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    CHN UNIT III

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    Meee (aly UNIT-III SHORT ANSWERS (2MARKS) 1. Define epidemiology Epidemiology is the branch of medicine that studies the distribution and determi health and disease in populations. It involves the investigation and analysis of patt causes, and effects of health and disease conditions in defined populati Epidemiologists use a variety of methods, including observational clinical trials, risk factors, track disease outbreaks, and evaluate tl iveness of interventions, The ultimate goal of epidemiology is to im th by identifying the causes of disease and informing the " and interventions to prevent and control its spread. 2. What are the asap The determinants of di He The factors that contribute to the development and progression of mares individuals and populations. These determinants can be ic predisposition, physiological factors such as age, sex, and immune individual behaviors such as smoking and alcohol consumption. 5 ‘These include physical factors such as air and water quality, climate, and geography, as well as social and economic factors such as housing, education, and access to healthcare. * Behavioral determinants: These include ir abuse. ual lifestyle factors such as diet, physical activity, and substance ‘+ Health system determinants: X eine aims to provide evidence-based information to inform public health ‘These include the availability, accessibility, and quality of healthcare services. * Socioeconomic determinants: ‘These include factors such as income, education, and occupation, which can impact an individual's access to resources and their ability to make healthy choices. 3. List the Aims of epidemiology x ‘The main aims of epidemiology are: tS * To describe the distribution of diseases: oO Epidemiology aims to describe the patterns of disease occurrence, including affected by the disease, where they live, and when and how the disease + To identify the determinants of diseases: \e) ioral Epidemiology aims to identify the risk factors that conti velopment and progression of diseases, including genetic, envi [and socioeconomic factors. * To evaluate the effectiveness of ints Epidemiology aims to evaluate the it uiblic health interventions, including screening programs, vaccination i ir health interventions aimed at preventing or controlling diseases. © Todevelop afore Epidemiolo, tgldevelop and test hypotheses about the causes and mechanisms of dis << /e new knowledge that can inform public health policies and pragai ‘0 provide a basis for public health policy and planning: icy and planning, including disease prevention and control strategies, resource allocation, and health education and promotion activities. ‘* To monitor and control the spread of diseases: Epidemiology aims to monitor the occurrence of diseases and to identify and control disease outbreaks, epidemics, and pandemics. 4. Write Uses of epidemiology Epidemiology has many practical uses in public health, medicine, and other fields. Some of the key uses of epidemiology include: * Disease surveillance: Epidemiology is used to monitor the occurrence and distribution of diseases in populations, and to identify trends and outbreaks of disease. This information is used to guide public health interventions and to inform disease prevention and control strategies. * Prevention and control of disease: we Epidemiology is used to identify the risk factors and determinants of disease, an¢ develop and evaluate interventions aimed at preventing and controlling the spi disease. This includes interventions such as vaccination campaigns, healt programs, and environmental interventions to reduce exposure to ge) © Clinical practice: a Epidemiology is used to inform clinical secon nctingeo ide the diagnosis and i q treatment of individual patients, For example, epi data on the prevalence and risk factors for a particular disease can help clinicians to make informed decisions about ‘screening and diagnostic testing. + Health policy and planning: G Epidemiology is used to int policy and planning at local, national, and international levels. hit the development of policies and strategies aimed at improving populatio and the allocation of resources to support these initiatives. D basic measurements used in epidemiology iologists use a variety of measurements to describe the occurrence and distribution iseases in populations. Some of the basic measurements used in epidemiology include: 1 * Incidence: Incidence is the number of new cases of a disease that occur within a specific time period ina defined population. It is often expressed as a rate, such as the number of new cases per 100,000 people per year. Incidence is used to measure the risk of developing a disease. * Prevalence: Prevalence is the total number of cases of a disease in a population at a specific point in time. It is often expressed as a proportion or percentage of the population, Prevalence takes into account both new and existing cases of disease, and is used to measure the overall burden of a disease in a population. © Mortality: Mortality is the number of deaths that occur in a population due to a specific disease or cause. It is often expressed as a rate, such as the number of deaths per 100,000 people per year. Mortality is used to measure the severity and impact of a disease. KS + Case-fatality rate: Case-fatality rate is the proportion of people diagnosed with a particular disea from that disease within a specific time period. It is often expressed oe 6. Define crude death rate Crude death rate is a basic measurement used in epi 62 describe the frequency of deaths in a population. It is calculated as the £59 ens ‘occurring in a population during a specific time period divided by the mid-year population of the same area or population at risk, and is typically exp ste per 1,000 or 100,000 population. The crude death rate provides a gene ‘of the overall mortality level in a population, but does not take into ace 2s in age, sex, or other demographic factors that can affect mortality rat re, age-specific death rates and other measures may be used to provi ou iled and accurate picture of mortality patterns in a population. o. meant by specific death rate i ic death rate is a measurement used in epidemiology to describe the frequency of feaths in a specific subgroup of a population, such as a particular age group or gender. It calculated as the number of deaths occurring in that specific subgroup during a specific time period divided by the total population ef that subgroup, and is typically expressed as a rate per 1,000 or 100,000 population. Specific death rates provide a more detailed and accurate picture of mortality patterns in different subgroups of a population, and can be used to identify disparities in mortality rates among different groups, For example, specific death rates for certain age groups or genders may be higher or lower than the overall crude death rate for the population, which can help public health of icials and policymakers to target interventions and resources more effectively. 8. Define case fatality rate Case fatality rate (CFR) is a measure of the severity of a disease, defined as the proportion of people diagnosed with a particular disease who die from that disease within a specific time period. It is calculated by dividing the number of deaths due to a particular disease by the number of people diagnosed with that disease, and multiplying the result 100 to express the rate as a percentage. ‘ CFR is typically used to measure the severity of acute, life-threatening seemed Ebola, SARS, or COVID-19. It is a useful measure because it takes into. rey 1 incidence and the lethality of a disease, and provides important inf ie the potential impact of an outbreak. CFR is influenced by factors suc! ilability and effectiveness of medical treatment, as well as the age, sex, conditions of the affected population. Therefore, it ro cc lethality of a disease in all situations. 9. Define proportional mo ite Proportional mortality rate used in epidemiology to describe the proportion of deaths ina ep that are attributed to a specific cause or group of jing the number of deaths due to a particular cause by the ication of the relative importance of different causes of death ina |, and can be useful in identifying priorities for public health interventions and irces. For example, a high PMR for a particular cause of death may indicate the need ‘or targeted screening, prevention, or treatment programs for that condition. 10. What do you meant by survival rate Survival rate is a measure used in epidemiology to describe the proportion of people with a specific disease or condition who survive for a given period of time after diagnosis. Tt is calculated by dividing the number of people who survive for a specified period of time \ after diagnosis by the total number of people diagnosed with the disease, and multiplying ‘the result by 100 to express the rate as a percentage. Survival rate can be used to assess the effectiveness of medical treatments and interventions for a particular disease or condition, as well as to provide prognostic information for patients and their families. For example, a high survival rate for a particular cancer may indicate that the available treatments are effective in controlling the disease and prolonging life, while a low survival rate may suggest the need for new or more effective treatments. 