Prof.DR.Dr.Soeharyo Hadisaputro, Sp.PD.

K-PTI, FINASIM
FINAL DEVELOPMENT OF
EPIDEMIOLOGY DEFINITION
Originally, epidemiology was concerned with
epidemics of communicable diseases.
More recently, epidemiologic methods have
been applied to chronic diseases, injuries,
violence, birth defects, maternal-child
health, occupational health, environmental
health, disaster, family planning, etc.

FINAL DEVELOPMENT OF
EPIDEMIOLOGY DEFINITION
Greek words : epi (upon) and Demos
(people); logos = science.
Last (1988) :
Includes of the application of this
study to the control of health problems.
Epidemiolgy is often referred to as the
basic science of public health.

Theories of Disease
Causation
Supernatural Theories
Hippocratic Theory
Miasma
Theory of Contagion
Germ Theory (cause shown via
Henle-Koch postulates)
Classic Epidemiologic Theory
Multicausality and Webs of
Causation (cause shown via Hills
postulates)
SENIOR EPIDEMIOLOGIST
IN THE WORLD

(1) ANTONIO V.LEUWENHOEK (1632)
(2) ROBERT KOCH (1882)
(3) MAX VAN PATTERNKOFER
(4) JOHN SNOW (1854)
(5) PERVICAL POTT
(6) JAMES LIND (1747)
(7) DOLL and HILL
Dr. John Snow (1813-1858)
PUBLIC HEALTH (Winslow,
1920)
Public Health is the science and art of (1)
preventing disease, (2) prolonging of life, and (3)
promoting of health and efficiency through
organized community effort for (a) the sanitation of
the environment (b) the control of communicable
infections the education of the individual in
personal hygiene (d) the organization of medical
and nursing service for the early diagnosis and
preventive treatment of disease (e) the development
of the social of living adequate for the maintenance
of health, so organizing these benefits and enable
every citizen to realize his birthright of health and
longevity.

JENIS TENAGA KESEHATAN
(kemampuan epidemiologi)
1) EPID Orientasi manager ? (mengerti
konsep-2 epid umum & bagaimana
menggunakannya)
2) EPID Profesional ? (epid deskriptif, epid
analitik, prinsip-2 epid & familier thd peny,
masalah kes & desain epid)
3) EPID Orientasi paramedik (petugas
kesehatan terkait- koleksi dan organisasi data
rutin)
PERAN EPIDEMIOLOGI DALAM
PELAYANAN KESEHATAN
1) Pencegahan & Pengendalian peny. (Metoda
mencari sebab)
2) Mendiagnosis & mengukur kebutuhan yad.
3) Perubahan perawatan
4) Merencanakan kegiatan
5) Menganalisis status demografi, statistik rutin
(morbiditas & mortalitas)
6) Menentukan kecenderungan epidemiologik
(surveilens, LAM dll)

THE RELATION BETWEEN EPIDEMIOLOGY
AND CLINICAL MEDICINE

POPULATION INDIVIDUALS
---------------------- ----------------
Studies/Assesment Diagnosis

Prevention Treatment

Evaluation Curing

Planning Caring

HIRSCH (1883) :
Epidemiologi adalah suatu
gambaran kejadian,
penyebaran dari jenis-jenis
penyakit pada manusia, pd
saat tertentu di bumi dan
kaitannya dgn kondisi
eksternal.


PERKEMBANGAN DEFINISI
EPIDEMIOLOGI (1)

GREENWOOD (1934) :
Epidemiologi adalah suatu ilmu
tentang penyakit dan segala macam
kejadian.
W.HAMPTON FROST (1972) :
Epidemiologi adalah pengetahuan
tentang berbagai fenomena (mass
phenomen) penyakit infeksi atau
sebagai riwayat alamiah penyakit
(natural history of disease.


PERKEMBANGAN DEFINISI
EPIDEMIOLOGI (2)

MAC MAHON (1970) :
Epidemiologi adalah studi tentang
penyebaran dan penyebab frekuensi
penyakit pada manusia dan menga
pa terjadi distribusi semacam itu.

R.MORTON, JR.HEBEL :
Epidemiology is the study of the
distribution and determinant of
diseases. We try to find out who gets
the disease and why.

