Antonio SlidesCarnival
Antonio SlidesCarnival
Antonio SlidesCarnival
BASIC SCIENCE OF
PUBLIC HEALTH
EPIDEMIOLOGY
The study of the distribution of health outcome or
disease within population and the factors that
determines the broader health outcomes and diseases
(risk factors)
In health care system epidemiologists focus mainly
their attentions from population level rather than
individual level.
HISTORY OF EPIDEMIOLOGY AND PIONEERS
OF EPIDEMIOLOGY
EARLY 20TH CENTURY Primary focus of epidemiology was
on infection diseases
END OF 20TH CENTURY The advent of the computer and
new methodology approaches in the health system completely
altered the field of epidemiology, which at that point is now a
standard area of medical science and the most fundamental
basic science of public health.
THE EPIDEMIOLOGY TRANSITION
▷ Described as the changes in population, age, distribution,
mortality fertility, life expectancy and causes of death.
▷ The human population since the early aged has gone into
four major disease transitions since the start of the
agricultural period ten thousand years ago.
THE EPIDEMIOLOGY TRANSITION
THE 1ST TRANSITION
Emerging of infectious disease and nutrition related diseases
and the beginning of the agriculture
e. ENVIRONMENTAL EPIDEMIOLOGY
▷ Focus on factors that can affect health outcomes and examples of
environmental exposure and factors.
f. NUTRITIONAL EPIDEMIOLOGY
▷ Examines association between nutrition and health outcomes, and
may focus on a diet and physical activity.
FIELD OF EPIDEMIOLOGY AND A PUBLIC HEALTH
STRUCTURAL INTERVENTION
It focuses on changing physical, social, and/or economic factors in the
environment to improve public health.
DESCRIPTIVE EPIDEMIOLOGY
▷ Characteristics of person such as age, sex weight and socio-economic
status.
▷ Characteristics of place such as a country, a province, a state, a city
zip code or census track and;
▷ Characteristics of time such as long term, short term variation, by
week or day so descriptive epidemiology deals with the frequency and
the distribution of diseases and the risk factors of the population and
can be used for the hypothesis generation but not to test the
hypothesis.
USES DESCRIPTIVE
EPIDEMIOLOGY
BIOMEDICAL PERSPECTIVE
▷ It focuses more on agents that cause disease and their mechanisms
and also on individual risk factors for health outcomes however social
and environmental factors are not part of biomedical prospective
POPULATION PROSPECTIVES
▷ It focuses on social, psychological, and environmental factors linked
to health outcomes.
Epidemiology Study
Design
A. EXPERIMENTAL STUDY DESIGN
▷ Commonly provide participants with an exposure of the drug that can
be either therapeutic or preventative. There are both individual and
community experimental studies
two types of experimental study design.....
1. RANDOMIZED CONTROL TRIALS
▷ Seek to measure and compare different events/outcomes that are
present or absent after the participants received the intervention
▷ In this epidemiological study design, there is a direct comparison
between two or more treatment groups, with one serving as a control
for other
A. EXPERIMENTAL STUDY DESIGN
B. THE CLINICAL CROSSOVER TRIAL
▷ Subjects switch from one treatment to the other, (after a certain
period of time exposure), that is crossing over to the other treatment
or exposure, as we don't want the effect of the first treatment to
carry over when a person switches to another treatment. There is
usually a period in between the two exposures called a wash-out
period, when no treatment is given
B. OBSERVATIONAL OR NON-EXPERIMENTAL
STUDY DESIGN
A. COHORT STUDY DESIGN
A type of observational study design that provides the foundation for
understanding other types of non experimental study design, and here
researchers follow mostly at risk study population overtime and evaluate
exposure overtime, then determine subsequently the rate or risk of
disease or health outcome.
B. OBSERVATIONAL OR NON-EXPERIMENTAL
STUDY DESIGN
A. COHORT STUDY DESIGN
A type of observational study design that provides the foundation for
understanding other types of non experimental study design, and here
researchers follow mostly at risk study population overtime and evaluate
exposure overtime, then determine subsequently the rate or risk of
disease or health outcome.
B. OBSERVATIONAL OR NON-EXPERIMENTAL
STUDY DESIGN
B. CASE CONTROL STUDIES DESIGN
▷ In this study design researcher begins by selecting diseased Individual
or individuals with the health outcome of interest which are known as
cases and researcher also select a group of individuals without a
disease known as control.
▷ Case-control study proceeds logically from the fact, the disease or
health outcome to cause the exposure of interest, as the researcher
look back in time what the exposure was in both the case groups and
the control group.
B. OBSERVATIONAL OR NON-EXPERIMENTAL
STUDY DESIGN
C. THE CROSS-SECTIONAL STUDY DESIGN
▷ Population base within which the occurrence of disease or health
outcomes are studied, or sometime both occurrences and the
exposure are studied simultaneously.
▷ Cross-sectional studies are often used to describe the occurrence of
the health outcome or exposure of a population and the measure
used to describe this occurrence is the prevalence.
▷ The cross-sectional study is also different from the case controlled
study which starts by selecting cases and control and then looks back
at the exposure in the past.
B. OBSERVATIONAL OR NON-EXPERIMENTAL
STUDY DESIGN
D. ECOLOGIC STUDY DESIGN
▷ It is an observational study design with a main characteristic that the
exposures or health outcomes are measured at group level. Let
compares the individual exposure and the group exposure
measurements.