Module 1 Flashcards
this is the study of the distribution & determinants of health-related states or events in a specified population and the application of this study for prevention and control of health problems
EPIDEMIOLOGY
what is the goal of epidemiology?
identify subgroups who are at higher risk for a disease and who will benefit most from disease-specific intervention
this is a specified target population about which conclusions are to be drawn
defined population
this avoids systematic sampling errors but requires consensus of all members of target population. however, this is not feasible in all cases
Random selection
True or False: Small sample size may be unrepresentative of the target population but these errors can be computed satistically
True because confidence in the conclusions drawn from a sample depends in part on its size. The larger the sample size, the more accurate.
What are the four attributes of epidemiology that make it a tool in improving public health?
- Searches for CAUSALITY such as genetic factors, environmental factors, and behavior
- Determines the NATURAL HISTORY from Good Health -> Subclinical changes ->Clinical Disease -> Death/Recovery
- Describes the HEALTH STATUS of populations over time
- Evaluates INTERVENTION such as Tx/Medical care, Health promo, Preventive measures, Public health services
What is the most crucial aspect in epidemiological studies?
Study Design
True or False: In epidemiological studies, you must consider all sources of bias and confounding and strive to increase them
False. Reduce them!!
True or False: Epidemiological studies does not consider ethical issues important
False. Very important
This is a type of epidemiological studies that measures and does not interfere with the target population
OBSERVATIONAL
Give examples of a Descriptive Epidemiological Study
Case report, Case Series
Give examples of Analytical Epidemiological Study
Correlational, Case-control, Cohort
Under what type of epidemiological studies is randomized control trial?
Experimental or Interventional
this is the state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
Health
what is the major challenge in measuring health & disease?
Lack of information because population health status is not fully measured in many parts of the world
How do we measure health?
Based on Prevalence and Incidence
These are the people who are susceptible to a given disease and can be defined by demographic, geographic, or environmental factors
Population at risk
this is the rate of occurence of new cases arising in a given period in a specified population
incidence
this is the frequency of existing cases in a defined population at a given point in time
prevalence
what is the focus of incidence?
Whether event/case is NEW and the time of ONSET
what is the focus of prevalence?
Presence/Absence of disease
Give the uses of Incidence Rates
Determining the risk of being ill
Main measure of ACUTE disease
Study of CAUSATION
Give the uses of Prevalence Rates
Probability of a population being sick
Study of BURDEN of CHRONIC diseases
Implication for HEALTH SERVICES
this refers to the prevalence data collected for one point in time
Point prevalence rate
this refers to the total number of cases at any time during a specified period divided by the number of cases at any time during a specific period divided by the population at risk midway through the period
Period prevalence rate
What are the factors that may INCREASE prevalence?
Long duration of disease Long life of patient without cure Increase in new cases In-migration of cases Out-migration of healthy people Improved DIAGNOSTIC facilities
What are the factors that may DECREASE prevalence?
Shorter duration of illness High case-fatality rate In-migration of healthy people Out-migration of cases Improved cure rate
this measures the denominator only at the beginning of the study and is often presented as cases per 1000
Cumulative incidence
measures the disease severity. This also refers to the proportion of cases with the disease who die within a specified time.
Case fatality rate
This dopes not take into account the chance of dying according to age, sex, race, SEC. etc
Crude Mortality
this refers to the ratio of number of deaths from a given cause per 100 or 1000 total deaths. This does not express the risk of the population
Proportionate Mortality
This is the most important variable in epidemiologic studies
Age because it shows greater variation
This variable is ambiguous and overlaps with nativity and religion
race/ethnicity
this refers to the gradual change in frequency over long periods of time (chronic diseases)
Secular trends
This refers to the increases or decreases of disease over a period of several years or within a year
Cyclical/seasonal trends
This indicates the response of a group in a specified place, exposed to a common source of infection, contamination, or other factors
Point epidemics
This refers to the closely grouped series of events/cases of a disease with well-defined distribution patterns in relation to time and place
clustering
this refers to the occurence of more cases of disease, injury, or other health-related conditions than expected in a given area, or among a specific group in a particular time
Epidemic
this is a mode of transmission involving droplet nuclei or dust in the air
Airborne transmission
distance of airborne transmission
10-20ft
this mode of transmission involves insects either mechanically thru a contaminated proboscis/feet, or biologically when there is growth or replication of an organism in the species
arthropod transmission
In this type of transmission, the infecting agent passes a stage of devt in an intermediate host
Biological
this refers to the constant presence of an agent or health condition within an area/pop’n
ENDEMIC
this refers to an epidemic occuring over a widespread are (multiple countries or continents)
PANDEMIC
what epidemic curves has a single brief exposure and does not persist over time? This does not involve person to person spread
Point Source Outbreak w/o Propagation
In this epidemic curve, exposure continues over a long period, many people are exposed simultaneously, and there is no case following the termination of exposure
Continuing Source Outbreak
This epidemic curve has irregular peaks, has a common source that is not well-controlled, and is seasonal/weather-related
Intermittent
this epidemic curve involves person to person spread and has a series of progressively taller peaks, each with an incubation period apart.
