EPIDEMIOLOGIC TRANSITION
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Transcript of EPIDEMIOLOGIC TRANSITION
EPIDEMIOLOGIC EPIDEMIOLOGIC TRANSITIONTRANSITION
Epidemiologic Transition:Epidemiologic Transition:Changes of fertility and mortality Changes of fertility and mortality
with modernizationwith modernization
Imhotep,
the "father of medicine". The word "Imhotep" means "he who comes in peace'
Herodotus, after his visit to Egypt in the 5th century B.C., stated that Egyptians were, with the Libyans, the healthiest people. This must have implied a good deal of sanitation. Cleanliness, was religious as well a hygienic obligation.
Prevention in Egypt
Medicine is a science from which one learns the states of the human body with respect to what is healthy and what is not, in order to preserve good health when it exists and restore it when it is lacking
Ibn Sina
Charles DarwinEvolution of Species
Abdel OmranEvolution of Disease
The Theory Of Epidemiologic The Theory Of Epidemiologic Transition (Abdel Omran)Transition (Abdel Omran)
1.1. The The Age of Pestilence and FamineAge of Pestilence and Famine
2.2. The The Age of Receding PandemicsAge of Receding Pandemics
3.3. The Age of Degenerative and Man-The Age of Degenerative and Man-Made DiseasesMade Diseases
The The Age of Pestilence and FamineAge of Pestilence and Famine
Characterized by high mortality Characterized by high mortality rates, wide swings in the mortality rates, wide swings in the mortality rate, little population growth and rate, little population growth and very low life expectancyvery low life expectancy, , vacillating betweeen 20 and 40 vacillating betweeen 20 and 40 yearsyears
Age of Receding PandemicsAge of Receding Pandemics
Epidemics become less frequent, Epidemics become less frequent, infectious diseases in general become infectious diseases in general become less frequent, a slow rise in less frequent, a slow rise in degenerative diseases begin to appeardegenerative diseases begin to appear, , Average life expectancy increases Average life expectancy increases steadily from about 30 to 50 yearssteadily from about 30 to 50 years
The Age of Degenerative and The Age of Degenerative and Man-Made DiseasesMan-Made Diseases
Mortality continues to decline and Mortality continues to decline and eventually approaches stability at a eventually approaches stability at a relatively low level.relatively low level.
Instead at looking at individual Instead at looking at individual diseases, we need to look at the diseases, we need to look at the
patterns of diseases patterns of diseases
Mortality is the fundamental Mortality is the fundamental factor in the dynamics of factor in the dynamics of
population growthpopulation growth
Mortality has no fixed upper limits. Mortality has no fixed upper limits. Thus if fertility approached its Thus if fertility approached its upper maximum, depopulation upper maximum, depopulation
would still occur.would still occur.
During the epidemiologic During the epidemiologic transition, a long-term shift transition, a long-term shift
occurs in mortality and disease occurs in mortality and disease patterns whereby pandemics of patterns whereby pandemics of
infection are replaced by infection are replaced by degenerative and man-made degenerative and man-made
diseases...diseases...
The shifts in disease patterns in The shifts in disease patterns in the 19th century were primarily the 19th century were primarily
related to changing SESrelated to changing SES (Developed Countries)(Developed Countries)
With the 20th Century more With the 20th Century more related with disease control related with disease control
activities independent of SESactivities independent of SES (Developing Countries)(Developing Countries)
Death Rates for TB in England Death Rates for TB in England and Walesand Wales
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Death Rates for TB in England Death Rates for TB in England and Walesand Wales
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TB Bacillus Identified
Chemotherapy
BCG Vaccination
Death Rates for Measles in Death Rates for Measles in Children in England and WalesChildren in England and Wales
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Death Rates for Measles in Death Rates for Measles in Children in England and WalesChildren in England and Wales
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Immunization begun
Epidemiologic Transition in Epidemiologic Transition in Developing and DevelopedDeveloping and Developed
CountriesCountries
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Developing
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High Incidence of NCDs in High Incidence of NCDs in Developing CountriesDeveloping Countries
Possible Infectious EtiologyPossible Infectious Etiology
Macronodular CirrhosisMacronodular Cirrhosis
Hepatocellular CarcinomaHepatocellular Carcinoma
Rheumatic Heart DiseaseRheumatic Heart Disease
Iron deficiency anemiaIron deficiency anemia
Related to Nutrition DeficiencyRelated to Nutrition Deficiency Endemic GoiterEndemic Goiter
Malnutrition Related Diabetes.Malnutrition Related Diabetes.
