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Epidemiology SJSM > Block 1 > Flashcards

Block 1 Flashcards

1
Q
A

Stationary pyramid:
Low fertility & mortality
High life expectancy
Developed countries (Most even across age groups)

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2
Q
A

Constrictive Pyramid:
Low fertility & mortality
High life expectancy

Well developed/rich countries

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3
Q
A

Expansive pyramid:
Hight fertility & mortality rate
Low life expectancy

Developing countries

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4
Q

Endemic

A

A base line of a disease that is normally seen in a population

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5
Q

Hyperendemic

A

Persistent/high levels of a disease normally seen in a population

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6
Q

Sporadic

A

A disease that occurs infrequently and irregularly in a population

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7
Q

Holoendemic

A

Endemic in children but not adults

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8
Q

Epidemic/outbreak

A

Epidemic: sudden increase in expected cases of a disease in a population (larger area)
Outbreak (ditto but for a smaller area)

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9
Q

Cluster

A

Smaller groups of high cases in a specific place/time

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10
Q

Pandemic

A

Global spread

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11
Q

Endemic common source
A brief exposure period with 1 incubation period

A

Point source

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12
Q

Endemic common source:
Multiple exposure points and incubation periods

A

Continuous

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13
Q

Epidemic Common source:
Different exposure sources and times and different incubation times

A

Intermittent

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14
Q

Propagated types

A

person-person
Vehicle-person
Vector-person

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15
Q

Mixed source

A

Common source + person-person

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16
Q

Outbreak analysis:
Description
Analytic
Control/follow-up

A

D: Confirm diagnosis/existence
A: Develop hypothesis/test
C: Control/public health measures

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17
Q

Fertility rate

A

(Women of childbearing age)
/(population)

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18
Q

Incidence rate/Attack Rate

A

(# New cases)/
(Population @ risk) x1000

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19
Q

Prevalence

A

(# All cases)/
(Total population) x1000

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20
Q

Primordial

A

Preventative law (tobacco tax laws)

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21
Q

Primary

A

Control risks (Vaccines)

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22
Q

Secondary

A

Early detection (screening)

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23
Q

Tertiary

A

Reduce complications (therapy/treatment)

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24
Q

YPLL

A

(life expectancy) -
(age @ death)

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25
Q

Proportionate mortality

A

(Deaths associated to the disease) /
(All deaths)

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26
Q

Crude mortality

A

All death/ all population

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27
Q

Cause-specific mortality

A

(death ass to disease within a 1yr) / (total population mid year)

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28
Q

Case fatality

A

(Death ass with disease @ specific time) /
(Population @ the same time)

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29
Q

Neonate mortality

A

(Death after 28 days)/
(live births)

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30
Q

Post natal mortality

A

(death between 28-365 days)/
(live births)

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31
Q

Infant mortality

A

Neonate mortality + infant mortality

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32
Q

Mean incubation period

A

Peak - exposure (day 1)

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33
Q

Birth rate

A

live births / total population

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34
Q

Endemic

A

amount of a particular disease that is usually present in a community

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35
Q

Hyperendemic

A

Refers to persistent, high levels of disease occurrence

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36
Q

Sporadic

A

disease that occurs infrequently and irregularly

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37
Q

Holoendemic

A

endemic in most of the children in a population, with the adults in the same population being less often affected

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38
Q

Epidemic/outbreaks

A

increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area

Outbreak: same definition of epidemic, but is often used for a more limited geographic area

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39
Q

Cluster

A

aggregation of cases grouped in place and time that are suspected to be greater than the number expected, even though the expected number may not be known

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40
Q

Pandemic

A

epidemic that has spread over several countries or continents, usually affecting a large number of people

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41
Q

A multinational outbreak of influenza
a) Hypoendemic
b) Endemic
c) Epidemic
d) Hyperendemic
e) Pandemic
f) Holoendemic

A

Pandemic

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42
Q

The long-term, relatively constant rate of occurrence of colorectal cancer in U.S. Women
a) Hypoendemic
b) Endemic
c) Epidemic
d) Hyperendemic
e) Pandemic
f) Holoendemic

A

Endemic

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43
Q
A
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44
Q

Epidemics can be classified according to the manner of spread through a population

A

Common-source (point, continuous, intermittent)
Propagated
Mixed
Other

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45
Q

Common-source

A

It is one in which a group of persons are all exposed to an infectious agent or a toxin from the same source.

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46
Q

Point-source

A

If the group is exposed over a relatively brief period, so that everyone who becomes ill does so within one incubation period, then the common-source outbreak is further classified as a point-source outbreak

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47
Q

Continuous common source outbreak

A

the range of exposures and range of incubation periods tend to flatten and widen the peaks of the epidemic curve.

