02 Epidemiological data sources and disease distribution 3.pptx

Epidemiological data sources and disease distribution

1. School of Public Health Department of Epidemiology Name: Li Yang Phone: [phone] QQ: 527293391 Wechat: liyang527293391 self-introduction 1

2. Preventive medicine Chapter III Disease distribution Teaching object: International Clinical Medicine undergraduate class 2022 Class Time: October 23 , 2024 (Wednesday 010203) Location: Room 305, Building 7 1

3. The definition and connotation of epidemiology; What are the uses of epidemiology? Classification of epidemiological research methods? Knowledge review 1

4. Sources of health-related data Common measurement index Disease distribution New course content 1

5. 【 Knowledge objective 】 Understand the sources of health-related data, learn how to measure health-related data, define commonly used measurement indicators, explain the three-stage distribution of diseases and their effects, memorize the terms of disease epidemic intensity and the characteristics of regions, time and populations, and understand the comprehensive analysis method of the three-stage distribution. Teaching requirement 1

6. 【 Ability goal 】 Through learning, can distinguish and specific application incidence, incidence density, time point prevalence, period prevalence, infection rate, mortality rate, case fatality rate. 【 Emotional goa 】 Let students understand the rigor and science of data sorting and analysis in scientific research work. Teaching requirement 1

7. Source 1: Routinely collected data : Various work records and report cards; Various statistical reports; Source 2: Data from thematic research : Field investigation -- current situation studies, case-control studies, cohort studies; Experimental research -- clinical trials, field trials, community intervention trials; Where can I find demographic and health-related data? Section I: Sources of health-related data Think about the problem？ 1

8. How to access demographic and health-related data? The website of the National Bureau of Statistics -http://www.stats.gov.cn/ The website of the Ministry of Public Security --http://www.mps.gov.cn/ Ministry of Health website --http://www.nhfpc.gov.cn/ The Chinese center for disease control and prevention - http://www.chinacdc.cn/xxfw/ggwss Section I: Sources of health-related data 1

9. Common measurement index incidence rate *** incidence rate = （The number of new cases of a disease in a population over a period of time） / （The number of people exposed to this population during the same period） *K Applications: Understanding epidemic characteristics; To explore the etiological factors; Put forward etiological hypothesis; Evaluate the effect of control measures; K=100% ， 1000‰ ， 10 000/ 万， 100 000/10 万 …… 1

10. attack rate *** attack rate =(number of new cases of a disease during the observation period)/(population exposed during the same period)*K Applications: Measurement of the frequency of new diseases in a small range and in a short time; Often used in the investigation of disease outbreaks or epidemics ; Common measurement index K=100% ， 1000‰ ， 10 000/ 万， 100 000/10 万 …… 1

11. secondary attack rate ， SAR Definition : refers to the percentage of susceptible contacts who develop illness between the shortest and longest incubation periods of certain infectious diseases in the total number of susceptible contacts. secondary attack rate =(number of cases among susceptible contacts during the incubation period)/(total number of susceptible contacts) *100% Applications: Often used to compare the strength of infectious diseases; Common measurement index 1

12. prevalence *** Definition: refers to the proportion of new and old cases of a disease in the total population at a particular time.It is divided into period prevalence and time point prevalence . Period prevalence = （ the number of new and old cases of a disease in a population during an observation period ） / （ the number of exposed populations during the same period ） *K K=100% ， 1000‰ ， 10 000/ 万， 100 000/10 万 …… Common measurement index 1

13. prevalence *** Time-point prevalence = （ the number of new and old cases of a disease in a population at a point in time ） / （ the population at that point ） *K Applications: Describe the occurrence or prevalence of chronic diseases with a longer duration; It can indicate the degree of burden of a disease in a certain area; K=100% ， 1000‰ ， 10 000/ 万， 100 000/10 万 …… Common measurement index 1

14. The main factors for the increase : An increase in new cases (i.e. increased incidence); With the improvement of treatment level, the patients did not die, but did not recover, and the course of disease was prolonged; Longer lives for those who are not cured; Case migration; Healthy people emigrate; Migration of susceptible persons; Improved diagnostic level; Increased reporting rates. Factors affecting the prevalence rate 1

15. Main factors for the decrease : Fewer new cases (reduced incidence); Increased mortality; The course of disease is shortened; The cure rate increased; Healthy people move in; Case migration. Factors affecting the prevalence rate 1

