
How pathogens
Transare passed
mission
Direct: Immediate transfer
- Direct contact
- Droplet spread
Indirect
- Airborne
- Vehicleborne
- Vectorborne
Modes of Transmission
of
the Agent to a New
:Host is
A mode of transmission
essential for the infectious agent
to bridge the gap between the
portal of exit from the reservoir
. and the portal of entry of the host
Modes of transmission can be
. classified as direct or indirect
Routes of transmission
Direct
Indirect
Skin-skin
Herpes type 1
Mucous-mucous
Food-borne
STI
Across placenta
toxoplasmosis
Through breast milk
HIV
Sneeze-cough
Influenza
Salmonella
Water-borne
Hepatitis A
Vector-borne
Malaria
Air-borne
Chickenpox
Ting-borne
Scarlatina
Exposure
A relevant contact depends on the agent
Skin, sexual intercourse, water contact, etc
(www)
Chain of Infection
Pathogen Reservoir Portal
of exit
Portal
Transmission of entry
- Agent enters
susceptible host
Respiratory
Oral
Skin
Intravenous
Gastrointestinal
Chain of Infection
Pathogen Reservoir Portal
of exit
Portal
Transmission of entry
New
host
- Final link is
a susceptible host
Levels of Prevention
Primary Prevention
The forestalling of the onset of illness or injury
during the pre-pathogenesis period (before the
disease process begins)
Secondary Prevention
The early diagnosis and prompt treatment of
diseases before the disease becomes advanced
and disability becomes severe
Tertiary Prevention
The retraining, reeducation, and rehabilitation of
the patient who has already incurred disability
Pencegahan primer
Adl
Upaya pencegahan yg dilakukan
saat proses penyakit belum mulai (pd
periode pre-patogenesis) dengan
tujuan agar tidak terjadi proses
penyakit
T.a: 1. Promosi kesehatan
2. Perlindungan khusus
Riwayat Alamiah Penyakit
31
Pencegahan sekunder
Adl
Upaya pencegahan yg dilakukan saat
proses penyakit sudah berlangsung
namun belum timbul tanda/gejala sakit
(patogenesis awal) dengan tujuan proses
penyakit tidak berlanjut
T.a:
1. Early diagnosis & prompt treatment
2. Disability limitation
Riwayat Alamiah Penyakit
32
Tingkat pencegahan
tertier
Bila telah terjadi defect /kerusakan struktural
ataupun disabilitas:
maka untuk mencegah semakin buruknya
kondisi atau menetapnya disabilitas
dilakukan usaha preventif tertier
dengan rehabilitasi
Riwayat Alamiah Penyakit
33
Prevention of Communicable
Diseases
Pathogen
Pasteurization
Chlorination
Antibiotics
Antivirals
Disinfectants
Prevention of Communicable
Diseases
Human Reservoir
Isolation
Surveillance
Quarantine
Drug treatment
Prevention of Communicable
Diseases
Portal of Exit
Gowns
Masks
Condoms
Hair nets
Insect repellents
Prevention of Communicable
Diseases
Transmission
Isolation
Hand washing
Vector control
Sanitary engineering
Sneeze glass
Sexual abstinence
Safer sex
Prevention of Communicable
Diseases
Portal of Entry
Masks
Condoms
Safety glasses
Insect repellents
Prevention of Communicable
Diseases
Establishment of Disease in New Host
Immunizations
Health education
Nutrition promotion
Sexual abstinence
Noncommunicable Disease
Model
Your genetic
endowment
Noncommunicable Disease Model
Your genetic
endowment
Behavioral
choices
Air
Pollution
Wa
te r
Qu
al i
ty
Eco
nom
ics
y
t
i
l
a
n
o
s
Per
re
Ca
h
alt tem
He ys
S
fs
li e
Be
Environment
Diseases of the Heart and Blood
Coronary heart disease (CHD):
Characterized by damage to the coronary
arteries.
Atherosclerosis: Narrowing of the blood
vessels resulting from the build-up of fatty
deposits on the walls of the blood vessel.
Cerebrovascular disease (stroke): Blood
supply to the brain is disrupted.
Cancer
Malignant neoplasm: Occurs when cells
lose control over their growth and division.
As these cells continue to grow they
eventually develop a new growtha
tumor
Metastasis: Parts of the tumor break off
and travel to the rest of the bodys organs
and continue their growth.
Other Top Noncommunicable
Diseases
1. Chronic obstructive pulmonary disease
2. Diabetes mellitus
3. Chronic liver disease and cirrhosis
Prevention of Noncommunicable
Diseases
Primary Prevention
Adequate food intake
Good opportunities for education, employment, and
housing
Efficient community services
Health promotion
Access to medical services
Protection from the environment
Protection from occupational hazards
Empowerment for ones own health
Prevention of Noncommunicable
Diseases
Secondary Prevention
Mass screenings
Case-finding measures
Adequate health personnel, equipment, and
facilities
Personal screening (self breast or testes
exams)
Hemoccult tests
Pap tests
Prevention of Noncommunicable
Diseases
Tertiary Prevention
Adequate emergency medical personnel,
services, and facilities
Understand unmodifiable risk factors
Significant behavioral or lifestyle changes
(Modifiable risk factors)
Support groups
Counseling
