Masa, Kassandra Joanne Viray, James Renzo BACKGROUND Major goal of epidemiology is to assist in the prevention and control of disease and in the promotion of health by discovering the cause of disease and the ways in which they can be modified. CONCEPT OF CAUSE Understanding of the causes of disease is important in the field of health not only for prevention but also in diagnosis and the application of treatment.
Cause of a disease is an event, condition,
characteristic, or combination of factors which plays an important role in producing the disease. FACTORS IN CAUSATION PREDISPOSING FACTORS ENABLING FACTORS PRECIPITATING FACTORS REINFORCING FACTORS PREDISPOSING FACTORS create a state of susceptibility to a disease agent. E.g. age, sex, previous illness. These may have no direct bearing on the cause of the disease but they aid other risk factors e.g. salivary gland diseases for caries development. ENABLING FACTORS environmental conditions which favor the development of disease. E.g. low income, poor housing, poor nutrition, inadequate medical facility. PRECIPITATING FACTORS specific or noxious agent, exposure to which can be associated with the onset of a disease. E.g. pollens in asthmatic attack. REINFORCING FACTORS factors which aggravates an already established disease or state. E.g. repeated exposure and unduly hard work. MULTIPLE CAUSATION Also known as Multiple Causality or Multifactorial Etiology
The requirement that more than one factor
be present for disease to develop, MULTIPLE CAUSATION Multiple factors can individually cause same disease of Interest. MULTIPLE CAUSATION Cumulative effect of factors causing disease. MULTIPLE CAUSATION Criteria for judging causality Temporal association Strength of association Consistency of association Biological plausibility Coherence of association Example of Models used: Epidemiologic triangle Web of causation Wheel model Pie model Web of Causation A popular metaphor for the theory of sequential and linked multiple causes of diseases and other health states. Implicates broadcast of events and represents an incomplete portrayal of reality. Web of Causation Wheel Model The model explains the etiology of disease by calling in to play host and environment interactions.
Similar to the epidemiologic triangle and web of causation
with respect to involving multiple causality
Maybe used to account to for occurrence of diseases e.g.
childhood lead poisoning Wheel Model Pie Model The model indicates that a disease maybe caused by more than one causal mechanism (also called as sufficient cause).
Sufficient cause defined as a set of minimal
conditions and events that inevitably produce disease. Pie Model