PERKEMBANGAN DEFINISI
EPIDEMIOLOGI (3)

ABDEL R.OMRAN (1970) :
Epidemiologi sebagai suatu ilmu
mengenai terjadinya dan distribusi
keadaan kesehatan, penyakit dan
perubahan pd pddk, begitu juga
determinannya serta akibat yg terjadi
pd kel. pddk.
ANDRES and S.NOREL (1989) :
EpidemiologI adalah ilmu
pengetahuan mengenai terjadinya
penyakit pada populasi manusia.


PERKEMBANGAN DEFINISI
EPIDEMIOLOGI (4)

L.H.ROHF and B.J.SELWYN
Epidemiology is the description
and explanation of the
differences in occurance of
events of medical concern in
subgroup of population, where
the population has been
subdivided according to some
characteristic according believed
to influence of the event.


PERKEMBANGAN DEFINISI
EPIDEMIOLOGI (5)

LILIENFELD (1977)
Epidemiologi adalah suatu
metode pemikiran tentang
penyakit yang berkaitan
dengan penilaian biologis dan
berasal dari pengamatan
suatu tingkat kesehatan
populasi.


PERKEMBANGAN DEFINISI
EPIDEMIOLOGI (6)

ELIZABETH BARRETT
Epidemiology is study of the
distribution and causes of diseases.

JS.MAUSNER, A.K.BAHN :
Epidemiology is concerned with the
extend and type of illness and injures
in groups of people and with the
factors which influence their
distribution.


PERKEMBANGAN DEFINISI
EPIDEMIOLOGI (7)


LAST (1988)
Epidemiology is study of the
distribution and determinants
of health-related states or
events is specified populations
and the application of this
study to control of problems.


PERKEMBANGAN DEFINISI
EPIDEMIOLOGI (8)

FINAL DEVELOPMENT OF
EPIDEMIOLOGY DEFINITION
The application of epidemiology to
study behaviors related to health and
well being is known as behavioral
epidemiology.
The applicationn of population based
information to decision making about
individual patients is often reffered to
as clinical epidemiology.


DIAGNOSIS :
(*) Clinical diagnosis strategies
(*) The clinical selection
(*) The selection of diagnostic test
(*) The interprataion of diagnostic data
(*) Early diagnosis.

MANAGEMENT :
(*) Making prognosis
(*) Deciding on the best therapy
(*) Deciding wether your treatment has done
harm.

AREA OF CLINICAL
EPIDEMIOLOGY
KEY CONCEPTS


Epidemiology is the study of the distribution and
determinants of diseases within human
populations.

Epidemiology can be used for descriptive
purposes, such as surveillance of the occurrence
(incidence) of a particular illness.

Epidemiology can be used for analytic purposes,
such as studying risk factors for disease
development.

KEY CONCEPTS



Epidemiologic methods can be used to assess the
performance of diagnostic test.

Epidemiology can be used to study the
progression or natural history of diseases.

Epidemiology methods can be used to study
prognostic factors, which are determinants of the
progression of a disease.

Epidemiology can be used to evaluate treatment
for a disease.

CONCEPT OF HEALTH STATUS
(1) THE TRADITIONAL (ECOLOGICAL) MODEL : (a)
Agent (b) Host Environment
(2) THE HEALTH FIELD CONCEPT (HL
Lamframboise, 1973) : (a) Environment (b) Life
style Biological (d) System of health service.
(3) THE ENVIRONMENT OF HEALTH (H.L.Blum,
1974; The Force field and wellbeing paradigms of
health) : (a) Environment (b) Behaviour (Life style)
Health service and (d) Heridity.
PSYCHO-
SOCIO-
SOMATIC
HEALTH
(well being)
H
E
R
E
D
I
T
Y
CULTURAL
SYSTEMS
POPULATION
Size distributin, growth rate
gene pool
NATURAL
RESOURCES
ENVIRONMENT
physical and
man made,
socio-cultural,
economic, education,
employment

HEALTH CARE SERVICES
prevention, cure,
rehabilitation
ECOLOGICAL
BALANCE
B
E
H
A
V
I
O
R
MENTAL HEALTH
Emotional satisfaction
Intelectual efficiency
adaptability