KONSEP TIMBULNYA PENYAKIT

Theories of Disease Causation

 Supernatural Theories
 Hippocratic Theory
 Miasma
 Theory of Contagion
 Germ Theory (cause shown via
Henle-Koch postulates)
 Classic Epidemiologic Theory
 Multicausality and Webs of
Causation (cause shown via Hill’s
postulates)
 USES OF EPIDEMIOLOGY
GENETIC FACTORS
1. Causation

GOOD HEALTH HEALTH

ENVIRONMENTAL FACTORS Death

(incluiding lifestyle)
2. Natural history Subclinical Clinical
Good health changes disease

3. Description of health status Recovery

of populations
Good health
Propotion with III health,
change over time, change III
with age, etc. health Time

Treatment medical care

4. Evaluation of Good health III health

Intervention
Health promotion
Preventive measures
Public health services
 NATURAL HISTORY OF
DISEASE

Exposure DEATH
Etiologic Sympton
Pathologic Diagnosis
Agent Changes Time

Subclinical Clinical RECOVERY

Manifestation Manifestation
 FACTUAL DESCRIPTION
(WHAT, WHO, WHEN & WHERE)

TO PROVE OF CONSTRUCTION OF
HYPOTHESIS HYPOTHESIS (WHY
& HOW)

WHAT NOW
 Epidemiologic Triad
Disease is the
result of forces
within a dynamic
system consisting
of:
Agent
Host
Environment
 Epidemiological TRIAD

Host
Intrinsic factors that
influence host susceptibility

Environment Agent
Extrinsic factors Biological
Opportunity for characteristic of agent
Event to occur
 AGENT OF HOST
DISEASE
FULCRUM

ENVIRONMET OF
LIFE

BIOLOGY PHYSIC SOCIAL ECONOMIC

DIAGRAM : keseimbangan kesehatan, titik keseimbangan (fulerum) dapat
berubah-ubah karena perubahan lingkungan hidup. (Leavell’s diagram of
healds equilibrium sariable fulerum position by changing envoironment)

Little agent More Agent Weaknes of

(not more) Healthy of and very
host host
virulent

Good Bad
Environment Environment

DIAGRAM : Balance of Health DIAGRAM : Imbalance of Health

BIOLOGICAL INTERACTION
 MODEL ECOLOGY

1 2
H A
A
H
E E
In crease in the ability of The pproportion of
an agent to infect and susceptiibles in the
cause in men human host population
is increased
A H

E
3
At equliibrium 4
H A
A H
H
E
Environmental change Enviromental change
facilities agent spruad afters host susceptibility
 TIGA ASPEK EPIDEMIOLOGI
• Agent : Substansi atau tenaga ok. kurang /
lebihnya merupakan hal yang esensial utk
terjadinya penyakit.
•Human Host : Faktor manusia yang
membantu terjadinya penyakit. (daya tahan, sifat
biologik, imunologik, tingkah laku dll)
•Environment : td. fisik, biologik, sosial,
ekonomik dan budaya.
Classic Epidemiologic Theory
• Agents
– Living organisms
– Exogenous chemicals
– Genetic traits
– Psychological factors and stress
– Nutritive elements
– Endogenous chemicals
– Physical forces
 ETIOLOGIC FACTORS FOR HUMAN
DISEASES & INJURIES
•Biologic Agent : Certain bacteria; viruses; prions;
ricketsia, age of exposure including in utero exposure.

•Chemical agents : Lead; mercury; certain

pesticide; hydrogen cyanide; certain medications,
arsenic, florine gas.

•Physical agents : Asbestos; trauma including

burns; ioninizing/non radiation; high voltage electricity.
 ETIOLOGIC FACTORS FOR HUMAN
DISEASES & INJURIES

•Nutritional factors : Overly high/low caloric

intake; low protein; vitamin deficiency;
calcium intake; sodium intake; saturated fat
intake.
•Life-style choices : Exercise level; tobacco use;
alcoholic beverage intake; dietary preference;
seat belt use; bicycle helmet use.
Classic Epidemiologic Theory
• Agents have characteristics such as
infectivity, pathogenicity and virulence
(ability to cause serious disease)
– They may be transmitted to hosts via
vectors
 ETIOLOGIC FACTORS FOR HUMAN
DISEASES & INJURIES

•Host characteristics : Genetic factors; immune

status; gender; concurent disease; level and type
of natural and suplemented estrogens, social
support; economical support, cultural support,
response of stress.
•Environmental factors : Heat; cold; certain
allegens; air pollution ; occupational exposures;
contaminants in drinking water, etc.
 FAKTOR PENYEBAB TERJADINYA
PENYAKIT PADA MANUSIA
•Environmental factors :
Faktor lingkungan pokok untuk terjadinya
penyakit, antara lain faktor lingkungan fisik,
lingkungan kimiawi, lingkungan biologik,
lingkungan ekonomi, sosial dan kultural. (cuaca
panas yang ekstrem, keadaan dingin yg ekstrem,
bahan alergi tertentu, polusi udara, paparan kaitan
dgn pekerjaan, kontaminasi air, dll.).
 Classic Epidemiologic Theory
(cont.)

• Environmental factors:
– Physical environment (heat, cold,
moisture);
– Biological environment (flora, fauna);
– Social environment (economic,
political, culture);
– Chemical environment;
 Classic Epidemiologic
Theory (cont.)
• Host factors:
– Immunity and immunologic
response
– Host behavior
 KEY CONCEPTS
Epidemiology is the study of the distribution and
determinants of diseases within human
populations.

Epidemiology can be used for descriptive

purposes, such as surveillance of the occurrence
(incidence) of a particular illness.

Epidemiology can be used for analytic purposes,

such as studying risk factors for disease
development.
 KEY CONCEPTS
Epidemiologic methods can be used to assess the
performance of diagnostic test.

Epidemiology can be used to study the

progression or natural history of diseases.

Epidemiology methods can be used to study

prognostic factors, which are determinants of the
progression of a disease.

Epidemiology can be used to evaluate treatment

for a disease.