COMMUNITY MEDICINE IV

Applied Epidemiology

General Description of the Course

This course of applied epidemiology is designed to equip the students with a comprehensive knowledge on the epidemiology of infectious and non-infectious diseases and their management. The focus will be given on the natural history of the disease, etiology, concept, distribution (international, regional and national), determinants, diagnosis and management (prevention, control and treatment). It is also designed to use fundamental knowledge of basic epidemiology in describing and explaining infectious and non-infectious diseases. Ultimately, the students will develop better understanding about the disease and application of that knowledge on health research and disease management.

The course content is divided into three groups:

Group 1: Epidemiology of infectious disease

Group 2: Epidemiology of non-infectious disease.

Group 3: Health services for communicable diseases.

The diseases to be considered under Group I are further divided into sub groups. Sub group I consists of common disease in Nepal and Sub group II contains the rarer diseases in Nepal. Emphasis will be laid on the diseases listed under sub group I and very little made for sub group II.

General Objectives

Students will be able to

  • identify the distribution and occurrence of the disease in population;
  • identify the health and non health determinants affecting the population exposed
  • study environment and ecosystem in which they live in and the specific agents which influence or determine health and disease
  • use epidemiology in understanding health problems and developing community health care for the entire population
  • organize control/preventive and management of diseases and other health problems appropriate to the existing physical, eco-biologicai and socio-cultural conditions

Specific Objectives

Group I: Epidemiology of infectious diseases

Students will be able to:

  • identify the infectious disease, and its causative agent by clinical as well as laboratory methods
  • describe the magnitude of health problem
  • discuss the route, mode and factors responsible for the transmission
  • institute immediate management of the case and effective control measures of:

A. Bacterial infections

Sub group I: Cholera, enteric fever (Typhoid and paratyphoid fevers), brucellosis staphylococcal infections, meningococcal meningitis, streptococcal infections, tuberculosis, sexually transmitted diseases and HIV/AIDS

Sub group II: Plague, tularaemia, anthrax, relapsing fevers (tick-borne and louse-borne relapsing fevers), leptospirosis, typhus fever, and lymphogranuloma venereum.

B. Viral infections

Sub group I — Chicken pox, herpes zoster, herpes simplex, measles (rubella), influenza, common cold, viral pneumonia, viral meningitis, poliomyelitis, rabies, mumps, viral gastroenteritis, general introduction of arboviral diseases, Japanese Encephalitis, dengue and viral Hepatitis A, B, C, D, E.

Sub group II — Small pox (history only), foot and mouth disease, encephalitis

C. Protozoal infections

Sub group I — Malaria, visceral leishmaniasis, amoebiasis, giardiasis, trichomoniasis; Use of insecticide for the control of vector borne diseases

Sub group il — Coccidiosis, balantidiasis, toxoplasmosis.

D. Helminthiasis

Sub group I — Taeniasis (Taenia saginata, T. solium), Hydatid infections, falariasis, trichuriasis, strongyloidiasis, ancylostomiasis, ascariasis (Nematodes).

Sub group II — intestinal flukes, lung fluke, liver fluke, schistosomiasis, draconculosis, toxocariasis, trichiniasis, capillariasis, tropical pulmonary eosinophila.

Group II: Epidemiology of non-infectious and chronic diseases

Student will be able to

  • describe epidemiology
  • analyse information in order to identify the determinants
  • discuss the impact on population of non-communicable diseases such as accidents (road traffic accident), injuries, violence, industrial hazards Chronic Obstructive Pulmonary Disease (COPD), bronchial asthma, alcoholism and drug addiction, cancer, peptic ulcer, myocardial insufficiencies, cerebro-vascular disease and nutritional deficiency diseases (anemia, iodine deficiency disorders and vitamin A deficiency, arsenicosis.

Group III: Health services for communicable and non-communicable diseases

Students will be able to

  • describe the operations of the following programmes: National Tuberculosis Center, TB Control Projects, Nepal TB Association- its hospital and community programs, Leprosy Control Project and Khokana Leprosarium; Sukraraj Infectious Diseases Hospital, Teku, Epidemiology and Disease Control Division, National Health Laboratory, Department of Health Services and other health institutions and disease control programs.
  1. Park JE and Park K. A Textbook of Preventive and Social Medicine
  2. Davidson’s Principles and Practice of Medicine
  3. Mohamed Illiyas, Community Medicine and Public Health, Medical Division Karachi Pakistan.
  4. Control of Communicable Diseases. American Public Health Association