Transcript epidemiology.PH

‫به نام‬
‫خدايي‬
‫كه دراين نزديكي است‬
‫اصول اپيدميولوژي دانشجويان بهداشت عمومي‬
‫فرزانه مباشري‪ -‬عضو هيأت علمي دانشگاه علوم پزشكي فسا‬
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‫مقدمه ای بر اپیدمیولوژی و‬
‫مفهوم گذار اپیدمیولوژیک و گذار سالمت‬
‫مطالب اصلی مورد بحث‪:‬‬
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‫تعریف و تاریخچه اپیدمیولوژی‬
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‫اجزا‪ ،‬اهداف و کاربردهای اپیدمیولوژی‬
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‫روش های همه گیری شناس ی‬
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‫تفاوت اپیدمیولوژی با بهداشت عمومی و پزشکی بالینی‬
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‫تعریف گذارسالمت و گذاراپیدمیولوژیک‬
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‫امواج گذاراپیدمیولوژیک‬
Scientific Study of Disease
Sub-molecular or molecular level (cell biology, biochemistry,
immunology)
tissue or organ level (anatomy, pathology)
individual level (clinical medicine)
population level (epidemiology):
Study of patterns of disease occurrence in human Populations
as a whole rather than of individuals.
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Epidemiology (definition)
 Epi: Up on
 Demos: Population
 Logus: Study
Study of distribution , frequency &
determinants of health-related states or
events in specified populations and
Application of this study to control of
health problems.
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Epidemiology Components

Distribution:


Who is getting the disease? Where? When?
Frequency:
Quantification of existence (prevalence) or occurrence
(incidence) of Diseases; Disability & Death
 Measurements of health states & events in community


Determinants:

Factors associated with health state; causal factors
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Epidemiology (Objectives)
1.
Identify etiology and risk factors
2.
Determine extent of disease
3.
4.
Study natural history & prognosis
Evaluate existing or new prevention or intervention
strategies
5.
Provide foundation for public policy decision
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What for?
1. Provide the scientific basis to prevent disease & injury
and promote health.
2. Identify sections of the population at greatest risk to
target interventions.
3. Investigate disease outbreaks.
4. Determine relative importance to establish priorities for
research & action.
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What for?
5. Study natural history of disease from precursor states
through clinical course.
6. Evaluate effectiveness of programs in improving the
health of the population.
7. Conduct surveillance of disease and injury occurrence in
populations.
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‫کاربردهای اپیدمیولوژی‬
‫چند سؤال‪:‬‬
‫‪ ‬چگونه به بهترین شکل می توان ازسرطان گردن رحم پیشگیری کرد؟‬
‫‪‬‬
‫آیا واکسن های طراحی شده برای پیشگیری ازسالک کارایی دارند؟‬
‫‪‬‬
‫بعد ازگذشت ‪ 30‬سال ازپیدایش ایدزدردنیا وضعیت فعلی آن چگونه است؟ راه انتقال‬
‫عمده آن درجوامع مختلف کدام است؟‬
‫‪ ‬چگونه می توان ازاثربخش ی یک داروی جدید دردرمان دیابت مطمئن شد؟‬
‫‪ ‬چرا امروزه بیماری های قلبي عروقي زیاد شده اند؟‬
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‫روش های همه گیری شناس ی‬
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‫طرح پرسش‬
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‫انجام مقایسه‬
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‫تصادفی کردن‬
‫جور کردن‬
‫استاندارد کردن‬
Basic questions in Epidemiology
1. Who
is getting the disease?
2. Where
3. When
is the disease occurring?
is the disease occurring?
4. How
much disease is out there?
5. Why
is the disease occurring?
6. What
7. How
is the course of disease?
can we prevent / treat the disease?
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‫اپیدمیولوژی‪ ،‬بهداشت عمومي و پزشکی بالینی‬
‫تفاوت اپیدمیولوژی با‬
‫بهداشت عمومي و‬
‫پزشکی بالینی چیست؟‬
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10 minutes rest
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The World Health is in Transition

Epidemiologic:
double burden of non-communicable diseases
“NCD” in many countries

Demographic:
Population ageing

Lifestyles:
Diets are rapidly changing
Physical activity reducing
Tobacco use increasing

Urbanization:
Growing cities

Globalisation:
Increasing global influences
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‫گذار سالمت‬
‫‪Health Transition‬‬
‫شايع ترين دليل گذارسالمت‪:‬‬
‫تغيیررفتارانسان ها‬
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‫گذار اپیدمیولوژیک‬
Epidemiologic Transition

Industrialization, Urbanization, Motorization

Changing the Environment
Changing the Behavior
Changing the Genetic
Health & Medical Promotion (Prevention)
Changing of the Population structure (Ageing)
Changing the Lifestyle

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
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
Non-communicable diseases Risk Factors
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Lifestyle Transition

Healthy Dietary Habits

Rest/Leisure-time Entertainments & physical activities

Smoking/Substance Abuse

Sexual behavior

Use of Health & Medical Services

Stress

Work-related issues
Work in Transition
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Work Transition

Work is more complicated/vary

Work is more skilled, more training is needed

Increasingly men have been replaced by machines

Work is more hazardous

The demand of workers has been increased

Shorter hours, 6-8 hours per day

Shorter days per week (4-6 days/week)

Shorter working years (20-30 years)
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‫گذار اپیدمیولوژیک‬
‫‪Epidemiologic Transition‬‬
‫ّ‬
‫اولین گذار‪:‬‬
‫اواخردوره پارینه سنگی و دوران نو سنگی‬
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‫دومین گذار‪ :‬آغازعصرجدید و انقالب صنعتی‬
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‫سومین گذار‪ :‬ازحدود سه دهه قبل‬
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‫سومین گذار اپیدمیولوژیک‬
Mortality Rates
Infectious Diseases
NCD
Epidemiologic Transition
By: Dr K. Mirzaei
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