HS310-03HS310-03 Epidemiology and Biostatistics Epidemiology and Biostatistics

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Epidemiology and Epidemiology and BiostatisticsBiostatistics

Week 1 – Chapter 1Week 1 – Chapter 1

““Epidemiology”Epidemiology”Oreta Samples, MPH, VTOreta Samples, MPH, VT

Epidemiology…Epidemiology…

Study of something that affects a Study of something that affects a populationpopulation

Study of factors that determine the Study of factors that determine the occurrence & distribution of disease in a occurrence & distribution of disease in a populationpopulation

One of the ways in which disease, injury One of the ways in which disease, injury and clinical practice are studiedand clinical practice are studied

Classical Vs. ClinicalClassical Vs. Clinical

ClassicalClassical Population oriented Population oriented

studies of the studies of the community origins of community origins of health problems.health problems.

ClinicalClinical Use of research Use of research

designs and statistical designs and statistical tools to study patient tools to study patient in health care settingin health care setting

Other Types of EpidemiologyOther Types of Epidemiology

Chronic Disease EpidemiologyChronic Disease Epidemiology Sampling and statistical analysisSampling and statistical analysis

Infectious Disease EpidemiologyInfectious Disease Epidemiology Laboratory supportLaboratory support

Syndronic EpidemiologySyndronic Epidemiology Patterns of symptoms and signsPatterns of symptoms and signs

DiseasesDiseases

Natural History of Natural History of Disease:Disease: Also known as the Also known as the

natural “progression” natural “progression” of a diseaseof a disease

Intervention Against Intervention Against Disease:Disease: TherapeuticTherapeutic

• Example: Example: Chemotherapy, Chemotherapy, radiation, surgical radiation, surgical interventionintervention

PreventativePreventative• Example: Anti-smoking Example: Anti-smoking

public service messagepublic service message

Disease ProfileDisease Profile

History of Disease:History of Disease: Diagnosis of Familial Diagnosis of Familial

Adenomatous Adenomatous Polyposis (commonly Polyposis (commonly known as “colon known as “colon cancer”)cancer”)

Intervention:Intervention: Therapeutic: Ileorectal Therapeutic: Ileorectal

anastomosis or anastomosis or ileostomy or colostomy ileostomy or colostomy (depending on (depending on severity)severity)

Preventive: Preventive: Colonoscopy on a Colonoscopy on a regular basis; dietary regular basis; dietary fiber increasefiber increase

Stages of DiseaseStages of Disease Pre-disease Stage: No disease presentPre-disease Stage: No disease present

Primary Prevention: Prevention of diseasePrimary Prevention: Prevention of disease

Latent Stage: Asymptomatic; disease is in progressLatent Stage: Asymptomatic; disease is in progress

Secondary Prevention: Treatment prevents progressionSecondary Prevention: Treatment prevents progression

Symptomatic Stage: Manifestation of diseaseSymptomatic Stage: Manifestation of disease

Tertiary Prevention: Slowing of diseaseTertiary Prevention: Slowing of disease

So What Causes a Disease?So What Causes a Disease?

Biological Mechanisms?Biological Mechanisms? Social Causes?Social Causes?

Environmental Causes?Environmental Causes?

The answer is:The answer is:

Social factors and environmental factors Social factors and environmental factors can contribute to the biological mechanism can contribute to the biological mechanism which triggers a diseasewhich triggers a disease

Circumstances Contributing to Circumstances Contributing to Disease ManifestationsDisease Manifestations

Host Factors: Ability to adapt to the Host Factors: Ability to adapt to the stresses that are produced by an agentstresses that are produced by an agent

Agent of Disease/illness (3):Agent of Disease/illness (3): Biological Agents (allergens, organisms, Biological Agents (allergens, organisms,

toxins, and food)toxins, and food) Chemical Agents (chemical toxins and dust)Chemical Agents (chemical toxins and dust) Physical Agents (Kinetically propelled energy Physical Agents (Kinetically propelled energy

such as bullets, cars, and blunt trauma)such as bullets, cars, and blunt trauma)

