Epidemiology

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1
 : study of the occurrence and distribution of health conditions such as disease, death, deformities or disabilities on human populations.
Epidemiology: study of the occurrence and distribution of health conditions such as disease, death, deformities or disabilities on human populations.
2
The Epidemiological Approaches
 
Concerned with disease distribution and frequency
The Epidemiological Approaches
Descriptive Epidemiology
Concerned with disease distribution and frequency
3
The Epidemiological Approaches
 
Attempts to analyze causes or determinants of disease through hypothesis testing
The Epidemiological Approaches
Analytical Epidemiology
Attempts to analyze causes or determinants of disease through hypothesis testing
4
The Epidemiological Approaches
 
Answers questions about the effectiveness of new methods for controlling diseases or for improving underling conditions
The Epidemiological Approaches
Intervention or Experimental Epidemiology
Answers questions about the effectiveness of new methods for controlling diseases or for improving underling conditions
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The Epidemiological Approaches
 
Attempts to measure the effectiveness of different health services and programs
The Epidemiological Approaches
Evaluation Epidemiology
Attempts to measure the effectiveness of different health services and programs
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 : the probability of a group or community developing an epidemic upon introduction of an infectious agent; the proportion of the immunes and the susceptible in the group
Herd Immunity: the probability of a group or community developing an epidemic upon introduction of an infectious agent; the proportion of the immunes and the susceptible in the group
7
Stages of Natural History of Disease
 : disease has not developed but factors that favor its occurrence are present
Pathogenesis: disease has developed, has three sub-stages:
Pre-symptomatic disease or early pathogenesis: individual has no symptoms that indicate presence of illness but in fact, pathogenic changes have begun
Discernible lesions: changes may be detectable through sophisticated laboratory tests; during this period, the early signs and symptoms of disease are developing
Advanced disease: anatomical or functional changes have produced recognizable signs and symptoms
Stages of Natural History of Disease
Prepathogenesis or susceptibility: disease has not developed but factors that favor its occurrence are present
Pathogenesis: disease has developed, has three sub-stages:
Pre-symptomatic disease or early pathogenesis: individual has no symptoms that indicate presence of illness but in fact, pathogenic changes have begun
Discernible lesions: changes may be detectable through sophisticated laboratory tests; during this period, the early signs and symptoms of disease are developing
Advanced disease: anatomical or functional changes have produced recognizable signs and symptoms
8
Stages of Natural History of Disease
Prepathogenesis or susceptibility: disease has not developed but factors that favor its occurrence are present
 : disease has developed, has three sub-stages:
Pre-symptomatic disease or early pathogenesis: individual has no symptoms that indicate presence of illness but in fact, pathogenic changes have begun
Discernible lesions: changes may be detectable through sophisticated laboratory tests; during this period, the early signs and symptoms of disease are developing
Advanced disease: anatomical or functional changes have produced recognizable signs and symptoms
Stages of Natural History of Disease
Prepathogenesis or susceptibility: disease has not developed but factors that favor its occurrence are present
Pathogenesis: disease has developed, has three sub-stages:
Pre-symptomatic disease or early pathogenesis: individual has no symptoms that indicate presence of illness but in fact, pathogenic changes have begun
Discernible lesions: changes may be detectable through sophisticated laboratory tests; during this period, the early signs and symptoms of disease are developing
Advanced disease: anatomical or functional changes have produced recognizable signs and symptoms
9
Stages of Natural History of Disease
Prepathogenesis or susceptibility: disease has not developed but factors that favor its occurrence are present
Pathogenesis: disease has developed, has three sub-stages:
 : individual has no symptoms that indicate presence of illness but in fact, pathogenic changes have begun
Discernible lesions: changes may be detectable through sophisticated laboratory tests; during this period, the early signs and symptoms of disease are developing
Advanced disease: anatomical or functional changes have produced recognizable signs and symptoms
Stages of Natural History of Disease
Prepathogenesis or susceptibility: disease has not developed but factors that favor its occurrence are present
Pathogenesis: disease has developed, has three sub-stages:
Pre-symptomatic disease or early pathogenesis: individual has no symptoms that indicate presence of illness but in fact, pathogenic changes have begun
Discernible lesions: changes may be detectable through sophisticated laboratory tests; during this period, the early signs and symptoms of disease are developing
Advanced disease: anatomical or functional changes have produced recognizable signs and symptoms
10
Stages of Natural History of Disease
