Basics Epidemiology

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January 5, 2011
A. According to the Word Origin Definition Epidemiology
If viewed from the origin of the word epidemiology comes from the Greek word consisting of 3 basis of the EPI, which means on or about, demos which means people and the last word logos meaning adalalah science. So epidemiology is the study of the population.
While in the modern sense at this point EPIDEMIOLOGY are:
“The study of the Frequency and Distribution (Distribution) and Determinat health problems in a group of people / communities as well as the determinants (factors – factors Affecting).
An initial study the emergence of science, travel, and the prevention of infectious diseases. But in its development to the present problems faced by residents not only infectious diseases, but also non-communicable diseases, degenaratif disease, cancer, mental illness, traffic accidents, and so forth. Therefore, the epidemiology has reached it.
2. Definition of Epidemiology According Opinions of Experts
As science is always evolving, always Epidemiology has developed understanding and therefore also been modified in terms / definitions. Some definitions have been put forward by epidemiologists,
some of which are:
a) Greenwood (1934)
Said that the epidemiology of the disease and learn all kinds of events that the group (herd) penduduk.adalah of the emphasis on population groups that lead to the distribution of a disease.
b) Brian Mac Mahon (1970)
Epidemiology is the study of the distribution and determinants of disease frequency in man. Epidemiology is the study of frequency spread and cause disease in humans and why there is such a distribution. Here has begun to determine the Occurrence and Distribution of the search for cause of an illness.
c) Wade Hampton Frost (1972)
Epidemiology defines knowledge as a mass phenomenon (Mass Phenomen) or infectious disease as the natural history (Natural History) infectious diseases.
Here it appears that at that time was only addressed to the attention of the epidemiology of infectious disease problems that occur / the public / mass.
d) Anders Ahlbom & Staffan Norel (1989)
Epidemiological studies concerning the occurrence of disease in human populations.
e) Gary D. Friedman (1974)
Epidemiology is the study of disease occurance in Human Populations.
f) Abdel R. Omran (1974)
Epidemiology is a science of the occurrence and distribution of health conditions, diseases and changes in population, as well as the determinants and consequences – consequences that occurred in the population.
g) Barbara Valanis
Epidemiology is the term derived from the greek languang (epid = upon; demos = people; logos = science).
h) Last (1988)
Epidemiology is the study of distribution and determinants of health – related states or events in specified population and the application of this study to control of problems.
i) Elizabeth Barrett
Epidemiology is the study of distribution and Causes of diseases.
j) Hirsch (1883)
Epidemiology is an overview of events, the spread of the type – the type of disease in humans at a given time in various places on earth and linking with external conditions
k) Judith S. Mausner; Anita K. Bahn
Epidemiology is concerned with the extend and types of illness and injuries in groups of people and with the factors influence the which Their distribution.
l) Robert H. Fletcher (1991)
Epidemiology is the discipline of research that discusses the distribution and determinants of disease in populations.
m) Lewis H. Rohf; Beatrice J. Selwyn
Epidemiology is the description and explanation of the differences in accurence of events of medical concern in subgroups of population, where the population has been subdivided According to some characteristic believed to influence of the event.
n) Lilienfeld (1977)
Epidemiology is a method of thinking about diseases related to biological assessments and observations derived from a population health level.
o) Moris (1964)
Epidemiology is a knowledge of healthy and sick of a population.
3. Definition of Epidemiology Judging from Various Aspects
a) Aspects of Academic
Academically, meaningful epidemiological analysis of health data, socio-economics, and the trend is going to identify and interpret the health changes that occurred or will occur in the general population or specific population groups.
b) Clinical Aspects
Review of clinical aspects, epidemiology means An attempt to detect early changes in the incidence or prevalence of which is done through clinical or laboratory findings at the beginning of a new disease and the onset of the epidemic.
c) the practical aspects
In practical terms means the science of epidemiology is aimed at preventing the spread of diseases that afflict individuals, groups or the general population.
d) Administrative Aspects
Epidemiology of the administrative capacity means an effort to know the state of society in a region or country in order to provide health services effectively and efficiently in accordance with community needs.
