EPIDEMIOLOGY

ENGR. MIGUEL G. CABANIT

Content
Outline
Topics for discussion

01 Definition of Epidemiology

02 Measuring Health and Diseases

03 Causation and Prevention

04 Communicable Diseases

05 Health Services and Policies

EPIDEMIOLOGY has its origins in the idea, first expressed over
2000 years ago by Hippocrates and others, that environmental
factors can influence the occurrence of disease.

However, it was not until the 19th century that the

distribution of disease in specific human
population groups was measured to any great
extent.
This work marked not only the formal beginnings of epidemiology
but also some of its most spectacular achievements; for example,
the finding by John Snow that the risk of cholera in London was
related, among other things, to the drinking of water supplied by
a particular company.

Snow's epidemiological studies were one

aspect of a wide-ranging series of
investigations that involved an
examination of physical, chemical,
biological, sociological and political
processes (Cameron & Jones, 1983).
On the basis of his meticulous research, Snow constructed a
theory about the communication of infectious diseases in general
and suggested that cholera was spread by contaminated water.

He was thus able to encourage improvements in the

water supply long before the discovery of the organism
responsible for cholera; his research had a direct impact
on public policy.
EPIDEMIOLOGY
It has been defined as "the study of the
distribution and determinants of health-
related states or events and disease
conditions in specified populations, and the
application of this study to control of health
problems".

It involves studying how diseases spread,

their risk factors, and the effectiveness of
health interventions.
 CIVIL ENGINEERS AND
ENVIRONMENTAL ENGINEERS

play significant role in the field of

epidemiology, particularly in the
prevention and control of diseases.

Water and Wastewater Management

Air Quality Control
Waste Management
Public Health Infrastructure
Emergency Response
Policy and Regulations
HEALTH
According to the World Health
Organization, health is a state of
complete physical, mental, and
social well-being and not merely
the absence of disease or
infirmity.

In a more practical sense,

epidemiologists define health as
“disease present” or “disease
absent”.
DISEASE
It is an abnormal condition that
affects the normal functioning of a
living organism, whether it’s a
human, animal, or plant.

It can be caused by various

factors, such as genetic or
developmental errors, infections,
poisons, nutritional imbalances,
toxicity, or unfavorable conditions
in the environment.
COMMON
DISEASES
SMALLPOX
CHOLERA
RHEUMATIC FEVER
RHEUMATIC HEART DISEASE
IODINE DEFICIENCY DISEASE
HIGH BLOOD PRESSURE
LUNG CANCER
HIV/AIDS
 Measures of
Disease Frequency
POPULATION AT RISK
The calculation depends on correct estimates of the numbers of people
under consideration. These figures should include only people who are
potentially susceptible to the diseases studied. Men should not be included
in calculations of the frequency of carcinoma of the cervix.

The part of a population which is susceptible to a disease is called the

POPULATION AT RISK. It can be defined on the basis of demographic or
environmental factors.
Measures of
Disease Frequency
POPULATION AT RISK
 Measures of
Disease Frequency
PREVALENCE & INCIDENCE
The PREVALENCE of a disease is the number of cases in a defined
population at a specified point in time, while its INCIDENCE is the number
of new cases arising in a given period in a specified population.

These are fundamentally different ways of measuring occurrence and the

relation between prevalence and incidence varies between diseases. There
may be a high prevalence and low incidence, as for diabetes, or a lmv
prevalence and high incidence, as for the common cold.
 Measures of
Disease Frequency
PREVALENCE RATE
The PREVALENCE RATE (P) for a disease is calculated as follows:
Number of people with the disease
or condition at a specified time
P= Number of people in the population
x 100
at risk at the specified time
Data on the population at risk are not always available and, in many studies,
the total population in the study area is used as an approximation. The
prevalence rate is often expressed as cases per 1000 or per 100 population.
 Measures of
Disease Frequency
PREVALENCE RATE
Several factors can influence prevalence rate. In particular:

the severity of illness (if many people who develop a disease die, its
prevalence is depressed);
the duration of illness (if a disease lasts a short time, its prevalence rate
is lower than if it lasts a long time);
the number of new cases (if many people develop a disease, its
prevalence is higher that if few people do so)
Measures of
Disease Frequency
PREVALENCE RATE
 Measures of
Disease Frequency
INCIDENCE RATE
The most accurate way of calculating incidence rate is to calculate what
Last (1995) calls “person-time incidence rate”. Incidence rate (I) is
calculated as follows:
 Measures of
Disease Frequency
INCIDENCE RATE
The numerator strictly refers only to first events of disease. The units of
incidence rate must always include a dimension of time (day, month, year,
etc.).

For each individual in the population, the time at risk is that during which the
person under observation remains disease-free. The denominator for the
calculation of incidence rate is the sum of all the disease-free time periods
in the defined time period of the study.
 Measures of
Disease Frequency
CUMULATIVE INCIDENCE RATE OR RISK
Cumulative incidence rate is a simpler measure of the occurrence of a
disease or health status. Unlike incidence rate, it measures the denominator
only at the beginning of a study. Cumulative incidence rate (CI) can be
calculated as follows:
 Measures of
Disease Frequency
CASE-FATALITY
Case-fatality is a measure of the severity of a disease and is defined as the
proportion of cases of a specified disease or condition which are fatal
within a specified time.
CAUSATION AND
PREVENTION
A major goal of epidemiology is to assist
in the prevention and control of disease
and in the promotion of health by
discovering the causes of disease and
the ways in which they can be modified.
The Concept of
CAUSE
An understanding of the causes of disease is important in the
health field not only for prevention but also in diagnosis and the
application of correct treatment.

