PUBLIC HEALTH

NURSING
EPIDEMIOLOGY
CHAVUMA COLLEGE OF NURSING AND MIDWIFERY
MR.B.NTEBEKA
INTRODUCTION
• The word Epidemiology is coined from a Greek word
which literally means the study of people.
• The modern methods of epidemiological studies were
developed with the sole purpose of making an inquiry
into outbreaks of infectious diseases.
• However, on the contemporary its scope and
application has been greatly extended with similar
methods being used to investigate the cause and
natural history of all types of disease.
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INTRODUCTION CONT’
• Epidemiology has also been used in the development of
preventive and treatment programs, in planning and
evaluation of health services.
• Epidemiology involves the study of people and not merely
individuals hence, enhancing the practice of nursing by
increasing the understanding of how diseases arise and
how they can be managed by individuals and the society
as a whole.

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GENERAL OBJECTIVE

At the end of the lecture/discussion, students should

be able to acquire knowledge on Epidemiology.

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SPECIFIC OBJECTIVES

At the end of the lecture/discussion, students should

be able to
1. Define terms in Epidemiology.
2. Outline the types of Epidemiology.
3. State the aims of Epidemiology.
4. List the Importance of Epidemiology.
5. Describe the scope of Epidemiology.
6. Explain the Epidemiological Approaches.
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DEFINITION OF TERMS

Epidemiology - It is the study of distribution and

determinants of health related events in specified
populations, and the application of this study to control
health problems (Porta, 2004).
• It is the study of distribution, frequency and
determinants of health problems in a specified
population (Lancaster, 2004)

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DEFINITION OF TERMS CONT’
Statistics – The science dealing with the collection,
presentation, analysis and interpretation of facts
(Porta, 2004).
Data – Pieces of information usually collected for a
specific purpose.
Communicable diseases – are those diseases spread by
direct contact with an infectious agent.
Epidemics – The temporal increases in the incidences
of disease (new cases) in a population.
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DEFINITION OF TERMS CONT’
Determinants of health - These are factors, exposures,
characteristics, behaviours and contexts that determine
(or influence) the patterns (Porta, 2004)
Incidence rate – the number of new cases of a diseases
arising in a population during a certain period of time.
• Indicator of reduction, stasis, increment of a disease
and evaluation of effectiveness of health interventions.
Morbidity – amount and type of illnesses that occur in a
community.
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DEFINITION OF TERMS CONT’
Prevalence rate – refers to the total number of existing
cases, episodes or events on a particular day. It
includes the number of cases in the past and have
continued to date.
Cohort – a type of study done on a group of people
who share common characteristics within a defined
period of time e.g. age, occupation.
Mortality – deaths that occur in the community.

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TYPES OF EPIDEMIOLOGY

DESCRIPTIVE – Study concerned with the distribution

and frequency of disease.
• Attends to questions like; What? Where? When?
Who? How often?
ANALYTICAL – Study that attempts to analyse the
causes and determinants of disease.
• Attends to questions like; What causes? Why is it
continuing?
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TYPES OF EPIDEMIOLOGY CONT’

EXPERIMENTAL – Study that is concerned with the use

of clinical and community trials to determine the
effectiveness of new methods in the control of health
problems e.g. trials for a new drug.
EVALUATION – Study that attempts to measure the
effectiveness of the health services or interventions
employed in the control of an epidemic.

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AIMS OF EPIDEMIOLOGY
Epidemiology has three major aims
• To describe the distribution and magnitude of
health problems in populations.
• To identify the etiological factors and disease
pathogenesis
• To provide data essential for planning and
implementation of services necessary to prevent
and treat disease.
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IMPORTANCE OF EPIDEMIOLOGY
Epidemiology enables you to;
• Know the disease etiology.
• Quantify data for effective prevention and control.
• Plan and Evaluate intervention programs.
• For baseline data when conducting research.
• Develop the rational for a preventive or therapeutic
community health programme.
• Understand the disease progression.
• Develop evidence based and practical policies e.g.
drug of choice.
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 SCOPE OF EPIDEMIOLOGY

The scope of epidemiology encompasses three main

components.
Disease Frequency – Measurement of how often the
disease occurs.
• Usually in form of rates; Prevalence, Incidence, Death
• Aids in the comparison of the disease frequency in
different populations or sub population and enables
development of strategies to control health problems.