4. According to the Center of Epidemiology Understanding Of Disease Control (CDC) 2002
The definition according to the CDC Epidemiology 2002, Last 2001, Gordis 2000 states that EPIDEMIOLOGY are: “Studies that study the distribution and determinants of diseases and health conditions in populations and their application to control problems – health problems”. From this sense, it is clear that epidemiology is a study, and it is a research study. Then whether it’s research …..? According to Leedy (1974), research is “a systematic quest for undiscovered truth”. (Meaning: a systematic search of the truth that has not been revealed).
Thus it can be concluded that there are three important components that exist in epidemiology, as follows:
1) Frequency of health problems
2) The spread of health problems
3) Factor-factors that influence the occurrence of health problems
Epidemiology was originally defined as the study of the epidemic. This means that only studying the epidemiology of infectious diseases alone but in the later development is also studying the epidemiology of non-infectious diseases, so that today can be interpreted as an epidemiological study on the spread of disease in humans in the context of its environment.
Also includes the study of disease patterns and the search for determinants of the disease. Can be concluded that the epidemiology is the study of the spread of disease and determinants that influence disease
Epidemiology is the science that has been known through historical records in ancient times and even thrive in conjunction with medical science because the two disciplines are related to each other. Epidemiology in the implementation of disease prevention and eradication program needs such as science kedoteran physiology, biochemistry, pathology, microbiology and genetics.
Differences between medical science with the science of epidemiology lies in the way of handling health problems. Medical science insists on a case by case while care epidemioogi kelmpok emphasis on the individual. Therefore, in addition to medical science, epidemiology also needs LMU-science disciplines such as demography, sociology, anthropology, geology, physical environment, economic, cultural and statiska.
In the development of the science of epidemiology is loaded with obstacles because not all medical experts agree that the methods used in epidemioogi. This is caused by differences in paradigms in addressing health issues among medical specialists with epidemiological methods, especially at the time of entry into force of the paradigm that the disease is caused by evil spirits.
Through the paradigm of success thanks to the persistent struggle of renowned scientists at the time. Such as around 1000 BC China and India have been introduced variolasi, 5th Century BC appear to Hippocrates who introduced his book on water, water and places, then Galen complete with atmospheric factors, internal factors and predisposing factors. Ages 14 and 15 terjjadi quarantine in a variety of diseases pioneered by V. Fracastorius and Sydenham, later in the year 1662 John Graunt introduce science mencatata biostat with PES & data metriologi death. In 1839 William Farr developed the statistical analysis, mathematical in epidemiology to develop a system of routine data collection on the number and causes of death compared to the pattern of mortality among people who are married and do not, and between workers of different types of work in the UK. Efforts have been made to develop a disease surveillance system continuously and use that information for planning and evaluation program has raised the name of William Farr as the founder of modern epidemiology.
Subsequently in 1848, John Snow used epidemiology methods in response to cholera epidemic in London, then developed the vaccination effort, the analysis of the outbreak, recent use of epidemiological methods in poisoning disease and cancer. Epidemiological surveillance of developments after World War II followed the development of specific epidemiologic. the same is done Chadwik In 1892 Edwin is doing research on the issue of sanitation in Britain, and Jacob Henle, Robert Koch, Pasteur developed the theory of contact transmission.
From these figures at least have put the concept of epidemiology is still valid today. These concepts include:
A. Environmental influences on the incidence of a disease
2. The use of quantitative data and statistics
3. Transmission of the disease
4. Experiments in humans
In the further development of the limits of epidemiology include at least three elements, namely:
A. Cover all diseases
Epidemiological study of all diseases, both infectious diseases and non-infectious diseases, like cancer, malnutrition (malnutrition), traffic accidents and workplace accidents, mental illness and so forth. Even in developed countries, this includes the epidemiology of health care activities.
