EPIDEMIOLOGY AND COMMUNITY HEALTH

HIMI, JOSBy

Saleh Ahmed School of Midwifery, Bauchi

Introduction

Epidemiology and Community health are two inseparable words in public health system. This is because they deal with prevention of disease, promotion of health and efficiency through organized community efforts. Epidemiology deals with the frequencies and types of illnesses and injuries that affect population while community health deals with the services that aim at protecting the health of the community.

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The knowledge of pattern, distribution and frequencies of diseases and how it effects the community is the major concern of every health organization. In fact, the success of epidemiology and community health activities rely greatly on effective transfer of information from health professional to general public. Thus health information management is the most veritable tool for the achievement of the desired goals of health for all.

Objectives

At the end of this presentation participants will be able to:-

Explain the terms epidemiology and community health.

State the uses of epidemiology Describe epidemiological tools of

measurements. Describe community health.

Epidemiology

Definition The word epidemiology is derived from

Greek terms- “epi”-upon, among, “demos” –people, district, “logos” –study, word, discourse.

Epidemiology literally is the study of something that affects population.

Jekel, Elmore and Katz (1996) defined epidemiology as the study of factors that determine the occurrence and distribution of disease in a population

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Onwasigwe (2004) views epidemiology as the study of the causes, distribution, determinants and deterrent of diseases, injuries and other health related condition in human population.

Epidemiology deals with the frequencies and types of illnesses and injuries in group of people and with factors that influence their distribution.

In summary, epidemiology is the study of factors that affect health of population

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Epidemiology therefore serves as a A) cornerstone of methodology of public

health research B) evidenced based medicine C) means of identifying risk factors for

diseases and determining optimal treatment approaches to clinical practice.

Uses of epidemiology

It is used in:- i) studying the history of diseases in

population in terms of profile, time & trends.

ii) determining the most common causes of death, diseases and disability.

iii) community diagnosis in terms of morbidity, and mortality rates and ratio.

iv) determining the effective control method of disease when known.

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v) provision of data for proper planning and evaluation of health services

vi) identifying deficiencies in ongoing programs

vii) identifying the priority areas for medical research

Basic Definitions in Epidemiology

Epidemics – the occurrence of the disease or groups of illnesses of similar nature clearly in excess of the expected rate for the place and time.

Pandemic –an epidemic usually affecting a large proportion of the populations occurring over a wide geographic area.

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Endemic – this refers to the constant presence of a disease or infectious agent within a given geographic area or population group. Sporadic – it the scattered about disease with cases occurring irregular, haphazardly from time to time and generally infrequently.Exotic- disease imported into a country , malaria in united kingdom.

Types of epidemiology

There are various ways of grouping epidemiology,a) Based on what it studied:- Classical epidemiology –it studies the community

origins of health problems particularly those related to nutrition, environment, human behavior, and psychologic, social, and spiritual state of population. Its aim is to discover risk factors.

Clinical epidemiology – it studies patients in health care settings in order to improve diagnosis and treatment of various diseases and the prognosis of patients already affected.(jekel,1996)

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B) Based on the steps in investigation and control.

According to onwasigwe (2004) there are :-1)Descriptive epidemiology:- it studies the amount

and distribution of disease within population by person, place and time. It is carried out to determine the frequency of disease, the kind of people suffering from it and where it occurs. It makes use of routinely collected data such as hospital data. Its study answers these questions

i) who are affected- ie the person(age,sex,race, marital status,etc)

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Ii) where do the cases occur:-ie the place(rural,urban,altitude,humidity,rainfall)

Iii) when do these cases occur :-ie time (monthly or annually ,secular trends-long term variation or cyclic changes –recurrent alterations in the frequency from annual or periodic)

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2) Analytical epidemiology :-this study is carried out to draw logical conclusion. The study is used to determine why the rate is high or low in a particular group. Analytical studies are hypothesis-testing studies used to verify the hypotheses.

It is different from descriptive studies because it studies individuals within a population not the entire population.

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Analytical studies involve two types of observation studies –

A) case control study B) cohort studyCase control study –known as retrospective

studies which is used to estimate cause-effect relationship between a suspected risk factor and a disease. In this study people diagnosed of having a disease(cases) are compared with those that do not have the disease(control).

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Cohort – is a group of persons at risk who share common characteristics or experience within a defined period of time.

Cohort study –this is a prospective study, incidence study and forward looking study which aims at obtaining additional evidence to support or reject the existence of an association between suspected risk factor or cause and disease

Epidemiological tools for measurement.

Sensitivity and specificity – for screening.Rates – to quantify disease-relative risk and odd ratio –to evaluate

association between factors and disease

Epidemiology of disease

This is the prerequisites for infection occurrence

Agent Reservoir (man, animals) Route of exit from the reservoir Channel of transmission-(air, water, formites) Pathogen’s capacity for survival Routes of entry (respiratory route,mouth) Host susceptibility-(mechanical protection of

skin and chemical, inflammatory response,immunity)

How Epidemiology is related to community health

Provide basic knowledge of disease trends and distribution, causes and contributing factors.

For planning health programmes eg procurement drugs

Advocacy Research Monitoring and evaluation.

Community health.

This is made up of two words- community and health.

Community:-is a group of individuals who are bound in time and space, dependent on each other and having common goals.

Health –According to WHO in 1986 health is defined as the extent to which an individual or group is able, on the one hand to realize aspirations and satisfy needs and on the other hand to change or cope with the environment.

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Community health is simply referred to as the health status of group of people and the actions and conditions to promote, protect and preserve their health.

However, park (2004), defined community health as the health status of the members of community, and the problems affecting their health as well as the totality of health care provided to the community.

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In broader sense community health implies integration of curative, preventive and promotive health services rendered to individual living in the same location.

The emphasis of community health is centred on two things namely:, community diagnosis and community treatment.

This therefore implies that the entire community is regarded as patient requiring diagnosis and treatment.

Community health activities

Community health activities are activities that are aimed at protecting and improving the health of a population or community.

These are as follows:- Maintenance of accurate birth and death

records. Protection of food and water supply. Maintenance of environmental sanitation –

including vector control and personal health care.

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Immunization Health education e.g. on healthy styles of

living. Community diagnosis by surveying and

monitoring community health needs and assessing the impact of intervention

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Thank you.