EPIDEMIOLOGY

1. Advance nursing seminar
On “epidemiology”
PRESENTED BY: ANGELA.V.RAI

3. STATISTICS OF DIABETES IN INDIA
• According to statistics from the International
Diabetes Federation (IDF), India has more
diabetics than any other nation of the world.
Current estimates peg the number of diabetics in
the country at about 62 million – an increase of
over 10 million from 2011 when estimates
suggested that about 50.8 million people in the
country were suffering from the disease. If you
think the disease has already reached endemic
proportions in the country, consider this. By the
year 2030, over 100 million people in India are
likely to suffer from diabetes, say researchers.

4. NATIONAL TB STATISTICS FOR INDIA
• India is the country with the highest burden of TB. The World
Health Organisation (WHO) TB statistics for India for 2015
give an estimated incidence figure of 2.2 million cases of TB
for India out of a global incidence of 9.6 million. The TB
incidence for India is the number of new cases of active TB
disease in India during a certain time period (usually a year).
• The estimated TB prevalence figure for 2015 is given as 2.5
million. The TB prevalence is the number of people in India
who are living with active TB. Prevalence is usually, but not
always given as a percentage of the population.
• It is estimated that about 40% of the Indian population is
infected with TB bacteria, the vast majority of whom have
latent TB rather than TB disease.

5. GENERAL OBJECTIVE:
•After completion of seminar the
students will be able to gain
knowledge about epidemiology and
utilize it in their day to day practice at
various level of nursing
administration, nursing education,
nursing research and community
health.

6. SPECIFIC OBJECTIVES:
• At the end of the seminar the students
will be able to:
• Illustrate the history of epidemiology.
• Define epidemiology.
• Explain scope of epidemiology.
• Select the epidemiology approach.
• Explain aim of epidemiology.

7. •Describe the measurement in
epidemiology.
•Enlist the tools of measurement.
•Indicate the measurement of morbidity.
•Indicate the measurement of mortality.
•Describe methods of epidemiology
studies.
•Explain the concept of disease
causation.

8. •Discuss theories and models of disease
of causation.
•Identify the screening for diseases.
•Explain aims and objectives of screening.
•Enlist the criteria for screening.
•List down the screening test.
•Explain about the role of nurse in
epidemiology.
•Discuss evidence based nursing practice
related to epidemiology.

9. INTRODUCTION:
• Epidemiology, literally means “the
study of what is upon the people”, is
derived from Greek word epi,meaning
“ upon or among ’’ ,demos, meaning
“people or district”, and logos,
meaning “study word discourse”,
suggesting that it applies only to
human populations.

11. DEFINITION:
•In 1983 a committee representing the
international epidemiology
association defined epidemiology as
“the study of the distribution and
determinants of health-related states
or events in specified populations,
and the application of this study to
control of health problems.”

13. EPIDEMIOLOGICAL APPROACH
1. Asking questions

14. 2.Making comparisons

15. AIMS OF EPIDEMIOLOGY:
The main aims of the epidemiology as
laid down by international
epidemiological association (IEA) are
given here.
• To described the distribution and
magnitude ( degree of size) of health
and disease problems among individuals
and groups (human population)

16. •To identify the etiology factors (risk
factors) of disease
•To provide data for planning,
implementation and evaluation of
services for the prevention, control and
treatment of disease and in setting up
of priorities among those services

17. MEASUREMENTS IN EPIDEMIOLOGY:
• Measurement of mortality
•Measurement of morbidity
• Measurement of disability
•Measurement of natality
• Measurement of the presence ,
absence or distribution of the
characteristic or attributes of the
disease

18. • Measurement of medical needs, health
care facilities , utilization of health
services and other health-related
events.
• Measurement of the presence, absence
or distribution of the environmental and
other factors suspected of causing the
disease.
•Measurement of demographic variables.

19. TOOLS FOR MEASUREMENTS:
The basic tools for measurements in
epidemiology are:
Rates
Ratios
Proportions

20. 1.MEASUREMENT OF MORBIDITY:
•Morbidity has been defines as “any
departure subjective or objective, from a
state of physiological well being’’. The
term is used equivalent to terms such as
sickness, illness, disability etc.