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48
Q

Intermittent common-source outbreak

A

outbreak often has a pattern reflecting the intermittent nature of the exposure

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49
Q

Propagated source

A

Results from transmission from one person to another:
person-to-person contact (syphilis)
vehicle-borne (Hepatitis B – use of needles)
vector-borne (mosquitoes)

cases occur over more than one incubation period

The epidemic usually declines after a few generations

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50
Q

Mixed source

A

epidemics have features of both common-source epidemics and propagated epidemics
The pattern of a common-source outbreak followed by secondary person-to-person spread

51
Q

How do you know when a potential outbreak is occurring?

A

Regular reviews of surveillance data from lab-confirmed reports or clinical reports of notifiable diseases to alter you of unusual increase in disease

52
Q

Outbreak alters

A

Health care providers
Public or community
Press/ TV
Public health surveillance

53
Q

If an outbreak is now starting focus on _____ & if the outbreak is nearly over identify the source to ________ outbreaks

A

control & prevent future outbreaks

54
Q

4 Goals of an outbreak investigation

A

Containing the infection
Protecting susceptible persons
Actively search for new cases
Case management

55
Q

phases of an outbreak investigation

A

Descriptive –> Analytic study –>Control/follow up

56
Q

Descriptive phase

A

Become “experts” about the disease
- Confirm the existence of an outbreak
- Confirm the diagnosis
- Assess patients & establish a case definition
- Orient the data in person, place, and time

57
Q

Analytic study

A
  • Develop a hypothesis & test it
  • Analyze the data & compare it with other studies
  • Formulate a conclusion or revise a hypothesis
58
Q

Control & follow-up

A
  • Implement control and preventative measures
  • Write and disseminate a report
  • Evaluate the preventative measures!!!
59
Q

Confirming the existence of an outbreak

A

compare observed with the expected number of cases and sources of data:
Surveillance data
Hospital records
Sentinel sites
Prescriptions/pharmacy stocks

60
Q

Case Classification Levels

A

Confirmed (clinical symptoms & labs)
Probable (Clinical symptoms/epidemiological link)
Suspect (compatible symptoms/possible epi link)

61
Q

Challenges of case findings

A
  • Not all cases are confirmed
  • Some infected persons might not seek medical attention
  • The exposed population might not be well defined
62
Q

Functions of descriptive epidemiology

A

-Helps characterize an outbreak by providing info about the who, what, when, & where
- ID’s the pop at risk
- Give clues about the agent, source, or mode of transmission
- Give info about the leading prevention and control measures
- Familiarize the investigator with the data

63
Q

Epidemic curve

A

An epidemic curve is a graphical depiction of an unusual increase in the number of cases of disease in a population

Y-axis: Number of cases of illness
X-axis: Date or time of illness onset

64
Q

Propagated epidemic

A

Series of peaks with one incubation period apart
Aka person-person spread

65
Q

Epi Curve- Point source

A

Curve with a peak and steeper upward slope rather than downward slope

66
Q

Epi curve- common source

Continuous exposure

A

Persistent over a period of time. In this instance the peak remains for a longer period, it will plateau. The top left figure is an example.

67
Q

Epi curve- common source

Intermittent exposure

A

Breaks between peaks

68
Q

Epi-curve mixed

A

not cause by one common source, but rather a propagated or progressive source.
The shape of the curve usually contains a series of peaks, which are usually about one incubation apart.

69
Q

Incubation period

A

Median incubation period = Peak - Exposure

70
Q

Cohort study

A

for small, well defined outbreaks, investigates all persons

71
Q

Case control study

A

larger outbreaks, investigates a sample of cases and controls

72
Q

Morbidity

A

Measures frequency of illness within populations ALIVE

73
Q

Prevalence

A

Frequency of all current cases

74
Q

Incidence

A

number of new cases

75
Q

Attack rate

A

incidence during a limited time such as during an epidemic

76
Q

Mortality

A

Measures frequency of deaths in given time, place and population

77
Q

Crude death rate

A

measures number of deaths in a given population over a specified time

78
Q

Disease specific death rates

A

measures number of deaths due to a specific disease in a given population over a specified time

79
Q

Natality

A

Birthrates or fertility rates

80
Q

Case investigations

A

Detailed report of one patient, usually for
-Rare diseases
-Unusual cases of common diseases
-Diseases nearing elimination (Measles, Rubella, Leprosy)

81
Q

Population based disease registery

A

contains records for people diagnosed with a specific type of disease who reside within a defined geographic region

82
Q

Hospital based disease registry

A

contains data on all the patients with a specific type of disease diagnosed and treated at that hospital

83
Q

Exposure based disease registry

A

contain information about individuals at high risk of disease due to exposure to hazardous substances in the workplace or environment

84
Q

Sentinel reports

A

-From selected representative reporting sites
-For monitoring key health indicators
-Provides early warning signals
-Can be for general or specific populations

85
Q

Surveys

A
  • Monitor changing prevalence over time if repeated periodically
  • can be costly
    -Good for assessment of Knowledge Attitude, Behavior, & Practice
86
Q

Rates

A

Tell us how fast the disease is occurring in a population

87
Q

Proportions

A

Tell us what fraction of the population is affected

88
Q

Birth Rate

A

Rate of live births in a population during a time period (usually the calendar year).