11. Define Morbidity wee Morbidity refers to the prevalence of illness, disease, injury, or disabili at a given time. Tt is a measure of the burden of illness in a “x i Kec acute and chronic conditions. Morbidity can be measured in a number of ways, includi ta i Oo, new cases of a lar disease or condition, the prevalence of the aah in the population at a given time, and the duration or severity of condition. Morbidity is an important public health indi ‘ause it can help to identify the prevalence and distribution of different‘di: and conditions in a population, as well as trends over time. This informatio (8 to develop targeted interventions and policies to prevent and eon of disease, reduce the burden of illness, and improve the overall healt! being of the population. 12, Oy Va ‘to the incidence of death in a population, usually measured as the number ‘occurring in a specific time period, typically expressed as a rate per 1,000 or 000 population. Mortality is a key measure of the health of a population and an important public health indicator. Mortality can be measured in a variety of ways, including crude mortality rate (the number of deaths in a population divided by the total population), age-specific mortality rate (the number of deaths in a specific age group divided by the total population of that age group), and cause-specific mortality rate (the number of deaths attributed to a specific cause divided by the total population). Mortality data is used by public health officials and policymakers to identify patterns and trends in disease and injury, to develop and evaluate health interventions and policies, and to allocate resources for disease prevention and control. Mortality rates can also be used to compare the health of different populations, to assess the impact of specific diseases or conditions, and to monitor progress towards public health goals. 13. Define incidence rate Incidence rate is a measure used in epidemiology to describe the frequency or rate of | * a) occurrence of new cases of a disease or condition ina population over a specified ti ~ period. It is calculated by dividing the number of new cases of the disease or c during the time period by the total person-time at risk in the population duri period, and multiplying the result by a constant factor (such as 1,000 or' express the rate per unit of population. Incidence rate is often used to track the spread and burden jous diseases, chronic diseases, and injuries, and to identify risk factor: k populations. It can also be used to evaluate the effectiveness of publ ferventions and policies in reducing the incidence of specific diseases or wo 14. What do yo! um sede Prevalence is a menare wet ology to describe the proportion of individuals in a population who have mit doecase condition, or risk factor at a particular point in time. It is calcul ing the number of individuals with the disease or condition by the total viduals in the population at a given time. x animportant measure in public health because it provides information about of disease in a population, and can help guide resource allocation and policy ons, Prevalence can be used to estimate the overall need for health services and ‘ interventions, to identify high-risk populations and areas, and to track changes in the ” incidence and prevalence of diseases over time. 15. List down the epidemiological methods ‘There are several methods used in epidemiology to study the distribution and determinants of diseases and health conditions in populations, Some of the most commonly used epidemiological methods include: + Descriptive epidemiology: This method involves the collection and analysis of data on the occurrence and distribution of diseases or health conditions in a population. It helps to identify patterns and trends in disease occurrence, and can provide clues about possible risk factors. * Analytic epidemiology: This method involves the testing of hypotheses about the relationship between a particular exposure or risk factor and a specific disease or health outcome. It can help to identify causal factors and inform interventions to prevent or control disease. + Experimental studies: we These studies involve the manipulation of one or more variables to evaluate theif O. a particular disease or health outcome. Randomized controlled trials (R ,e i experimental study that are commonly used in epidemiology to So tiven of interventions. © Observational studies: 2 over time to identify risk les of observational studies 's8-sectional studies. ‘These studies involve the observation of individual factors for a particular disease or health out include cohort studies, case-control studi 16. What are is of prevention ‘There are three ere intion in public health, each with a different focus and approach: vention: of prevention aims to prevent the onset of disease or injury before it occurs, by ing the underlying causes and risk factors. Primary prevention strategies include Ith promotion and education, vaccination, environmental and workplace safety measures, and lifestyle interventions such as healthy eating and regular physical activity * Secondary prevention: This level of prevention aims to detect and treat disease or injury at an early stage, before it causes significant harm or disability. Secondary prevention strategies include screening and diagnostic tests, early treatment and management of disease, and rehabilitation and support services for people with chronic conditions. ow + Tertiary prevention: This level of prevention aims to minimize the impact of disease or injury that has already occurred, and prevent further complications or disability. Tertiary prevention strategies include ongoing medical treatment and monitoring, rehabilitation and support services, and palliative care for people with advanced or terminal illness. 17. Difference between epidemic and endemic Here is a tabular comparison between epidemic and endemic: ‘An outbreak of adisease The const ‘that spreads rapidly and usual Definition affects a large number of ifi people in a short period A ie area or time n group Occurrence en and persistent Affects a predictable Size of affected population umber of people in a given ‘area or population group Limited spread within “3 — Dorie often involving population, often involving person-to-person environmental or lifestyle transmission factors Occursoverarelatively 20, occurat any tine, and er Seri ped et te, can persist for years or typically a few weeks toa vee ‘les yee \ ae OS Often requires urgent Requires ongoing public health interventions surveillance and Contre! measures to control the spread of management to prevent or disease, such as quarantine, control the disease, such as isolation, or vaccination rgutine screening, ‘treatment, or lifestyle interventions ‘Malaria in sub-Saharan Africa, Dengue fever in Southeast Asia, Chagas disease in Latin America COVID-19 pandemic, Ebola Examples 18. What are the epidemiological approaches a Epidemiology is a broad field that encompasses a variety of different approaches methods for studying the distribution and determinants of health and diseas ‘the main epidemiological approaches include: vy * Observational studies: ‘These studies involve observing and collecting data ona See uals, without actively intervening or manipulating any variables. Ty} Ft ional studies include cross-sectional studies, case-control studies, and, striate © Experimental studies: These studies involve actively i ipulating one or more variables, and comparing the outcomes to . Types of experimental studies include randomized controlled tri ‘and quasi-experimental studies. * Descriptive This approac! on describing the distribution of health and disease in a population, includi of incidence, prevalence, and mortality. Descriptive epidemiology often “0 charts, tables, and maps to visualize the data, Ww \nalytical epidemiology: is approach aims to identify and understand the determinants of health and disease, by ‘comparing groups with and without a particular condition, or by analyzing the relationships between risk factors and health outcomes. X 19. Define epidemic. An epidemic is an outbreak of a disease that occurs suddenly and spreads rapidly through population, affecting a large number of individuals within a defined geographic area or population group. Epidemics can occur for a variety of reasons, including the introduction of a new pathogen, changes in the environment or social conditions, or the emergence of drug-resistant strains of a disease. Epidemics often require urgent public health interventions to control the spread of disease, such as quarantine, isolation, or vaccination. Examples of epidemics include the COVID-19 pandemic, the Ebola outbreak in West 20. Name four epidemic disease «N Africa, and the influenza pandemic of 1918, There are many diseases that can cause epidemics, but here are four nee oe diseases: © COVID-19: ‘Oo COVID-19 is a respiratory illness caused by the SARS-CoV. emerged in late 2019 and quickly spread around the world, causing a a) femic * Ebola: Ebola is a highly contagious viral di severe hemorrhagic fever, with a high mortality rate, Outbreaks of Ebola ‘ed sporadically in Africa since the 1970s. ° Influenza: Influenza, or the fi Contagious respiratory illness caused by influenza viruses. ‘Major influenza my occurred throughout history, including the 1918 pandemic that killed mi ple worldwide, i$ a bacterial disease that causes severe diarrhea and dehydration, and is spread jh contaminated food and water. Cholera epidemics have occurred throughout history, particularly in areas with poor sanitation and hygiene. 21. Define cohort In epidemiology, a cohort is a group of individuals who share a common characteristic or experience, and are followed over time to observe outcomes such as disease incidence or mortality. Cohort studies are a type of observational study that can be used to study the relationship between risk factors and health outcomes. In a cohort study, participants are typically selected based on a common exposure or characteristic (such as occupation, age, or lifestyle factors), and then followed over time to observe the development of disease or other health outcomes. Cohort studies can be prospective (where the study starts at a point in time and follows participants forward in time) or retrospective (where data is collected retrospectively from existing records or surveys). Cohort studies are often considered the gold standard for observational studies because they can help establish a cause-and-effect relationship between risk factors and outcomes, and can provide insights into the natural history and progression of disease. 22. Define pandemic ‘A pandemic is an outbreak of an infectious disease that spreads across as multiple continents or worldwide, and affects an exceptionally hi population. Pandemics are often caused by the emergence of a strain of an existing pathogen that the population has i Examples of pandemics include the current conn 19 , the 1918 influenza pandemic, and the HIV/AIDS pandemic. Pandemi oe ‘significant impacts on public health, the economy, and society as a whole, e coordinated global efforts to control their spread and mitigate their saa 23. Define s =a toa disease or health condition that occurs infrequently red instances. Sporadic cases of a disease occur at random linked to any particular outbreak or epidemic. Sporadic cases may be of factors, including individual genetics, environmental exposures, or like endemic or epidemic diseases, sporadic diseases do not have a consistent jern of occurrence in a particular population or geographic area. Examples of sporadic iseases include certain types of cancer, rare genetic disorders, and some infectious diseases that occur in isolated cases. In epidemiology, and in isolat inter 24. List the Types of cohort study There are two main types of cohort study: © Prospective cohort study a Ina prospective cohort study, the study population is identified at the beginning of the study, and participants are followed over time to observe the development of the outcome. of interest. Participants are typically chosen based on their exposure status (e.9., smoking, ‘occupational exposure) or other characteristics of interest (e.9., age, sex). The study investigators collect data on the exposure and outcome at regular intervals throughout the study period. Prospective cohort studies are generally considered to be the strongest observational study design for evaluating causality because they can establish the ‘temporal relationship between exposure and outcome. * Retrospective cohort study: . xOy Ina retrospective cohort study, the study population is identified based on existi sources (e.g., medical records, insurance claims databases). Participants are cl exposed and unexposed groups based on their exposure status at some point and data on the outcome of interest are collected retrospectively. Retro cohort studies can be useful for studying rare or long-term outcomes, but. be subject to biases and limitations due to incomplete or inaccurate data. & OS 25. Define reservoir > lace where an infectious agent (such as a virus, ind multiplies, and from which it can be transmitted n be a human, animal, or environmental source of an , the natural reservoir for the Ebola virus is thought to be the virus without getting sick, and can transmit it to humans contaminated body fluids. an important factor in the transmission and control of infectious . Identifying the reservoir of an infectious agent can help public health of icials levelop strategies to prevent or control the spread of the disease. For example, in the case of Ebola, efforts to control the spread of the disease may involve measures such as identifying and isolating infected individuals, tracing and monitoring their contacts, and In epidemiology, a reservoir refers bacterium, or parasite) nor toa susceptible infectious agent. Fi fruit bats, whi 26. Define carrier In epidemiology, a carrier is a person who is infected with a pathogen (such as a virus, bacterium, or parasite) but does not show any symptoms of the disease and can still spread the pathogen to others. Carriers can be a source of infection for others and can play an important role in the transmission and persistence of infectious diseases. There are different types of carriers, including healthy carriers, convalescent carriers, ‘and chronic carriers. Healthy carriers are people who are infected with a pathogen but remain asymptomatic throughout the course of their infection. Convalescent carriers are people who have recovered from an illness but continue to shed the pathogen for a period of time after they have recovered. Chronic carriers are people who continue to shed the * pathogen for an extended period of time, sometimes for years or even for the rest of ® initial exposure to roms of the disease to multiply and spread any signs of illness. a. Define incubation period In epidemiology, the incubation period is the time interval ‘an infectious agent (such as a virus or bacteria) and the ot cor infection. During the incubation period, the path; within the body, but the infected person may not’ The incubation period can vary depending fectious agent and the individual's immune response. Some infectious agent a short incubation period (e.g.,a few hours or days), while others have a Yaubation period (e.g., weeks or even months). For example, the incubation period influenza virus is typically 1-4 days, while the incubation period for HE\ ange from a few weeks to several years. 28) & quarantine ine is a public health strategy used to prevent the spread of infectious diseases parating and restricting the movement of people who have been exposed toa Contagious disease but are not yet showing symptoms. Quarantine can be used to limit the ‘transmission of infectious agents during the incubation period, when infected individuals may be unknowingly spreading the disease. ‘Quarantine measures may be mandatory or voluntary and may be applied to individuals, groups, or entire communities, During a quarantine, individuals may be required to stay in a designated location, such as their home, a hospital, or a government facility, for a specified period of time to monitor their health and prevent the spread of the disease. cv Quarantine measures may also include restrictions on travel, social gatherings, and other activities that could increase the risk of transmission. 29. Mention the types of agent. In epidemiology, the term “agent” refers to the biological or physical factor that causes disease or health problems. There are several types of agents that can cause disease, ie chan pee a ‘These are microorganisms, such as bacteria, viruses, fungi, and parasites, that cé the body and cause disease. a simanoguas \ ‘These are toxic substances, such as pollutants, pesticides, and sop that can cause illness or health problems when ingested, inhaled, through the skin, © Physical agents: ‘These are environmental factors, such as radi ; noise, and vibration, that can cause iliness or injury. * Nutritional agents: G ‘These are factors to nutrition, such as deficiency or excess of certain vitamins or mney fect health and lead to disease. are caused by a wide range of pathogens, incl id fungi. Zoonotic diseases can be transmitted through direct contact wi animals, their secretions, or their excreta, as well as through contaminated food, water, and vectors such as mosquitoes and ticks. ‘Some examples of zoonotic diseases include: * Rabies, a viral disease that is transmitted through the bite of an infected animal, such as a dog or bat. x) * Salmonellosis, a bacterial infection that is commonly transmitted through contaminated food, such as undercooked meat or eggs. © Lyme disease, a bacterial infection that is transmitted through the bite of an infected tick. * Toxoplasmosis, a parasitic infection that can be acquired by handling infected cat feces or consuming contaminated food or water. 31. Explain different modes of transmission of disease ‘ x os Diseases can be transmitted from one person to another through different modes of transmission. Understanding the mode of transmission of a disease is essential in developing effective prevention and control strategies. Here are the dif fere! imodes transmission: AS Diseases that spread through direct contact between i septible individuals ore transmitted by direct transmission. Examples incl ng, kissing, sexual contact, or contact with body fluids, such as blood, saliva, * Indirect transmission: Diseases that spread through an i indirect transmission. Exar such as doorknobs or object or environment are transmitted by Contact with contaminated surfaces or objects, Is, or inhalation of infectious droplets in the air. + Vector: ion: Diseases itted by the bite of an infected insect or animal are transmitted by vec 4a ission. Examples include malaria, dengue fever, and Zika virus, whi itted by mosquitoes, and Lyme disease, which is transmitted by ticks. & -borne transmission: Diseases that are transmitted through contaminated food or water are transmitted by food-borne transmission, Examples include salmonella and E. coli infections, which are commonly transmitted through contaminated food, and cholera, which is transmitted through contaminated water. 32. Define vector In epidemiology, a vector is an organism, typically an insect or arthropod, that transmits disease-causing pathogens from one host to another. Vectors can carry and transmit a wide range of pathogens, including bacteria, viruses, and parasites, and they play a significant role in the transmission of many infectious diseases. Examples of vectors include mosquitoes, which transmit diseases such as malaria, dengue fever, and Zika virus: ticks, which transmit Lyme disease and Rocky Mountain spotted fever: and fleas, which transmit plague. Vectors can also include animals, such as rodents or bats, that carry and transmit disease-causing pathogens to humans. 33. List out the vector borne disease oO There are many vector-borne diseases that can be transmitted to hu e bites of infected insects or animals, Here are some examples of c borne bres Ae) ‘Malaria - transmitted by the Anopheles mosquito * ie © Dengue fever - transmitted by the Aedes mesnisy + Zika virus - transmitted by the Aedes * Yellow fever - transmitted by the ee. mosquitoes + Chikungunya - transmitted by thd + West Nile virus -transmitt lex oopite + Lyme disease - 1 + Rocky Mountain * ronanitted by ticks © Plague - tra leas on rodents . NS itted by sandflies ae do you meant by transmission chain Geen ‘the transmission chain refers to the series of events that occur in the Le ‘transmission of an infectious disease from one host to another. The chain typically involves three main components: the infectious agent, the host, and the mode of transmission, The transmission chain begins with the infectious agent, which is the pathogen responsible for causing the disease, The infectious agent must first be present in the environment in order to infect a host. ‘The next component is the host, which is the organism that becomes infected with the infectious agent. The host may be a person, an animal, or even a plant, depending on the specific disease. The third component is the mode of transmission, which refers to the way in which the infectious agent is passed from one host to another. Modes of transmission can include direct contact with an infected individual, contact with contaminated surfaces or objects, inhalation of droplets from an infected person's cough or sneeze, or transmission via a vector such as an insect or animal. Each link in the transmission chain is critical for the disease to be transmitted x successfully from one host to another. < 35. Define communicable period er ‘The communicable period refers to the duration of time during whi eS infected with an infectious disease is able to transmit the pat! when the individual is first infected with the pathogen x capable of spreading the disease to others. . Tt begins ‘re no longer oS the specific infectious diseases, such as influenza, the i only a few days. For other diseases, may be much longer, lasting weeks or even The length of the communicable period can vary disease, as well as the individual who is infec communicable period may be relatively such as tuberculosis, the communi months. xO 36. Def unity Immunity lity of an organism to resist or defend against infections, diseases, or of ful foreign bodies, such as viruses or bacteria, I+ is a complex + involves the recognition and elimination of foreign substances, known as , By specialized cells and molecules within the body's immune system. There are two main types of immunity: innate immunity and adaptive immunity. Innate immunity is the body's first line of defense against foreign invaders and is present from birth. It includes physical barriers, such as skin and mucous membranes, as well as specialized cells and molecules that can recognize and attack a wide range of foreign substances. ‘Adaptive immunity, on the other hand, is developed over time in response to exposure to specific antigens. 37. What is survellience Surveillance refers to the systematic collection, analysis, and interpretation of health data related to a specific disease or condition. The purpose of surveillance is to monitor disease trends and patterns, identify outbreaks or clusters of disease, and inform public health interventions and policies. ‘Surveillance systems can vary widely in terms of their scope and focus, but generally al involve the collection of data from a variety of sources, including health care providers,” N laboratories, and public health agencies. This data is then analyzed and interpreted t identify trends and patterns, as well as to identify any unusual or concerning pat disease activity. 38. What is meant by convalescent carrie} A convalescent carrier is a person who has recovered continues to carry and potentially transmit the pat the pathogen remains in the body even after ti ‘experiences a relapse of the disease. Convalescent carriers can pose a rena |, as they may not be aware that they are still carrying the pathogen at wingly spread it to others. This is particularly true for diseases that we Hed through close contact or respiratory droplets, such as eR OVI a) « Qrerene between active and passive immunity hers, This can occur when recovered, or when the person Source of antibodies Produced by the body's | Transferred from another immune system in response individual or animal to exposure to a pathogen Onset of protection Takes time to develop, Immediate usually days to weeks | Duration of protection Long-term protection, ‘Short-term protection, potentially lifelong typically weeks to months Ability to provide memory Yes No response. 2 Examples Vaccinations, natural ‘Antibody therapies, maternal antibodies passed through the placenta or breast milk SHORT ESSAYS (5MARKS) 1. Describe the epidemiological approaches. techniques used in epidemiological research to underst determinants of health and disease, ‘There are several epidemiological approaches, sit strengths and weaknesses, and each suited to different research questi designs, Some of the common epidemiological approaches include: 1) Descriptive Epi Descriptive epidemic a population. This and identifies step in of the distribution of diseases or health outcomes in ides a picture of the burden of a disease in a population of occurrence. This type of epidemiology is often the first ing a disease and its impact. It involves collecting data on the number of ion by age, gender, ethnicity, and other demographic factors, and any changes over time. ) Analytical Epidemiology: Analytical epidemiology aims to identify the causes or risk factors associated with a particular disease. It involves comparing the frequency of the disease in exposed and non- ‘exposed groups to identify any differences that may be due to a specific exposure or risk factor. This approach includes cohort studies, case-control studies, and cross-sectional studies. 3) Experimental Epidemiology: Experimental epidemiology involves the use of experimental designs to test interventions aimed at preventing or controlling disease. This approach includes randomized controlled trials, which involve randomly assigning participants to either an intervention or control group to test the ef fectiveness of an intervention. 4) Molecular Epidemiology: Molecular epidemiology involves the use of molecular and genetic techniques to study the distribution and determinants of disease. This approach includes studies of genetic susceptibility to diseases, the role of genetic mutations in disease development, and the _ x use of genetic markers to identify disease outbreaks. we 5) Social Epidemiology Social epidemiology is the study of the social determinants of health and dis g approach recognizes that social and economic factors such as income, occupation, and social support can significantly impact health out. ves studying the distribution of disease according to social and e¢ rors and exploring the pathways by which social determinants influence heal V 6) Ecological Epidemiology: Ecological epidemiology is the study of the health outcomes. This approach expl pollution, water quality, and clit ‘. between the environment and ‘ects of environmental factors such as air ‘oh health. It involves studying the distribution of disease across geographi identifying any environmental risk factors. In su NOt ‘approaches are diverse and include both quantitative and qualitative ‘approaches are critical for understanding the distribution and determi Ith and disease in populations and for informing public health policy “oO; rions, \..) © 2. Explain the basic measurement used in epidemiology In epidemiology, various measurements are used to understand and quantify the ceccurrence and distribution of diseases and health-related events in populations, These measurements provide valuable information for assessing the burden of diseases, identifying risk factors, evaluating interventions, and formulating public health policies. One of the fundamental measurements in epidemiology is the calculation of rates. A rate is a measure of the frequency of an event or condition in a population over a specific period of time. It represents the number of occurrences of an event divided by the population at risk during a given time period. Rates allow for the comparison of disease occurrence between populations with different sizes or over different time periods. To calculate a rate, we need to define several key components: + Numerator: ‘The numerator represents the number of events of interest, such as the number of cases of a specific disease or the number of deaths due to a