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Epidemiology
The study of the distribution and determinants of health-related states of events in specified populations and the application of this study to the prevention and control of health problems (Last, 1988)
Epidemiology
The study utilizes concepts and methods form other fields of study such as biology, sociology, demography and environmental science and statistics.
Study
(Epidemiology)
surveillance, observation, research, and experiments
Distribution
(Epidemiology)
time, places, and groups of people affected
Determinants
(Epidemiology)
physical, biological, chemical, economic, genetic, and behavioral factors that affect health
Health-related States/Events
(Epidemiology)
disease, cause of death, lifestyle, and use of health services
Specified Populations
(Epidemiology)
Identifiable characteristics (e.g. Occupational hazards)
Application to Prevention and Control
(Epidemiology)
Address the aim of public health: to promote, to protect, and restore health
Epidemiologist
A person who studies epidemiology
Public Health Surveillance
The ongoing systematic collection, analysis, and interpretation of health related-data needed for the planning, implementation, and evaluation of public health practice
Public Health Surveillance
HCW may take an active or passive role
Notifiable Disease Reporting System (NDRS)
Field Health Service Information System (FHSIS)
National Epidemiology Sentinel Surveillance System (NESSS)
Expanded Program on Immunization (EPI) Surveillance System
HIV-AIDS Registry
(5) Philippine Integrated Disease Surveillance and Response
Law on Reporting of Notifiable Disease
R.A. 3573
R.A. 3573
Law on Reporting of Notifiable Disease
R.A. 11332
R.A. 3573 was repealed with a new law ___ ___
"Mandatory Reporting of Notifiable Diseases and Health Events in Public Health Concern Act"
R.A. 11332
R.A. 11332
"Mandatory Reporting of Notifiable Diseases and Health Events in Public Health Concern Act"
Disease Outbreak
The occurrence of disease in excess of what would normally be expected in a defined community geographical area or season
Disease Outbreak
also considered a previously unknown disease
Assessment of the health system of the community
Elucidation of the natural history of disease
Determination of disease causation
Prevention and control of disease
Monitoring and evaluation of health intervention
Provision of evidence for policy formulation
(6) Practical application of Epidemiology
Multiple causation theory
Natural history of disease
Levels of prevention of health prevention
Concepts of causality and association
(4) Concepts in epidemiology
Multiple Causation Theory
(Concepts in Epidemiology)
Disease development does not rest on a single cause but rather results from multiple factors.
Ecologic Triad (Triad of Epidemiology)
(Concepts in Epidemiology: Multiple Causation Theory)
Models in disease causation
- most helpful to the nurse because it highlights not only the host’s and agent’s roles in disease development but also regards the role of environment as important in disease causation.
Agent
Host
Environment
(Concepts in Epidemiology: Multiple Causation Theory)
(3) Ecologic Triad (Triad of Epidemiology)
Agent
(Concepts in Epidemiology: Multiple Causation Theory - Ecologic Triad (Triad of Epidemiology))
Models in disease causation
- is any element, substance, force animate or inanimate which serve as a stimulus to initiate or perpetuate a disease process.
Agent
(Concepts in Epidemiology: Multiple Causation Theory - Ecologic Triad (Triad of Epidemiology))
Models in disease causation
- Biological
- Physical
- Chemical
- Mechanical
- Nutritive
Host
(Concepts in Epidemiology: Multiple Causation Theory - Ecologic Triad (Triad of Epidemiology))
Models in disease causation
- is any organism that harbors and provide nourishment for another organism
Host
(Concepts in Epidemiology: Multiple Causation Theory - Ecologic Triad (Triad of Epidemiology))
Models in disease causation
- Demographic characteristics
- General health status
- Body defenses
- State of immunity & immunological response
- Human behavior
Environment
(Concepts in Epidemiology: Multiple Causation Theory - Ecologic Triad (Triad of Epidemiology))
Models in disease causation
- the sum total of all external conditions and influences that affect the life and development of an organism
Physical
(Concepts in Epidemiology: Multiple Causation Theory - Ecologic Triad (Triad of Epidemiology))
Models in disease causation
- Environment
: inanimate surroundings such as the geophysical conditions and climate
Biological
(Concepts in Epidemiology: Multiple Causation Theory - Ecologic Triad (Triad of Epidemiology))
Models in disease causation
- Environment
: living things such as plants and animal life (vectors)
Socio-economic
(Concepts in Epidemiology: Multiple Causation Theory - Ecologic Triad (Triad of Epidemiology))
Models in disease causation
- Environment
: economic development, social disruptions
Iceberg Principle
(Concepts in Epidemiology: Multiple Causation Theory)
describe a situation in which a large percentage of a problem is subclinical, unreported, or otherwise hidden from view.
