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EPI Module 2

pre-pathogenesis the stage that occurs before the onset of the disease. The agent, or exposure, that causes disease has yet to interact with the host, or person who gets the disease.
Example of pre-pathogenesis in an infectious disease like AIDS this stage is before HIV enters the body. In lung cancer this stage is before an exposure, like cigarettes.
pathogenesis the biologic onset of disease
Examples of pre-pathogenesis as AIDS begins to develop in the human body, after HIV infection, or as the cancer begins to grow in the lungs, after exposure to the cancer-causing agents in cigarettes
incubation period asymptomatic; before symptoms appear in an infectious disease
Latency period asymptomatic; before symptoms appear in a chronic disease
sub-clinical Before symptoms of a disease appear
clinical when the disease symptoms appear
Final endpoints for the progression of disease recovery, disability, or death
Stages of pathogenesis onset, symptoms, diagnosis, treatment
primary prevention activities activities that occur before the biological onset of the disease, during the pre-pathogenesis stage of disease progression
Active interventions activities typically directed at the person and require “active” behavior change on their part.
Passive interventions actions typically directed at the environment to, in turn, facilitate “passive” changes to behavior
How are primary prevention activities designed? They are designed to prevent exposure to the agent, or risk factor, that causes disease
Secondary prevention activities these are designed to hinder the progress of disease. These activities occur after exposure has occurred – after the onset of disease
Secondary prevention approaches to intervention are typically aimed at improving, or hastening, the diagnosis of a disease
tertiary prevention activities These activities occur after diagnosis of the disease and are typically meant to prevent, limit, and/or alleviate disability from disease. These activities seek to maximize a person’s health, once diagnosed.
What are the two types of epidemiology? Descriptive epidemiology and Analytic epidemiology
Descriptive epidemiology This describes the distribution of disease. Key variables include person, place, time
Analytic epidemiology This describe the determinants of disease. Key variables are host, agent, environment
three main objectives of descriptive epi To permit evaluation of trends in disease and compare across sub-groups,To provide a sound basis for provision and evaluation of health services, To identify problems to be studied by further analytic methods
Short version of the three main objectives of descriptive epi monitor known disease, identify new disease, planning, generate hypotheses
Epidemiologic descriptions focus on three key variables person, place and time
Person Age, Gender, Race
Place Between countries, Within countries, Urbanicity
Time Point, Secular, Seasonal
Count (a),number of cases of a disease. ex 50 students who smoke cigarettes. It cannot tell us how large a problem a particular disease or other health problem is, relative to the size of the population.
Proportion (a / a+b), proportion of population with disease ex. 50/100 or 50% school smokes cigarettes. Proportions are represented as percentages
Rate (a / a+b ; includes time), is a proportion that includes, or is specific to, some measure of time. includes prevalence rate, incidence rate Ex. 261.7 per 100,000 persons in 2006
Ratio (c / d), is a more general form of a proportion or a rate and is simply defined as a one number divided by another. includes rate ratio, odds ratio, “relative risk”Ex. used routinely in analytic epidemiology
Measures of frequency used most often in epidemiology typically fall into two broad categories prevalence and incidence
Prevalence the proportion of a certain population that is affected by a disease, or other health phenomenon, at a particular point in time, indicates the extent of a public health problem focuses primarily on existing cases of disease
Two types of prevalence point prevalence and period prevalence
Incidence rates can be helpful in indicating emerging epidemic, focuses solely on new (incident) cases of disease
Two types of incidence cumulative incidence, incidence density
Point prevalence (a / a+b; time?), a = number of existing cases of disease, a + b = total number of people in population at a particular point in time (e.g., Jan 1, 2008)
Period prevalence (a / a+b; time), a = number of existing and new cases, a + b = average number of people in population over a period of time (e.g., Jan 1-Dec 31, 2008)
Cumulative incidence (a / a+b; time); a = number of new cases of disease, a + b = total number of people at-risk over a period of time (e.g., Jan 1-Dec 31, 2008)
Incidence density (a / a+b; time); a = number of new cases of disease, a + b = total number of person-years at-risk over a period of time (e.g., Jan 1-Dec 31, 2008)
Prevalence calculation Prevalence = Incidence x Duration
Created by: audrey90