Prepathogenesis or susceptibility: disease has not developed but factors that favor its occurrence are present
Pathogenesis: disease has developed, has three sub-stages:
Pre-symptomatic disease or early pathogenesis: individual has no symptoms that indicate presence of illness but in fact, pathogenic changes have begun
 : changes may be detectable through sophisticated laboratory tests; during this period, the early signs and symptoms of disease are developing
Advanced disease: anatomical or functional changes have produced recognizable signs and symptoms
Stages of Natural History of Disease
Prepathogenesis or susceptibility: disease has not developed but factors that favor its occurrence are present
Pathogenesis: disease has developed, has three sub-stages:
Pre-symptomatic disease or early pathogenesis: individual has no symptoms that indicate presence of illness but in fact, pathogenic changes have begun
Discernible lesions: changes may be detectable through sophisticated laboratory tests; during this period, the early signs and symptoms of disease are developing
Advanced disease: anatomical or functional changes have produced recognizable signs and symptoms
11
Stages of Natural History of Disease
Prepathogenesis or susceptibility: disease has not developed but factors that favor its occurrence are present
Pathogenesis: disease has developed, has three sub-stages:
Pre-symptomatic disease or early pathogenesis: individual has no symptoms that indicate presence of illness but in fact, pathogenic changes have begun
Discernible lesions: changes may be detectable through sophisticated laboratory tests; during this period, the early signs and symptoms of disease are developing
 : anatomical or functional changes have produced recognizable signs and symptoms
Stages of Natural History of Disease
Prepathogenesis or susceptibility: disease has not developed but factors that favor its occurrence are present
Pathogenesis: disease has developed, has three sub-stages:
Pre-symptomatic disease or early pathogenesis: individual has no symptoms that indicate presence of illness but in fact, pathogenic changes have begun
Discernible lesions: changes may be detectable through sophisticated laboratory tests; during this period, the early signs and symptoms of disease are developing
Advanced disease: anatomical or functional changes have produced recognizable signs and symptoms
12
Stages of Natural History of Disease - Level of Prevention
Prepathogenesis/Susceptibility -  
Stages of Natural History of Disease - Level of Prevention
Prepathogenesis/Susceptibility - Primary
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Stages of Natural History of Disease - Level of Prevention
Early Pathogenesis/Pre-symptomatic -  
Stages of Natural History of Disease - Level of Prevention
Early Pathogenesis/Pre-symptomatic - Secondary
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Stages of Natural History of Disease - Level of Prevention
Discernible early lesions -  
Stages of Natural History of Disease - Level of Prevention
Discernible early lesions - Tertiary
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Stages of Natural History of Disease - Level of Prevention
Advanced Disease -  
Stages of Natural History of Disease - Level of Prevention
Advanced Disease - Tertiary
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Primary Prevention
 : prevention of emergence of risk factors
Primary Prevention
Primordial prevention: prevention of emergence of risk factors
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Primary Prevention
 : removal of the risk factors or reduction of their levels
Primary Prevention
Specific protection: removal of the risk factors or reduction of their levels
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Concept of Causality & Association
  cause - refers to the fact that the factor must be present for the disease to occur
Concept of Causality & Association
Necessary cause - refers to the fact that the factor must be present for the disease to occur
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Concept of Causality & Association
  cause - indicates that if a factor is present, the disease can occur, but the factor's presence does not always result in the disease's occurrence
Concept of Causality & Association
Sufficient cause - indicates that if a factor is present, the disease can occur, but the factor's presence does not always result in the disease's occurrence
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Concept of Causality & Association
  - there is an occurrence of 2 variables more often than would be expected by chance
Concept of Causality & Association
Association - there is an occurrence of 2 variables more often than would be expected by chance
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Concept of Causality & Association
  - probability of an unfavorable event - disease, disability, defect, death
Concept of Causality & Association
Risk - probability of an unfavorable event - disease, disability, defect, death
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Descriptive Epidemiology
 : the presumptive identification of unrecognized diseases or defects through the application of diagnostic tests or laboratory examinations and clincal assessment that can be applied rapidly and inexpensively
Descriptive Epidemiology
Screening: the presumptive identification of unrecognized diseases or defects through the application of diagnostic tests or laboratory examinations and clincal assessment that can be applied rapidly and inexpensively
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Descriptive Epidemiology
  - done to look for previously unidentified cases of diseases
Descriptive Epidemiology
Case finding - done to look for previously unidentified cases of diseases
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Descriptive Epidemiology
  - the proportion of persons with a disease who test positive on a screening test; tests the probability of correctly identifying a positive case of a disease (true positive)
Descriptive Epidemiology
Sensitivity - the proportion of persons with a disease who test positive on a screening test; tests the probability of correctly identifying a positive case of a disease (true positive)
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Descriptive Epidemiology
  - the proportion of persons without a disease who test negative on a screening test; tests the probability of correctly identifying a non-cases (true negative)
Descriptive Epidemiology
Specificity - the proportion of persons without a disease who test negative on a screening test; tests the probability of correctly identifying a non-cases (true negative)
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Descriptive Epidemiology
High sensitivity - False  
Descriptive Epidemiology
High sensitivity - False negative
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Descriptive Epidemiology
High specificity - False  
Descriptive Epidemiology
High specificity - False positive
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Descriptive Epidemiology
Sensitivity/True-Positive Rate Formula =  
Descriptive Epidemiology
Sensitivity/True-Positive Rate Formula = (# True positive/Total with disease) x 100
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Descriptive Epidemiology
Specificity/True-Negative Rate Formula =  
Descriptive Epidemiology
Specificity/True-Negative Rate Formula = (# True negative/Total without disease) x 100
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Descriptive Epidemiology
False-Negative Rate Formula =  
Descriptive Epidemiology
False-Negative Rate Formula = (# False negative/Total with disease) x 100
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Descriptive Epidemiology
False-Positive Rate Formula =  
Descriptive Epidemiology
False-Positive Rate Formula = (# False positive/Total without disease) x 100
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Descriptive Epidemiology
 : the basis for determining the community's reaction against disease invasion since it represents the immunity and susceptibility levels of individuals comprising the population
Descriptive Epidemiology
Herd immunity: the basis for determining the community's reaction against disease invasion since it represents the immunity and susceptibility levels of individuals comprising the population
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Descriptive Epidemiology
  - a situation when there is a marked upward fluctuation in disease incidence
Descriptive Epidemiology
Epidemic - a situation when there is a marked upward fluctuation in disease incidence
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Descriptive Epidemiology
  - The proportion of the susceptible are high compared to the proportion of the immunes
Descriptive Epidemiology
Epidemic - The proportion of the susceptible are high compared to the proportion of the immunes
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Descriptive Epidemiology
  - the occurrence of disease implies the habitual presence of disease in a given geographic location accounting for the low number of both immunes and susceptible
Descriptive Epidemiology
Endemic - the occurrence of disease implies the habitual presence of disease in a given geographic location accounting for the low number of both immunes and susceptible
36
Descriptive Epidemiology
  - Disease occurs every now and then affecting only a small number of people relative to the total population
Descriptive Epidemiology
Sporadic - Disease occurs every now and then affecting only a small number of people relative to the total population
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Descriptive Epidemiology
  - represents progressive opportunities for progressive transfer or transmission of an infectious agent to a susceptible host and depends on the frequency of contact and facility of transmission
Descriptive Epidemiology
Exposure or Contact Rate - represents progressive opportunities for progressive transfer or transmission of an infectious agent to a susceptible host and depends on the frequency of contact and facility of transmission
38
Descriptive Epidemiology
  - the probability of contact between the source of infection and the susceptible host and depends upon the number of sources of infection, the number of immunes, and location of the source of infection
Descriptive Epidemiology
Chance - the probability of contact between the source of infection and the susceptible host and depends upon the number of sources of infection, the number of immunes, and location of the source of infection
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Descriptive Epidemiology
The nurse characterizes the pattern of disease occurence in terms of date or time onset. This is indicated by the   curve
Descriptive Epidemiology
The nurse characterizes the pattern of disease occurence in terms of date or time onset. This is indicated by the epidemic or attack curve
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Descriptive Epidemiology