Web of Causation
(Concepts in Epidemiology: Multiple Causation Theory)
shows the relationship between different multiple factors that contribute to the cause of a disease
Natural History of Disease
(Concepts in Epidemiology)
Seeks to identify factors related to the course of a disease once established in order to determine its duration and the probability of recovery, death, or specific complications.
Natural History of Disease
(Concepts in Epidemiology)
Help the nurse and other people to implement measures to prevent pathologic processes to progress.
Pre-pathogenesis
Pathogenesis
(Concepts in Epidemiology)
(2) Natural History of Disease
Pre-pathogenesis
(Concepts in Epidemiology: Natural History of Disease)
the disease has not developed but factors that favor its occurrence are present.
Pathogenesis
(Concepts in Epidemiology: Natural History of Disease)
The disease that developed into:
- Pre-symptomatic disease or early pathogenesis
- Discernible lesions
- Advanced disease
Pre-symptomatic disease or early pathogenesis
Discernible lesions
Advanced disease
(Concepts in Epidemiology: Natural History of Disease)
(3) Pathogenesis
Pre-symptomatic disease or early pathogenesis
(Concepts in Epidemiology: Natural History of Disease - Pathogenesis)
individual has no symptoms that indicate the presence of illness but in fact, pathogenic changes have begun.
Discernible lesions
(Concepts in Epidemiology: Natural History of Disease - Pathogenesis)
changes may be detectable through sophisticated laboratory tests, during this period and the early signs & symptoms of diseases are developing.
Advanced disease
(Concepts in Epidemiology: Natural History of Disease - Pathogenesis)
anatomical or functional changes have produced recognizable signs & symptoms.
Prevention
(Concepts in Epidemiology)
___ refers to identification of potential problems so that the nurse can minimize or eradicate possible disability or deformity in a population at risk.
Primary Prevention
(Concepts in Epidemiology: Levels of Prevention of Health Problems)
activities directed to the healthy population, focusing on prevention of emergence of risk factors and removal or reduction of risk factors
Primary Prevention
(Concepts in Epidemiology: Levels of Prevention of Health Problems)
strengthen host resistance; interrupt the chain of infection
Primary Prevention
(Concepts in Epidemiology: Levels of Prevention of Health Problems)
surveillance, quarantine, segregation, isolation
Secondary Prevention
(Concepts in Epidemiology: Levels of Prevention of Health Problems)
aims to identify and treat existing health problems at the earliest possible time.
Secondary Prevention
(Concepts in Epidemiology: Levels of Prevention of Health Problems)
control or eradication of the health problem
Secondary Prevention
(Concepts in Epidemiology: Levels of Prevention of Health Problems)
screening, case finding, disease surveillance
Secondary Prevention
(Concepts in Epidemiology: Levels of Prevention of Health Problems)
prompt and appropriate treatment
Tertiary Prevention
(Concepts in Epidemiology: Levels of Prevention of Health Problems)
limits disability progression
Tertiary Prevention
(Concepts in Epidemiology: Levels of Prevention of Health Problems)
the nurse attempts to reduce the magnitude or severity of the residual effects of infectious diseases and non-infectious diseases.
Disease does not occur at random.
Disease has identifiable CAUSAL and PREVENTIVE factors
(Concepts in Epidemiology: Concept of Causality and Association)
(2) Premises
Cause of a disease
(Concepts in Epidemiology: Concept of Causality and Association)
any event, condition, characteristic or combination of these factors that play an important role in producing the disease.
Cause of a disease
(Concepts in Epidemiology: Concept of Causality and Association)
a cause must precede a disease and the ___ ___ ___ ___ must be necessary and sufficient for the occurrence of disease.
Necessary cause
(Concepts in Epidemiology: Concept of Causality and Association)
refers to the fact that the factor must be present for the disease to occur.
Sufficient cause
(Concepts in Epidemiology: Concept of Causality and Association)
indicates that if a factor is present, the disease can occur, but the factor’s presence does not always result in the disease occurrence.
Risk
(Concepts in Epidemiology: Concept of Causality and Association)
probability of an unfavorable event, disease, disability, defect or even death.
Risk
(Concepts in Epidemiology: Concept of Causality and Association)
must be identified and dealt with to prevent diseases.