Propagated Spread
This is due to a specific infectious (biological) agent or its toxic products capable of being transmitted from man to man, animal to man, animal to animal, or environment to man
Communicable disease
This refers to a factor/form of energy whose presence/abscence or excessive presence/deficiency cause disease or other adverse effects
Agent
This refers to a person/other living organism that is susceptible to or harbors an infectious agent
Host
this is an extrinsic factor that affects an agent and the opportunity for exposure
Environment
This is a step in the investigation of an epidemic wherein the researchers do the following:
Prepare for Field Work
Establish the existence of an Outbreak
Verify Diagnosis
Definition of the problem
This is a step in the investigation of an epidemic wherein the researchers do the following:
- ) Define & identify cases by establishing a case definition and identifying and counting cases
- ) Perform descriptive epidemiology
Appraisal of existing facts
What is the third step in the investigation of an epidemic ?
Formulation of hypothesis
This is a step in the investigation of an epidemic wherein the researchers do the following:
Reconsider/Redefine Hypothesis
Execute additional epidemiologic studies
Do other types of studies such as lab, environmental, etc
Testing the hypothesis
This is a step in the investigation of an epidemic wherein the researchers do the following:
Implement control & prevention
Communicate Findings
Conclusions and practical applications
What are the three ways to terminate an epidemic?
- exhaustion of the susceptible population
- Elimination of the agent
- Closure of secondary transmission
refers to the proportion of exposed persons who become infected
Infectivity
refers to the proportion of infected individuals who develop clinically apparent disease
Pathogenicity
refers to the proportion of clinically apparent cases that are severe or fatal
Virulence
this is the habitat in which an infectious agent normally lives, grows, and multiplies
Reservoir
What are the risk factors for non-communicable disease?
Tobacco, Sedentary lifestyle, alcoholism, unhealthy diet
What is the leading cause of death? (Non-communicable)
Cardiovascular Diseases
identify the type of epidemic spread:
21 cases of shigellosis among children and workers at a day care center over a period of 6 weeks, no external source identified incubation period for shigellosis is usually 1—3 days)
Propagated
identify the type of epidemic spread:
36 cases of giardiasis over 6 weeks traced to occasional use of a supplementary reservoir (incubation period for giardiasis 3–25 days or more, usually 7–10 days)
Intermittent or continuous common source
identify the type of epidemic spread:
43 cases of norovirus infection over 2 days traced to the ice machine on a cruise ship (incubation period for norovirus is usually 24–48 hours)
Point source
22 cases of legionellosis occurred within 3 weeks among residents of a particular neighborhood (usually 0 or 1 per year)
this reflects:
a. epidemic
b. pandemic
c. endemic
Epidemic
About 60 cases of gonorrhea are usually reported in this region per week, slightly less than the national average
this reflects:
a. epidemic
b. pandemic
c. endemic
Endemic
Over 20 million people worldwide died from influenza in 1918–1919
this reflects:
a. epidemic
b. pandemic
c. endemic
Pandemic
refers to the progression of a disease process in an individual over time, in the absence of treatment
Natural history of disease
This stage of subclinical disease, extending from the time of exposure to onset of disease symptoms, is usually called? During this stage, disease is said to be asymptomatic (no symptoms) or inapparent
incubation period
True or False: Although disease is not apparent during the incubation period, some pathologic changes may be detectable with laboratory, radiographic, or other screening methods.
