PENGANTAR EPIDMIOLOGI PENYKIT MENULAR

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EpidemiologiDefinisi

Studi yg mempelajari distribusi dan determinant status atau kejadian yg berhubungan dengan kesehatan pada sekelompok populasi, dan aplikasi studi ini adalah untuk mengkontrol / mengendalikan masalah kesehatan

Last ed. Dictionary of Epidemiology

Epidemiologi PenyakitamenularDefinisi :

Epidemiologi penyakit menular terfokus dalam mempelajari distribusi dan determinan penyakit menular dalam populasi.

Epidemiologi PenyakitamenularKlasifikasi Penyakit Berdasarkan etiologi (kausa)Penyakit infeksi

Penyakit non infeksi

Etiologi (organism) : Tuberkulosis, Campak, Malaria, dsbManifestasi klinik : Meningitis, Encefalitis, Rinitis, Diare ??, dsb

Epidemiologi PenyakitamenularBerdasarkan Durasi :

Penyakit akut

Penyakit kronik

Peak symptoms within 3 months (acute) or longer than 3 months (chronic)

Epidemiologi PenyakitamenularAcute infection vs. chronic infection Acute Infection An infection characterized by sudden onset, rapid progression, and often with severe symptoms

Chronic Infection An infection characterized by delayed onset and slow progression

*Acute Diseases MENULAR

TIDAK MENULAR

Chronic Diseases MENULAR

TIDAK MENULARCommon cold, pneumonia,mumps, measles, pertussis,typhoid fever, cholera

Appendicitis, poisoning, trauma

Tuberculosis, AIDS, Lyme disease,syphilis, rheumatic fever

Diabetes, coronary heart disease,osteoarthritis, cirrhosis of the liverTypes of Diseases Examples

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Definition of communicable diseasesA communicable disease is an illness due to a specific infectious (biological) agent or its toxic products capable of being directly or indirectly transmitted:

from man to man, from animal to man, from animal to animal, or from the environment (through air, water, food, etc..) to man.

Definition of communicable diseasesEpidemiology The study of the transmission of diseaseCommunicable Disease A disease that can be transmitted from one individual to another Contagious Disease A communicable disease that is easily spread from one individual to anotherNoncommunicable Disease A disease that is not transmitted from one individual to another

Definition of communicable diseasesCommunicable Diseases-biological agents

Biological agents = microorganism

- Virus-Bacteria - Protozoa- Fungus- Helminthes - Others form of microorganism

Non Communicable Diseases-Non biological Agents

- Physics- Nutrition- Chemical-etc

Definition of disease & infectious diseaseDisease

Any deviation from a condition of good health and well-being

Infectious Disease

A disease condition caused by the presence or growth of infectious microorganisms or parasites

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EtiologiDurasiAkutKronisInfeksiCommon coldPneumoniaCampakGondonganPertusisTyphoidKoleraKustaTBCAIDSDemam rheumatikHepatitis BNon InfeksiKeracunan (intoksikasi insektisida dan logam, dsb)TraumaPenyakit Jantung KoronerDiabetes MellitusKankerStroke

Classification of Diseases & Health Problems

Organ or Organ Systemi.e., heart disease, kidney disease, respiratory infection

Causative AgentBiological AgentsChemical AgentsPhysical Agents

Communicable vs Non communicableAcute vs ChronicPeak symptoms within 3 months (acute) or longer than 3 months (chronic)

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Chap 4: Prevention and Control

Causative Agents for Diseases & InjuriesBiological AgentsChemical AgentsPhysical AgentsVirusesRickettsiaeBacteriaFungiProtozoaMetazoaPesticidesFood additivesPharmacologicsIndustrial chemicalsAir pollutantsCigarette smokeHeatLightRadiationNoiseVibrationSpeeding objects

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DEFINITIONSINFECTIONThe entry, development or multiplication of an infectious agent in the body tissues of man or animals

INFECTIOUS DISEASEA clinically manifest disease of man/animal resulting from an infection

COMMUNICABLE DISEASE- An illness due to a specific infectious agent OR its toxic products that arises through transmission from a reservoir to a susceptible host either directly or indirectly

Some communicable diseases may not be infectious BUT all infectious diseases are communicable.communicable but not infectious:-tetanus- botulism- staphylococcal food poisoning

INCUBATION PERIOD- time interval between initial contact with an infectious agent and the first appearance of symptoms associated with the infection

COMMUNICABLE PERIOD- time during an infectious agent may be transferred from an infected host/reservoir to another susceptible host

Communicable Disease Model

Epidemiologic

TriangleModel

Communicable Disease Model

Agent The element that must be present in order for the diseases to occur

Communicable Disease Model

AgentHostAny susceptible organism invaded by an infectious agent

Communicable Disease Model

AgentHostEnvironment

All other factors that inhibitor promote disease transmission

Chain of Infection

A model to conceptualize the transmission of a communicable disease from its source to a susceptible host

Chain of Infection

Pathogen- The disease-causing agent

Chain of InfectionThe habitat in which an infectious agent normally lives and growsHuman: Anthroponoses, symptomatic or asymptomaticAnimal: ZoonosesEnvironmental: Plants, soil, and water

Pathogen

Reservoir

Chain of InfectionThe path by which an agent leaves the source host

Pathogen

Reservoir

Portalof exit

Chain of InfectionModes of Transmission Direct: Immediate transfer - Direct contact - Droplet spread Indirect - Airborne - Vehicleborne - Vectorborne

PathogenHow pathogens are passed

Reservoir

Portalof exit

Trans-mission

Modes of Transmission of the Agent to a New Host: A mode of transmission is essential for the infectious agent to bridge the gap between the portal of exit from the reservoir and the portal of entry of the host.

