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Unit 1
Epidemiological Investigation
Learning Objectives
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Epidemiology
the study of the distribution and
determinants of heath-related states or
events (including disease) in specific
populations, and the application of
this study to the control of health
problems
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Epidemiological Investigations
A number of distinct purposes
Approach not merely individuals but group of persons or
whole population
Purposes:
1. Distribution
Where it occurs (place)
Surveillance
When it occurs (time)
Descriptive
Who are affected (person)
Analytical study
2. Determinants /causes/risk factors
3. Application to control/prevention
Operational study
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Surveillance
Descriptive studies
Include activities to
monitor the speed
of spread of
infectious diseases
Analytical studies
Concerns activities related to identifying possible
causes for the occurrence of disease
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Surveillance
to watch over
Steps:
Systematic collection
Orderly consolidation
Analysis of data
Information
Application of
information
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Purpose of Surveillance
Types of Surveillance
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Active
Passive
Sentinel health events
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Uses of Surveillance
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Descriptive studies
First phase of investigation
Time/space/person dimensions
Uses:
Burden (prevalence/mortality/morbidity)
Allocate resources
Hypothesis generation
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3.
Case reports
Case series
Ecological studies
Group 1
Group2
Time 1 Time 2
4.
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Analytical studies
Purpose:
1.
2.
Case control
Cohort studies
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Disease
Exposure ?
Exposure ?
No disease
Retrospective nature
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Affected
Relatives
of cases
Not affected
Affected
Relatives
of
control
Not affected
Direction of inquiry
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Cohort study
exposed
exposed
not exposed
not
exposed
Followup period
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Cohort study
Incidence among
exposed
exposed
Incidence among
non-exposed
not
exposed
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Disease
Relatives
of cases
No Disease
Eligible
subjects
Relatives
of
control
Disease
No Disease
Direction of inquiry
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Differences
Case control
Outcome to exposure
Retrospective
Cheap and quick
Techniques crude
For infrequent or rare
diseases, may be the only
practical approach
Studies are short lived
Neither incidence or
prevalence can be
calculated
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Cohort
Exposure to outcome
Prospective
Expensive & time
consuming
Techniques refined
Very large cohorts are
required and not to be
practical
Studies are long lived
Yields incidence rate
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Experimental
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Experimental studies
Purposes:
1. To confirm an etiological hypothesis
2. To evaluate or assess the effectiveness
of therapeutic or preventive measures
before applying them to the community
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Eligible
subjects
No cure
Randomize
Cure
DEC
plus
ivermectin
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No cure
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