16. prevalence of infection *** Definition: refers to the proportion of the number of people currently infected with a pathogen in the tested population at a certain time, usually expressed as a percentage. Infection rate = （ n umber of patients infected）/（ n umber of persons tested） *100% Application: It is more widely used, especially for the investigation of those recessive infections, pathogen carriers and mild and atypical cases. Common measurement index 1

17. mortality rate *** Definition: Indicates the proportion of the total number of deaths in a population in a certain period of time, and is the most commonly used indicator to measure the risk of death in a population. mortality rate = （ t otal number of deaths of a population in a given year）/（average population of the population in the same period） *K Common measurement index K=100% ， 1000‰ ， 10 000/ 万， 100 000/10 万 …… 1

18. mortality rate *** Applications: Mortality is an indicator that reflects the total death level of a population, and is used to measure the death risk of a population in a certain period and a certain area. Crude and specific mortality rates (by sex, age, etc.) Infant mortality: It is a sensitive indicator that reflects the level of health care or economic development of a region. Calculation of specific mortality rate： Male mortality rate = （ n umber of male deaths in a given year）/（total number of males in a given year） *K Common measurement index K=100% ， 1000‰ ， 10 000/ 万， 100 000/10 万 …… 1

19. case fatality rate *** Definition: The proportion of patients (numerator) who die of a disease in a certain period of time (denominator) indicates the risk of death of a patient due to the disease. Case fatality rate = (number of deaths due to a disease in a given period)/(number of cases due to a disease in the same period) *K Common measurement index K=100% ， 1000‰ ， 10 000/ 万， 100 000/10 万 …… 1

20. case fatality rate *** Applications: Indicates the death probability of a confirmed disease, which can reflect the severity of the disease ; It can also reflect the medical level and diagnosis and treatment capacity; It is often used for acute infectious diseases, less for chronic diseases. Common measurement index 1

21. survival rate *** Definition: refers to the proportion of patients receiving a treatment or a patient who are still alive after n years of follow-up. Survival rate = (number of surviving cases followed up for N years)/(number of cases followed up for N years) *100% Applications: It can be used to evaluate the long-term curative effect of some diseases with long course. Common measurement index 1

22. I ncidence rate Incidence rate : calculation of the frequency of an outbreak; Prevalence rate (time, period) : the degree of burden of a disease in a place; Mortality rate (crude and specific ---- infant mortality rate ) : sensitive indicator of economic development; Case fatality rate : reflects the severity of the disease; Survival rate : Evaluating the long-term outcome of the disease Note the application and difference of the above common frequency indicators. summary distinction 1

23. An epidemiological survey of lung cancer was conducted at a disease surveillance site in 2023, with a population of 102,000 on July 1 , 2023. On January 1 of the same year, the population of the monitoring site was 98,000 , 120 cases of lung cancer were recorded on January 1 , and 5 new cases were found on the same day, 200 new cases of lung cancer in 2023, and the number of lung cancer deaths in the same year was 100 . Question : What is the incidence of lung cancer in 2023? What is the prevalence of lung cancer on January 1, 2023 ? What is the prevalence of lung cancer in 2023 ? What is the death rate from lung cancer in 2023? What is the case fatality rate for lung cancer in 2023? Case Study 01 1

24. The average annual population of this monitoring site in 20 23 = 102,000 Incidence of lung cancer in 20 23 = 200/102,000 =196.1/100,100 The prevalence of lung cancer on January 1, 20 23 = (120+5) / 98,000 = 127/100,000 The prevalence of lung cancer in 20 23 = (120+200) / 102,000 =320/ 100,000 Lung cancer death rate in 20 23 =100 / 102,000 =98/100,100 Case fatality rate for lung cancer in 20 23 =100/ (120+200) *100%=31.2% Case Study 01 1

25. Disease distribution*** An important part of epidemiological research Is the core of descriptive research It is the basis of analytical research It is the basis for formulating disease prevention and control strategies and measures importance 1

26. content 1

27. Population distribution age sex behavior occupation Marriage and family Behavior and lifestyle other 1

28. age Generally speaking, the incidence of chronic diseases increases with age, and the incidence of acute infectious diseases decreases with age. Figure 2-2 Age-specific prevalence of chronic diseases in China (‰) (China Health Statistical Yearbook, 2008) Population distribution 1