High Incidence of NCDs in Developed CountriesHigh Incidence of NCDs in Developed Countries CardiovascularCardiovascular
CHDCHD
Deep Vein ThrombosisDeep Vein Thrombosis
RespiratoryRespiratory
EmphysemaEmphysema
Lung CALung CA
Female GenitalFemale Genital
EndometriosisEndometriosis
Endometrial CAEndometrial CA
BreastBreast
Breast CABreast CA
Fibrocystic DiseaseFibrocystic Disease
Male GenitalMale Genital
Prostrate CAProstrate CA
MetabolicMetabolic
NIDDMNIDDM
Causes of DeathCauses of Death
Age 15-44Age 15-44 AccidentsAccidents
CACA
CHDCHD
Age 45-54Age 45-54 CHDCHD
CACA
AccidentsAccidents
Age 15-44Age 15-44 AccidentsAccidents
CHDCHD
CACA
Age 45-54Age 45-54 CHDCHD
CACA
AccidentsAccidents
Developed Developing
35 years
14 years
Changing Life ExpectanciesChanging Life Expectancies
20 yrs
5 yrs
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USEgypt
40 44 48 52 56 60 64 68 72 76
Population Life Expectancy
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InfectionCA
CHD
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Violence
Increasing Life Expectancy and Causes of Death
Incidence of Stomach CAIncidence of Stomach CAMalesMales
0 20 40 60 80 100
Nigeria
India
US White
US NW
UK
Finland
Iceland
Columbia
Japan
Breast Cancer IncidenceBreast Cancer IncidenceFemalesFemales
0 5 10 15 20 25 30
Japan
Nigeria
Brazil
Singapore
Jamaica
Poland
UK
US NW
US Whites
CHD Death RatesCHD Death RatesMales, aged 45-54Males, aged 45-54
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Thailand
Guatamala
Japan
Egypt
Italy
Bulgaria
US
UK
Scotland
Finland
Epidemiologic Transition
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Infectious Diseases
NCD
Epidemiologic Transition
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CA
CHDNIDDM
Trauma
OMRAN THEORYOMRAN THEORY
1.1. The The Age of Pestilence and FamineAge of Pestilence and Famine
2.2. The The Age of Receding PandemicsAge of Receding Pandemics
3.3. The age of triple health burdenThe age of triple health burden
1.1. The The Age of Pestilence and FamineAge of Pestilence and Famine
2.2. The The Age of Receding PandemicsAge of Receding Pandemics
3.3. The Age of Degenerative and Man-Made DiseasesThe Age of Degenerative and Man-Made Diseases
DEVELOPED COUNTRIES
DEVELOPING COUNTRIES
The Age of Triple Health Burden The Age of Triple Health Burden (Tiga Beban Ganda Kesehatan)(Tiga Beban Ganda Kesehatan)
1.1. Masih tingginya angka kesakitan penyakit Masih tingginya angka kesakitan penyakit menular “klasik”.menular “klasik”.
2.2. Tingginya angka kesakitan dan kematian Tingginya angka kesakitan dan kematian akibat Penyakit Tidak Menular (Non-akibat Penyakit Tidak Menular (Non-Communicable Disease).Communicable Disease).
3.3. Munculnya penyakit baru Munculnya penyakit baru (new emerging (new emerging Infectious Disease)Infectious Disease)
Beban Penyakit 1Beban Penyakit 1
Penyakit ini merupakan masalah kesehatan yang Penyakit ini merupakan masalah kesehatan yang besar di hampir semua Negara berkembang besar di hampir semua Negara berkembang apalagi negara tersebut berada pada daerah tropis apalagi negara tersebut berada pada daerah tropis dan sub-tropisdan sub-tropis
Angka kesakitan dan kematian relatif cukup Angka kesakitan dan kematian relatif cukup tinggi dan berlangsung sangat cepat menjadi tinggi dan berlangsung sangat cepat menjadi masalahnyamasalahnya
ex :Tuberkulosis (TB), Kusta, Diare, DBD, ex :Tuberkulosis (TB), Kusta, Diare, DBD, Filariasis, Malaria, Leptospirosis Filariasis, Malaria, Leptospirosis
Beban Penyakit 2Beban Penyakit 2
Masalah utamanya adalah angka kematian akibat Masalah utamanya adalah angka kematian akibat penyakit tidak menular (PTM) di Indonesia sudah lebih penyakit tidak menular (PTM) di Indonesia sudah lebih tinggi daripada kematian akibat penyakit menulartinggi daripada kematian akibat penyakit menular
Pada tahun 1995 kematian akibat penyakit tidak Pada tahun 1995 kematian akibat penyakit tidak menular sebesar 41,7 persen dan tahun 2007 meningkat menular sebesar 41,7 persen dan tahun 2007 meningkat menjadi 59,5 persen, ini yang tercatat di pelayanan menjadi 59,5 persen, ini yang tercatat di pelayanan kesehatan bagaimana dengan yang tidak tercatat ?kesehatan bagaimana dengan yang tidak tercatat ?
Ex :Hipertensi, Diabetes Mellitus, Penyakit Ex :Hipertensi, Diabetes Mellitus, Penyakit Cardiovaskuler (CVD), Ischemic Heart Disease, PPOK, Cardiovaskuler (CVD), Ischemic Heart Disease, PPOK, KankerKanker
Beban Penyakit 3Beban Penyakit 3
Penyakit ini rata-rata disebabkan oleh virus lama Penyakit ini rata-rata disebabkan oleh virus lama yang berganti baju (bermutasi)yang berganti baju (bermutasi)
Angka kesakitan dan kematian pada penyakit ini Angka kesakitan dan kematian pada penyakit ini sangat tinggi dan berlangsung sangat cepatsangat tinggi dan berlangsung sangat cepat
Ex : HIV (1983), SARS (2003), Avian Influenza Ex : HIV (1983), SARS (2003), Avian Influenza (2004), H1N1 (2009) (2004), H1N1 (2009)
Let' s We Make That Let' s We Make That DDream ream CCome ome TTruerue
What ‘What ‘DDream"ream"
To Make Indonesian HealthTo Make Indonesian Health
Back to NatureBack to Nature
Improved Physical activityImproved Physical activity A Healthier Diet, less saturated A Healthier Diet, less saturated
fats, more fiberfats, more fiber Less StressLess Stress
FINISHFINISHTHANK YOUTHANK YOU
Importance ofGeographic Patterns