  epidemic - characterized by simultaneous exposure of a large number of susceptible to a common infectious agent
Descriptive Epidemiology
Point source epidemic - characterized by simultaneous exposure of a large number of susceptible to a common infectious agent
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Descriptive Epidemiology
  epidemic - caused by a person-to-person transmission of disease agent
Descriptive Epidemiology
Propagated epidemic - caused by a person-to-person transmission of disease agent
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Descriptive Epidemiology
  variation - recurrent fluctuations of disease that may exhibit cycles lasting for certain periods
Descriptive Epidemiology
Cyclic variation - recurrent fluctuations of disease that may exhibit cycles lasting for certain periods
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Descriptive Epidemiology
  variation - changes in disease frequency over a period of many years
Descriptive Epidemiology
Secular variation - changes in disease frequency over a period of many years
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Analytical Epidemiology
The   to an individual developing a disease due to a particular exposure is derived by comparing the occurrence of a disease in a population exposed to the suspected factor to the occurrence of a disease in a population not exposed to the suspected factor
Analytical Epidemiology
The relative risk to an individual developing a disease due to a particular exposure is derived by comparing the occurrence of a disease in a population exposed to the suspected factor to the occurrence of a disease in a population not exposed to the suspected factor
45
Analytical Epidemiology
A relative risk ratio of   means that the risk is the same for both exposed and non-exposed populations while a risk greater than   indicates excess risk in the exposed group
Analytical Epidemiology
A relative risk ratio of 1.0 means that the risk is the same for both exposed and non-exposed populations while a risk greater than 1.0 indicates excess risk in the exposed group
46
Analytical Epidemiology
Relative Risk Ratio (RRR) Formula =  
Analytical Epidemiology
Relative Risk Ratio (RRR) Formula = (Incidence rate among those exposed/Incident rate among those not exposed)
47
Analytical Epidemiology
  - establishes the probability of disease development as a result of being exposed to a suspected factor
Analytical Epidemiology
Odds ratio - establishes the probability of disease development as a result of being exposed to a suspected factor
48
Analytical Epidemiology
An odds ratio equal to   suggests that the factor is NOT a risk factor to the disease or condition
Analytical Epidemiology
An odds ratio equal to 1.0 suggests that the factor is NOT a risk factor to the disease or condition
49
Analytical Epidemiology
Odds Ratio Formula =  
Analytical Epidemiology
Odds Ratio Formula = ad\/bc
50
Analytical Epidemiology
  - absolute effect of the exposure or the excess risk of thr disease to a causal agent
Analytical Epidemiology
Attributable risk - absolute effect of the exposure or the excess risk of thr disease to a causal agent
51
Analytical Epidemiology
Attributable risk formula =  
Analytical Epidemiology
Attributable risk formula = Incidence rate among exposed - Incidence rate among non-exposed
52
Descriptive Epidemiology
  - simultaneous occurrence of epidemic of the same disease in several countries
Descriptive Epidemiology
Pandemic - simultaneous occurrence of epidemic of the same disease in several countries
53
 : backbone of preventing disease
Epidemiology: backbone of preventing disease
54
 : backbone of preventing infection
Handwashing: backbone of preventing infection
55
Epidemiologic Triangle (HEA)
H  - any organism that harbors and provides nourishment for another organism
Environment - the sum total of all external conditions and influences that affects the development of an organism which can be biological, social, and physical
Physical - inanimate surroundings (geophysical conditions of the climate)
Biological - living things (plant and animal life)
Socio-economic - may be in the form of level of economic development of the community, presence of social disruptions
Agent - intrinsic property of microorganism to survive and multiply in the environment to produce disease
Epidemiologic Triangle (HEA)
Host - any organism that harbors and provides nourishment for another organism
Environment - the sum total of all external conditions and influences that affects the development of an organism which can be biological, social, and physical
Physical - inanimate surroundings (geophysical conditions of the climate)
Biological - living things (plant and animal life)
Socio-economic - may be in the form of level of economic development of the community, presence of social disruptions
Agent - intrinsic property of microorganism to survive and multiply in the environment to produce disease
56
Epidemiologic Triangle (HEA)
Host - any organism that harbors and provides nourishment for another organism
E  - the sum total of all external conditions and influences that affects the development of an organism which can be biological, social, and physical
Physical - inanimate surroundings (geophysical conditions of the climate)
Biological - living things (plant and animal life)
Socio-economic - may be in the form of level of economic development of the community, presence of social disruptions
Agent - intrinsic property of microorganism to survive and multiply in the environment to produce disease
Epidemiologic Triangle (HEA)