29. Figure 2-3 Age distribution characteristics of breast cancer incidence in four groups of different populations Population distribution 1

30. sex Genetic characteristics Endocrine metabolism Physiological and anatomical characteristics Different inner qualities Pathogenic factor exposure characteristics Affects disease susceptibility Sex difference Comparison of morbidity, prevalence and mortality, also expressed by sex ratio and composition of causes of death. Population distribution Above factors 1

31. Population distribution 1

32. occupation Occupational exposure to different physical factors, chemical factors, biological factors and occupational mental stress can lead to occupational differences in disease distribution. Population distribution 1

33. Race and ethnicity 表 2-4 美国 2004-2008 年不同种族癌症年龄调整发病率（ 1/10 万） （ SEER ， 2011 ） Population distribution 1

34. Marriage and family Behavior and lifestyle smoking tipple Taking drugs, Bad behavior, Sedentary lifestyle, etc. Floating population Religious belief Population distribution 1

35. Regional distribution The distribution characteristics of diseases in different regions reflect the difference in the role of pathogenic factors in these regions, and the fundamental reason is caused by the different distribution of risk factors and pathogenic conditions of diseases. There are two methods of zoning: Administrative division act Natural l andscape l aw 1

36. Distribution between and within countries The distribution of diseases in different countries Figure 2-4 Age-adjusted incidence of male esophageal cancer (1/100,000) (GLOBOCAN, 2010) Regional distribution 1

37. Figure 2-5 Cardiovascular disease mortality and total mortality among men aged 35-74 years in selected countries (1/100,000) (American Heart Association, 2002) Regional distribution 1

38. The distribution of diseases in different parts of the same country Regional distribution Table 2-5 Regional distribution of schistosomiasis in 2003 1

39. Urban and rural distribution Regional distribution Table 2-6 Mortality rate of Top 10 Diseases among urban and rural residents in China in 2007 (1/100,000) 1

40. endemic clustering The occurrence and frequency of diseases in a certain area is higher than that in the surrounding area. It is suggested that the specific pathogenic factors in this area have an impact on the health of the population. Regional distribution 1

41. endemic clustering endemic ： Due to the influence of natural or social factors, a disease often exists in a certain area or only occurs in a certain range of people, and it is called endemic when it does not need to be imported from abroad. Divided into three categories: Statistical locality - Social factors Natural endemism - natural factors Natural epidemic source - animal to animal transmission Regional distribution 1

42. Imported disease Also known as foreign diseases, where the country or the region does not exist or has eliminated infectious diseases, from abroad or other regions when introduced, called imported infectious diseases. For example, in the 1980s, AIDS was introduced into China. Regional distribution 1

43. endemic disease *** A relatively stable and frequent disease confined to a specific area. Such as: endemic fluorosis, endemic arsenic poisoning, iodine deficiency disease. The criteria for determining whether a disease is endemic are: Residents of the area have a high incidence of the disease. People living in other areas have low or no incidence. After moving into the area for some time, the incidence is consistent with that of the local population. After moving out of the area, the incidence decreased, the symptoms of the disease reduced or self-healing. Local susceptible animals can develop the same disease. Regional distribution 1

44. Time distribution Short-term fluctuation seasonality periodicity Long-term trend 1

45. rapid fluctuation Generally refers to a disease epidemic or outbreak that lasts for a few days, weeks or months, and is a special way of existence of the disease. The meaning is similar to an outbreak. Wide range Smaller range Such as food poisoning in the collective canteen, typhoid, dysentery and measles outbreaks or epidemics. Time distribution 1

46. seasonal variatio ， seasonality The incidence of diseases increases in a certain season. Seasonality comes in two forms: Strict seasonality Seasonal rise Time distribution 1

47. Figure 2-6 Seasonal distribution of Japanese encephalitis in four provinces and cities (1955) (Geng Guanyi, 1996) Time distribution 1

48. cyclic variation ， periodicity Definition: refers to the phenomenon that the frequency of disease fluctuates regularly according to a certain time interval, and an epidemic peak occurs every few years. Figure 2-8 Measles incidence in Zhejiang Province, 1951-2007 (Xu Xuqing, 2009) More common in respiratory infectious diseases, influenza, epidemic cerebrospinal meningitis, measles, whooping cough, chickenpox, diphtheria and other diseases. