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P3- COMMUNITY HEALTH > EPIDEMIOLOGY > Flashcards

EPIDEMIOLOGY Flashcards

(103 cards)

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1
Q

Who is credited as the first epidemiologist ?

A

Hippocrates

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2
Q

Who introduced the term “epidemic” “Endemic”

A

Hippocrates

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3
Q

Who was the first to quantify birth , death, and disease occurrence ?

A

John graunt in XVII

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4
Q

Which very important epidemiologist studies influenza , yellow fever and scarlet fever

A

Noah Webster in XVIIIes

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5
Q

Who is considered the father of modern vital statistics and surveillance

A

William Farr

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6
Q

Which anaesthesiologist studied the natural.history of cholera

A

John snow XIXes

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7
Q

Definition of epidemiology

A

Study of distribution and determinants of health related events in specified populations and application of this study to control of health problems

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8
Q

3 main activities of an epidemiologist

A

Describe an event ( time place and person)
Analyse association between event and determinants ( risk factors of disease or death )
Make recommendations (preventive , control measures )

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9
Q

Types of trends of health event in terms of timing

A

seasonal trend - linear graph with weeks or months as the x axis

Secular trend - over several years to predict evolution of dx, to see effect of control measures or other events

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10
Q

What are the 3 main reasons to describe distribution of health event by place

A

Information about geographic distribution, dissemination route, cluster of cases

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11
Q

What is the role of using a map in distribution by place description

A

To see clearly areas with cases and possible sources of exposure

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12
Q

What is the goal of describing distribution by person

A

To see who is at risk

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13
Q

What are 3 ways to describe by person a health event

A

Demographic -age, sex, ethnicity etc
Socio economic - occupation, education..
Indivuals - blood group, vaccination, smokers, alcohol…

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14
Q

How do you present data of distribution by person ?

A

Table , graphs

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15
Q

Objectives of epidemiology

A

Identify causes and risk factors of diseases
Measure mortality and morbidity in populations
Natural history and prognosis
Evaluate new and existing preventive measures
Public health policies basis
Individual decisions regarding health

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16
Q

Health definition

A

State of complete physical , mental , and spiritual well-being and not merely the absence of any disease or infirmity

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17
Q

4 determinants of health (4Hs)

A

Hereditary (intrinsic factors)
Habitat
Habits
Health services

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18
Q

Disease definition

A

Illness of people , animals, or plants caused by infection or failure of health rather than an accident

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19
Q

Stages of natural history of dx

A

Susceptibility
Exposure
Presymptomatic dx / sub clinical dx
Clinical disease
Diagnosis
Disability or recovery or death

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20
Q

Stages of disease

A

Incubation - entrance of pathogen to appearance of first symptoms

Prodromal - onset of non specific signs and symptoms to more specific

Illness- signs and symptoms specific to dx

Convalescent- acute symposium and signs disappear

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21
Q

The

A
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22
Q

What are the levels of prevention

A

Primordial - action to minimize future health hazard addressing broad health determinants instead of personal

Primary - prevention of dx in a person free of dx

Secondary - Early detection of disease abd treatment to prevent complications and disability

Tertiary - complications occurred so aim is to decrease disability or handicap

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23
Q

Component of epidemiological triad in communicable dx

A

Host
Agent
Environment

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24
Q
A

Illness transmitted from a person, an Aminah or inanimate source to another person either directly or indirectly through a vector or other means

