Mod 3: epidemiology Flashcards
The study of the distribution and determinants of health-related states of events in specified populations and the application of this study is to the prevention and control of health problems
Epidemiology
What is the application of epidemiology
The prevention and control of health problems
The study utilizes concepts and methods from other fields of study such as biology, sociology, demography and environmental science and statustics
Epidemiology
Example of study (4)
Surveillance
Observation
Research
Experiments
Examples of distribution (3)
Time
Place
Group of people affected
Wha do you call the physical, biological, chemical, economic, genetic, and behavioral factors that affect health
Determinants
Examples of health related states/events (4)
Disease
Cause of death
Lifestyle
Use of health services
Example of specified population (1)
Identifiable characteristics
Goals of the Application to prevention and control (2)
Address the aims of public health
To promote, to protect and restore health
Person who studies eppidemiology
Epidemiologist
The ongoing systemic collection, analysis, and interpretation of health of health-related data needed for planning, implementation and evaluation of public health practice
Public health surveillance
Philippine Integrated Disease Surveillance & Response (5)
NDRS: Notifiable Disease Reporting System
FHSIS: Field Health Service Information System
NESSS: National Epidemiology Sentinel Surveillance System
HIV - AIDS Registry
EPI: Expanded Program On Immunization Surveillance
What is RA 11332
Mandatory Reporting of Notifiable Disease and Health Events in Public Health Concern Act
A law that the Pres. of the Republic of the Philippine shalle declare a state of Public Health Emergency in the event of an epidemic of national and/or international concern which threatens national security in order to mobile governmental and non-governmental agencies to respond to the threat
Sec. 7 of RA 11332
the occurrence of disease in excess of what would normally be expected in a defined community geographical area or season
Disease outbreak
also considered as “unknown disease”
disease outbreak
Practical Application of Epidemiology (6)
- Assessment of the health system of the community
- Elucidation of the natural history of disease
- Determination of disease causation
- Prevention and control of disease
- Monitoring and evaluation of health intervention
- Provision of evidence for policy formulation
Concepts of epidemiology (4)
- Multiple causation theory
- Natural history of disease
- Levels of prevention of health problems
- Concept of causality & association
Disease development does not rest on a single cause but rather results from multiple factors.
Multiple Causation Theory
Models in Disease Causation (3)
- Ecologic triad (Triad of epidemiology)
- Iceberg Principal
- Web of causation
most helpful to the nurse because it highlights not only the host’s and agent’s roles in disease development but also regards the role of environment as important in disease causation.
Ecologic Triad (Triad of Epidemiology)
is any element, substance, force animate or inanimate which serve as a stimulus to initiate or perpetuate a disease process.
agent
Example of agents (5)
Physical
Biological
Chemical
Mechanical
Nutritive
is any organism that harbors and provide nourishment for another organism
Host
Examples of host (5)
- Demographic characteristics
- General health status
- Body defenses
- State of immunity & immunological response
- Human behavior
the sum total of all external conditions and influences that affect the life and development of an organism
Environment
example of environment (3)
- Physical – inanimate surroundings such as the geophysical conditions and climate
- Biological – living things such as plants and animal life (vectors)
- Socio-economic – economic development, social disruptions
describe a situation in which a large percentage of a problem is subclinical, unreported, or otherwise hidden from view.
Iceberg Principle
shows the relationship between different multiple factors that contribute to the cause of a disease
Web of Causation
- Seeks to identify factors related to the course of a disease once established in order to determine its duration and the probability of recovery, death or specific complications.
natural history of disease
Help the nurse and other people to implement measures to prevent pathologic processes to progress.
natural hospital of disease
Stages of Natural History of Disease (2)
Pre-pathogenesis
Pathogenesis
3 Substages of Pathogenesis
Pre-symptomatic Disease/Early Pathogenesis
Discernible lesions
Advanced Disease
Stage of Natural History of Disease:
the disease has not developed but factors that favor its occurrence are present.
pre-pathogenesis
Substages of Pathogenesis:
individual has no symptoms that indicate the presence of illness but in fact, pathogenic changes have begun.
Pre-symptomatic disease or early pathogenesis
Substages of Pathogenesis:
– changes may be detectable through sophisticated laboratory tests, during this period, the early signs & symptoms of diseases are developing.
Discernible lesions
Substages of Pathogenesis:
- anatomical or functional changes have produced recognizable signs & symptoms.
Advanced disease
refers to identification of potential problems so that the nurse can minimize or eradicate possible disability or deformity in a population at risk.
Prevention
Levels of Prevention of Health Problems (3)
Primary
Secondary
Tertiary
Levels of Prevention of Health Problems:
activities directed to the healthy population, focusing on prevention of emergence of risk factors and removal or reduction of risk factors
Primary prevention
Levels of Prevention Of Health Problems:
strengthen host resistance; interrupt the chain of infection
Primary prevention
Levels of Prevention of Health Problems:
- surveillance, quarantine, segregation, isolation
Primary prevention
Levels of Prevention of Health Problems:
aims to identify and treat existing health problems at the earliest possible time.
Secondary Prevention
Levels of Prevention of Health problems:
control or eradication of the health problem
Secondary Prevention
Levels of Prevention of Health problems:
screening, case finding, disease surveillance
Secondary prevention
Levels of Prevention of Health problems:
prompt and appropriate treatment
secondary prevention
Levels of Prevention of Health problems:
limits disability progression
Tertiary Prevention
Levels of Prevention of Health problems:
the nurse attempts to reduce the magnitude or severity of the residual effects of infectious diseases and non-infectious diseases.