2. Population
If the medical clinic oriented images of the individual diseases epidemiology is focused on the distribution of disease in populations (people) or groups.
3. Ecological approach
Studied the frequency and distribution of disease on the overall background of the human environment both the physical environment, biological, and social. This is an ecological approach. The occurrence of disease in a person’s total assessed from humans and their environment.
A. Budiarto, Eko.2003. Introduction Epidemiologi.Jakarta: Book Medical Publishers EGC
2. Bustan MN (2002). Introduction to Epidemiology, Jakarta, Rineka Notices
3. Nasry, Nur basics of epidemiology
4. FKM UNHAS course archive 2006
A. Descriptive epidemiology: epidemiological only describe the magnitude of health problems that occurred in the community
2. Analytical epidemiology: epidemiological addition to describing the magnitude of health problems, also look for factors that cause health problems in the community
Ad 1. Descriptive Epidemiology
• The magnitude of health problems is described in three epidemiological variables: one (person), where (place) and time (time)
• How to describe health problems can be in the form: narrative, tables, graphs or drawings / maps
Ad 2. Analytical Epidemiology
• Epidemiology in addition to describing the magnitude of the problem analytically with three epidemiological variables are also looking for the causes of health problems they will
• How to find the causes by doing research
The purpose of Epidemiology
A. Outlines the distribution and magnitude of the problem of an illness in the community (Descriptive Epidemiology)
2. Provide data for planning, implementation, and evaluation of prevention programs and treatment of disease eradication, and determine the priorities among those programs.
3. Finding the cause and origin of the factor of disease. (Analytic epidemiology)
Application of Epidemiology
 Observation of Epidemiology (epidemiological surveillance): the observation of signs of outbreaks in the community.
 surveillance activities performed by collecting data, then record and analyze the emergence of disease events (plague)
 Epidemiologic Research: nature and conduct more in-depth analysis and conclusions.
 The study aims to find the causes of disease or to prove the hypothesis that has been made based on the study of problems that have occurred
Of the ability of epidemiologists to determine the distribution and factors causing health problems that required the direct intervention is expected to have the role of epidemiology in public health include:
a) Identify the factors that play a role in the occurrence of diseases or health problems in society.
b) Provide the necessary data to perencanaankesehatan and make decisions.
c) To assist in evaluating the health program that is or has been done.
d) Develop a methodology to analyze the state of a disease in an attempt to resolve or mitigate them.
e) Direct intervention is needed to address the problem to be solved.
a) Health problems as subject and object of epidemiology
Epidemiology is not just studying the problems of diseases, but also includes a very extensive health problems found in masyatrakat. Among family planning issues, environmental issues, procurement of health workers, provision of health facilities, and so forth. Thus, the subject and objekepidemioloh = gi issues related to overall health.
b) A group of Human Health Issues
Of work in studying the epidemiology of health problems, will utilize data from the assessment of a group of people, whether it mengyangkut disease problems, family planning or environmental health. Having analyzed and made known penyebabbnya prevention efforts as a follow-up.
c) Use of Data on the Frequency and Distribution of Health Problems in Formulating a cause of health problems
Work of epidemiologists will be able to know a lot about health problems and the cause of the problem by analyzing data on the frequency and distribution of health problems that occur in a human group or society. By exploiting differences kemeduian performed statistical tests, it can be formulated in the causes of health problems.
In the modern era and today’s technological developments epidemiolgi sparked widespread coverage. In broad outline the range or scope of epidemiology include:
A. Epidemiology of Infectious Diseases
2. Epidemiology of Non Communicable Diseases
3. Epidemiology of Reproductive Health
4. Environmental Health Epidemiology
5. Epidemiology of Occupational Health
6. Epidemiology of Health Emergency
7. Epidemiology of Mental Health
8. Epidemiology Planning
9. Epidemiological behavior
10. Genetic Epidemiology
11. Nutritional Epidemiology
12. Epidemiology of Youth
13. Epidemiology Demographics
14. Clinical Epidemiology
15. Epidemiology Causality
16. Epidemiology of Health Services
17. and so on.