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25
Requirements of transmission process in communicable dx
26
Communicable disease definition
Ilness transmitted from a person, an Animal or an inanimate source to another person either directly, through a vector or others
27
Requirements for transmission
Agent Source/reservoir Portal exit Suitable mode of transmission Portal of entry Susceptible host
28
Transmission triad
Host Agent Environment
29
Important information about host in communicable disease
Age Sex Race Religion SES Marital status Lifestyle Comorbidities g Genetic makeup
30
Types of agent in communicable disease
Biological Microorganism Chemical Toxins Tobacco Alcohol Drugs Physical Trauma Radiation Fire Nutrition Lack of, excess of
31
What is infectivity of the agent
Ability of agent to cause infection
32
What is pathogenicity of an agent
Ability to cause an overt disease after infeciton
33
What is the virulence of an agent
Ability to cause severe disease
34
What is toxigenicity of an agent
Ability to produce a toxin
35
What is antigenicity for an agent
Ability to induce antibody formation and therefore an immune state in susceptible host
36
What is resistance of an agent
The ability of the agent to withstand environmental conditions during its transfer from one place to another
37
Are reservoir and source the same
No
38
What is a carrier
Individual who harbors infectious agent without showing signs or Symptoms of dx but can transmit it
39
4 Types of carriers
Healthy/asymptomatic Incubatory Convalescent carrier Chronic
40
What are patterns of communicable dx occurrence
Sporadic Endemic (hyperendemic or seasonal) Epidemic Pandemic
41
What are some epidemic patterns
Point source Continuous exposure Intermittent exposure
42
3 principle of diseas control
Eliminate reservoir Interrupt pasthway of transmission Protect susceptible host
43
How to eliminate reservoir of infection in disease control
Treat infected Patients and Carriers  isolate patient Quarantine If zoonosis destroy or vaccinates animals infected If non-living reservoir avoid exposure
44
How do you interrupt transmission in disease control?
Improve personal hygiene Improve environmental sanitation Control vectors using pesticides mosquito control repel
45
How do you protect susceptible host in disease control
Adequate nutrition Adequate exercise Adequate rest Health education Active or passive immunization Anti-infective drugs Chemoprophylaxis preventive treatment
46
Definition of outbreak
Occurrence of more cases of a disease than expected in a given area over a particular period of time
47
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When doing outbreak investigations, what are your objectives
Control outbreak Prevent future outbreak Provide statutorily mandated services Strengthen surveillance at local level Advance knowledge about disease Training opportunities
49
Steps in outbreak investigations
Prepare field work Confirm outbreak Make diagnosis Identification of cases Descriptive data collection and analysis Develop hypothesis Analytical studies to test hypotheses Additional studies Implementation of specific control measures Communication outbreak report
50
What is a ratio?
A fraction in which the numerator is not included in the denominator
51
What is a proportion?
Fraction in which the numerator is included in the denominator
52
What is rate
It’s a ratio in which there is a relationship between the numerator or and denominator in terms of time
53
What is morbidity
Extent of burden of a disease which is found through rates and proportion
54
What are the two measures of morbidity?
Incidence prevalence
55
What is incidence
Number of cases of a disease occurring within a specified time period in the population at risk
56
What is the formula for incidence
Number of new cases in a specified population / a number of susceptible individual in that same population*1000
57
What are the types of incidence rates
Cumulative rates- assume all individual under observation have been followed u the entire duration specified Incidence density - not all individuals under observation are followed for the same duration Attack rate - used to investigate acute outbreaks in limited duration and when outcomes follows exposure quickly
58
59
What is the concept of person-time when calculating incidence
Since not all individuals followed for same amount of time, this concept takes into account the duration of risk of each person at risk in the denominator
60
What is prevalence
Proportion of person at specified time with a disease Number of cases of disease present in the population at specified time /number of persons in population at that time *1000
61
62
Type of prevalence
Period prevalence - prevalence of dx during specified period Point prevalence - prevalence of disease at a particular point in time
63
What is the formula connecting prevalence and incidence
Point prevalence = incidence * duration of disease
64
What are the uses of prevalence
Measure burden of a disease For planning - health facilities, services etc Projections of burden
65
Importance of measuring mortality
