dr/Dalia Ahmed Mohamed

Vital statistics

By
Dalia Ahmed Mohamed
Assistant Professor of Public Health
dr/Dalia Ahmed Mohamed
 Vital statistics

Is the branch of medical

statistics concerned with
measurement of health status
of the community through
registration and presentation of
vital events as indicators.
dr/Dalia Ahmed Mohamed
Past-Where have we been?

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Present – Where are we now?

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Future-Where are we going?

dr/Dalia Ahmed Mohamed

 Vital statistics categories
• 1- Morbidity indicators: include incidence
rate, prevalence rate and attack rate
• 2- Mortality indicators include: crude death
rate, age specific death rate, cause specific
mortality rate, proportionate mortality rate
and case fatality rate
• 3- Natality indicators: include fertility
indicators

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dr/Dalia Ahmed Mohamed
 Morbidity Statistics
• There are two basic measures to assess the
frequency of the disease:
A. Incidence rate:
• B. Prevalence rate:
• A RATE is composed of a numerator (number of
events), a denominator (population at risk for the
event) and the specified time in which events occur
(in case of incidence rate) or the specific time in
which the data were collected (in case of prevalence
rate) and a multiplier (constant: 100, 1000, 100,000)
• Most rates are proportions: the numerator is a subset
of denominator dr/Dalia Ahmed Mohamed
 Incidence Rate
• It is the number of new (reported) cases of a
particular disease over a certain time period
and locality per 1000 at-risk population in the
same time period and locality

Example: Incidence of acute meningitis in Egypt 1995=

No of reported cases of meningitis throughout year 1995 in Egypt X 100, 1000

Total at-risk population in Egypt year 1995

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 Incidence Rate
∀ • Measures the amount with which unaffected persons develop
a particular disease(newly diagnosed cases ) per unit of
person-time
∀ • It is usually used in measuring the frequency of acute
diseases (communicable) per time
∀ • Measuring the incidence of chronic diseases done through
follow up of disease-free individuals and detection of cases
throughout time.
• The decrease in the incidence rate may be due to : enhanced
resistance to disease, change in the disease etiology, an
effective prevention program for infectious diseases (e.g.
immunization) or program that reduces exposure to a risk factor
for the disease( antismoking program and cancer lung)
dr/Dalia Ahmed Mohamed
 The attack rate
• is a type of the incidence rate where the
frequency of occurrence of a disease
for the same individual is considered.
Example: the attack rate of diarrhea
was 40 attacks per 1000 under-five
children per year.

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 Prevalence Rate
• It is the number of all cases [new and old] of
a particular disease diagnosed during a
survey study in a given locality (area) during a
certain time period per 100 examined at-risk
individuals.

Example: Prevalence of Diabetes in Egypt 1994=

No of new and old cases (≥ 20 years of age) X 100
Total Number of examined individuals (≥ 20 years of age)

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 Prevalence Rate
Measures the amount of disease already
present in a population
It is a good measure for chronic diseases as it
measures the accumulated cases by time for
both the new and old cases.
It is used for measuring the prevalence of non-
communicable diseases and some
communicable diseases (e.g. TB, Bilharziasis)

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 Prevalence Rate
 Survey studies (using screening
tests/diagnostic tests) are conducted to
measure the prevalence of the diseases
where reporting and registration are lacking
 Proper clinical examination and investigations
provide accurate data about the prevalence.
Personal interviews provide underestimation
of the prevalence rate

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 Prevalence Rate
• The prevalence of the disease depends on its
incidence rate and the duration of illness
• High prevalence may be due to high incidence or long
duration of the disease
• Successful control of the diseases with no cure
prologs life and increase the prevalence
• Low prevalence may be due to low incidence, short
duration (rapid recovery or death) or both
• Successful treatment with complete recovery (cure) or
the occurrence of disease complications that lead to
rapid death, decrease the prevalence rate
dr/Dalia Ahmed Mohamed
 Disease Burden
• Measurement of the disease burden depends on the
time (years) lost due premature death and the time
lived with disability.
• The Disability Adjusted Life Years (DALYs) for a
specific health problem in the population equal:
sum of years lost due to premature death and years of
life lived with disabilities by survivors with such health
problem, weighted by the severity of the disability.
• Quality of life (physical, mental, emotional and
spiritual) could be measured by Quality Adjusted Life
Years (QALYs). dr/Dalia Ahmed Mohamed
dr/Dalia Ahmed Mohamed
 Fertility Statistics
• The following indicators are used in
measurement of fertility in the community.
Those indicators are used also to evaluate
the effectiveness (impact) of family planning
program. Fertility indicators include:
• 1. Crude Birth Rate (CBR)
• 2. General Fertility Rate (GFR)
• 3. Fecundity Rate (FR)
• 4. Age Specific Fertility Rate (ASFR)
• 5. Total Fertility Rate (TFR)
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 Fertility Statistics
• For the first three indicators: The sources of
data are the vital statistics on births and
demographic data on total population and
number of females in the reproductive age.
Those data are collected from health offices
all over the country.
• For the other two indicators: The sources of
data are community-based surveys

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 1-Crude Birth Rate (CBR):
• Crude Birth Rate is the number of live births per 1000
population in certain year and locality.
• CBR= Number of LBs in a certain year and locality X1000
Mid Year Population in the same year and locality
• The CBR in Egypt year 2004 is 25.8 per thousand
populations.
• CBR, as most annual rates, relates demographic
events to the population at midyear (the population in
July 1st.), which is considered to be the average
population at risk during the year.
dr/Dalia Ahmed Mohamed
 1-Crude Birth Rate (CBR):

 CBR is less sensitive indicator for

measurement of fertility and to compare
between countries, because it relates births to
the midyear population, with no consideration
to the age and sex structure of the population.
 This indicator has the advantages of
being one of the vital statistics indicators,
where the well-established information
system provides the most updated data.

dr/Dalia Ahmed Mohamed

 2- General Fertility Rate
(GFR):
 GFR is the number of live births per 1000
females aged 15-49 years in a given year and
locality.

• G FR = No. of live births in a certain year and locality X 1000

No. of females aged 15-49 years in the same year and locality •

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 2- General Fertility Rate
 GFR in Egypt year 2005 is 108 births /1000
females in the child bearing age.
 The GFR is much more indicative of changes in
fertility than is the crude birth rate because it relates
births more nearly to the age-sex group at-risk of
giving birth (i.e. women 15-49 years of age). This
eliminates distortions that might arise because of
different age and sex distribution in a total population.
 Egypt 2005 data showed that Females in the
Reproductive Age constitute 25% of the total
population. The GFR is estimated to be 4 times the
CBR
• GFR does not consider whether those females are
married or not. dr/Dalia Ahmed Mohamed
 Fecundity Rate (FR):
∀ • FR = No. of LBs in a certain year and locality X 1000
No. of married WRA in the same year and locality

• Studies in Egypt showed that MWRA

constitute 16.7% of the total population
(about one sixth of the population). The
FR is estimated to be 6 times the CBR

dr/Dalia Ahmed Mohamed

 Fecundity Rate (FR):

• Fecundity rate is a more sensitive fertility

indicator than the GFR, because it relates
births to Married Women in the Reproductive
Age (MWRA).
• Both the GFR and FR do not consider the
fertility capacity within the reproductive period
(15-49 years of age). Young women have
higher fertility capacity than the very young
and the older women within the reproductive
period
dr/Dalia Ahmed Mohamed
 4- Age Specific Fertility
Rate (ASFR):
• ASFR is the number of live births to women in
specific age interval (usually 5 years) per
1000 females in the same age interval, in a
certain year and locality
Example: ASFR for women aged 20-24 =
No. LBs to WRA 20-24 years in a certain year and locality X 1000
Number of females aged 20-24 years in the same year and locality

dr/Dalia Ahmed Mohamed

 Age Specific Fertility
ASFR is more sensitive indicator for measurement
of fertility for the females in the different age
groups within the reproductive period.
ASFR is used to calculate the Total Fertility Rate.
Data derived from the Demographic and Health
Survey provides information about ASFR.
ASFR identify the specific age group, who needs
more efforts for family planning program.
ASFR assess the magnitude of the problem of at-
risk pregnancies (Teen age and after 35 years old
ASFR).
dr/Dalia Ahmed Mohamed
5- Total Fertility Rate (TFR):
∀ • TFR is the average number of children that
would born alive to a woman during her
reproductive life, if she pass through all her
childbearing years, conforming to the age-
specific fertility rates of a given year.
∀ • For comparison between countries, TFR is
used because it is standardized for age and
the age structure of the individual countries.
∀ • Calculation of TFR: TFR could also be
calculated by multiplying the ASFR for each
group (5-year age group) by 5, then adding
the seven group together (see the table 4.1).
dr/Dalia Ahmed Mohamed
Table (4.1) Age Specific Fertility Rates (ASFR) and
Total Fertility Rates (TFR) in Egypt, 2005 (EDHS
2005).

TFR, 2005 ASFR, 2005 Age Groups

240 48 15-19
875 175 20-24
970 194 25-29
625 125 30-34
315 63 35-39
95 19 40-44
10 2 45-49
3130 Total fertility / 1000 Women
3.1 Total Fertility/Woman
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dr/Dalia Ahmed Mohamed