Day4 Tutorial 1 Edited cm tutorial for test.pptx
- 2. 2 What is health ? WHO definition:- Health is a complete physical, mental & social well- being and not merely an absence of disease or infirmity. In recent years, this statement has been amplified to include the ability to lead a “socially and economically productive life”.
- 3. 3 Determinants of health • Biological • Behavioral & Socio-cultural coditions • Environmental • Socio-Economic Conditions • Health Services • Ageing of the population • Gender • Human Rights • Equity & social justice • Science & Technology • Information & Communication
- 4. 4 Dimensions of health • Physical • Mental • Social • Spiritual • Emotional • Vocational • Others
- 6. 6
- 7. 7 Not shown by • Measles • Tetanus • Rubella • Pertusis • Rabies
- 8. 8 EPIDEMIOLOGY • The study of the occurrence and distribution of health-related events, states, and processes in specified populations, including the study of the determinants influencing such processes, and the application of this knowledge to control relevant health problems
- 9. 9 Epidemiological Triad: Agent Host Env Factors
- 11. 11 Components of epidemiology: • Disease frequency • Distribution-Time, Place, Person • Determinants-Eg.-Lung cancer, CVD
- 12. 12 Tools of Measurement in epidemiology: • Rate-Numerator, Denominator, Time specification & Multiplier • Ratio-Numerator is not a component of the denominator • Proportion- is a ratio that indicates the relation in the magnitude of a part of the whole. The numerator is always included in the denominator
- 13. 13 Incidence • The Number of new cases occurring in a defined population during a specified period of time • I=No. of new cases of specified ds. during a given time period/Population during that period×1000 Prevalence • A Total number of individuals who have an attribute or disease at a particular time(or during a particular period) divided by the population at risk of having the attribute or disease at this point of time or midway through the period
- 14. 14 Endemic, Epidemic,Pandemic • Endemic: constant presence of disease or infectious agent within a given geographic area or population group without importation from outside • Epidemic: The occurrence in a community or region of cases of an illness, specific health-related behaviour, or other health –related events clearly in excess of normal expectancy • Pandemic: An epidemic occurring over a very wide area, crossing international boundaries, and usually affecting a large number of people
- 15. 15 Modes of transmission: Direct • Direct contact • Droplet infection • Contact with soil • Inoculation into skin or mucosa • Transplacental Indirect • Vehicle borne • Vector borne-Mechanical, Biological • Air borne-Droplet nuclei, Dust • Fomite Borne • Unclean hands and fingers
- 16. 16 Carrier & Types of carrier: • An infected person or animal that harbors a specific infectious agent without discernible clinical disease and serves as a potential source of infection for others. • By Type: Incubatory Carriers, Convalescent Carriers, Healthy Carrier • By Duration: Temporary,Chronic
- 17. 17 Incubation Period: • The time interval between invasion by an infectious agent and the appearance of the 1st sign or symptom of the disease in question
- 18. 18 Levels of prevention Natural history of disease
- 19. 19 • Primordial- before the emergence of risk factors Health education • Primary- risk factor present but no disease prevention in pre pathogenesis stage Health promotion & Specific protection • Secondary- disease started pathogenesis phase Early Dx and T/t • Tertiary- Diseases in progress/over Disability limitation, Rehab
- 20. 20
- 21. 21 Attack rate & Secondary attack Rate & Case fatality rate : • Attack Rate: No. of new cases of a specified ds. during a specified time interval/Total population at risk during the same interval×100 • SAR: No. of exposed persons developing the disease within the range of incubation period following exposure to a primary case • Case fatality rate: No.of deaths from a specified disease during a specified time period /no, of cases of the disease during the same time period×100
- 22. 22 PQLI & HDI
- 23. 23 • PQLI :- Physical quality of life index (1-100)= India 77.67(rank 117/193) 1. Literacy rate 2. Infant mortality rate 3. Life expectancy @1 yr of age • HDI:- Human development Index (0-1)= India 0.644 (rank 134/ 193) 1. Mean years of schooling/Education index/ Enrollment ratio 2. Purchasing power parity/ income per capita 3. Life expectancy @birth Highest PQLI state Lowest PQLI state Odisha? Highest HDI state Lowest HDI state Odisha?
- 24. 24 Mortality Indicators Crude death rate Life expectancy MMR (rate/ratio) IMR Under 5 Mortality rate Age-specific death rate Case fatality rate
- 25. 25 Morbidity Indicators Incidence Prevalence Notification rate Admission rate Discharge rate
- 26. 26 Disability Rates Event type ( No of days restricted/ Bed disability days/ work loss days) Person type ( Limitation of mobility/ Limitation of activity) DALE QALY DALY=(YLL+YLD)
- 27. 27 SDG
- 28. 28 Health specific goal • SDG3 – Good Health & well being ; Ensure healthy lives & promote well being for all at all ages
- 29. 29 Disease Control: • Reduction In transmission to such a low level that it stops to be public health concern • Reduction in INCIDENCE DURATION FINANCIAL BURDEN COMPLICATIONS
- 30. 30 ELIMINATION • Complete interruption of transmission but organism still present • Regional/ country term • Guinea worm 2000 • Leprosy 2005 • MT, NT 2016 • Yaws 2016
- 31. 31 ERADICATION • Complete extermination of organism • Global term • All or none phenomenon • Small pox 8th may 1980 • Polio virus Type2 20th sept 2015 • Rinderpest (cattle disease)
- 32. 32 Monitoring vs Surveilance • Monitoring- analysis of performance of routine measurement • Surveillance – ongoing systematic process of all factors affecting a disease ( data collection, compilation, compilation, analysis and interpretation and its application)
- 33. 33 • Monitoring • Continuous overlooking progress of health activity • No inbuilt action component • No feedback • One time linear process • Smaller concept • Surveillance • Continuous scrutiny of all factors affecting a disease with attention, authority & suspicion • Inbuilt action component is present • • Feedback is inbuilt • Cyclical continuous process • Broader concept
- 34. 34 Sentinel Surveillance • Used to identify missed or hidden cases • HIV- in blood bank, anti natal clinic, STD clinic • Identify both old and new cases
- 35. 35 Types of study design in epidemiology: Observational: • Descriptive: Case Report, Case Series, • Analytical: Cross-sectional, Cohort, Case-control, Ecological, Nested case-control Experimental/interventional • Randomized Control trials • Field trial • Community trial
- 36. 36 Blinding • A process where study participants are prevented from knowing certain information that may somehow influence them. • Single blind: participants • Double blind: Doctor & Study participants • Tripple blind: Investigator, participant, person analyzing data
- 37. 37 Randomization • Randomization is a statistical procedure by which the participants are allocated into groups usually called study and control groups, to receive or not to receive an experimental preventive or therapeutic procedure, manoeuvre, or intervention