Host - any organism that harbors and provides nourishment for another organism
Environment - the sum total of all external conditions and influences that affects the development of an organism which can be biological, social, and physical
Physical - inanimate surroundings (geophysical conditions of the climate)
Biological - living things (plant and animal life)
Socio-economic - may be in the form of level of economic development of the community, presence of social disruptions
Agent - intrinsic property of microorganism to survive and multiply in the environment to produce disease
57
Epidemiologic Triangle (HEA)
Host - any organism that harbors and provides nourishment for another organism
Environment - the sum total of all external conditions and influences that affects the development of an organism which can be biological, social, and physical
  - inanimate surroundings (geophysical conditions of the climate)
Biological - living things (plant and animal life)
Socio-economic - may be in the form of level of economic development of the community, presence of social disruptions
Agent - intrinsic property of microorganism to survive and multiply in the environment to produce disease
Epidemiologic Triangle (HEA)
Host - any organism that harbors and provides nourishment for another organism
Environment - the sum total of all external conditions and influences that affects the development of an organism which can be biological, social, and physical
Physical - inanimate surroundings (geophysical conditions of the climate)
Biological - living things (plant and animal life)
Socio-economic - may be in the form of level of economic development of the community, presence of social disruptions
Agent - intrinsic property of microorganism to survive and multiply in the environment to produce disease
58
Epidemiologic Triangle (HEA)
Host - any organism that harbors and provides nourishment for another organism
Environment - the sum total of all external conditions and influences that affects the development of an organism which can be biological, social, and physical
Physical - inanimate surroundings (geophysical conditions of the climate)
  - living things (plant and animal life)
Socio-economic - may be in the form of level of economic development of the community, presence of social disruptions
Agent - intrinsic property of microorganism to survive and multiply in the environment to produce disease
Epidemiologic Triangle (HEA)
Host - any organism that harbors and provides nourishment for another organism
Environment - the sum total of all external conditions and influences that affects the development of an organism which can be biological, social, and physical
Physical - inanimate surroundings (geophysical conditions of the climate)
Biological - living things (plant and animal life)
Socio-economic - may be in the form of level of economic development of the community, presence of social disruptions
Agent - intrinsic property of microorganism to survive and multiply in the environment to produce disease
59
Epidemiologic Triangle (HEA)
Host - any organism that harbors and provides nourishment for another organism
Environment - the sum total of all external conditions and influences that affects the development of an organism which can be biological, social, and physical
Physical - inanimate surroundings (geophysical conditions of the climate)
Biological - living things (plant and animal life)
  - may be in the form of level of economic development of the community, presence of social disruptions
Agent - intrinsic property of microorganism to survive and multiply in the environment to produce disease
Epidemiologic Triangle (HEA)
Host - any organism that harbors and provides nourishment for another organism
Environment - the sum total of all external conditions and influences that affects the development of an organism which can be biological, social, and physical
Physical - inanimate surroundings (geophysical conditions of the climate)
Biological - living things (plant and animal life)
Socio-economic - may be in the form of level of economic development of the community, presence of social disruptions
Agent - intrinsic property of microorganism to survive and multiply in the environment to produce disease
60
Epidemiologic Triangle (HEA)
Host - any organism that harbors and provides nourishment for another organism
Environment - the sum total of all external conditions and influences that affects the development of an organism which can be biological, social, and physical
Physical - inanimate surroundings (geophysical conditions of the climate)
Biological - living things (plant and animal life)
Socio-economic - may be in the form of level of economic development of the community, presence of social disruptions
A  - intrinsic property of microorganism to survive and multiply in the environment to produce disease
Epidemiologic Triangle (HEA)
Host - any organism that harbors and provides nourishment for another organism
Environment - the sum total of all external conditions and influences that affects the development of an organism which can be biological, social, and physical
Physical - inanimate surroundings (geophysical conditions of the climate)
Biological - living things (plant and animal life)
Socio-economic - may be in the form of level of economic development of the community, presence of social disruptions
Agent - intrinsic property of microorganism to survive and multiply in the environment to produce disease
61
Patterns of Occurrence and Distribution
 
