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Principles of Epidemiology
Part (I)
UNIVERSITY OF TABUK, FACULTY OF MEDICINE
COMMUNITY MEDICINE MODULE
(MED 402)
November, 2016
Learning Outcomes
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To become a doctor, promote & maintain people safety & health, treat
patients & reduce their suffering.
Doctors responsibility:
Practice of evidence-based medicine.
Communication skills:
Patients queries & interaction skills.
Equity:
Resources for health care are limited.
Research.
Epidemiology
(Definition)
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Epidemiology:
Epidemiology:
Study:
Epidemiology is a scientific discipline with sound methods of
scientific inquiry at its foundation.
Distribution:
Frequency.
Pattern: time, place, and person.
Determinants:
Any factor, whether event, characteristic, or other definable entity,
that brings about a change in a health condition or other defined
characteristic.
Health-related states or events: Rrisk, CD & NCD
Specified populations.
Application.
(CDC: Principles of Epidemiology, 3rd Edition).
Parts of Epidemiology
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Descriptive epidemiology:
Analytic epidemiology:
Interventional epidemiology:
Subspecialties include:
Applied epidemiology.
Clinical epidemiology.
Environmental epidemiology.
Genetic epidemiology.
Genomic epidemiology.
Molecular epidemiology.
Social epidemiology.
Nutritional epidemiology.
Spatial epidemiology.
Terminology & Definitions
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Community:
Medicine:
Health:
Public health:
Disease:
A physiological or psychological dysfunction.
A condition in which body health is impaired.
A departure from a state of health.
An alteration of the human body interrupting the performance of
vital functions.
Illness:
A subjective state of not being well.
A disease or period of sickness affecting the body or mind.
Sickness:
The state of being ill.
A particular type of illness or disease
A state of social dysfunction.
Historical Evolution of Epidemiology
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400 BC:
Hippocrates published On Airs, Water, and Places which presented the
epidemiologic principles of the observation and recording of patients habits, diets,
and environments in the prediction of disease patterns.
1662:
John Graunt, London. published a landmark analysis of mortality data.
1747:
James Lind did a randomized, control trial to establish the cause of scurvy.
1946:
CDC was established from the Office of Malaria Control in War Areas.
1977:
The last naturally occurring case of smallpox was diagnosed in a Somali man.
Important People in Community Medicine
Recognized as a founder of
clinical medicine and
epidemiology.
Emphasized detailed
observations of patients &
accurate recordkeeping.
Historical Evolution of Epidemiology
Designed first
experiments to use a
concurrently treated
control group.
Important People in Community Medicine
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Edward Jenner:
Ignac Semmelweis:
Pioneered hand washing to help prevent the spread of septic infections in
mothers following birth.
Dramatically reduced the rate of childbed fever by the institution of hand-
washing.
Historical Evolution of Epidemiology
Father of epidemiology.
John Graunt:
P. C. A. Louis:
Bloodletting:
The surgical removal of
some of a patient's blood for
therapeutic purposes.
Important Places in Community Medicine
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Cuba (1898):
Walter Reed conducted important research on yellow fever.
Tuskegee, Alabama:
The site of the famous Tuskegee Study of Untreated
Syphilis in Negro Male.
Framingham, Massachusetts:
The site of Framingham Heart Study.
Important Places in Community Medicine
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Plague:
Killed one third of Europes population in the Middle Ages.
Scurvy:
The scourge of sailors, it limited the distance that ships could
travel.
Smallpox:
Caused approximately 400,000 death in the 18th century and
blinded 33% of survivors.
AIDS:
The modern plague.
It ended sexual revolution.
Objectives of Epidemiology
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Objectives of epidemiology:
Uses of epidemiology:
Field investigation:
Epidemic investigation
Cluster investigation
Core Epidemiologic Functions
(Descriptive & Analytic Studies)
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Design
Conduct
Analyse
Interpret
Core Epidemiologic Functions
(Evaluation)
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Effectiveness:
Refers to the ability of a program to produce the intended
or expected results in the field;
Efficacy:
Is the ability to produce results under ideal conditions.
Efficiency:
Refers to the ability of the program to produce the intended
results with a minimum expenditure of time and resources.
Core Epidemiologic Functions
(Multidisciplinary Team Function)
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Team sport
Policy development:
Definition
Textbooks:
1. K. Park's (2015): Textbook of Preventive and Social Medicine. Banarsidas Bhanot-Jabalpur. 23rd edition.
2. Text Book of Public Health and Community Medicine. RajVir Bhalwar, Department of Community
Medicine, Armed Forces Medical College, Pune, in collaboration with WHO, India Office, New Delhi
(2009).
3. Lucas, A. and Gilles, H. (2003): Short Textbook of Public Health Medicine for the tropic, 4th edition, Oxford
University Press Inc., New York, USA.
4. Portney, L. G. and Watkins, M. P. (2008): Foundation of Clinical Research. Applications to Practice. 3rd
edition.
5. Kumar, R.(1996): Research methodology. A step by step guide for beginners. 3rd edition.
6. Miller, D. C. (1991): Handbook of Research Design and Social Measurement. 5th edition.
7. Altman, D. G. (1991):Practical statistics for medical research. Boca Ratn, Chapman & Hall/ CRC;
Websites:
1. World Health Organization (WHO): http://www.who.ch
2. Centers for Disease Control and Prevention (CDC), USA: http://www.cdc.gov
3. The Johns Hopkins Bloomberg School of Public Health, OPENCOURSEWARE (OCW) project:
http://ocw.jhsph.edu
4. The WWW Virtual Library (Medicine and Health): Epidemiology
(http://www.epibiostat.ucsf.edu/epidem/epidem.html).
THANK YOU
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