True
The onset of symptoms marks the transition from what stages?
subclinical to clinical disease
persons who are infectious but have subclinical disease are called
Carriers
an infectious disease that is transmissible under natural conditions from vertebrate animals to humans.
zoonosis
occurs through skin-to-skin contact, kissing, and sexual intercourse, also refers to contact with soil or vegetation harboring infectious organisms.
direct contact
refers to spray with relatively large, short-range aerosols produced by sneezing, coughing, or even talking
Droplet Spray
What agent has an incubation period of few mins to 30 mins and cause paralytic shell poisoning?
Saxitoxin
How long is Salmonella’s incubation period? What are its clinical effects?
6-48 hrs,
Diarrhea often with fever and cramps
How long is the SARS-related corona virus’ incubation period?
3-10days but usually 4-6 days
What agent has an incubation period of
Human Immunodeficiency Virus
When is the usual time of diagnosis?
Stage of clinical disease
1) Remove the exposure
2) Remove the ability of the exposure to go to that person by correcting the environment, or
3) Strengthening the immune system of the person
These are the goals of what level of prevention?
Primary Prevention
What is the main goal of Secondary Prevention
Detect early pathologic changes and treat the person
immediately
What is the main goal of Primary Prevention
Prevent a person from developing a disease
What is the main goal of Tertiary prevention
Treatment and correct the complication
What do you call the kind of primary prevention wherein the person has to be actively the activity for them to be protected
Active Participation
This kind of primary prevention is just part of the daily routine activities
Passive Participation
This level of prevention involves:
Procedures that detect and treat pre-clinical pathological changes
Control disease progression
Secondary Prevention
Most of the time, your secondary prevention techniques are….
screening and laboratory tests
The following are goals of what level of prevention?
o Prevent damage and pain from the disease
o Slow down the disease
o Prevent the disease from causing other problems (“complications”)
o Give better care to people with the disease
o Make people with the disease healthy again and able to do what
they used to do
• Soften the impact of illness on the patient’s function, longevity, and
quality of life
Tertiary Prevention
In this kind of condition, tertiary prevention’s focus is on rehabilitation or assisting the patient to accommodate
to his disability
Irreversible conditions
In this kind of condition, tertiary prevention’s focus is on reduction of population prevalence
Reversible conditions
In this kind of condition, tertiary prevention’s focus is on increasing prevalence if it prolongs survival
Incurable conditions
The risk or vulnerability of an individual to certain
disease entity
Susceptibility
The event pertaining to any factors that may or may
not cause a certain disease
Exposure
It is the basis for the concept of QUARANTINE especially during an emerging epidemic or endemic diseases. • It is feasible to generate your differentials / diagnoses through SCREENING at this stage
Stage of Subclinical Disease
would cover the ability to do ADLs (Activities of
Daily Living) in an OLOF (Optimum Level of Functioning) and/or an increased in the QOL (Quality of Life), and among others.
In what stage is this outcome seen?
Positive outcomes.
STAGE OF RECOVERY, DISABILITY OR DEATH
would entail any disability, further compromised
state of health and general well being, limited executive functions, inability to optimally perform ADLs, a significant decrease in QOL, and even death of an individual. All of these outcomes are determined by your Epidemiological Triangle.
In what stage is this outcome seen?
Negative outcomes.
STAGE OF RECOVERY, DISABILITY OR DEATH
a consideration of overall learned health practices. Its main goals are to:
• Impart accurate evidence-based knowledge to individuals, group of individuals and to the community for the prevention certain diseases
• Advocacy on general health practices.
Health Care Outcome Continuum
These are diagnostics modalities and supportive/adjuncts to therapy. It is usually short term and for monitoring purposes. In the clinical settings, this is used in medical
researches and a preferred method of determining health
outcomes due to its convenience and ease
Surrogate/Disease-oriented health outcome
The most important determinant of health
outcome due to its longer duration of observation. It reflects an improved health state.
Clinical/Patient-oriented health outcome
defined as the value of disease-related cases as well as the complications and co-morbidities. Either had the disease or having the disease;
MORBIDITY
the state of having a disease accompanied by
another disease entity. i.e DM patients with HPN and Syndrome X
CO-MORBIDITY
– defined as the number of deaths in relation to certain
factors (age, specific cause of death, total number of deaths).
MORTALITY