The intermittent occurrence of a few isolated and unrelated cases in a givem locality; cases are few and scattered
Patterns of Occurrence and Distribution
Sporadic
The intermittent occurrence of a few isolated and unrelated cases in a givem locality; cases are few and scattered
62
Patterns of Occurrence and Distribution
 
Rabies
Patterns of Occurrence and Distribution
Sporadic
Rabies
63
Patterns of Occurrence and Distribution
 
Continuous occurrence throughout a period of time, of the usual number of cases in a given locality; The disease is therefore always occurring in the locality and is more or less inherent in that locality
Patterns of Occurrence and Distribution
Endemic
Continuous occurrence throughout a period of time, of the usual number of cases in a given locality; The disease is therefore always occurring in the locality and is more or less inherent in that locality
64
Patterns of Occurrence and Distribution
 
Schistosomiasis in Leyte and Samar
Patterns of Occurrence and Distribution
Endemic
Schistosomiasis in Leyte and Samar
65
Patterns of Occurrence and Distribution
 
Filariasis in Sorsogon
Patterns of Occurrence and Distribution
Endemic
Filariasis in Sorsogon
66
Patterns of Occurrence and Distribution
 
Tuberculosis
Patterns of Occurrence and Distribution
Endemic
Tuberculosis
67
Epidemiology
  - an ongoing systematic collection, analysis, interpretation, and dissemination of health data
Epidemiology
Public Health Surveillance - an ongoing systematic collection, analysis, interpretation, and dissemination of health data
68
Epidemiology
  - a hospital-based information system that monitors the occurrence of infectious diseases with outbreak potential
Epidemiology
National Epidemic Sentinel Surveillance System (NESSS) - a hospital-based information system that monitors the occurrence of infectious diseases with outbreak potential
69
Descriptive Epidemiology
  epidemic - characterized by a rapid increase in cases followed by a rapid decline, often associated with a single source of exposure
Descriptive Epidemiology
Point source epidemic - characterized by a rapid increase in cases followed by a rapid decline, often associated with a single source of exposure
70
Descriptive Epidemiology
  epidemic - cases continue to occur over an extended period, often due to repeated or continuous exposure to a source
Descriptive Epidemiology
Continuous common-source epidemic - cases continue to occur over an extended period, often due to repeated or continuous exposure to a source
71
Descriptive Epidemiology
  epidemic - epidemic curve has multiple peaks with gaps in between
Descriptive Epidemiology
Intermittent common-source epidemic - epidemic curve has multiple peaks with gaps in between
72
Descriptive Epidemiology
  epidemic - a gradual increase in the number of cases with each new case being a source of infection for others
Descriptive Epidemiology
Propagated epidemic - a gradual increase in the number of cases with each new case being a source of infection for others
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