Risk of dying from dx Disease severity Effectiveness of treatment surrogate for dx incidence if ver lethal and short duration
66
Crude death rate.
Quantitative expression of mortality Total of deaths from all causes in 1 year/ mid year pop*1000
67
Age specific death rate formula
Number of death in specified age group/ number of persons in that age group at specific period *1000
68
Perinatal mortality rate formula
Number deaths 28weeks+ and infants under 7days in a year / number of live births +fetal death 28w+ in same year *1000
69
Infant mortality rate formula
Number of deaths of children less than 1yr in a year/ number live birth in same year *1000
70
Neonatal mortality rate formula
Number of deaths children under 1 month in a year / number of live birth *1000
71
Post neonatal mortality rate formula
Number of deaths children aged 1month-1year / live births *1000
72
Fœtal death rate
Fetus dead in a year/ total foetal death +live births *1000
73
Fetal death ratio formula
Number of fetal deaths in a year / number of live births in a year *1000
74
Cause specific death rate formula
Number of death from specified dx in one year/ mid year pop *1000
75
Case fatality rate formula
Number of person dying within specified time after disease onset or diagnosis /number of individuals with specified dx in same period *100
76
Proportionate mortality
Number of death for specified cause in a year/ total number of deaths in that year *100
77
Maternal mortality ratio formula
Maternal death due to obs causes in specified period/ total live births in same period *100,000
78
Maternal mortality rate
Maternal deaths due to obs causes in specified period / women in fertile age in same period *100,000
79
2 type of studies in epidemiology
Observational and experimental
80
Types of observational studies
81
What is observational study
Nature takes its courses and investigator measures but does not intervene
82
What is experimental study
Investigator intervenes and measures outcomes
83
Descriptive vs analytical
Descriptive - generate idea or hypothesis for association between risk factor and illness Analytical - comparison group to see association between risk factors and illness in two groups
84
Characteristics of Cross sectional studies
“Prevalence study” Defined population Sample of population to measure variables of interests through usually a suvery Good for chronic , common, non fatal events 4 outcomes. - exposed+dx, exposed+no dx, not exposed+dx, not exposed+no dx
85
Advatanges of cross sectional study
Can study entire pop or sample Estimate of prevalence Standard data collection tool Quick , Inexpensive Can be repeated to get trend
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88
Disadvantage of cross sectional
Difficult to establish cause effect relationship Cases may be mis classified due to changes in exposure Not good for rare dx Cannot measure risk
89
Cohort studies characteristics
Identify effets of an exposure with respect To certain outcome Start with population free of dx and then monitor exposure to see outcomes Can calculate incidence rates , relative risk , attributable risk
90
Relative risk formula in cohort study
Determine if rate of incidence in exposed is grater than in unexposed Incidence in exposed group / incidence in unexposed group
91
Attributable risk inn cohort study
Incidence rate in exposed - incidence rate in non exposed
92
Merit and demerit of cohort study
Merit : true relative risk and incidence calculable, can lead to prospective studies about other association , less bias Demerit : large number of subject required, long follow up period, high attrition rate, bias, costly, changes in diagnostic and methods with time
93
Case control characteristics
Find Association between exposure to risk factors and disease of interest ‘Start with outcome or no outcome and try to find if they were exposed Uses odd ratio - ratio of forces of morbidity between. Exposed non not exposed
94
How to calculate odd ratio in case control study
95
Merits and demerit of case control study
Merits - Good for rare dx ,Cheap , Fewer participants , Retrospective study so no need to follow up Demerit - recall bias, incomplete information, no estimate of incidence of disease , difficult selection Of control.
96
Look up direct and indirect standardization of rates
97
Definition of diagnostic test
Determine presence or absence of dx when subject shows signs and symptoms of dx
98
Definition of screening test
Identify patient who may have dx when asymptomatic
99
Definition of validity of test
Ability of test to differentiate between patient suffering from dx and those not suffering
100
What is specificity of test
Ability of test to detect those who have dx True positive / diseased
101
What is Specificity of test
Ability of test to detect who do not have the dx True negative / non diseased
102
Predictive value of test
Positive predictive value - proportion of patients who test positive who actually have the dx True negative Negative predictive value - proportion of patients who tested negative who do not have the dx
103
What is a reliable test
Reproducible Repeatable Reliable

P3- COMMUNITY HEALTH (1 decks)

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