INTRODUCTION TO

EPIDEMIOLOGY

Dr. Norazura Ismail

zuraismail@ump.edu.my
Faculty of Technology, UMP
 Lesson outcome

• At the end of this lecture, student should be

able to:
1. define the term “epidemiology”
2. understand the history of epidemiology
3. explain the scope and uses of epidemiology
4. describe the responsibilities of an epidemiologist
 Epidemiology

• Bread and butter of public health

• It contributes knowledge of what, where, when,
why and how of diseases and its occurrence
• Health and disease can be studied in 3 basic
ways;
i. Observation of effects on individuals
ii. Laboratory experiments
iii. Measuring their distribution in population
(epidemiology)
 Definition of
Epidemiology (1)

• From the Greek word

– Epi: upon
– Demos: people
– Logos: doctrine
– Literal translation: the doctrine of what is upon
the people
 Definition of
Epidemiology (2)

• International Epidemiology Association

– The study of distribution and determinants of
health related states and events in the population
and the application of this study to the control of
health problems

• The primary unit of concern is groups of

persons NOT individuals
 Historical
Perspective (1)
Hippocrates John Graunt Dr. John Snow
1620 - 1674 1813 - 1858
• Explain disease • Founder of vital • Fathers of
occurrence from a statistics epidemiology
rational instead of
supernatural
• Quantified patterns of • Found the source of
viewpoint
disease, birth and cholera outbreak, long
death, noted male- before the organism
• Suggested female disparities, was found by Robert
environmental and high infant mortality, Koch
host factors e.g. urban-rural
behaviours might differences and • Showed that
influence the seasonal variations companies taking
development of
water from sewage-
disease
polluted sections
delivered water to
homes with an
increased incidence of
cholera
 Historical
Perspective (2)
William Farr Sir Austin
Bradford Hill
1807 - 1883
1897 - 1991
• Father of modern vital • English epidemiologist
statistics and and statistician
surveillance
• Pioneered the
• Systematically collect randomized clinical
and analyze Britain’s trial
mortality statistics
• Studied the
• Set up a system for relationship between
routinely recording cigarette smoking and
the causes of death lung cancer – brought
in the important
concept of risk
Sir William Richard
Shaboe Doll
1912 - 2005
• British physiologist
• The foremost
epidemiologist of the
20th century, turning
the subject into a
rigorous science
• Studied the
relationship between
cigarette smoking and
lung cancer - –
brought in the
important concept of
risk
 Epidemiological
Perspective (1)

• Epidemiology is about information: the

information needed for health planning,
supervision and evaluation of health-
promotion and disease-control activities.

• The key components of the data needed can

be approached through a series of questions.
 Epidemiological
Perspective (2)

Who? Where? When?

Who is
Where did it
affected? When did it
happen?
happen?
Age, sex,
Place of
ethnic Month,
residence,
group, season of
geographical
occupation, years
distribution,
heredity,
place of (time
personal
exposure factors)
habits
(place
(person
factors)
factors)
 Epidemiological
Perspective (3)

What? How? Why?

How did the

disease Why did it
What is the occur? occur?
disease or Interplay of
condition, its the specific
clinical agent, vector The reasons
manifestation and source of for the
and infection, disease
diagnosis? susceptible outbreak
groups and
other
contributing
factors
 Epidemiological
Perspective (4)

What
What action is now
now? to be taken as a
result of the
information
gained?
 Scope of Epidemiology

• Covers all major health problems in the

community:
– Communicable diseases
– Chronic degenerative, metabolic, neoplastic
diseases
– Nutritional deficiencies
– Occupational health and injuries
– Mental and behavioural disorders
 Uses of
Epidemiology (1)

• The most important – to increase the

understanding of disease by looking at
communities or populations.
– It is used to determine the health of a population
by the design, conduct and interpretation of
studies.
 Uses of
Epidemiology (2)

• Describing the natural history of disease

– Inapparent, sub-clinical and carrier states and
precursor states of chronic diseases, clinical stages
seen in hospitals and medical practice
 Uses of
Epidemiology (3)

• Monitor the health of populations

(surveillance) to chart changes over time,
place and person as well as determine which
diseases are of most public health importance.
– Able to predict and advise methods of control
 Uses of
Epidemiology (4)

• Identify causative agents, the factors in the

web of causation, the populations at highest
risk, environmental and other determinants.
– E.g. one can determine what are the contributory
factors for lung cancer, e.g. smoking, occupation
etc. determine what is the risk of developing a
disease in the presence of that factor (risk due to
smoking) and what can be achieved by removing
that risk (benefits of cessation of smoking)
 Uses of
Epidemiology (5)

• Supplies information necessary for health

planning and development, management of
programmes of disease prevention and
control and supplies tools for evaluating
health programmes (operations research)
 Uses of
Epidemiology (6)

• Provides a foundation for public policy and for

making regulatory decisions especially those
relating to environmental problems.
 Responsibilities of
epidemiologist
• Carry out public health administration
• Conduct disease surveillance
• Investigate and bring about rapid control of
disease outbreaks
• Plan and supervise specific health programmes
for disease control
• Conduct health surveys, operations research, and
programme evaluation
• Describe the natural history of a disease and
identify its causes
 Exercise

• Briefly explain the following terminologies:

– Physiology
– Psychology
– Clinical manifestation
– Diagnosis
– Communicable disease
– Non-communicable disease

• Submit – today (28th Feb 2014) by 5.00pm in my

pigeon hole
 Group Assignment

• Work in pair (2 members/group)

• Select one (1) contributor towards epidemiology
(Must be different from other group)
• Prepare a 2-3 pages report about the selected
contributor including background information
and contributions towards the development of
epidemiology
• Date of submission – 5th March 2014
Group Members Contributor
1 Maisarah William Farr
Zarifah
2 Nik Umi John Graunt
Shazlin
3 Fatihah John Snow
Asmui
THANK YOU