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SCOPE OF EPIDEMIOLOGY CONT’

Disease Distribution – Deals with the fact that disease

is never uniformly distributed in populations but rather
occurs in patterns.
• These patterns give rise to hypothesis (tentative
idea) about the causative risk factors.
Determinants of Disease – Aims at identifying the
etiological factors contributing to the disease.
• Analytical studies help in development of scientific
health interventions for problems.
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EPIDEMIOLOGICAL APPROACHES
• Epidemiologic approaches are the various methods in
which data is gathered, analyzed and reports written with
regard to various diseases distribution and determinants.
• They enable us to plan and evaluate disease
management in communities.

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EPIDEMIOLOGICAL APPROACHES
CONT’
DESCRIPTIVE STUDIES
• Basic studies and usually the first phase of
epidemiological studies that seek to describe the
situation as it is.
• Utilizes simple descriptive statistics such as
percentage tables and graphs to describe the disease
situation.
• These studies generate hypothesis.
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DESCRIPTIVE STUDIES CONT’

Individual based studies; they reflect on single

individuals as the unit of study
• Case report – a single unique case is reported as it
is identified by the health worker.
• Case series- several case reports that have similar
characteristics are analyzed so as to draw
conclusions in relation to the particular disease of
interest.

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DESCRIPTIVE STUDIES CONT’

Population based studies

• Surveys – Fact-finding studies that rapidly draw
conclusion about conditions affecting the entire
population.
• Cross sectional studies- Use advanced methodology
and analysis to obtain detail about a condition in a
huge population.
• Correlation studies- Compare one variable or
characteristic of a population with one or more others
E.G. smoking and lung disease.
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EPIDEMIOLOGICAL APPROACHES
CONT’
ANALYTICAL STUDIES
• These are the second major type of epidemiological
studies.
• These studies are more advanced in methodology and
analysis and their findings are more generalizable as
compared to descriptive studies.
• While descriptive studies generate hypothesis these
ones test hypothesis.
• Can be prospective or retrospective in nature
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ANALYTICAL STUDIES CONT’

Prospective studies (Cohort studies)

• Studies individuals with an exposure of interest
(cohorts) and compared with those without exposure.
• Analysis is then done to find out if those who had
exposure will develop the outcome of interest more
than those without exposure.
• For instance workers in a factory (exposed to silica)
followed up to establish if they will manifest the
Silicosis compared with a similar group not exposed.
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ANALYTICAL STUDIES CONT’

Retrospective (case control studies)

• Easier to conduct, consume less time and cheaper.
• Involves two groups, with the disease of interest
(case) and without (control).
• Past history is taken to establish common exposure
that might have caused the disease.
• These studies are however prone to recall biases. E.g.
measles patients (case) and a group without (control)
asked about the immunization status for analysis.
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EPIDEMIOLOGICAL APPROACHES CONT’
EXPERIMENTAL STUDIES
• Follows results gathered from the descriptive and
analytical studies.
• Conducted in a controlled environment where the
researcher has control over all variables.
• Useful in isolation of the actual disease causative
agent.

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EXPERIMENTAL STUDIES CONT’
• They are very strict and also very expensive. They
require highly specialized personnel and equipment.
• Clinical trials – Carefully and ethically designed
research investigations in which subjects are assigned
to the different modes of intervention simultaneously
in the same period e.g. New drug
• Community trials - These are studies involving the
entire community.
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SUMMARY
• The study of the distribution, frequency and the
determinants of disease is epidemiology.
• Its main aims include identification of etiological
factors, describing the disease distribution and
providing data that is essential in the planning and
implementation of disease prevention and treatment
strategies.
• Its wider scope utilises observational and
experimental epidemiological approaches.
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