The rapid development of epidemiology in such a challenge for health workers to be more careful in taking actions that do not deviate from the range. As for who triggered the rapid development of knowledge and technology is the development of increasingly sophisticated needs of the community who menununtut increased primarily in the health field so that an increasingly complex society. In addition, epidemiological methods are used for infectious diseases can also be used for non-infectious diseases.
Natural history of a disease can be classified in five stages:
A. Pre Pathogenesis
This stage there has been interaction between the host with the seeds of disease, but this interaction occurs outside the human body, in the sense of germs outside the human body and have not entered into the body. In these circumstances have not found any signs of disease and the host immune system is still strong and can resist the disease. This situation is healthy.
2. The incubation stage (already entered Pathogenesis)
At this stage the germs enter the body of the host, but the symptoms do not appear. Each disease has a different incubation period. Cholera 1-2 days, which is a chronic disease such as lung cancer, AIDS, etc..
3. Early disease stages
This phase is calculated from the appearance of disease symptoms, at this stage of the host had fallen ill but still lightweight and can still perform daily activities. When the disease is treated promptly, may be cured, but if not, it could get worse. This terganting endurance of man himself, such as nutrition, rest and good care at home (self care).
4. Advanced disease stage
When host disease gets worse, because it is not treated / tertur not / do not pay attention to suggestions that are given early in the disease, then go to the advanced stage of disease. The host looks helpless and no longer able to do the activity. This stage hosts require intensive care and treatment.
5. Final stages of the disease
The final stage is divided into five circumstances:
a. Complete recovery (form and function of the host’s body back to functioning as the previous state / bebeas of disease)
b. Cured but disabled; end host disease / disease free, but his recovery is not perfect, because it occurs with disabilities (physical, mental and social) and is highly dependent of the disease against the host organs.
c. Career: the career course of the disease as if suspended, because the symptoms of the disease was gone, but the host’s body still contained the seeds of disease, which at one point when decreasing the host immune system will be re-recurrence. This situation is not only harmful to the host itself, but can be harmful to others / society, because it can be a source of disease transmission (human reservoir)
d. Chronic course of the disease at this stage seems stalled, but the symptoms did not change. In other words, do not get heavy or light. This state of the host still remain in a state hospital.
e. Died; If the condition is severe disease and can no longer be treated, thus stopping the course of disease because the host dies. This situation is not the desired state.
In public health there are 5 (five) level disease prevention according to Leavell and Clark. At point 1 and 2 performed in the pre-hospital and performed at the point 3,4,5 sick.
A. Health improvement (health promotion)
a. Healthy and sufficient food supply (quality and quantity)
b. Improvement of hygiene and environmental sanitation, such as water supply, garbage disposal, excreta disposal and waste.
c. Health education to the community. For example for the upper middle class in developing countries against the risk of coronary heart disease.
d. Exercise regularly according to individual ability.
e. Entertainment opportunities for mental and social development.
f. Advice marriage and responsible sex education.
2. General and specific protection against certain diseases (general and specific protection)
a. Providing immunization to vulnerable groups to prevent the disease.
b. Isolation of patients with infectious diseases, such as the bird flu.
c. Prevention of accidents both in public and workplaces.
d. Protection of materials that are carcinogenic, toxic substances and allergy.
e. Control of pollution sources.
3. Enforcement of early diagnosis and prompt and appropriate treatment (early diagnosis and prompt treatment)
a. Finding the case as early as possible.
b. Finding people in the community by way of examination. For example, blood tests, lung rontgent.
c. Looking for all those who have been associated with infectious disease (contact person) to be supervised so that if the disease can arise immediately given treatment.
d. Improve the regularity of treatment to patients.
e. Provision of appropriate treatment at the beginning of each case.