particular cause within a defined population and time period. . me. © Denominator: Ne ‘The denominator represents the population at risk of experiencing the event < specified time period. The population at risk refers to individuals who are the event and can be affected by it. + Time period: The time period over which the events are counted is an essential calculation. It could be a year, a month, a week, or any other of rate period. Consistency in the time period is important for accu risons between different populations or time periods, ‘The formula for calculating a rate is as foll Rate = (Number of events / Population ‘The multiplier is used to aes For instance, it could be wed incre ‘the rate per 100,000 population or per 1,000 person-years. ) x Multiplier ste to a specific population size or time period. Si a calculate the incidence rate of a specific infectious disease in a popilatic ‘the course of one year. We identify 50 new cases of the disease during period, and the population at risk is determined to be 10,000 individuals. The la for the incidence rate would be: Incidence Rate = (50 cases / 10,000 population) x 100,000 (to standardize to per 100,000 population) Calculating the above expression, the incidence rate for this example would be 500 cases per 100,000 population. Rates in epidemiology can be used for various purposes, such as comparing disease occurrence across different populations or time periods, identifying high-risk groups or areas, assessing the impact of interventions, and monitoring trends over time. They provide valuable information to researchers, public health officials, and policymakers for understanding the burden of diseases and making informed decisions to protect and promote the health of populations. 3. Explain the epidemiological triad. we The epidemiological triad, also known as the epidemiological triangle or web of ci a conceptual framework used in epidemiology to understand the complex it between the host, agent, and environment in the development and non-infectious diseases. The three components of the epidemiological triad are: “ © Host: The host refers to the person or population 2 of developing the disease. Host factors that can influence disease suse lude age, sex, genetics, underlying health conditions, and behaviors. = Agent: The agent refers t Agents can include i 9? chemical, or physical factor that causes the disease. ‘agents such as viruses, bacteria, parasites, and fungi, as well such as chemicals, radiation, and other environmental factors. nt refers to the physical, social, and cultural factors that influence disease em Environmental factors can include climate, air quality, water quality, access to healthcare, living conditions, and socioeconomic status. The epidemiological triad suggests that disease occurs when the host, agent, and environment interact ina way that leads to disease development. For example, an infectious agent such as a virus may cause disease in a susceptible host who has weakened immune defenses due to a pre-existing condition. The environment may also play a role in disease development, for example, by providing favorable conditions for the spread of the infectious agent, such as poor sanitation or crowded living conditions. The epidemiological triad is useful in understanding the complex interplay between multiple factors in disease development and spread. It can be used to identify potential risk factors and interventions to prevent and control disease. By understanding the interactions between the host, agent, and environment, epidemiologists can develop effective strategies for disease prevention and control. 4. Describe the measurements of morbidity epidemiology, several measurements are used to quantify morbidity. Some of the com! used measurements of morbidity are: womans @ Incidence is the number of new cases of a disease or health conditi AN ina Morbidity refers to the incidence or prevalence of illness or disease in a population. In aw population during a specified time period. Incidence provides a the risk of developing a disease or condition in a population. Incidence sed as a rate (eg,, the number of new cases per 100,000 people per as a proportion (e.g., the number of new cases per total population at risk), < + Prevalence \y Prevalence is the total number of porticular point in time. population. Prevalence te people) or asa ren + Point she Point pi fers to the proportion of the population that has a disease or health condition a! fic point in time. Point prevalence is useful for estimating the burden of disease in a population. * Period prevalence: isease or health condition in a population at a jes a measure of the burden of disease ina das arate (e.g., the number of cases per 100,000 1e number of cases per total population) Period prevalence refers to the proportion of the population that has a disease or health condition during a specific time period. Period prevalence is useful for estimating the overall burden of disease in a population. © Attack rate: Attack rate is the proportion of people who become ill with a disease among those who are at risk of developing the disease during an outbreak or epidemic. Attack rate is useful for assessing the severity of an outbreak or epidemic and for identifying risk factors for disease transmission. * Disability-adjusted life years (DALYs): DALYs are a measure of the burden of disease that combines the years of life lost due to premature death and the years of life lived with disability. DALYs are used to estimate the impact of a disease on a population and to prioritize public health interventions. In summary, these measurements of morbidity provide important information for understanding the occurrence and burden of disease in a populat risk factors for disease development and inform public health interventions for disease prevention and control, 5. Describe the measurements of mortality. \ Mortality refers to the number of deaths that occur in a | ‘epidemiology, several measurements are used to quantify mortality. monly used measurements of mortality are: * Crude mortality rate: < Kore population during a specified time period lity rate provides a measure of the overall risk as a rate per 1000 or 100,000 people per year. Crude mortality rate is the number of divided by the total population. C1 of death in a population. It + Age-specifi Age-specific mortality bate is the number of deaths in a specific age group divided by the total ro ‘age group during a specified time period. Age-specific mortality rate of the risk of death in a particular age group. It is expressed as a ‘or 100,000 people in that age group per year. Cause-specific mortality rate: NG © * Cause-specific mortality rate is the number of deaths due to a specific cause divided by the total population during a specified time period, Cause-specific mortality rate provides ‘a measure of the risk of death due to a particular cause in a population. It is expressed as a rate per 1000 or 100,000 people per year. + Case fatality rate: \n. They can help identify. ee Case fatality rate is the proportion of people who die from a specific disease among those who have the disease during a specified time period. Case fatality rate provides a measure of the severity of a disease and the effectiveness of treatments for the disease, © Standardized mortality ratio (SMR): SMR is a measure of the excess mortality in a population compared to a standard population. SMR is calculated by dividing the observed number of deaths in a population by ‘the expected number of deaths based on the age and sex distribution of a standard population. SMR provides a measure of the overall mortality burden in a population after ‘adjusting for dif ferences in age and sex. OY «Years of potential life lost (YPLL): o YPLL is a measure of the premature mortality burden in a population. YPLL i ieee multiplying the number of deaths by the difference between the age at a standard age of death. YPLL provides a measure of the impact of the overall health of a population. mortality on In summary, these measurements of mortality provide jt information for understanding the occurrence and burden of death i stion. They can help identify risk factors for premature mortality and infors health interventions for reducing the mortality burden in a population. 