Académique Documents
Professionnel Documents
Culture Documents
Epidemiology
Epidemic ! Epi "#!! Upon &
Demos "#!! Population
Logy +, Logos ! Study
0&12 !! 342150&16 7!87 40!0&1298
,1: ;1;!4+#,&;<=0>?,!842150&1 (Epidemic) 4>C8D89E 42#:F8:7!<:
Hippocrates (460 >L ,8 ..) "#!N1F=!,O2&421598=P0Q,! D, 87 <=0
D8# &QF,R=<=0<85<=0:51 Graunt (.. 1662) 1=,!=D4+,
V,!W># X4>C85 Scurvy 0!,,04=4>C8004=88Z 51 Lind (.. 1747) 1=,!
9VF"8>?,!85\L151 Jenner (.. 1796) <=0#,8&N1F 4>C8:F8<&&Q,!!
0&12 N1F< 0&1Q,!,2:598;! London >04,!W 51 Snow (..
1854) =!878!0&12,+#8Z 4V8 <=0>?,!85 Pellagra 51
Goldberger (.. 1923) 8!1=,!"8>?,!85 Poliomyelitis 51 Francis (.. 1954)
D;>N1F !0&1298D:F8Z 4>C84#&50&1<=05:21:,
(Communicable disease) 4+,&7!1 <:98:#f8 5#4>C8>gEQ,!>0V42#4>=#8
R><&&N>4>C85NF4V+7, (Non-communicable disease) <=054+7,! (Chronic disease) 4>C8D89E
4>=#8<>=!1!= 4 3Epidemiologic transition6 <:7!87 NN1F2O #49VF98
50&1<&&412 0ND89VF98>gEQ,!59Z N1F 80&12N1F
k8R><&&Q,!!0&12 4+#,9FN1FQF,R=988N>&;<=0>?,!85NF4V+7, <=0
54+7,!8421R><&&<=02O 9Z Q78=<&&
1!878 2V0&12!NN1F1Q,&4Q:Q,!,R< :4l0 350&16 ,:,N> <:
N1FQQ,&4Q:,,N>5,+#8Z :=,18>gEDOPD;Q#N9V 356 4V8 &14m&<=0
,;&:2 +,<F<:>gE#,R8 ,!<<=0DOPD;Q mD82O<=00&8
!0&12N>9VF98<FNQ>gEN1F 82V=8!4m8F,!8 30&126
N9V 3DQ2V6 (Discipline) 51:! <:4>C8 34+#,!+,6 (Tools) #9VF98>gEDOPD;Q
4m887804>C82! 400&12N48+7,4l04+#,!#4>C8Q,!DQ2V4,! 98QP0#
DQ2V,+#8Z 48+7,2V4l0DQ 4V8 DQ2V5V8D: 984+#,!Q,!,<=0&25
DQ2VW:2D:W:2Q,!8;98<!;:!Z +,DQ2V=D: 5
<=02O!<#4#QF,!&f:1 1!878 0&12 !4>C84+#,9F&!
2O (Methodology) 985<=0>gE!<<=0DOPD;Q <=01F4:;f=874,!
#82V;89Z ,!0&1298q80Q,! 32O6 #9VF982 (Research methodology) "#!