                              Live births Simple formula:  -------------------  x 1,000
                               Population
89
Q

Fertility Rate

A

Rate of live births among women of childbearing age (ages 15-44) in a population during a time period (usually the calendar year).

                              Live births          X 1,000 Simple formula:    ------------------
                       Women of childbearing age
90
Q

Incidence

A

new cases in at risk population
useful in cohort studies
mainly for acute conditions or diseases

91
Q

Prevalence

A

of all cases in the entire population
Useful in the study of the burden or chronic disease

92
Q

Factors affecting prevalence

A

Duration of disease (longer = higher prev)
Fatality rates (higher = lower prev)
Occurrence of new cases
In-migration of cases vs healthy people
Out-migration of cases vs healthy people
Susceptible cases vs cure rate of cases
Diagnostic facilities

93
Q

Incidence

A

Incidence =

No. of new cases of a disease occurring in the population at risk during a specified period of time
————————————————————– (1000)
No. of persons who are at risk of developing the disease during that period of time

94
Q

Prevalence

A

prevalence=
No. of all cases of a disease present in the population at a specified period of time
——————————————————-(1000)
No. of persons in the population at that specified time

95
Q

In a city with a population of 1,000,000, 10,000 individuals have HIV disease. There are 1000 new cases of HIV disease and 200 deaths each year from the disease. There are 2500 deaths per year from all causes. Assuming no net emigration from or immigration to the city, the incidence of HIV disease in this city is given by which of the following?
200/1,000,000
800/1,000,000
1000/990,000
2500/1,000,000
10,000/990,000
10,000/1,000,000

A

incidence =
1000/(1,000,000 -10,000)
1000/990,000

96
Q

A state with a population of 4,000,000 contains 20,000 people who have disease A, a fatal neurodegenerative condition. There are 7,000 new cases of the disease a year and 1,000 deaths attributable to disease A. There are 40,000 deaths per year from all causes. What is the incidence of the disease?
A. 1000/4,000,000
B. 6000/4,000,000
C. 7000/4,000,000
D. 20,000/4,000,000
E. 40,000/4,000,000

A

Incidence=

7,000/(4,000,000 - 20,000 =3,980,000 round up)

7000/4,000,000

97
Q

Recently, investigators working with the health department of Elmira county collected the following cancer statistics. As of December 31, 2000, 100 cases of prostate cancer were counted, 20 of which were diagnosed since January 1, 2000. As of the same date, the adult population of the county was 10,000, 60% of whom were female. Based on the statistics provided what is the prevalence of prostate cancer in Elmira County in the year 2000?
5 per 1000
10 per 1000
15 per 1000
20 per 1000
25 per 1000

A

Prevelance=

10,000 (60% female, 40% male)
0.4 * 10,000 =4,000

100/4000* 1000 =25 per 1000

98
Q

Population of the city of Atlantis on March 30, 2003 was 183,000. 26 new cases of active TB occurred between January 1 and June 30, 2003. According to the city register on June 30, 2003 there were 264 active TB cases.
What is the incidence rate of active cases of TB for the 6-month period ?
7 per 100,000 population
14 per 100,000 population
26 per 100,000 population
28 per 100,000 population
130 per 100,000 population

A

Incidence =
26/(183,000-264)

26/182,736 (1000) = 0.14 per 100,000

99
Q

in an outbreak of gastroenteritis with 50 cases among a population at risk of 2500, the attack rate of disease is

A

AR= 50/2500 = 0.02 or 2/100 0r 20/1000

100
Q

After a dinner attended by 100 people, 12 individuals become ill. All 100 people are interviewed about their food consumption at the dinner. The interviews show that 8 of the 12 people who are ill and 25 of the 88 who are healthy ate fish.

A

Number of sick people
who ate a particular food
Attack Rate = ————————————–
Total number of people
who ate this food

AR= 8/33 =0.24*

101
Q

Secondary attack rate

A

a measure of the frequency of new cases among contacts of known cases

           new cases among contacts of primary    
           cases during the period                       Sec. AR = ----------------------------
             total number of contacts during the 
             same period
102
Q

At a day-care center, 10 of the 50 children develop acute viral conjunctivitis (pink eye) within a 1-week period. Another 30 of the children also develop pink eye in the following 2 weeks.