21. INCIDENCE :
• Incidence rate is defined as “the number
of new cases occurring in a defined
population during a specified period of
time”.
PREVALENCE:
The term disease prevalence refers
specifically to all current cases (old and
new) existing at a given point in time, or
over a period of time in a given
population. Prevalence is of two types

22. Prevalence is of two types:
-Point prevalence
-Period prevalence

23. MEASUREMENT OF MORTALITY:
-Crude death rate
-Specific death rate
-Case fatality rate ( ratio )
-Proportional mortality rate (ratio)
-Survival rate
-Adjusted or standardized rates

24. METHODS OF EPIDEMIOLOGY
STUDIES:
Epidemiologists employ three different
methods or approaches for
epidemiology studies which are:
• Descriptive method
• Analytical method
• Experimental method

25. A. DESCRIPTIVE METHOD
There are two different designs to
conduct descriptive studies in
epidemiology.
1. CROSS-SECTIONAL STUDIES
AND
2. LONGITUDINAL STUDIES.

26. B.ANALYTICAL METHOD
Analytical studies are more specific in
focus, test hypothesis and attempt to
determine casual factors of disease.
Analytical studies are of two types:
1. CASE CONTROL STUDY :
2. COHORT STUDY :

27. Cohort studies can be designed in three
different ways. These are:
•Prospective cohort.
•Retrospective cohort.
•A combination of retrospective and
prospective cohort.

28. B EXPERIMENTAL METHOD

29. CONCEPT OF DISEASE CAUSATION:
Disease as 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.
– WEBSTER

30. THEORIES AND MODELS OF
DISEASE CAUSATION:
SUPERNATURAL THEORY
THE GERM THEORY
THEORY OF EPIDEMIOLOGY TRIAD
MULTIFACTORIAL CAUSATION
THEORY
DEVER’S EPIDEMIOLOGY MODEL

31. NATURAL HISTORY OF DISEASE:
1. Prepathogenesis phase:
2. Pathogenesis phase:

32. SCREENING FOR DISEASES:
Screening is defined as the search for
unrecognized disease or defect by
means of rapidly applied tests,
examinations or other procedures in
apparently healthy individuals.
Screening differs from periodic health
examinations in the following aspects:
• Capable of wide application
• Relatively inexpensive
• Requires little physician time

33. • SCREENING is testing for infection for
infection or disease in population or in
individuals who are not seeking health care.
• CASE-FINDING is the use of clinical and
laboratory tests to detect disease in
individuals seeking health care for other
reasons.
• DIAGNOSTIC TEST is defined as the use of
clinical or laboratory procedures to confirm
the existence of disease in patients with
signs and symptoms presumed to be caused
by the disease.

34. AIMS AND OBJECTIVES OF
SCREENING:
• To sort out from a large group
apparently healthy persons likely to
have the disease.
• To bring those who are apparently
abnormal under medical supervision
and treatment.

35. • USES OF SCREENING :
• Case detection:
• Control of disease :
• Research purposes :
• Educational opportunities :

36. TYPES OF SCREENING:
1. Mass screening
2. High risk or selective screening
3. Multiphase screening

37. CRITERIA FOR SCREENING :
•The criteria for screening are based on
two considerations: “The DISEASE to
be screened and the TEST to be
applied.”

38. SCREENING TEST
The test must satisfy the criteria of :
•ACCEPTABILITY
• REPEATABILITY
• VALIDITY

39. EVALUATION OF SCREENING
PROGRAMMES:
•Randomized controlled trials
•Uncontrolled trials
•Other methods

40. CONCLUSION:
-Epidemiology is concerned with the
distribution and determinants of health
and diseases, morbidity, injuries,
disability and mortality in population.
-Epidemiology knowledge can be
applied to prevent the occurrence of
new cases of disease, eradicate
existing cases, and prolongs the lives
of people with disease.

41. BIBLIOGRAPHY