4>C8D2#!#82V;DQ2V4>C8:F,!48RF
2 Medical Epidemiology
% (Definition)
0&124>C8D:#+,=!0Q,!598>0V <=0>g#,2O2=
+,4>C8D4:;#9F4210<&&878 0&12q82!#& 5 +,
4m&>X NN1F421&8;Z 81F5,D#4Z 8 <:8&!80=P0&!,!#4D#!:,
42158,+#8Z =P01!=87 ,4>C8=P0!8O; +,4>C8f=DfD:,
>g&!,!98D2#!<1=F,
1Q,! Epidemiology #82V51#N>,&8#D;1 +,
Epidemiology: 3The study of the distribution and determinants of health-related states or
events in specified populations and the application of this study to control of health problems6 (Last,
1995)
"#!04m8N1F 187N1F84,7!48+7,Q,!DQ2V (Discipline) <=08N>9VF
(Implication) =NF7! 2 >0
+,+-.+/
0&12 =P04+,8&V821,+#8Z #984+#,!5 "#!,<&!N1F
4>C8 4 01& N1F<
1. Sub-molecular +, Molecular level "#!N1F< ! Cell biology, Biochemistry <=0
Immunology
2. Tissue +, Organ level "#!N1F< ! Histopathology <=0 Anatomic pathology
3. Individual level "#!N1F< ! Clinical medicine
4. Population level "#!N1F< ! Epidemiology
54+#,9FN1F,!RF#D&RPD# ;1 !4>C8:F,!9VFO2 8;Z 01&
Classification
fRF<80&12,,4>C8 3Classical6 <=0 3Clinical epidemiology6 1!87
Classical (Traditional) epidemiology +, The big E Epidemiology =P04>C8
Population oriented <=04>C8>gEQ,!598V;V8 4V8 >gE#4#QF,!& Nutrition
D2#!<1=F, W:2 Psychosocial D89E Classical epidemiology 0;!48F898F8 Risk factor
#08N>DR>?,!85
Classical epidemiology 878 !<F09VF methodology Q,!<&&418m: <:
4>C898 Health care setting 51:;>0D!=4+#, Improve f=5 7!98<!
Diagnosis, Treatment <=0 Prognosis <=051#;1;!=Q,! Clinical epidemiology +,
4+#,k8:1D28998fRF>X (Clinical decision) 82V<&!8!4 Clinical
epidemiology 3Clinical decision analysis6 <:8751#N><=F 0<&98P<
4+#,4>C8=1D&D8984+#,!Q,! Terminology 0! Classical epidemiology <=0 Clinical
epidemiology !80&12&!=; &EE:2 3Public health epidemiology6 Q784+#,<
9F4m8<::!981F8Q,! Content <=0 Methodology 0!0&127!D,!<Q8!87
8,878 !<DQ,Q,!0&12,,N>:=;>gE<=05# 4V8
Cancer epidemiology +, :>g4D#!# 4V8 Nutritional epidemiology 4>C8:F8 <:
1!=m!!1<821 <=0=Q,!0&1217!412,R
Chapter 1 Introduction to Epidemiology 3
;<
-7;=+>
= +7?:7@
0&12&&:,2D:<<=0DOPD;Q=,! 4V8
1. +C%DEC++, Natural History I Clinical Picture
!0&12 0V9F<4QF9=P0Q,!59800:!Z N1FV1481Q78
4V8 4+#,! AIDS <=0,Q,!fRF>X 9800:!Z =!# HIV infection
fRF>X4&8:7!<:42#4>C8 80#!42154DF84=+,1<=0N::=! +,=P0
,<=0,<D1!Q,!Q1 Vitamin A 9800:!Z
2. +77%?+;;< (Mode of Transmission)
M<N
QF,R=#N1F4m&&98=P0Q,!4\?0!5 (Surveillance) <=0
D,&D85 (Investigation) 09F80&12N1FD;:2q8984+#,!:21:,Q,!5 "#!08N>DR
2DR898Q78:,N> RF984+#,!:21:,87 9F80&12D812O>?,!85N1F
,8#&D4:;#<F2!Q,!5 4V8 !8fR>F X5 AIDS 4+#,>L .. 1981 9F421
D;:2q85 AIDS :21:,!4D8O 9VF4Qml18 <=0N1F&4=+,1+,D#
D14=+,1 9F:<=085&98&;>?,!85 ,24V8 9VF Condom N9VF
4Qml18 <=0 Screen 4=+,1,89FfRF>X 4>C8:F8
3. +E%7C;@IPQRR,C7
!82!0&12D89E04>C84+#,9F&D4:; (Cause) +,>g
4D#! (Risk factor) :,4215 4+#,>05V8981F8DOPD;Q D4:;+,>g1!= ,N1F
==P0<=0R><&& "#!9F4210&12<Q8!:!Z : 4V8
Environmental epidemiology >g!1F8D2#!<1=F,
Occupational epidemiology >g!1F8,V
Nutritional epidemiology >g!1F85V8D:
Genetic epidemiology >g!1F88O;
Social epidemiology >g!1F8D! 2:9 <=0
Health service epidemiology >g!1F8&2D;Q
4. +PT+,%
0&12 N1FV+#,4>C8 3D:<!>?,!856 (The science of prevention)
!<F2!0&124!,!410ND2DR8D4:;Q,!5N1F <:QF,R=#N1F
!0&12887 9F=q84!,#08N>9VF98>?,!85N1F4>C8,!1 51N
4>C8:F,!RF984+#,!5,8 4V8
4 Medical Epidemiology
;
1 88>0V 88fRF: <=0,::,2:5 (:, 1,000) 98:&=#
0&1Q,!5 ;! London >04,!W 0!8# 9 ~ ! 2 D2!
.. 1854 <8:&87>0>
/,
%U8P P P V+ R8%%; ,;;
Southwark and Vauxhall Company 167,654 844 5.0
Lambeth Company 19,133 18 0.9
7. +[%% %E%7?:7@
988185&!DOPD;Q q+,8!8 4>C8:F,!4>C8Q,!
>gEDOPD;Q878 51=04,1 :1!=,>0,&1F 81=1&DEQ,!
>gE 81<8!&;5 4=+, Community health intervention programme 1
<=0>0428f= <=0>&>;!0&81!=9F>0D2O212#!Q78 :=,181f=0&
(Impact) #4219VF:878Z 4>C8:F8 "#!::!Z 4=87 :!m:F,!,2O
!0&121F87!878
8. +;,7%M%-
98?,!F,!:,= 4+,# 44D98P#4F;Q4>C85#1,0D4:;
!8 (Occupational disease) +,N1F&D2, +,D2#!DOPR>5,+#8Z
fRF4D0:F,!=q84!,#09F=4V+,# 5#4>C8,R878 421DfD&>g#
4#QF,!&!8+,,#N1F& QF,R=!0&120D9F :,&N1F9801&8#! "#!
D8N>9VF,F!,2!98=N1F 98!:;=:!>04 fRF2<=0P0=RQ;8 0N1F&
,&9F&!=!0&12<=08f=#N1FN>9VF,F !,2!98V78=
Clinical Practice
0&12NN1FDE:,!8DOPD;Q4878 <:!DE981F8<,
1F 7!8748+#,!<:F,!,QF,R=Q,!>0V (Population-based) 984+#,!:!Z #4#QF,!
&fR>F X DE874,! #9F421D:!0&12<Q8!94+#,8N>9VF!
<514l0 8#8+, Clinical epidemiology 1!87
Chapter 1 Introduction to Epidemiology 7
:%@+
1. Beaglehole R. Basic Epidemiology. Geneva: World Health Organization, 1993: 1-11.
2. Friedman GD. Primer of Epidemiology. 4th edition. New York: McGraw-Hill Incorporated, 1994:
1-8.
3. Gordis L. Epidemiology. Philadelphia: WB Saunders Company, 1996: 3-12.
4. Greenberg RS. Medical Epidemiology. 2nd edition. New Jersey: prentice Hall International, 1996:
1-13.
5. Hennekens CH. Epidemiology in Medicine. Boston: Little Brown and Company, 1987: 3-15.
6. Jekel JF. Epidemiology, Biostatistics and Preventive Medicine. Philadelphia: WB Saunders
Company, 1996: 4-16.
7. Kramer MS. Clinical Epidemiology and Biostatistics, A Primer for Clinical Investigators and
Decision-Makers. Berlin: Springer-Verlag, 1988: 3-10.
8 Medical Epidemiology
8. Last JM. A Dictionary of Epidemiology. 3rd edition. New York: Oxford University Press, 1995: 55.
9. Lilienfeld DE. Foundation of Epidemiology. 3rd edition. New York: Oxford University Press, 1994:
1-21.
10. Page RM. Basic Epidemiological Methods and Biostatistics, A Practical Guidebook. Boston: Jones
and Bartlett Publishers, 1995: 1-47.
11. Stone DB. Introduction to Epidemiology. Madison: Brown & Benchmark Publishers, 1996: 1-10.
12. Streiner DL. PDQ Epidemiology. 2nd edition. St. Louise: Mosby, 1996: 1-13.