Q1. What is the first attack rate of conjunctivitis at this day-care center?

Q2. What is the secondary attack rate of conjunctivitis at this day-care center?

A

10/50 = 0.2 0r 20%

30/40 = 0.75 or 75%

103
Q

A new vaccine is introduced, which effectively prevents the development of Disease X. Over time, what will be the effect upon the incidence of Disease X.
Incidence will increase
Incidence will decrease
Incidence will stay the same
Incidence will decrease then increase

A

Incidence will decrease prevalence will not change

104
Q

An experimental drug that selectively binds malignant lymphocytes has been shown to significantly prolong survival in patients with stage 3 and stage 4 chronic lymphocytic leukemia (CLL). If this new drug were widely used, what changes in the incidence and prevalence of CLL would be expected?
Incidence will decrease, prevalence will decrease
Incidence will not change, prevalence will increase
Incidence will increase, prevalence will not change
Incidence will not change, prevalence will not change
Incidence will decrease, prevalence will increase

A

Incidence won’t change but prevalence will actually increase.

105
Q

Crude mortality rates

A

Crude mortality=

Population at mid yr

106
Q

Cause-specific mortality rate

A

Population at a yr

107
Q

Case fatality rate

A

of cases of the disease in the same time period

# of cases of the disease in the same time period

108
Q

Proportionate mortality ratio

A

Total death in the population in the same yr

109
Q

Maternal mortality rate

A

number of maternal deaths in a given area in a yr
——————————————————————(10)
Number of live births in the same area during same yr

110
Q

An outbreak of illness from Infection X disease took place in the United States between July and October, 2001. Two of 21 patients with Infection X disease died. This measurement of disease is best described as
Case fatality
Crude mortality
Cause specific mortality
Incidence
Prevalence

A

Case fatality

111
Q

YOPLL

A

Life expectancy - age at death

112
Q

There are 250 deaths per year in a population of 100,000. What does this represent?
Adult mortality rate
Cause-specific mortality rate
Case fatality rate
Crude mortality rate
Proportionate mortality rate

A

Crude mortality rate

113
Q

The country of Badheart had a population of 100,000,000 in 1995. There were 10,000,000 deaths reported in that same year, of which 5,000,000 were from heart disease. All together, 20,000,000 citizens of Badheart had heart disease in 1995. What was the crude death rate in Badheart in 1995?
50 per 1000 population
250 per 1000 population
500 per 1000 population
200 per 1000 population
100 per 1000 population

A

crude death=

10,000,000/100,000,000 (1000)

100 per 1000 population

114
Q

In an Asian country with a population of 6 million people, 60,000 deaths occurred during the year ending December 31, 1995. These included 30,000 deaths from cholera in 100,000 people who were sick with cholera.

What was the crude mortality rate in 1995?
What was the cause-specific mortality rate from cholera in 1995?
What was the case-fatality rate from cholera in 1995?
What was proportionate mortality from cholera in 1995?

A

Crude death
= 60,000/6,000,000 = 0.01 *1000 =10 per 1000

Cause-spec
= 30,000/100,000 = 0.03*1000 =30 per 1000

Prop death
= 30,000/60,000 = 500 per 1000

115
Q

Neonatal mortality rate

A

Infant deaths prior to day 28
————————————– X 1,000
Live births

116
Q

Post neonatal mortality rate

A

Infant deaths from day 28 through day 365
——————————————————–X 1,000
Live births

117
Q

Infant mortality rate

A

neonatal mortality rate + post-neonatal mortality rate

118
Q

Primary prevention

A

denotes an action taken to prevent the development of a disease in a person who is well
and does not (yet) have the disease in question.

EX. Immunization

119
Q

Secondary prevention

A

involves identifying people in whom a disease process has already begun but who have not yet developed clinical signs and symptoms
of the illness

EX. Screening

120
Q

Tertiary prevention

A

denotes preventing complications in those who have already developed signs and symptoms of an illness and have been diagnosed (i.e., people
who are in the clinical phase of their illness)

EX. Treatment/therapy

121
Q

Herd immunity

A

defined as the resistance of a group
of people to an attack by a disease to which a large proportion of the members of the group are immune. If a large percentage of the population is immune, the entire population is likely to be protected, not just those who are immune

122
Q

AR

A

Number of people at risk in whom
a certain illness develops
—————————————————-
Total number of people at risk

123
Q

Endemic means that a disease:
a. Occurs clearly in excess of normal
expectancy
b. Is habitually present in human populations
c. Affects a large number of countries
simultaneously
d. Exhibits a seasonal pattern
e. Is prevalent among animals

A

b. Is habitually present in human populations

124
Q
A

Epidemiology SJSM (5 decks)

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