Epidemiological

Methods

Study of distribution and determinants of health related events and its

application to control health problems.
IMS BANGALORE

At the end of the session, you

will be able to

Enumerate two different types of epidemiological

methods .
To define descriptive epidemiology and describe
importance of time, place and person distribution.
Enumerate three kinds of time fluctuations in
disease occurrence.
To describe disease load in terms of prevalence and
incidence.
To differentiate cross sectional and longitudinal
studies.
To enumerate two used of descriptive epidemiology.

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Epidemiology: Definition
Dynamic study of the
Determinants
Occurrence
Distribution

Of health and disease in a population

Control
Pattern

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So, Epidemiology

Is the basic science of public health

Provides insight regarding the nature,

causes, and extent of health and disease

Provides information needed to plan and

target resources appropriately

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Epidemiology is a Quantitative
Discipline

Measures of frequency
Counts and rates

Measures of association
Relative risk
Odds ratio

Statistical inference
P-value
Confidence limits

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To Study disease
occurrence
Observational studies- Investigator only
measures. Does not interfere.
--Descriptive studies.
--Analytical studies .
Experimental studies. Also called
Interventional studies. Active attempt by
investigator.

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Kinds of Epidemiology
Descriptive
Analytic

Study of the occurrence and

distribution of disease

Further studies to determine the

validity of a hypothesis concerning
the occurrence of disease.

Experimental
Deliberate manipulation of the
cause is predictably followed
by an alteration in the effect
not due to chance
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Descriptive vs.Analytic
Epidemiology

Analytic

Descriptive

Used when little is

known about the
disease

Rely on
preexisting data

Who, where, when

Illustrates
potential
associations

Used when insight

about various
aspects of disease is
available

Rely on development
of new data

Why

Evaluates the
causality of
associations

Both are

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Observational studiesdescriptive
Observation on population or individual.
(dengue in gokula ).
Time distribution- When disease
occurring?
Place distribution- Where ?
Person Who is getting it ?

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Descriptive Epidemiology

1. Defining population-Whole population in a

geographic area, or representative
population. Should be large enough. Age,
sex, occupation and other information. Also
called Population at Risk. Framingham
study !

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Descriptive Epidemiology

2. Disease under study-Precise with validity.

Well defined diagnostic method acceptable
to the population. If not defined precisely, it
leads to errors.
Operational definition of the disease. Once
accepted, it cannot be changed.
Example- Dengue.

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Descriptive -Time
distribution
Disease is seasonal, ? Periodic fluctuation ?
Short term fluctuation
EPIDEMIC .-Occurrence in a community of
illness or event clearly in excess of normal
expectancy.
Periodic fluctuation
Long term trends

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Endemic, Epidemic and Pandemic

Endemic - The habitual presence (or usual occurrence) of a

disease within a given geographic area
Epidemic - The occurrence of an infectious disease clearly
in excess of normal expectancy, and generated from a
common or propagated source
Pandemic - A worldwide epidemic affecting an
exceptionally high proportion of the global population

Number
of Cases
of
Disease

Time

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Types of epidemics

Common source epidemic- 1.Point

source- brief exposure, epidemic is severe,
all case in one incubation period. Food
poisoning.
2. Continuous or repeated
exposure- Gonorrhea, respiratory infection,
water contamination.

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Types of epidemics- Propagated

epidemics
Infectious, Person to person.
Gradual rise, fall over a long period.
Long term transmission. Herd immunity ?

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Periodic fluctuations
Seasonal trend, -Measles, URTI, Diarrhea,.
Cyclic trend- Influenza (H1N1).

Long term trends- CVD, Tuberculosis,

NIDDM.

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Place distribution.
Geographical variation- environment, diet,
etc.
International variation- Ca stomach (Japan Vs
USA ) , Ca Oral cavity (India )
National variation Malaria Sabah ,
Sarawak. Filariasis- Perak, Sabah.
Migration studies- Tuberculosis among
migrants in Malaysia.

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Person
Age
Hobbies
Sex
Pets
Occupation
Travel
Immunization status Personal Habits
Underlying disease
Stress
Medication
Family unit
Nutritional status
School
Socioeconomic factors Genetics
Crowding
Religion
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Measurement of disease
Disease load in a population.
Mortality, Morbidity, Disability .
Morbidity- Incidence, Prevalence.
Prevalence- All current cases existing at a
given point of time in a given population.
Incidence- Number of NEW cases occurring
in a defined population during a specific
time.
How to measure ?
Hypothesis.

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Measures

Morbidity: Refers to the presence of disease

in a population

Mortality: Refers to the occurrence of death

in a population

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Prevalence vs. Incidence

Prevalence is the number of existing

cases of disease in the population during a
defined period.

Incidence is the number of new cases of

disease that develop in the population
during a defined period.

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Prevalence
Prevalence: The number of existing cases in
the population during a given time period.
PR = # existing cases during time period
population at same point in time
Prevalence rates are often expressed as a
percentage.

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Incidence Rates

Population denominator:
IR = # new cases during time period X K
specified population at risk

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Example (Incidence Rate)

During a six-month time period, a total of 53
nosocomial infections were recorded by an
infection control nurse at a community
hospital. During this time, there were 832
patients with a total of 1,290 patient days.
What is the rate of nosocomial infections
per 100 patient days?
53 X 100
4.1 infections per
IR =
=
100 pt. days
1,290 pt. days

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What is a hypothesis?

An educated guess

an unproven idea

based on observation or reasoning, that can

be proven or disproven through
investigation.

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Studies

Cross sectionalSingle examination

of a cross section
of population.
Prevalence study.

Longitudinal
Repeated
observation in the
same population.
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Uses of Descriptive
Epidemiology
trends in health and disease and allow
comparisons among countries and
subgroups within countries
Provides clue to disease etiology.
provides a basis for planning, provision
and evaluation of services
identifies problems to be studied by
analytic methods (?)and to test
hypotheses related to those problems

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IMS BANGALORE

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. Circle the most appropriate explanation on Prevalence rate:

a. the number of patients who have the disease at a particular
time, divided by the population at risk of having the disease at
that time.
b. the number of new cases of a diseased in a population over a
period of time.
c. not useful for developing HIV/AIDS control programme.
d. useful for developing Avian flu control programme.
e. not useful for any disease control programme.

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Questions

What is Epidemic ?

What is endemic ?

What is pandemic ?

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Following are steps in

Descriptive studies
1.
2.
3.
4.
5.

Define population
Define the disease
Randomized trial
Measurement of a disease.
Formulate an hypothesis.

drpatki@gmail.com

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