Modes of transmission can be classified as direct or indirect.

Routes of transmissionDirect

Skin-skin Herpes type 1 Mucous-mucous STI Across placenta toxoplasmosis Through breast milk HIV Sneeze-cough Influenza

Indirect

Food-borne Salmonella Water-borne Hepatitis A Vector-borne Malaria Air-borne Chickenpox Ting-borne Scarlatina

Exposure A relevant contact depends on the agent Skin, sexual intercourse, water contact, etc

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Chain of Infection

Pathogen

Reservoir

Portalof exit

Trans-mission - Agent enters susceptible host

Portalof entryRespiratoryOralSkinIntravenousGastrointestinal

Chain of Infection

Pathogen

Reservoir

Portalof exit

Trans-mission - Final link isa susceptible host

Portalof entry

Newhost

Levels of PreventionPrimary PreventionThe forestalling of the onset of illness or injury during the pre-pathogenesis period (before the disease process begins)Secondary PreventionThe early diagnosis and prompt treatment of diseases before the disease becomes advanced and disability becomes severeTertiary PreventionThe retraining, reeducation, and rehabilitation of the patient who has already incurred disability

Pencegahan primerAdl Upaya pencegahan yg dilakukan saat proses penyakit belum mulai (pd periode pre-patogenesis) dengan tujuan agar tidak terjadi proses penyakitT.a: 1. Promosi kesehatan

2. Perlindungan khususRiwayat Alamiah Penyakit*

Pencegahan sekunderAdl Upaya pencegahan yg dilakukan saat proses penyakit sudah berlangsung namun belum timbul tanda/gejala sakit (patogenesis awal) dengan tujuan proses penyakit tidak berlanjutT.a:

1. Early diagnosis & prompt treatment2. Disability limitationRiwayat Alamiah Penyakit*

Tingkat pencegahan tertier

Riwayat Alamiah Penyakit*

Bila telah terjadi defect /kerusakan struktural ataupun disabilitas:

maka untuk mencegah semakin buruknya

kondisi atau menetapnya disabilitas dilakukan usaha preventif tertier dengan rehabilitasi

Prevention of Communicable Diseases PathogenPasteurization Chlorination Antibiotics Antivirals Disinfectants

Prevention of Communicable DiseasesHuman ReservoirIsolationSurveillance QuarantineDrug treatment

Prevention of Communicable DiseasesPortal of ExitGownsMasksCondomsHair netsInsect repellents

Prevention of Communicable DiseasesTransmissionIsolation Hand washingVector controlSanitary engineering Sneeze glassSexual abstinenceSafer sex

Prevention of Communicable DiseasesPortal of EntryMasksCondomsSafety glassesInsect repellents

Prevention of Communicable DiseasesEstablishment of Disease in New HostImmunizationsHealth educationNutrition promotionSexual abstinence

Noncommunicable Disease Model

Your geneticendowment

Noncommunicable Disease Model

Your geneticendowment

PersonalityBeliefsBehavioralchoices

EnvironmentHealth CareSystemWater QualityAirPollutionEconomics

Diseases of the Heart and BloodCoronary heart disease (CHD): Characterized by damage to the coronary arteries.Atherosclerosis: Narrowing of the blood vessels resulting from the build-up of fatty deposits on the walls of the blood vessel.Cerebrovascular disease (stroke): Blood supply to the brain is disrupted.

CancerMalignant neoplasm: Occurs when cells lose control over their growth and division. As these cells continue to grow they eventually develop a new growtha tumorMetastasis: Parts of the tumor break off and travel to the rest of the bodys organs and continue their growth.

Other Top Noncommunicable Diseases Chronic obstructive pulmonary diseaseDiabetes mellitusChronic liver disease and cirrhosis

Prevention of Noncommunicable DiseasesPrimary PreventionAdequate food intakeGood opportunities for education, employment, and housingEfficient community servicesHealth promotionAccess to medical servicesProtection from the environment Protection from occupational hazardsEmpowerment for ones own health

Prevention of Noncommunicable DiseasesSecondary PreventionMass screeningsCase-finding measuresAdequate health personnel, equipment, and facilitiesPersonal screening (self breast or testes exams)Hemoccult testsPap tests

Prevention of Noncommunicable DiseasesTertiary PreventionAdequate emergency medical personnel, services, and facilitiesUnderstand unmodifiable risk factors Significant behavioral or lifestyle changes (Modifiable risk factors)Support groupsCounseling

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