Tertiary prevention
2 Premises of the Concept of Causality & Association
- Disease does not occur at random.
- Disease has identifiable CAUSAL and PREVENTIVE factors
what are the concept of causality & association (5)
cause of disease
necessary cause
sufficient case
risk
association
Concept of Causality and Association:
any event, condition, characteristic or combination of these factors that play an important role in producing the disease.
cause of disease
Concept of Causality and Association:
a cause must precede a disease and the cause of a disease must be necessary and sufficient for the occurrence of disease.
cause of disease
Concept of Causality and Association:
refers to the fact that the factor must be present for the disease to occur.
necessary cause
Concept of Causality and Association:
indicates that if a factor is present, the disease can occur, but the factor’s presence does not always result in the disease occurrence.
sufficient cause
Concept of Causality and Association:
probability of an unfavorable event, disease, disability, defect or even death.
risk
Concept of Causality and Association:
must be identified and dealt with to prevent diseases.
risk
Concept of Causality and Association:
concurrence of 2 variables under investigation and are often associated with each other
association
Factors Associated with Increased Risk of Disease (3)
Predisposing factor
Enabling factor
Reinforcing factor
Factors Associated with Increased Risk of Disease:
any characteristic of an individual, a community or an environment that predisposes behavior or other conditions related to health.
Predisposing factor
Factors Associated with Increased Risk of Disease:
any characteristic of an individual, group or the environment that facilitates or make possible a certain health behavior or other conditions affecting health.
enabling factor
Factors Associated with Increased Risk of Disease:
any reward or punishment or any feedback following or anticipated as a consequence of health behavior.
reinforcing factor
PRINCIPLES IN EPIDEMIOLOGY (6)
- Health is a state of equilibrium. A delicate balance for many factors.
- Infection is not synonymous with disease
- No disease occurs by chance alone because it follows its own recognizable pattern of occurrence.
- Disease causation is complex
- Knowledge of the distribution of disease overtime is valuable to the nurse in the community
- An epidemic curve is merely a graphic display of disease onsets overtime, hours, days or weeks
Functions of the Nurse in Epidemiology (12)
- Coordinate with other team members during an epidemic
- Render or supervise nursing care
- Accomplish and keep records and reports and submit to proper office/agency
- Maintain surveillance to the occurrence of disease
- Participate in case finding and collection of lab specimen
- Conduct health teachings
- Refer cases when necessary
- Organize, coordinate, and conduct community health education programs
- Perform and teach household members methods of disinfection
- Follow up cases
- Isolate cases of communicable diseases
- Coordinate with other concerned community agencies
4 possible outcomes of infection
- there may be overt clinical illness
- an in apartment of subclinical infection may occur in which the person shows no symptoms but is shedding the agent
- infected person may be a carrier
- whether or not disease occurred, the agent may persist quietly in the host’s tissue for long periods of time
Phases of Epidemiological Approach (4)
Descriptive epidemiology
Analytical epidemiology
Interventional or Experimental epidemiology
Evaluation epidemiology
Phases of Epidemiological Approach:
aims to describe the occurrence of health conditions in the community in terms of the attributes of the people, pattern of disease and characteristics of the place when the disease appeared
Descriptive epidemiology
Phases of Epidemiological Approach:
concerned with disease distribution and frequency
descriptive epidemiology
Phases of Epidemiological Approach:
Case finding and screening activities
descriptive epidemiology
Phases of Epidemiological Approach:
Attempts to identify the possible factors associated with disease occurrence.
analytical epidemiology
Phases of Epidemiological Approach:
aims to test effectiveness of intervention programs designed to prevent and control disease utilizing randomized controlled or clinical trials and field or community trials.
interventional or experimental epidemiology
Phases of Epidemiological Approach:
attempts to measure effectiveness of different health services and intervention programs
evaluation epidemiology
Levels of Disease Occurrence:
occurs when the proportion of susceptible are high compared to the immunes; increase in disease incidence
epidemic
Levels of Disease Occurrence:
occurrence of disease that implies habitual presence of disease in a given geographic location; rates are predictable; consistently present
endemic
Levels of Disease Occurrence:
occurrence of disease that implies habitual presence of disease in a given geographic location; high levels of disease occurrence; persistently present
hyperendemic
Levels of Disease Occurrence:
disease occur every now and then affecting a small number of people relative to the population
sporadic
Levels of Disease Occurrence:
global occurrence of a disease affecting several countries or continent
pandemic
Levels of Disease Occurrence:
The occurrence of disease in excess of what would normally be expected in a defined community geographical area or season (WHO)
outbreak
Levels of Disease Occurrence:
also considered in a previously unknown disease
outbreak
Levels of Disease Occurrence:
refers to an aggregation of cases grouped in place in time that are suspected to be greater than the number expected
cluster
Outline of plan for an epidemiological investigation (4)
- Establish fact or presence of epidemic
- Establish time and space relationships of the disease
- Relations of the characteristics of the group of community
- Correlation of all data obtained
Determining characteristics of the community and population: (3)
herd immunity
exposure or contact rate
chance
Determining characteristics of the community and population:
represents the immunity and susceptibility levels of the population
herd immunity
Determining characteristics of the community and population:
occurs when a high percentage of the community is immune to a disease (through vaccination and/or prior illness), making the spread of this disease from person to person unlikely.
herd immunity
Determining characteristics of the community and population:
represents opportunities for progressive transfer or transmission of an infectious agent to a susceptible host
exposure or contact rate
Determining characteristics of the community and population:
depends on the frequency of contact and facility of transmission.
exposure or contact rate
Determining characteristics of the community and population:
is the probability pf contact between the source of infection and the susceptible host
chance