The philosophy of science continues to make contributions to the

understanding of the process by which causal inferences, i.e.
judgements linking postulated causes and their outcomes, are
made.
The Concept of
CAUSE
A cause of a disease is an event, condition, characteristic or a
combination of these factors which plays an important role in
producing the disease.

Logically, a cause must precede a disease. A cause is termed

sufficient when it inevitably produces or initiates a disease and
is termed necessary if a disease cannot develop in its absence.
The Concept of
CAUSE
The Concept of
CAUSE
FACTORS IN CAUSATION
Predisposing factors, such as age, sex and previous illness, may
create a state of susceptibility to a disease agent.

Enabling factors such as low income, poor nutrition, bad housing,

and inadequate medical care may favor the development of
disease. Circumstances that assist in recovery from illness or in the
maintenance of good health could also be called enabling factors.

Precipitating factors like exposure to a specific disease agent or

noxious agent may be associated with the onset of disease or state.

Reinforcing factors such as repeated exposure and unduly hard

work may aggravate an established disease or state.
 PREVENTION
The decline in death rates that occurred is seen in many
developing countries, mainly as a result of general
improvements in standards of living, especially in nutrition
and sanitation.

Significant control of certain diseases has been achieved

through specific preventive measures (for example,
immunization against poliomyelitis), but in general the role
of specific medical therapies has been less important.
COMMUNICABLE
DISEASES
Communicable diseases, also known as infectious or
transmissible diseases, are illnesses that spread
from one person or animal to another, either
directly through contact with bodily fluids, or
indirectly through contact with contaminated
surfaces, ingestion of contaminated food or water,
or via vectors like mosquitoes. They are caused by
pathogens such as viruses, bacteria, fungi, and
protozoa.
Health Services and Policies
The Philippines is focused more on improving
public health outcomes and managing the spread
of diseases.

The Department of Health (DOH) actively monitors

and controls communicable diseases through
surveillance systems, vaccination programs, and
health education campaigns.

The Philippine Health Insurance Corporation

(PhilHealth) provides financial access to health
services, including those related to epidemiology
and disease prevention.
DOH Health Services
The Department of Health (DOH) in the Philippines has
several disease monitoring and control programs
aimed at addressing various health concerns. Here
are a couple of key programs:

DENGUE PREVENTION AND

CONTROL PROGRAM
This program focuses on combating dengue fever,
a mosquito-borne viral disease. It includes
strategies for early detection, management of
cases, and community engagement for preventive
measures.
DOH Health Services
PHILIPPINE CANCER
CONTROL PROGRAM
This initiative aims to reduce the
burden of cancer through early
detection, improved access to care,
and the development of national
policies on cancer prevention and
control.
DOH Health Services
PHILIPPINE ACCELERATION
ACTION PLAN FOR
TUBERCULOSIS (PAAP-TB)
This aims to achieve tuberculosis elimination
in the Philippines by integrating tuberculosis
elimination commitments into the mandates,
policies, and work programs of government
agencies.
DOH Health Services
AEDES-BORNE VIRAL
DISEASES PREVENTION AND
CONTROL PROGRAM
This program addresses diseases such as
dengue, zika, and chikungunya, which are
transmitted by Aedes mosquitoes.
DOH Health Services
CHILD HEALTH & DEVELOPMENT
STRATEGIC PLAN
It is a strategic framework for planning
programs and interventions that promote and
safeguard the rights of Filipino children.
DOH Health Services
EMERGING AND RE-EMERGING
INFECTIOUS DISEASE PROGRAM
This program prevents and controls emerging
and re-emerging infectious diseases from
becoming public health problems.
PUBLIC POLICIES
REPUBLIC ACT NO. 11332
It is also known as the “Mandatory Reporting of
Notifiable Disease and Health Events of Public
Health Concern Act”.

This act provides policies and prescribes

Quality Health
procedures on surveillance andfor response
All to
notifiable diseases, epidemics, and health
events of public health concern.
PUBLIC POLICIES
REPUBLIC ACT NO. 11332
The act aims to protect the right to health of the
people, instill health consciousness, and protect
the public from health threats through efficient
and effective disease surveillance.

It includes measures Quality

forHealth for All
the establishment of
Epidemiology and Surveillance Units (ESUs) at all
levels of the DOH, in public and private health
facilities, and in ports and airports.
PUBLIC POLICIES
PHILIPPINE INTEGRATED
DISEASE SURVEILLANCE AND
RESPONSE (PIDSR)
The PIDSR is a framework that supports the
implementation of public health surveillance
and action.
Quality Health for All
It outlines the roles and responsibilities of
various government and non-government
actors in responding to health emergencies,
such as the COVID-19 outbreak.
PUBLIC POLICIES
REPUBLIC ACT NO. 10354
It is also known as the “Responsible Parenthood
and Reproductive Health Act of 2012”.

This law aims to provide universal access to

methods of contraception, fertility control,
sexual education, Quality Health care.
and maternal for All
PUBLIC POLICIES
REPUBLIC ACT NO. 10643
It is also known as the “Graphic Health
Warnings Law”.

This law requires graphic health warnings on

tobacco products to inform the public of
Qualitywith
health risks associated Health for Alluse.
tobacco
PUBLIC POLICIES
REPUBLIC ACT NO. 10747
It is also known as the “Rare Diseases Act of
the Philippines”.

This law ensures that patients with rare

diseases have access to comprehensive
medical care andQuality Health for All
treatment.
PUBLIC POLICIES
REPUBLIC ACT NO. 11223
It is also known as the “Universal Health Care
Act”.

This law guarantees equitable access to

quality and affordable health care services for
all Filipinos. Quality Health for All