Epidemiology

General description of the course

This course of epidemiology is designed to equip the students with a comprehensive knowledge on the need, philosophy, concepts, strategy, methods and use of epidemiology. It is also designed to develop health research competencies and attitude to apply epidemiological principles in the community/individual health diagnosis and health care practices.

General objectives

Students will be able to

  • Define and measure health and disease and discuss its natural history, occurrence and causation
  • Identify the health and non-health factors affecting the population exposed, the environment and ecosystem in which they live in, and the specific agents which influence or determine health and disease, as a basis for the health care of the communities.
  • Use epidemiology in understanding health problems and developing community health care for the entire population.
  • Organize control/preventive measures and appraise management of diseases and other health problems appropriate to the existing physical, eco-biological and socio-cultural conditions.
  • Appreciate designing and approaches to research

Specific objectives

Students will be able to

  • describe the concept of epidemiology, historical development of epidemiology and practices and its use in health management and patient care;
  • define health and disease, natural history of disease and models of disease occurrence and causation (epidemiological triad, wheel, web of causation and pie).
  • Explain the need and principles of classifying diseases
  • Describe different sources of epidemiological data, their types, uses, reliability and weakness, and appraise the data critically
  • Define infections, communicable/non-communicable diseases, case, host (primary and intermediate), agent, environment, carriers, parasites, vectors, reservoir, incubation period, latency, persistency, infectivity, antigenicity, virulence, pathogenicity, saprophytes, eco-health
  • Explain various terminologies used in the epidemiologic description of communicable and non-communicable diseases including type of epidemics (common source, propagated and cyclical), endemicity, sporadic, pandemic, epizootic, enzootic etc.
  • Explain mechanism of transmission of infection in terms of
  • Describing the processes of transmission of communicable diseases
  • explaining host, parasite and the environment relationship
  • ways of breaking the transmission cycle
  • describe levels of prevention and discuss control and prevention of communicable diseases
  • explain immunity and the role played by the body defense mechanisms in relation to
  • antigen and antibody
  • basic immuno-biology
  • active and passive, natural and artificial immunity
  • herd immunity
  • mechanism of immuno-compromised conditions
  • define immunization, types of immunization, contraindication of immunization, immunization schedule in Nepal as a method of control carry out epidemiological investigations of infectious and non-infectious diseases and describe general principles of investigation of an epidemic with examples
  • discuss the measurement of disease
  • Frequency measures (rate, ratio, proportion,
  • Prevalence, incidence and other epidemiological indices,
  • Measures of association
  • describe characteristics disease/health status in terms of persons, place and time
  • importance and need for collecting information on the people/person affected with a disease,
  • Role of intrinsic and extrinsic factors associated with person/s including ethnicity in disease distribution
  • intrinsic and extrinsic conditions of place and migration
  • Role of place in disease occurrence
  • geographical distribution of diseases and comparison of disease occurrence at international, regional and local levels;
  • describing seasonal clustering of disease
  • describing clustering and cyclic fluctuations of disease
  • describing secular trends of the disease
  • describe the types and nature, and use of various epidemiologic studies; describe errors in epidemiological studies (chance, bias, confounding), describe the concept of cause and role of epidemiological studies to establish causal relationship in terms of relative risk, odds ratio; types of association and predictive values of such associations
  • describe the strategies of epidemiology in terms of
  • explaining ways and means of assembling the facts on the types of people affected with a disease and various circumstances in which it occurs.
  • discussing hypothesis regarding the distribution and cause or determinants of the disease/problem (s) in the population or area;
  • formulating hypothesis and test it scientifically or epidemiologically (descriptive, comparative, analytical, interventional and experimental epidemiology), and
  • making review, appraise, present, propagate and apply various epidemiological studies.
  1. Bonita and Beaglehole. Basic Epidemiology. WHO Publications
  2. Park JE, Park K. Textbook of Social and Preventive Medicine
  3. Lilienfied & Lilienfield Fundamentals of Epidemiology
  4. Robert H Fletcher, Suzanne W Fletcher and Edward H Wagner. Clinical Epidemiology, Second Edition, Williams and Wilkins 1988.