6. Describe the sitet used in epidemiological studies Epidemiological stu. ned to investigate the distribution, determinants, and ‘outcomes of hi isease in populations. There are different types of epidemiologi and each type uses different methods to collect and analyze data. Some of nly used methods in epidemiological studies are: tional studies: tional studies are designed to observe and describe the natural course of events a population without any intervention, The main types of observational studies are: + Cross-sectional studies: Cross-sectional studies collect data at a single point in time to estimate the prevalence of a disease or health condition in a population. Cross-sectional studies are useful for generating hypotheses and for identifying the distribution of disease in a population. © Cohort studies: Cohort studies follow a group of people over time to investigate the incidence of a disease ‘or health condition in relation to exposure to a risk factor, Cohort studies are useful for identifying risk factors for disease and for estimating the magnitude of the association between exposure and disease. * Case-control studies: Case-control studies compare the frequency of exposure to a risk factor between people with a disease (cases) and people without the disease (controls). Case-control studies are. useful for identifying risk factors for disease and for estimating the magnitude of the af association between exposure and disease, OO oo 2) Experimental studies: yy Experimental studies are designed to test the effectiveness of an in preventing or treating a disease. The main types of experiment ‘+ Randomized controlled trials (RCTs): 7 \&) RCTs randomly assign participants to receive eith: fention or a placebo or standard treatment. RCTs are useful for th efficacy and safety of an intervention and for establishing SKN © Quasi-experimental studies; ear on-randomized design to evaluate the effectiveness of etal studies are useful when it is not feasible or ethical to ‘an intervention. Quasi- conduct an RCT. \y 3 iptive studies: iptive studies are designed to describe the distribution of a disease or health ition in a population, The main types of descriptive studies are: \ °. © Ecological studies: Ecological studies use aggregated data to investigate the association between exposure to a risk factor and the occurrence of disease in a population. Ecological studies are useful for generating hypotheses and for identifying patterns of disease distribution. * Case reports and case series: Case reports and case series describe the clinical characteristics and outcomes of individual patients with a disease or health condition. Case reports and case series are useful for identifying rare or new diseases and for generating hypotheses. In summary, epidemiological studies use different methods to collect and analyze data, depending on the research question and the type of study design. These methods are essential for investigating the distribution, determinants, and outcomes of health and disease in populations and for informing public health interventions, . we 7. Explain about descriptive epidemiology Descriptive epidemiology is a branch of epidemiology that is concerned ania distribution of health and disease in populations. Descriptive ej ise WE ‘to identify patterns of disease occurrence and distribution and to generate about the factors that contribute to these patterns. The goal of femiology is to provide a snapshot of the burden of disease in a popul to identify subgroups that are most affected by the disease. Novi of data on the frequency and in & population. The data are often collected ds, disease registries, and surveys. Descriptive describe the distribution of disease in a population, Descriptive epidemiology involves the coll distribution of a disease or health c ‘from existing sources, such as epidemiology uses several mi including + Prevleeg: WY Preval tion of individuals in a population who have a specific disease or rea a specific point in time or during a specified time period. Prevalence measure of the burden of disease in a population. Incidence: Incidence is the number of new cases of a disease or health condition that occur ina population during a specific time period. Incidence provides a measure of the risk of developing a disease in a population. + Mortality: Mortality is the number of deaths that occur in a population due to a specific disease or health condition. Mortality provides a measure of the impact of disease on the overall health of a population oe Descriptive epidemiology also uses several measures to describe the distribution of disease in different subgroups of a population, including: + Age-specific rates: Age-specific rates are the rates of disease occurrence or mortality in specific age groups of a population. Age-specific rates provide a measure of the age-related risk of disease. © Sex-specific rates: x Sex-specific rates are the rates of disease occurrence or mortality in males and a ina population. Sex-specific rates provide a measure of the gender-related risk of disease. * Geographic distribution: gv? Geographic distribution describes the spatial distribution of di ow ina population. Geographic distribution can help identify on ial factors that contribute to disease, Descriptive epidemiology also uses graphical met SS ‘as maps and charts, to visualize the distribution of disease in a population. gtaphical methods can help identify patterns and trends in disease occur provide insights into the factors that contribute to these patterns. t ) In summary, descripti logy is a fundamental branch of epidemiology that aims to describe the dis ‘of disease in a population. Descriptive epidemiology provides an import: ion for identifying patterns of disease occurrence and for the factors that contribute to these patterns. Descriptive epide essential tool for public health professionals to understand the burden of st a population and to develop targeted interventions to prevent and control generating hy 8. Explain about analytical epidemiology Analytical epidemiology is a branch of epidemiology that focuses on identifying the causal factors of diseases by analyzing the patterns and relationships of health events in populations. Unlike descriptive epidemiology, which describes the distribution of disease in a population, analytical epidemiology investigates the relationships between the exposure. to risk factors and the occurrence of disease in populations. Analytical epidemiology is divided into two main types of study designs: observational studies and experimental studies. 1) Observational studies: Observational studies are non-interventional studies in which researchers observe the occurrence of disease in populations and analyze the associations between risk factors and the occurrence of disease. Observational studies can be further divided into two types: cross-sectional studies and longitudinal studies. * Cross-sectional studies: * Cy Cross-sectional studies are observational studies that assess the relationship bet ik factors and disease at a single point in time. In cross-sectional studies, researc! collect information on both the exposure and the outcome at the same time. * Longitudinal studies: \ Longitudinal studies are observational studies that assess the p between risk factors and disease over a period of time. In longitudinal’ studi irchers collect information on the exposure at the beginning of the follow participants over time to observe the occurrence of disease. \) 2) Experimental studies: Experimental studies are interventi exposure to a risk factor to Experimental studies can (RCTs) and commur \e effect on the occurrence of disease. divided into two types: randomized controlled trials controlled trials (RCTs): RCTs ‘tal studies in which participants are randomly assigned to a treatment 11701 group, In RCTS, the exposure to the risk factor is controlled and the the occurrence of disease is measured, * Community trials: Community trials are experimental studies in which interventions are implemented at the community level to observe the effect on the occurrence of disease. Analytical epidemiology uses several statistical methods to analyze the associations between risk factors and the occurrence of disease. Some of the statistical methods used in analytical epidemiology include: © Risk ratios: Risk ratios measure the ratio of the risk of disease among those exposed to a risk factor to the risk of disease among those not exposed to the risk factor. = Odds ratios: Odds ratios measure the odds of exposure among those with the disease compared to the odds of exposure among those without the disease. © Confidence intervals: Confidence intervals provide a range of values within which the true association be! ‘the risk factor and the disease is likely to lie. xo In summary, analytical epidemiology is a branch of epidemiol. tes the causal relationships between risk factors and the occurrence of populations Analytical epidemiology uses both observational and experi designs and employs several statistical methods to analyze the associat risk factors and develop and implement targeted interventions to prevent and control 9. Explain about Con Experimental epidemio experiments to in which the occur of inter disease. The findings from analytical epidemiology < h of epidemiology that involves conducting lity of diseases. It is a type of interventional study design a risk factor is manipulated to observe its effect on the Experimental epidemiology is used to determine the effectiveness ich as drugs or vaccines, in preventing or treating diseases. al epidemiology involves the following steps: * Selection of study population The study population is selected based on specific inclusion and exclusion criteria, and participants are randomly assigned to the intervention group or the control group. «Exposure and intervention: In the intervention group, participants are exposed to the intervention, such as a drug or vaccine, while the control group receives a placebo or standard care. + Follow-up: Participants are followed over time to observe the occurrence of disease or health outcomes. + Data analysis: ‘The data collected from the study are analyzed to determine the effect of the intervention on the occurrence of disease or health outcomes. safety of new drugs or vaccines. Clinical trials are typically conducted in three phases: * Phase 1: < Phase 1 clinical trials are conducted in a small group of healthy individuals to he safety and dosage of the intervention. "het 0° Experimental epidemiology is commonly used in clinical trials to evaluate the efficacy and _ ow Phase 2 clinical trials are conducted ina larger group of the disease or condition to determine the efficacy and safety of th ion. © Phase 3: Ss Phase 3 clinical trials are conducted in ip of individuals with the disease or condition to confirm the efficacy es of the intervention and to collect additional information on adverse oe. it demic is ‘used to evaluate the effectiveness of public health ity-based interventions to prevent or control the spread of studies, communities are randomly assigned to receive the 1rd care, and the effect of the intervention on the occurrence of ‘tal epidemiology has several advantages over other study designs, such os rvational studies. Experimental studies allow researchers to manipulate the exposure to the risk factor, control for confounding variables, and establish a cause-and-effect relationship between the risk factor and disease, However, experimental studies can also be more costly, time-consuming, and complex to conduct compared to observational studies. In summary, experimental epidemiology is a branch of epidemiology that involves conducting experiments to study the causality of diseases, It is commonly used in clinical trials to evaluate the efficacy and safety of new drugs or vaccines and in public health interventions to prevent or control the spread of infectious diseases. Experimental epidemiology allows researchers to manipulate the exposure to the risk factor, control for confounding variables, and establish a cause-and-effect relationship between the risk factor and disease. 