Measurements of Epidemiology

Bilqis Yasmin M.Sc Nursing

Epidemiology: Is defined as study of distribution and determinants of various disease frequency. Measurements: Is the science of calculations. Measurements are important in day to day life in relation to seven Ds i.e. Death, disease, Delivery, Distribution, Determinants, Demographic variables and Disability.

Scope of Measurements : Basic measurements of epidimology: 1. Mortality, morbidity, disability, natality. 2. Presence/absence or distribution of environmental and other factors suspected of causing disease. 3. Presence/absence or distribution of characteristics of disease. 4. Medical needs, health care facilities, utilization of heath services and other health related events. 5. Measurement of demographic variables.

Basic requirements of measurements are: 1. Validity 4. Sensitivity 2. Reliability. 5. Specificity 3. Accuracy Important terms: 1. Variate: piece of information referring to patient disease. Variate can be a. Discrete: present or absent e.g. ca. lung. b. Continuously distributed e.g. B.P, height.

2. Circumstances: any factor in the environment suspected to cause the disease i.e. air, water, pollution. Frequency of discrete variable/circumstances is expressed as a Rate In relation to Population. Frequency of continuously distributed variable/circumstances is expressed in the form of frequency distribution using mean, centile, SD.

Basic Tools of measurements: Rates, Ratios, Proportion. Rates: Measures occurrence of some particular event (disease or death) in the pop. during a given time period. Elements of Rate : numerator, denominator, specific time period, constant number e.g. D rate = [(num D/yr)/ mid yr pop] x 1000

Ratio: Expresses a relation in size between two random quantities. Broadly ratio is the result of dividing one quantity by another i.e. X : Y or X/Y e.g. WBC : RBC = 1:600 e.g. [(number of children with scabies at a certain time) / (number of children with malnutrition at a same time)], sex ratio, doc pop ratio, NPR etc.

Proportion: is the ratio which indicates the relation in the magnitude of the part of the whole. It is always expressed as a percentage e.g. [(num of children with scabies at a certain time) / (num of children in the village at the same time)] x 100 = proportion

Concept of Numerator and Denominator Numerator: is number of times an event i.e. sickness, birth, death episode has occurred in the population during a specific time period. Numerator is the component of denominator in calculating rate but not ratio. Denominator: Numerator has little meaning unless it has denominator. It may be related to population or to total events.

Related to population: Mid year population - 1st July Population at risk capable of acquiring disease. Person time combination of person & time. Person distance passenger & miles. Sub groups of pop age, sex, occupation.

Mortality rates: Death rate can be crude mortality rate or specific mortality rate. Crude mortality rate Numerator includes all the deaths Specific mortality rate It is disease specific e.g. the numerator is death due to measles in a particular area in a particular year and denominator is mid year pop of that area in same year.

Morbidity rate: The incidence and prevelance rates are the two most commonly used rates in community health. Incidence Rate refers to the occurrence of new cases during a particular period i.e. one year in a population exposed to risk in a particular area. Attack rate is similar to incidence rate which represents the incidence of illness among exposed population during specified time period.

Prevalence Rate: It refers to total number of cases pertaining to any disease existing in a community at a given time. It depends on incidence and duration of disease Conclusion: Measurements of epidemiology are used for planning health services, determining effectiveness of services and providing feedback for further panning