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EPIDEMIOLOGICAL DEFINITIONS MORBIDITY Morbidity is a diseased state, disability or poor health due to any cause.

Morbidity has been defined as any departure, subjective or objective, from a state of physiological well-being. It can be measured in terms of 3 units: Persons who were ill that is severity The illnesses (periods or spells of illness)that these persons experienced that is frequency The duration (days, weeks, etc) of these illnesses. Morbidity may be used to refer to the existence of any form of disease, or to the degree that the health condition affects the patient. In epidemiology and actuarial science, the term morbidity rate can refer to either the incidence rate, or the prevalence of a disease or medical condition. Uses 1) To describe the extent and nature of disease load in the community. 2) They provide comprehensive and accurate information on patient characteristics 3) They serve as starting point for etiological studies 4) Needed for monitoring and evaluation of disease control activities.

MORTALITY Mortality is the condition of being mortal, or susceptible to death. It indicates the development of medicine and technology in a country. If a country has a high mortality rate that suggests about its poor or lack of medical facilities or inadequate utilization of resources. The aim of modern medicine today is to reduce the mortality and morbidity rates in a country. Thus, improving the overall health status of the people and the nation. ENDEMIC (En- in; demos- people) It refers to the constant presence of a disease or infectious agent within a given geographic area or population group, without importation from outside; may also refer to the usual or expected frequency of the disease within such area or population group. Example: common cold is endemic in a given area because somebody in that area will always have it. When conditions are favorable an endemic may burst into an epidemic. e.g.: hepatitis A, Typhoid fever EPIDEMIC (Epi- upon; demos-people) The unusual occurrence in a community or region of disease, specific health-related behavior (e.g.: smoking) or other health related events (traffic accidents) clearly in excess of expected occurrence. It covers diseases such as measles, chickenpox and cholera which are compressed in time, also the modern slow epidemics of noncommunicable diseases(e.g. coronary heart disease, lung cancer), in which the time scale is shifted from days or weeks to years. In excess of expected occurrence there is no agreement on what constitutes a significant excess.

For example; In United States of America a disease like cholera is not normally present in the population, even one case would constitute a potential epidemic in US. But in Bangladesh or India, where cholera is always present, a few hundred cases a year may be usual or expected incidence (endemic situation). In India, several hundred or thousands of cases would have to occur for it to be termed as an epidemic. PANDEMIC An epidemic usually affecting a large proportion (population) of the population, occurring over a wide geographic area such as a section of a nation, the entire nation, a continent or the world. Example: influenza pandemics of 1918 and 1957. Acute hemorrhagic conjunctivitis in 1971 and 1981. SURVEY The systematic collection of information, forming part of a scientific study constitutes a survey. It is a planned process. It gives enormous information about the population studied. e.g.: survey of F.Y.BSc nursing students on anemia. SURVEILLANCE Surveillance has been defined as the continuous scrutiny of the factors that determine the occurrence and distribution of disease and other conditions of ill-health. Surveillance is essential for effective control and prevention, and includes the collection, analysis, interpretation and distribution of relevant data of action. Surveillance connotes exercise of continuous scrutiny of health indices, nutritional status, environmental hazards, health practices and other factors that may affect health. Thus we have epidemiological surveillance, nutritional surveillance, demographic surveillance, etc.

Objectives To provide information about new and changing trends in the health status of a population. e.g.: morbidity, mortality, nutritional status or other indicators and environmental hazards, health practices and other factors that may affect health. To provide feed-back which may be expected to modify the policy and the system itself and lead to redefinition of objectives. Provide timely warning of public health disorders so that interventions can be mobilized. MIGRATION Migration is the movement of people across a specified boundary for the purpose of establishing a new or semi-permanent residence. Example: movement of people from villages to cities in search of employment. Migration may be of two types: 1. Internal migration that is movement of people within the country. 2. International migration which means the movement of people from one country to another. International migration is also called as emigration. EMIGRATION Emigration is the relocation of people from one country to reside in another. People mainly emigrate for many reasons, including increasing ones chance of employment or improving quality of life. Example; Nurses migrate to US or UK for better job prospects. Some birds migrate from one country to another in search of better pastures.

QUARANTINE Quarantine has been defined as the limitation of freedom of movement of such well persons or domestic animals exposed to communicable disease for a period of time not longer than the longest usual incubation period of the disease, in such a manner as to prevent effective contact with those not so exposed Quarantine measures are applied by a health authority to a ship, an aircraft, a train, road vehicle, another means of transport or container, to prevent the spread of disease, reservoirs of disease or vectors of disease. It comprises of: Absolute quarantine, which is same as above Modified quarantine e.g.: selective partial limitation of freedom of movement, such as exclusion of children from school. Segregation, defined as the separation for special consideration, control of observation of some part of a group of persons (or domestic animals) from the others to facilitate control of a communicable disease. e.g.: removal of susceptible children to homes of immune persons In contrast to isolation, quarantine applies to restriction on healthy contacts of an infectious disease. Quarantine has now declined as disease control methods have come into the picture.

BIBLIOGRAPHY Basavanthappa B.T. (2001),Community Health Nursing. Jaypee Brothers, Medical Publishers; India. Park K, (2004),Parks textbook of preventive and social medicine. Seventeenth edition, Banarasidas Bhanot Publishers; Jabalpur. Online references Health Statistics and Health Information Systems.19th June 2005; Available from: URL: http://www.who.int/healthinfo/mort2005survey/en/ An Encyclopedia Britannica Copany.19th June2011; Available from: URL: http://www.merriam-webster.com/dictionary/emigrate/ The Free Dictionary by Farlex.19th June, 2011: Available from: URL: http://www.thefreedictionary.com/survey/