Manifestations (continued)Manifestations (continued)

Environmental: May effect the probability Environmental: May effect the probability and circumstances of contact between and circumstances of contact between host and agents.host and agents. Examples include:Examples include:

• SanitationSanitation• Road ConditionsRoad Conditions• OvercrowdingOvercrowding• Poor EconomicsPoor Economics

Challenge Time !!!Challenge Time !!!# 1# 1

A group of 20 male college students A group of 20 male college students volunteer/consent to have their PSA volunteer/consent to have their PSA levels checked three times yearly (every levels checked three times yearly (every 4 months) for the four years they are in 4 months) for the four years they are in college as part of a study by University college as part of a study by University Hospital on prostate cancer. Is this study Hospital on prostate cancer. Is this study considered to be:considered to be:

A.A. Clinical EpidemiologyClinical EpidemiologyB.B. Classical EpidemiologyClassical Epidemiology

# 2# 2

If an epidemiologist is sent out to investigate suspected food If an epidemiologist is sent out to investigate suspected food poisoning at a church picnic after reports of 20 people becoming poisoning at a church picnic after reports of 20 people becoming ill with symptoms of vomiting/diarrhea occurring three hours after ill with symptoms of vomiting/diarrhea occurring three hours after the picnic ended, he is practicing:the picnic ended, he is practicing:

A.A. Infectious disease epidemiologyInfectious disease epidemiology

B.B. Syndromic epidemiologySyndromic epidemiology

C.C. Classical epidemiologyClassical epidemiology

D.D. Clinical epidemiologyClinical epidemiology

E.E. Both b and cBoth b and c

F.F. Both a and dBoth a and d

# 3# 3

The natural progression of a disease is The natural progression of a disease is also known as:also known as:

A.A. Preventive interventionPreventive intervention

B.B. Pre-disease stagingPre-disease staging

C.C. Natural History of DiseaseNatural History of Disease

D.D. None of the AboveNone of the Above

# 4# 4

The susceptibility of an immuno-The susceptibility of an immuno-compromised individual to common colds compromised individual to common colds and other illnesses is a:and other illnesses is a:

A.A. Environmental FactorEnvironmental Factor

B.B. Disease FactorDisease Factor

C.C. Host FactorHost Factor

D.D. Conditional FactorConditional Factor

# 5# 5

Within the stages of disease, which of Within the stages of disease, which of the following stages may be defined by the following stages may be defined by manifestation of disease symptoms?manifestation of disease symptoms?

A.A. Secondary PreventionSecondary Prevention

B.B. Symptomatic StageSymptomatic Stage

C.C. Pre-disease StagePre-disease Stage

D.D. Latent StageLatent Stage

VECTORSVECTORS

Defined:Defined: Insects, arthropods Insects, arthropods

and animals which aid and animals which aid in the spread of in the spread of disease by themselves disease by themselves being a host capable being a host capable of transmitting disease of transmitting disease causing organisms to causing organisms to the host they are living the host they are living onon

Examples:Examples: Mosquitoes = West Mosquitoes = West

Nile VirusNile Virus Tick = Lyme DiseaseTick = Lyme Disease Rats = Bubonic PlagueRats = Bubonic Plague Mosquitoes = Canine Mosquitoes = Canine

HeartwormHeartworm Snail = Haemonchus Snail = Haemonchus

contortus (nematode)contortus (nematode)

How Vectors WorkHow Vectors Work(Taken from http://www.grandriverveterinaryhospital.com/images/heartwormlifecycle.jpg)(Taken from http://www.grandriverveterinaryhospital.com/images/heartwormlifecycle.jpg)

Risk Factors for DiseasesRisk Factors for Diseases

BBiological/Behavioraliological/Behavioral

EEnvironmentalnvironmental

IImmunologicalmmunological

NNutritionalutritional

GGeneticsenetics

SServices, Social, Spiritualervices, Social, Spiritual

Any Questions ?Any Questions ?