4. Limitation of disability (dissability Limitation)
a. Excellent treatment and care to the patient recovered and no complications occurred.
b. Prevention of complications and disability.
c. Improvement of health facilities as a support for the possible treatment and more intensive treatment.
5. Health recovery (rehabilitation)
a. Develop rehabilitation institutions by involving the community.
b. Awaken the public to accept them back by giving at least moral support for those concerned to survive.
c. Seek settlement of social rehabilitation so that every patient who has been able to defend themselves disabled.
d. Extension and continuation of the efforts that must still be done someone after he recovered from an illness.
Beaglehole (WHO, 1993) divides prevention into 3 sections: primordial prevention (primary prevention) is the pre pathogenesis, primary prevention (prevention of the first), namely health promotion and general and specific protection, secondary prevention (prevention of the second level) is early diagnosis and prompt treatment and tertiary prevention (prevention of the third level) is dissability Limitation.
The size frequency of the disease show the magnitude of health problems found in the human / community. This means that when associated with a disease problem shows many groups of people who became ill. To know the frequency of health problems that occur in a group of people / communities do these steps:
1) Find a health problem, by the way: people who come to the clinic, reports of people who come to the clinic.
2) Research / Health Survey. For example: Household Health Survey
3) A case study. For example: in cases of post-tsunami disaster.
Simply put, epidemiological studies can be divided into two groups as follows:
A. Descriptive epidemiology, the Cross Sectional Study / cross-sectional study / prevalence studies or surveys.
2. Analytic epidemiology: consists of:
a. Non-experimental:
1) Study cohort / follow up / incidence / longitudinal / prospective studies. Diartiakan cohort as a group of people. Purpose of the study to find the result (disease).
2) case-control studies / case control study / retrospective studies. The goal is to find factors that cause disease.
3) Ecological Studies. This study using ecology as a source of material for the empirical investigation of risk factors or characteristics that are in a constant state of society. For example, air pollution caused by fuel combustion that occurs in big cities.
b. Experimental. Where research can manipulate / control the factors that may affect the results of the study and expressed as the best test to determine the cause and effect relationship as well as tests related to the etiology, control, against the disease and to answer other scientific problems. Experimental studies were divided into 2 (two), namely:
1) Clinical Trial. Example:
a) Provision of hypertension medication in people with high blood pressure to prevent stroke.
b) Provision of Tetanus Toxoid in pregnant women to reduce the frequency of Tetanus Neonatorum.
2) Community Trial. Example: The study of substances provision of fluoride in drinking water.
A. The variable
 Age
 Gender
 Type Peketjaan
 Pengahasilan
 Type of conduct
 Marital Status
2. Variable Place
3. Variable Time
 Short-Term
 Change in Status
 Changes in morbidity
General understanding of the epidemiology is a branch of the study of the distribution, frequency, and determinants of a disease that occurs in a group in a population.
There are three important components that exist in epidemiology:
 Frequency of health problems
 The spread of health problems
 Factors that influence the occurrence of health problems
Epidemiology divided by 2 is: Descriptive Epidemiology and Analytic Epidemiology. Epidemiology objectives are:
A. Outlines the distribution and magnitude of the problem of an illness in the community (Descriptive Epidemiology).
2. Provide data for planning, implementation, and evaluation of prevention programs and treatment of disease eradication, and determine the priorities among those programs.
3. Finding the cause and origin of the factor of disease. (Analytic epidemiology)
Epidemiology is very influential in the science of nursing. In the nursing community health nursing, the technical term (CHN) or community health nursing, where the science of epidemiology is used as a means of CHN research and observation on the job and as a basis for intervention and evaluation of epidemiological research literature.

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