1. HIMI, JOS
By
Saleh Ahmed
School of Midwifery, Bauchi

2.  Epidemiology and Community health are two
inseparable words in public health system. This
is because they deal with prevention of disease,
promotion of health and efficiency through
organized community efforts. Epidemiology
deals with the frequencies and types of
illnesses and injuries that affect population
while community health deals with the services
that aim at protecting the health of the
community.

3.  The knowledge of pattern, distribution and
frequencies of diseases and how it effects the
community is the major concern of every health
organization. In fact, the success of
epidemiology and community health activities
rely greatly on effective transfer of information
from health professional to general public.
Thus health information management is the
most veritable tool for the achievement of the
desired goals of health for all.

4.  At the end of this presentation participants will
be able to:-
 Explain the terms epidemiology and
community health.
 State the uses of epidemiology
 Describe epidemiological tools of
measurements.
 Describe community health.

5.  Definition
 The word epidemiology is derived from Greek
terms- “epi”-upon, among, “demos” –people,
district, “logos” –study, word, discourse.
 Epidemiology literally is the study of
something that affects population.
 Jekel, Elmore and Katz (1996) defined
epidemiology as the study of factors that
determine the occurrence and distribution of
disease in a population

6.  Onwasigwe (2004) views epidemiology as the
study of the causes, distribution, determinants
and deterrent of diseases, injuries and other
health related condition in human population.
 Epidemiology deals with the frequencies and
types of illnesses and injuries in group of
people and with factors that influence their
distribution.
 In summary, epidemiology is the study of
factors that affect health of population

7.  Epidemiology therefore serves as a
 A) cornerstone of methodology of public health
research
 B) evidenced based medicine
 C) means of identifying risk factors for diseases
and determining optimal treatment approaches
to clinical practice.

8.  It is used in:-
 i) studying the history of diseases in
population in terms of profile, time & trends.
 ii) determining the most common causes of
death, diseases and disability.
 iii) community diagnosis in terms of morbidity,
and mortality rates and ratio.
 iv) determining the effective control method of
disease when known.

9.  v) provision of data for proper planning and
evaluation of health services
 vi) identifying deficiencies in ongoing
programs
 vii) identifying the priority areas for medical
research

10.  Epidemics – the occurrence of the disease or
groups of illnesses of similar nature clearly in
excess of the expected rate for the place and
time.
 Pandemic –an epidemic usually affecting a
large proportion of the populations occurring
over a wide geographic area.

11. -
Endemic – this refers to the constant
presence of a disease or infectious agent
within a given geographic area or
population group.
Sporadic – it the scattered about disease
with cases occurring irregular,
haphazardly from time to time and
generally infrequently.
Exotic- disease imported into a country ,
malaria in united kingdom.

12.  There are various ways of grouping epidemiology,
a) Based on what it studied:-
 Classical epidemiology –it studies the community
origins of health problems particularly those
related to nutrition, environment, human behavior,
and psychologic, social, and spiritual state of
population. Its aim is to discover risk factors.
 Clinical epidemiology – it studies patients in
health care settings in order to improve diagnosis
and treatment of various diseases and the
prognosis of patients already affected.(jekel,1996)

13.  B) Based on the steps in investigation and control.
According to onwasigwe (2004) there are :-
1)Descriptive epidemiology:- it studies the amount
and distribution of disease within population by
person, place and time. It is carried out to
determine the frequency of disease, the kind of
people suffering from it and where it occurs. It
makes use of routinely collected data such as
hospital data. Its study answers these questions
 i) who are affected- ie the person(age,sex,race,
marital status,etc)

14.  Ii) where do the cases occur:-ie the
place(rural,urban,altitude,humidity,rainfall)
 Iii) when do these cases occur :-ie time
(monthly or annually ,secular trends-long term
variation or cyclic changes –recurrent
alterations in the frequency from annual or
periodic)

15. 2) Analytical epidemiology :-this study is carried
out to draw logical conclusion. The study is
used to determine why the rate is high or low
in a particular group. Analytical studies are
hypothesis-testing studies used to verify the
hypotheses.
It is different from descriptive studies because it
studies individuals within a population not the
entire population.

16.  Analytical studies involve two types of
observation studies –
 A) case control study
 B) cohort study
Case control study –known as retrospective
studies which is used to estimate cause-effect
relationship between a suspected risk factor
and a disease. In this study people diagnosed
of having a disease(cases) are compared with
those that do not have the disease(control).

17.  Cohort – is a group of persons at risk who
share common characteristics or experience
within a defined period of time.
 Cohort study –this is a prospective study,
incidence study and forward looking study
which aims at obtaining additional evidence to
support or reject the existence of an association
between suspected risk factor or cause and
disease

18.  Sensitivity and specificity – for screening
.Rates – to quantify disease
-relative risk and odd ratio –to evaluate
association between factors and disease

19.  This is the prerequisites for infection occurrence
 Agent
 Reservoir (man, animals)
 Route of exit from the reservoir
 Channel of transmission-(air, water, formites)
 Pathogen’s capacity for survival
 Routes of entry (respiratory route,mouth)
 Host susceptibility-(mechanical protection of skin
and chemical, inflammatory response,immunity)

20.  Provide basic knowledge of disease trends and
distribution, causes and contributing factors.
 For planning health programmes eg
procurement drugs
 Advocacy
 Research
 Monitoring and evaluation.

21.  This is made up of two words- community and
health.
 Community:-is a group of individuals who are
bound in time and space, dependent on each
other and having common goals.
 Health –According to WHO in 1986 health is
defined as the extent to which an individual or
group is able, on the one hand to realize
aspirations and satisfy needs and on the other
hand to change or cope with the environment.

22.  Community health is simply referred to as the
health status of group of people and the actions
and conditions to promote, protect and
preserve their health.
 However, park (2004), defined community
health as the health status of the members of
community, and the problems affecting their
health as well as the totality of health care
provided to the community.

23.  In broader sense community health implies
integration of curative, preventive and
promotive health services rendered to
individual living in the same location.
 The emphasis of community health is centred
on two things namely:, community diagnosis
and community treatment.
 This therefore implies that the entire
community is regarded as patient requiring
diagnosis and treatment.

24.  Community health activities are activities that
are aimed at protecting and improving the
health of a population or community.
 These are as follows:-
 Maintenance of accurate birth and death
records.
 Protection of food and water supply.
 Maintenance of environmental sanitation –
including vector control and personal health
care.

25.  Immunization
 Health education e.g. on healthy styles of
living.
 Community diagnosis by surveying and
monitoring community health needs and
assessing the impact of intervention

26.  Thank you.