HIMI, JOSBySaleh AhmedSchool of Midwifery, Bauchi
Epidemiology and Community health are twoinseparable words in public health system. Thisis because they deal with prevention of disease,promotion of health and efficiency throughorganized community efforts. Epidemiologydeals with the frequencies and types ofillnesses and injuries that affect populationwhile community health deals with the servicesthat aim at protecting the health of thecommunity.
The knowledge of pattern, distribution andfrequencies of diseases and how it effects thecommunity is the major concern of every healthorganization. In fact, the success ofepidemiology and community health activitiesrely greatly on effective transfer of informationfrom health professional to general public.Thus health information management is themost veritable tool for the achievement of thedesired goals of health for all.
At the end of this presentation participants willbe able to:- Explain the terms epidemiology andcommunity health. State the uses of epidemiology Describe epidemiological tools ofmeasurements. Describe community health.
Definition The word epidemiology is derived from Greekterms- “epi”-upon, among, “demos” –people,district, “logos” –study, word, discourse. Epidemiology literally is the study ofsomething that affects population. Jekel, Elmore and Katz (1996) definedepidemiology as the study of factors thatdetermine the occurrence and distribution ofdisease in a population
Onwasigwe (2004) views epidemiology as thestudy of the causes, distribution, determinantsand deterrent of diseases, injuries and otherhealth related condition in human population. Epidemiology deals with the frequencies andtypes of illnesses and injuries in group ofpeople and with factors that influence theirdistribution. In summary, epidemiology is the study offactors that affect health of population
Epidemiology therefore serves as a A) cornerstone of methodology of public healthresearch B) evidenced based medicine C) means of identifying risk factors for diseasesand determining optimal treatment approachesto clinical practice.
It is used in:- i) studying the history of diseases inpopulation in terms of profile, time & trends. ii) determining the most common causes ofdeath, diseases and disability. iii) community diagnosis in terms of morbidity,and mortality rates and ratio. iv) determining the effective control method ofdisease when known.
v) provision of data for proper planning andevaluation of health services vi) identifying deficiencies in ongoingprograms vii) identifying the priority areas for medicalresearch
Epidemics – the occurrence of the disease orgroups of illnesses of similar nature clearly inexcess of the expected rate for the place andtime. Pandemic –an epidemic usually affecting alarge proportion of the populations occurringover a wide geographic area.
-Endemic – this refers to the constantpresence of a disease or infectious agentwithin a given geographic area orpopulation group.Sporadic – it the scattered about diseasewith cases occurring irregular,haphazardly from time to time andgenerally infrequently.Exotic- disease imported into a country ,malaria in united kingdom.
There are various ways of grouping epidemiology,a) Based on what it studied:- Classical epidemiology –it studies the communityorigins of health problems particularly thoserelated to nutrition, environment, human behavior,and psychologic, social, and spiritual state ofpopulation. Its aim is to discover risk factors. Clinical epidemiology – it studies patients inhealth care settings in order to improve diagnosisand treatment of various diseases and theprognosis of patients already affected.(jekel,1996)
B) Based on the steps in investigation and control.According to onwasigwe (2004) there are :-1)Descriptive epidemiology:- it studies the amountand distribution of disease within population byperson, place and time. It is carried out todetermine the frequency of disease, the kind ofpeople suffering from it and where it occurs. Itmakes use of routinely collected data such ashospital data. Its study answers these questions i) who are affected- ie the person(age,sex,race,marital status,etc)
Ii) where do the cases occur:-ie theplace(rural,urban,altitude,humidity,rainfall) Iii) when do these cases occur :-ie time(monthly or annually ,secular trends-long termvariation or cyclic changes –recurrentalterations in the frequency from annual orperiodic)
2) Analytical epidemiology :-this study is carriedout to draw logical conclusion. The study isused to determine why the rate is high or lowin a particular group. Analytical studies arehypothesis-testing studies used to verify thehypotheses.It is different from descriptive studies because itstudies individuals within a population not theentire population.
Analytical studies involve two types ofobservation studies – A) case control study B) cohort studyCase control study –known as retrospectivestudies which is used to estimate cause-effectrelationship between a suspected risk factorand a disease. In this study people diagnosedof having a disease(cases) are compared withthose that do not have the disease(control).
Cohort – is a group of persons at risk whoshare common characteristics or experiencewithin a defined period of time. Cohort study –this is a prospective study,incidence study and forward looking studywhich aims at obtaining additional evidence tosupport or reject the existence of an associationbetween suspected risk factor or cause anddisease
Sensitivity and specificity – for screening.Rates – to quantify disease-relative risk and odd ratio –to evaluateassociation between factors and disease
This is the prerequisites for infection occurrence Agent Reservoir (man, animals) Route of exit from the reservoir Channel of transmission-(air, water, formites) Pathogen’s capacity for survival Routes of entry (respiratory route,mouth) Host susceptibility-(mechanical protection of skinand chemical, inflammatory response,immunity)
Provide basic knowledge of disease trends anddistribution, causes and contributing factors. For planning health programmes egprocurement drugs Advocacy Research Monitoring and evaluation.
This is made up of two words- community andhealth. Community:-is a group of individuals who arebound in time and space, dependent on eachother and having common goals. Health –According to WHO in 1986 health isdefined as the extent to which an individual orgroup is able, on the one hand to realizeaspirations and satisfy needs and on the otherhand to change or cope with the environment.
Community health is simply referred to as thehealth status of group of people and the actionsand conditions to promote, protect andpreserve their health. However, park (2004), defined communityhealth as the health status of the members ofcommunity, and the problems affecting theirhealth as well as the totality of health careprovided to the community.
In broader sense community health impliesintegration of curative, preventive andpromotive health services rendered toindividual living in the same location. The emphasis of community health is centredon two things namely:, community diagnosisand community treatment. This therefore implies that the entirecommunity is regarded as patient requiringdiagnosis and treatment.
Community health activities are activities thatare aimed at protecting and improving thehealth of a population or community. These are as follows:- Maintenance of accurate birth and deathrecords. Protection of food and water supply. Maintenance of environmental sanitation –including vector control and personal healthcare.
Immunization Health education e.g. on healthy styles ofliving. Community diagnosis by surveying andmonitoring community health needs andassessing the impact of intervention