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DR. M. R.

Gajendragad
Principal Scientist NIVEDI , Bengaluru, India.

ORGANIZATION

OF THE TALK

Introduction Basic concepts of Epidemiology Why do we need Epidemiology Uses of Epidemiology Types of Epidemiological studies

WHAT IS DISEASE ?
Any impairment of normal physiological function affecting all or part of an organism, especially a specific pathological change caused by infection, genetic defect, or environmental stress, etc., producing characteristic identifiable group of signs or symptoms

TIME -

EPIDEMIC CURVES

DISEASES FALL INTO THREE


CATEGORIES
Endemic diseases of Strategic importance e.g. Foot and Mouth Disease (FMD) Chicken pox

1 2 3

Diseases requiring tactical attention e.g. Peste des Petits Ruminants (PPR) Dengu fever

Emerging or evolving diseases e.g. Bovine spongiform encephalitis (BSE)

Epidemiology is the study of disease in populations and of factors that determine its occurrence. The key word being POPULATION. Literally,

= epi = upon = demo = people = logo = discoursing

The study of that which is upon people The study of disease in populations

Veterinary epidemiology is the study of disease in animal population

It includes investigation and assessment of other health related events viz., productivity.

EPIDEMIOLOGICAL TRIAD
The disease results from the interaction between the agent, (etiology) and the susceptible host (livestock population) in an environment that supports transmission of the agent from a source to the host.

Host

Genotype Nutrition Immunity Behaviour

Biologic Chemical, Physical (injury, trauma) Stress

Environment
Environmental factors are extrinsic factors that affect the agent and the host and the opportunity for exposure.

Sanitation Weather 8 Pollution Husbandry

EPIDEMIOLOGY IS FUNDAMENTALLY ABOUT


Population

Place Time

Of Disease

Epidemiological analysis & insight results in


Identifying and understanding the spatial-temporal variation in disease

Why do we need Epidemiology?

MANAGING
Multiple

DISEASE RISKS

perspectives, including:

Food risk Zoonotic risk Trade risk

WHY DO WE NEED EPIDEMIOLOGY?


To support and sustain:

Basic societal needs


Basic economic needs

GOOD EPIDEMIOLOGY CAN HELP SOCIETAL & ECONOMIC NEEDS

SUSTAIN

BASIC

To live and thrive, we need:

Nutritious safe food Clean water Public health (therapeutic/diagnostic/preventative)

For economic prosperity, we need:


Labour (Healthy work force) Products (Agricultural trade opportunities - food security: abundance) Markets (Commercial choice - Food safety: pathogen free)

HOW DO WE SAFEGUARD SOCIETAL & ECONOMIC DRIVERS?


We need to understand disease occurrence Who, what, where, and when of disease,
Who What Where When

= = = = = =

What species/what population What clinical signs/what disease Where is it/what environment factors When has it occurred/seasonal/sporadic How is it spread/mode of transmission Why has it occurred now and here

The aim is to understand how and why


How Why

These are the key factors for managing and controlling disease

EPIDEMIOLOGY: PROVIDING EVIDENCE FOR POLICY TO PROTECT & SUPPORT SUSTAINABLE PROSPEROUS SOCIETY

Understanding Who, What, Where, When, How & Why of disease occurrence is essential information for:
Managing disease events (reactive) Developing biosecurity & animal husbandry policy (proactive)

Leading to:

Better understanding of health & disease status

To help protect:
Livelihoods Livestock production/Trade

To provide:
Improved food safety (less zoonotic disease risk) Sustainable food supply (less livestock risk/food security)

SKILLS REQUIRED TO DO THIS INCLUDE KNOWING HOW TO:

Observe & record disease events correctly

Disentangle the relevant from the irrelevant

Describe distributions

Allowing accurate & valid comparisons


Determine relationships & measure correlations Making sense of it all, account for error, variance, bias & confounding

Measure associations

Provide informed insight

These are part of the science & art of epidemiology

WHY

IS INTERPRETATION NEEDED?

In reality, epidemiology is much more than finely dressed statistics

Kenneth Rothman (2002) Epidemiology an Introduction. Oxford University Press

Epidemiology is the process of building disease jigsaw puzzles


Puzzles with Lots of pieces Rarely, if ever, will we find all of the pieces The pieces are often fuzzy in what they are and how they fit together Sometimes we put them together incorrectly The disease picture we are trying to construct can change

EPIDEMIOLOGICAL ENQUIRY STARTS WITH DATA


Data emphasizes evidence Data collection involves:

Outbreak Investigations (Field Epidemiology) Ongoing Surveillance Active, Passive, Targeted, Syndromic, Sentinel, Early Warning, Monitoring

Data

collection requires appropriate infrastructure

Practice,
Evidence based policy

USES OF EPIDEMIOLOGY
1. 2. 3. 4. 5.

6.

Determination of the origin of a disease whose cause is known. Investigation & control of a disease whose cause is either unknown or poorly understood. Acquisition of information on the ecology and natural history of a disease. Planning and monitoring of disease control programmes. Assessment of the economic effects of a disease & analysis of the costs and economic benefits of alternative control programme. Monitoring and Risk factor analysis.

DETERMINE THE ORIGIN OF THE DISEASE WHOSE CAUSE IS KNOWN

INVESTIGATE

AND CONTROL OF A DISEASE WHOSE

CAUSE IS EITHER

UNDERSTOOD

UNKNOWN OR POORLY

Epidemiological observations and studies are used to identify the cause of a disease and there by plan the control strategies Examples
Protective effect of cowpox virus against human small pox. Feeding of meat and bone meal contamination to cattle developed bovine spongiform encephalopathy.

ACQUISITION

OF INFORMATION ON THE ECOLOGY

AND NATURAL HISTORY OF A DISEASE

Ecosyste m
Natural history of the disease
Agent or the etiology which infects host

Environment influences health and disease

Environmental influences and disease experience are not constant in time or uniform in space Epidemiology tries to describe and identify the environmental links with disease occurrence Anthropogenic impacts on reservoir-host communities that encourage pathogen dispersal In particular cross-species pathogen dispersal

Disease ecology is about

Host or the Animal that gets infected

PLANNING AND MONITORING OF A


DISEASE CONTROL PROGRAMMES
Disease in an animal population disease Amount of disease Surveillance & monitoring Costs involved Benefits gained. Factors associated with occurrence

DISEASE CONTROL PROGRAMME

The Four Most Common Types of Epidemiological Studies

Cohort Study The "What will happen to me?" study follows a group of healthy people with different levels of exposure and assesses what happens to their health over time. Case Control Study The "why me?" study investigates the prior exposure of individuals with a particular health condition and those without it to infer why certain subjects, the "cases," become ill and others, the "controls," do not. Occupational Epidemiological Study The occupational study can be designed using any standard epidemiologic design, simply selecting working people with particular jobs or exposures as subjects. Cross-Sectional Study The "Am I like my neighbors?" study compares groups in terms of their current health and exposure status and assesses their similarities.

Thanks for your endurance.

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