10. Explain detail about cohort study A cohort study is a type of observational study in which a group of individuals who share a” we common characteristic or expasure are followed over time to observe the occurrence oF én outcome or health outcome of interest. Cohort studies are used to study the associ between exposure to a risk factor and the occurrence of disease or other outcomes, Ina cohort study, a group of i start of the study are identified and classified based on thei status. The exposed group consists of individuals who have been interest, while the unexposed group consists of indi the risk factor. The cohort study can be either prospec} tive: + Prospective cohort study: © have not been exposed to participants are identified at the beginning of to observe the occurrence of the outcome of interest. participants is determined at the start of the study, and data Ina prospective cohort st the study and foll The exposure st on the out sure are collected over time. . Ni ive cohort study: ive cohort study, the study participants are identified at the start of the Coy based on their exposure status and the outcome of interest has already occurred. X: Data on exposure and outcome are collected retrospectively from medical records or other sources. Cohort studies can be used to calculate several measures of association, including relative risk (RR), which is the ratio of the incidence rate of the outcome in the exposed group to ‘the incidence rate of the outcome in the unexposed group. The RR can be used to determine the strength of the association between exposure to the risk factor and the ‘occurrence of the outcome of interest. Ee Cohort studies have several advantages, including: © The ability to measure the incidence of disease in exposed and unexposed groups over time. * The ability to control for confounding variables by design or through statistical analysis. + The ability to establish the temporal relationship between exposure and outcome. ‘+ The ability to study multiple outcomes or exposures. x However, cohort studies can be expensive and time-consuming to conduct, particularly i “we they involve following participants over a long period of time. Additionally, cohort can suffer from selection bias, loss to follow-up, and measurement errors. individuals who share a common characteristic or exposure observe the occurrence of an outcome or health outcome of inter ies can be used to calculate measures of association and establish relationship between exposure and outcome. While cohort studies advantages, they can be expensive and suffer from biases and m errors. In summary, a cohort study is a type of observational study mm a group of i 11, Describe the ci A case-control of observational study that is commonly used in epidemiology tte the association between a potential risk factor and a particular disease or. jcome. In a case-control study, individuals who have the disease or outcome, of int (cases) are compared to individuals who do not have the disease or controls) with respect to their exposure to potential risk factors. inst step in a case-control study is to identify cases and controls, Cases are individuals who have the disease or outcome of interest, while controls are individuals who do not have the disease or outcome, The cases and controls are then matched on certain characteristics that are known to be associated with the disease or outcome, such as age, gender, or other demographic factors. The next step is to determine the exposure status of cases and controls. This is done by collecting data on the potential risk factors for the disease or outcome of interest. The exposure status is then compared between cases and controls to determine whether there is an association between the potential risk factor and the disease or outcome, ‘The association between the exposure and outcome is usually expressed as an odds ratio (OR), which is the ratio of the odds of exposure among cases to the odds of exposure ‘among controls. An OR greater than 1 indicates that the exposure is associated with an increased risk of the disease or outcome, while an OR less than 1 indicates that the exposure is associated with a decreased risk. Case-control studies have several advantages, including: They are useful for investigating rare diseases or outcomes. “ow They are less expensive and time-consuming than cohort studies. ‘They can be used to study multiple potential risk factors simultaneously. ow ‘They can be conducted retrospectively, which is useful for diseases or that have long latency periods. \ However, case-control studies have some limitations, inclydi «They are prone to selection bias, which occ: Ss controls are not representative of the population from whi drawn, + They are prone to recall bias, which n cases and controls do not accurately report their exp. * They do not allow for the c are useful for investigating rare diseases or outcomes and can be less i ‘time-consuming than cohort studies. However, case-control studies are selection and recall bias and do not allow for the calculation of incidence rates. 12. Explain about levels of prevention Levels of prevention refer to the various stages of intervention that can be employed to prevent the occurrence or progression of disease. There are three levels of prevention’ primary, secondary, and tertiary. Primary Prevention: Primary prevention involves interventions that aim to prevent the onset of a disease before it occurs. This is achieved by reducing exposure to risk factors and promoting healthy behaviors. Examples of primary prevention include vaccination programs, health education campaigns, and policies that restrict the sale of harmful substances such as tobacco and alcohol. = Secondary Prevention: Secondary prevention aims to identify and treat diseases in their early stages, before they become more severe and cause complications. This is achieved through regular, = ~*~ screening and testing, followed by appropriate medical interventions. Examples of Ae secondary prevention include mammography screening for breast cancer, colonosc screening for colon cancer, and regular blood pressure and cholesterol checks Do cardiovascular disease. \) «Tertiary Prevention: ~ Tertiary prevention aims to manage and reduce the complicatis lished diseases, to prevent further deterioration and to improve quality f.life. ‘achieved through medical interventions and rehabilitation programs aoe revent complications and disability. Examples of tertiary prevention includ ‘ation programs for individuals with stroke, cardiac rehabilitation pi in with heart disease, and palliative care for individuals with ter liness. In summary, the tI NOY prevention - primary, secondary, and tertiary - aim to prevent the occ reiesin of disease through different stages of intervention. verre aims to prevent the onset of disease, secondary prevention ait identify and treat diseases in their early stages, and tertiary manage and reduce the complications of established diseases. All three ion are important in maintaining public health and reducing the burden of 13. Describe the uses of epidemiology Epidemiology is the study of the distribution and determinants of health and disease in populations. It is a critical field in public health, and has a wide range of applications in both research and practice. Some of the major uses of epidemiology are: * Disease surveillance: x. Epidemiology is used to monitor the occurrence and distribution of diseases in populations. This helps to identify disease outbreaks, track disease trends over time, and identify changes in disease patterns. Disease surveillance data can be used to guide public health policy, allocate resources, and plan interventions to control the spread of disease. © Identification of risk factors: Epidemiology is used to identify risk factors for disease, such as genetic, environmental, and lifestyle factors. This information can be used to develop prevention strategies and interventions to reduce the risk of disease in populations. aan + Evaluation of interventions: we Epidemiology is used to evaluate the effectiveness of public health interventior medical treatments. This involves conducting studies to determine whether i have the desired effect, and identifying any unintended consequences. The ¥i these studies can be used to refine and improve interventions, S health policy. pol + Public health policy development: ‘ Epidemiology is used to inform the development of pi wid licies and guidelines. = This involves synthesizing the available evidence idence, prevalence, and risk factors of diseases, and using this monty lop recommendations for disease prevention and control. healthcare delivery is involves assessing the quality of care, identifying disparities in ac: and evaluating the impact of health policies and interventions on health . ion and promotion: © Health services che S Epidemiology is used oe effectiveness and efficiency of health services and logy is used to develop health education and promotion programs. This involves fying the factors that influence health behaviors and developing interventions to promote healthy behaviors and prevent disease. In summary, epidemiology has many uses in public health, including disease surveillance, identification of risk factors, evaluation of interventions, public health policy development, health services research, and health education and promotion. These applications of epidemiology are critical to improving population health and reducing the burden of disease. 