INTRODUCTION OF EPIDEMIOLOGY

Transkripsi

1 INTRODUCTION OF EPIDEMIOLOGY P. Lutfi Ghazali 1 1/22/2016

2 DEFINITION OF EPIDEMIOLOGY the study of how disease is distributed in populations and of the factors that influence or determine this distribution. the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to control of health problems. the science of occurrence of diseases in human population. the study of the distribution and determinant of diseases and injuries in human populations 2 1/22/2016

3 DISTRIBUSI & DETERMINAN I. Epidemiologi Deskriptif II. Distribusi Variabel: Time (when), Place (where), Person (who) Epidemiologi Analitik Determinan Variabel: (how & why) Host Agent Environment Keturunan Perilaku Lingkungan Pelayanan Kesehatan

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7 OBJECTIVES OF EPIDEMIOLOGY to identify the etiology or the cause of a disease and risk factors[1] to determine the extent of disease found in the community. to study the natural history and prognosis of disease. to evaluate new preventive and therapeutic measures and new modes of health care delivery. to provide the foundation for developing public policy and regulatory decisions relating in environmental problems. [1] is factors that increase a person s risk for disease 7 1/22/2016

8 Di sana terdapat 100 kasus Tuberkulosis Paru

9 Di sana terdapat 100 kasus Tuberkulosis Paru 1. Populasi apa yang diobservasi? 2. Kapan observasi dilakukan?

10 Di sana terdapat 100 kasus Tuberkulosis Paru 1. Populasi apa yang diobservasi? 2. Kapan observasi dilakukan? Pada 1 Januari 2016 terdapat 100 kasus Tuberkulosis Paru di Kecamatan A, Kabupaten X

11 Pada 1 Januari 2016 terdapat 100 kasus Tuberkulosis Paru di Kecamatan A, Kabupaten X KEBIJAKAN

12 Pada 1 Januari 2005 terdapat 100 kasus Tuberkulosis Paru di Kecamatan A, Kabupaten X JUMLAH KASUS DI KECAMATAN A KECAMATAN B Tuberkulosis Paru 25 0 dengan Efusi Pleura Tuberkulosis Paru Penyakit Paru KEBIJAKAN

13 Measurement of Morbidity and Mortality Rates are defined as follows : Number of events in a specified period x k Population at risk of these events in a specified period 13 1/22/2016

14 Measurement of A ratio expresses the relationship between two numbers in the form : X --- x k Y 14 1/22/2016

15 Measurement of A proportion is a specific type of ratio in which the numerator is include in the denominator, and the resultant value is expressed as a percentage : X x k X + Y 15 1/22/2016

16 Measurement of Incidence rates measure the probability that healthy people will develop a disease during a specified period of time or the number of new cases of a disease in a population over a period time Number of new cases of a disease over a period of time Population at risk 16 1/22/2016

17 Measurement of Prevalence rate measures the number of people in a population who have the disease at a given time. Number of existing cases of a disease at a point of time Total Population 17 1/22/2016

18 Natural History of Disease Preclinical Phase Clinical Phase outcome Biological onset Symptom Diagnosis Therapy of disease Detectable by screening Lead Time 18 1/22/2016

19 Natural History of Disease 19 1/22/2016

20 Stage of Suspectibility Disease not yet developed Presence of risk factors Stage of Pre-clinical Disease No disease manifestation Progression under clinical horizon (no detectable signs and symptoms)

21 Stage of Clinical Disease Recognizable signs and symptoms Divided based on morphological alteration, functional limitation or objective assesment. Stage of Disability Outcome of disease : death disease controlled with disability disease controlled without disability recover

22 PREVENTION Definition The goals of medicine are to promote health, to preserve health, to restore health when it is impaired, and to minimize suffering, and distress. These goals are embodied in the word prevention, which is easiest to define in the context of levels, customarily called primary, secondary and tertiary.

23 Primary Prevention the protection of health by personal and community-wide effect. e.g. preserving good nutritional status, physical fitness, emotional wellbeing, immunizing against infectious diseases, and making environment safe. Aims : altering suspectibility and reducing exposure Strategy : 1. General health promotions 2. Specific protective measures

24 Secondary Prevention the measures available to individuals and populations for early detection and prompt and effective intervention to correct depatures from good health Aims : cure disease, slow the progression, prevent complication, cut off the chain of transmission Strategy : 1. Early detection of disease (screening) 2. Prompt treatment of disease

25 Tertiary Prevention the measures available to reduce or eliminate long term impairments and disabilities, minimize suffering caused by existing depatures from good health, and to promote the patient s adjusment to irremediable conditions Aims : allevation of disability and restoration of effective functioning Strategy : 1. Limitation of disability 2. Rehabilitation

26 PENYAKIT PREVENSI / UPAYA PENCEGAHAN TAHAP KERENTANAN (Suspectibility) PREVENSI PRIMER Contoh : penyuluhan kesehatan, imunisasi TAHAP PREKLINIS TAHAP KLINIS PREVENSI SEKUNDER Contoh : deteksi dini kanker payudara, pengobatan TB Paru dengan DOTS TAHAP KECACATAN (Disability) PREVENSI TERSIER Contoh : fisioterapi, rehabilitasi

27 KEJADIAN LUAR BIASA (KLB) 27 1/22/2016

28 PENETAPAN KLB Terjadinya peningkatan kasus baru 2 kali atau lebih dibandingkan dengan minggu/bulan yang sama pada periode waktu tahun sebelumnya di suatu wilayah desa, ATAU Terjadinya peningkatan jumlah kasus di suatu wilayah 2 kali lebih dari minggu sebelumnya, ATAU Munculnya kesakitan di suatu wilayah kecamatan yang selama 1 tahun terakhir tidak ada kasus.

29 MANAJEMEN KLB Data epidemiologi Frekuensi penyakit (morbiditas, mortalitas) Distribusi penyakit (tempat, waktu, manusia) Determinan penyakit (faktor risiko, penyebab). Keadaan masyarakat Keadaan sosial budaya (misal: kepercayaan) Keadaan ekonomi (misal: keluar masuknya manusia, hewan dan barang-barang dari dan ke daerah KLB yang dapat atau diduga dapat mengakibatkan penularan atau penyebaran penyakit) Keadaan keamanan (misal: keadaan yang berkaitan dengan faktor psikologis antara lain kekhawatiran, ketakutan, kepanikan, dan faktor-faktor lainnya. PROGRAM PENANGGULANGAN KLB

30 SISTEM SURVEILANS RESPONS Sekumpulan kegiatan yang dilakukan terus menerus secara sistematik yang meliputi: Case detection Reporting Investigation and confirmation Analysis and interpretation Action: control/response, policy, feedback