Intro. to Epidemiology–Exam 1 – Flashcards
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Epidemiology
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Cornerstone of public health; focuses on the distribution and causes of disease in human populations and on developing and testing ways to prevent and control disease. Sheds light on why a disease originates, how it spreads, and its effective control.
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Epidemiologic Transition
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The transition from acute infectious, parasitic, and nutritional deficiency diseases as the predominant causes of morbidity and mortality to a predominance of noninfectious chronic diseases.
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GINI Coefficient
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Measure of income inequality (high in countries where few control the economy).
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Doll and Hill-Criteria of Judgment
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-Consistency of independent studies -Strength of association -Dose response -Biological plausibility -Specificity -Temporal sequence of cause and effect -Coherence of findings
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Uses of Epidemiology
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1. Establish disease etiology (study of the causes of disease) 2. Assess health status of populations
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Jesse Lazear
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Discovered that the Yellow Fever vector was the mosquito. He infected self to prove it and later died.
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Ronald Ross
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Discovered Malaria vector was mosquito; bed nets.
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Joseph Goldberger
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Pellegra, Vitamin B6 deficiency
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John Graunt
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One of the first demographers, developed yearly mortality bill
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James Lind
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Scurvy (vitamin C deficiency)
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Robert Koch
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Discovered TB, Mycobacterium and Vibrio Cholerae
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Fred Soper
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Eradicated Malaria mosquito in Brazil, success led to Global Malaria Eradication Program; Used DDT = Harmful on environment when misused.
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Maurice Hilleman
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Developed vaccines for Measles, Mumps, Hep. A and B, Chicken Pox, Meningitis, Pneumonia, and many others
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Edward Jenner
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Smallpox vaccine
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Alexandre Yersin
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Rat fleas = Bubonic plague
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Louis Pasteur
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Germ Theory of Disease and developed Rabies vaccine
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Koch-Henle Postulates
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Used to establish a causative relationship between a microbe and disease; -Microorgasnism must be present in every case. -Microorganism must be isolated and grown in pure culture. -Innoculation of microorganism into susceptible host must reproduce disease. -Microorganism must be observed and recovered from host.
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West Nile Virus
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1999 first detected in N. America; dead crows in NYC; Encephalitis in animals at Bronx zoo and in humans. Vector was mosquito.
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Malaria
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Caused by a parasite that enters red blood cells; kills one million African children/year. Adults gain partial immunity through multiple infections. One easy solution is bed nets treated with insecticide and anti-malarial drugs.
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River Blindness (Onchocerciasis)
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Parasitic disease caused by filiarial worm; Vector: Black Fly; Endemic (regularly found in a group of people) in parts of Africa; Merck provided Mectizane - anti-worm drug.
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Leading Causes of Death Worldwide
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Heart Disease, Infection, Cancer, Stroke, COPD
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Prevalence
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Number of existing cases during a given time period Example: In a survey of 1,150 women who gave birth in Maine in 2000, a total of 468 reported taking a multivitamin at least 4 times a week during the month before becoming pregnant. Calculate the prevalence of frequent multivitamin use in this group.
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Incidence
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Number of new cases of disease (or health phenomenon) during a given time period Example: In 1990, 41,595 new cases of AIDS were reported in the United States. The 1990 midyear population was estimated to be 248,710,000. Calculate the 1990 AIDS incidence rate.
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Relationship b/w Odds and Proportion
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Odds=Proportion/(1-proportion) Proportion=Odds/(Odds +1)
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Rates
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Involve a measure of time Crude rate: no adjustment for any factor Specific rate: specific for a certain group (i.e. race) Adjusted rate: adjusted for a particular factor (i.e. age) Why is adjustment for age important?
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Other Measures of Mortality: Case-Fatality Rate
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# of deaths during a specific time period due to cause X / # of individuals during a specific time period with cause X
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Other Measures of Mortality: Proportional mortality ratio (PMR)
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# of deaths during a specific time period due to cause X / # of ALL deaths during a specific time period
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Descriptive epidemiology
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Purpose: describe disease patterns and generate hypotheses
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Emerging health problem: Zika virus
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Virus causes mild symptoms Fever, rash, joint pain, conjunctivitis Symptoms resolve within days to a week Treatment: Rest Potential link to microcephaly in newborn babies of infected mothers
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John Stuart Mill's Canons
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Method of Difference Difference in disease rates may be due to difference of a factor Method of Agreement Similarity in disease rates may be due to a common factor Method of Concomitant Variation Frequency of disease varies according to the potency of a factor Method of Residues Removal of factor reduces rate of disease
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Method of Concomitant Variation
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Frequency of disease varies according to the potency of a factor.
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Approaches for Descriptive Epidemiology
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Case reports/Case series Cross-sectional studies -Individual level -Ecologic: (Ecologic fallacy: Bias that might occur because an association observed between variables on an aggregate level does not necessarily represent the association that exists at an individual level)
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Person, place, and time
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Person: Who gets the disease? Age, race, education, income, etc Place: Where does the disease occur? International, national, urban/rural, local Time: When is the disease occurring? Cyclic, seasonal, secular trends, point epidemics, clustering
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Sources of data for use in epidemiology
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Publicly available data: Census Data, Vital statistics, Disease Registries, Survey Data Planned studies - involve collection of new data Privacy and confidentiality issues
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Vaccines
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Weakened virus which spikes immune system when injected (actually causes disease). "Molecular star wars"
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Levels of Prevention
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Primary: Prevent Exposure Secondary: Screening and early detection Tertiary: Limit disability after diagnosis
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Positive vs Negative Declaration
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Negative declaration = "There is no difference..."
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ASMR
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Age Standard Mortality Rate
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Publicly Available Data: U.S. Census
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Every 10 Years; used for calculating disease and death rates.
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Publicly Available Data: Nat. Vital Stats. System
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Births, fetal deaths, deaths, marriages, divorces
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Publicly Available Data: Disease Registries
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Central databases for the collection of info. about a disease (ex. SEER)