14. Discuss the natural history of disease. The natural history of disease is the process by which a disease develops and progresses in an individual or population over time, in the absence of medical intervention. The natural history of a disease can be divided into several stages, which are as follows: * Pre-pathogenesis stage: This stage includes the factors that predispose individuals to a disease, suchas genetic x and environmental factors, lifestyle choices, and social determinants of health. These No factors increase the risk of developing a disease, but do not directly cause it. oO * Subclinical stage: In this stage, the disease is present but has not yet caused any symptom an individuals with high blood pressure may not experience any symptoms, but their blood pressure is higher than normal and can lead to complications if eft Un of the disease. At this stage, the disease diagnosed and medical intervention is initiated, + Remtuton storey xD In some cases, the di \ 0 haan through medical treatment or the body's natural defenses. F , individuals with bacterial infections can be treated with antibiotics and ptoms may resolve within a few days. * Clinical stage: N\ This stage is characterized by the onset it development of clinical signs the disease persists over a prolonged period of time and may cause ongoing ‘and complications. Examples of chronic diseases include diabetes, arthritis, and * Sequela stage: This stage is characterized by the long-term consequences of the disease, which may include physical, psychological, or social disabilities. For example, individuals with a history of stroke may experience long-term cognitive or motor deficits. The natural history of disease varies depending on the specific disease and the individual's genetic and environmental factors. By identifying the risk factors and stages of disease development, public health practitioners can design interventions that target specific stages of the natural history of disease, such as prevention programs that aim to reduce rrisk factors or early detection and treatment programs that aim to prevent complications, 15. Enumerate the dynamics of disease transmission ‘The dynamics of disease transmission refer to the factors that influence the spread and ® N transmission of infectious diseases within a population. These factors include the AN characteristics of the disease-causing agent, the host, and the environment. The. are the key dynamics of disease transmission: ‘The infectious agent refers to the microorganism that causes tI . Such as a virus, bacteria, fungus, or parasite. The characteristics of the in nt play a significant role in disease transmission, including the mode of ish (eg. airborne, waterborne, or vector-borne), the infectious dose (i.e. the nui iG Cd vorscions required to cause an infection), the virulence (i.e. the severity ofthe se), and the incubation period (i.e. the time between exposure and the a roms). © Host: imal that is infected with the disease. The ‘05 age, sex, immune status, and underlying health conditions, can infl ‘susceptibility to infection and the severity of the disease. Host factor a role in disease transmission, as some people may be asymptomatic cra and can unknowingly spread it to others. OF ironment: ‘environment refers to the physical, social, and cultural factors that influence disease e ‘transmission. Environmental factors that can influence disease transmission include the availability of clean water and sanitation, the density and mobility of the population, and the presence of vectors or reservoirs that can harbor the infectious agent. The host refers to the pé characteristics of * Modes of transmission: ‘The mode of transmission refers to the way in which the infectious agent is spread from person to person or from animal to person. There are several modes of transmission, including direct contact (e.g. touching, kissing), indirect contact (e.g. touching contaminated objects), airborne transmission (e.g. through respiratory droplets), waterborne transmission (e.g, through contaminated water), and vector-borne transmission (eg. through mosquitoes or ticks). ‘+ Transmission dynamics: The transmission dynamics refer to the factors that influence the spread of the disease within a population over time. These factors include the basic reproduction number (RO), which is the average number of secondary infections that result from one infected person, the serial interval, which is the time between successive cases in a chain of transmission, _ cand the herd immunity threshold, which is the proportion of the population that needs *< be immune to the disease in order to prevent sustained transmission. Public health interventions that target the infectious agent, the host, and + can be used to interrupt disease transmission and reduce the “< NN diseases. 16. Explain modes of transmission Modes of transmission refer to the various infectious diseases are spread from one person to another or from my .. Understanding the mode of transmission of a disease is important oN, effective strategies to prevent and control its spread. The followi 0) or modes of transmission of diseases: © Direct transmissic ~ the infectious agent is transmitted directly from an by direct transmission include sexually transmitted infections (STIs), DS, and influenza. © Indirect transmission: Indirect transmission occurs when the infectious agent is transmitted through an intermediary, such as a contaminated object or surface, food, or water. This can happen when a person touches a contaminated object or surface and then touches their mouth or rose, or when a person eats or drinks contaminated food or water. Examples of diseases ‘transmitted by indirect transmission include salmonella, norovirus, and hepatitis A. © Airborne transmission: Airborne transmission occurs when the infectious agent is spread through the air, usually ‘through small droplets or particles that are generated when an infected person coughs or sneezes. These droplets can remain suspended in the air for a short period of time and can be inhaled by others, leading to infection. Examples of diseases transmitted by airborne ‘transmission include tuberculosis, measles, and COVID-19. + Vector-borne transmission: Vector-borne transmission occurs when an infectious agent is transmitted by a vector, which is usually an insect or other arthroped that carries the pathogen from one host to a another. Examples of vector-borne diseases include malaria, dengue fever, and Lyme. Ne = oS © Vertical transmission: her of fspring during pregnancy, childbirth, or breastfeeding. Exa transmitted by vertical transmission include HIV, hepatitis 8, Measures to prevent disease transmission may include iene Use of personal protective equipment, vaccination, environmental ind vector control. 17. Explain the segs of an Epidemic. When an outbreak or oe: it is essential to investigate and control it as soon as possible to prevent ful of the disease. The following are the steps involved in investigating an Vertical transmission occurs when the infectious agent is transmit? soe her to iseases re confirm the existence of an epidemic by reviewing surveillance data ‘ing it to historical data or baseline rates. This helps to determine if the of cases is higher than expected and if the outbreak is unusual. + Define the case: ‘The next step is to define the case by developing a case definition that includes clinical and laboratory criteria, This helps to identify cases that are part of the outbreak and distinguish them from unrelated cases. + Identify cases and obtain information: X ‘Once the case definition is established, the next step is to identify cases and obtain information about them. This can be done by reviewing medical records, interviewing patients, and conducting laboratory tests. * Conduct descriptive epidemiology: Descriptive epidemiology involves the collection and analysis of data on the outbreak to describe the distribution of cases by person, place, and time. This helps to identify patterns and risk factors associated with the outbreak + Develop hypotheses: . w Based on the results of the descriptive epidemiology. hypotheses can be developed t

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