Association
(Concepts in Epidemiology: Concept of Causality and Association)
concurrence of 2 variables under investigation and are often associated with each other
Predisposing factor
Enabling factor
Reinforcing factor
(3) Factors associated with increased risk of disease
Predisposing factor
(Factors associated with increased risk of disease)
any characteristic of an individual, a community or an environment that predisposes behavior or other conditions related to health.
Enabling Factor
(Factors associated with increased risk of disease)
any characteristic of an individual, group or the environment that facilitates or make possible a certain health behavior or other conditions affecting health.
Reinforcing factor
(Factors associated with increased risk of disease)
any reward or punishment or any feedback following or anticipated as a consequence of health behavior
1. No disease occurs by chance alone because each follows its own recognizable pattern of occurrence.
2. Health is a state of equilibrium, a delicate balance of many factors.
3. Disease causation is complex.
4. Infection is not synonymous with disease
5. Knowledge of the distribution of disease overtime is valuable to the nurse in the community.
6. An epidemic curve is merely a graphic display of disease onsets overtime, hours, days, or weeks.
(6) Principle in Epidemiology
1. Maintain surveillance of the occurrence of notifiable diseases.
2. Coordinate with other team members during an outbreak.
3. Participate in case finding and collection of lab specimen.
4. Isolate cases of communicable diseases.
5. Render or supervise nursing care.
6. Perform and teach household members methods of disinfection.
7. Conduct health teachings.
8. Follow-up cases.
9. Organize, coordinate, and conduct community health education campaign.
10. Refer cases when necessary.
11. Coordinate with other concerned community agencies.
12. Accomplish and keep records and reports and submit to proper office/agency.
(12) Functions of the Nurse in Epidemiology
Descriptive Epidemiology
Analytical Epidemiology
Interventional or Experimental Epidemiology
Evaluation Epidemiology
(4) Phases of Epidemiological Approach
Descriptive Epidemiology
(Phases of Epidemiological Approach)
aims to describe the occurrence of health conditions in the community in terms of the attributes of the people, pattern of disease and characteristics of the place when the disease appeared
Descriptive Epidemiology
(Phases of Epidemiological Approach)
concerned with disease distribution and frequency
Descriptive Epidemiology
(Phases of Epidemiological Approach)
Case finding and screening activities
Analytical Epidemiology
(Phases of Epidemiological Approach)
Attempts to identify the possible factors associated with disease occurrence.
Interventional or Experimental Epidemiology
(Phases of Epidemiological Approach)
aims to test effectiveness of intervention programs designed to prevent and control disease utilizing randomized controlled or clinical trials and field or community trials.
Evaluation Epidemiology
(Phases of Epidemiological Approach)
attempts to measure effectiveness of different health services and intervention programs
Epidemic
Endemic
Hyperendemic
Sporadic
Pandemic
Outbreak
Cluster
(7) Levels of Disease Occurrence
Epidemic
(Levels of Disease Occurrence)
occurs when the proportion of susceptible are high compared to the immunes; increase in disease incidence
Endemic
(Levels of Disease Occurrence)
occurrence of disease that implies habitual presence of disease in a given geographic location
Hyperendemic
(Levels of Disease Occurrence)
occurrence of disease that implies habitual presence of disease in a given geographic location
Sporadic
(Levels of Disease Occurrence)
disease occur every now and then affecting a small number of people relative to the population
Pandemic
(Levels of Disease Occurrence)
global occurrence of a disease affecting several countries or continent
Outbreak
(Levels of Disease Occurrence)
The occurrence of disease in excess of what would normally be expected in a defined community geographical area or season (WHO)
Outbreak
(Levels of Disease Occurrence)
also considered in a previously unknown disease
Cluster
(Levels of Disease Occurrence)
refers to an aggregation of cases grouped in place in time that are suspected to be greater than the number expected
Herd immunity
Exposure or Contact Rate
Chance
(3) Determining characteristics of the community and population
Herd Immunity
(Determining characteristics of the community and population)
represents the immunity and susceptibility levels of the population
Herd Immunity
(Determining characteristics of the community and population)
occurs when a high percentage of the community is immune to a disease (through vaccination and/or prior illness), making the spread of this disease from person to person unlikely.
Exposure or Contact Rate
(Determining characteristics of the community and population)
represents opportunities for progressive transfer or transmission of an infectious agent to a susceptible host
Exposure or Contact Rate
(Determining characteristics of the community and population)
depends on the frequency of contact and facility of transmission.
Chance
(Determining characteristics of the community and population)
is the probability pf contact between the source of infection and the susceptible host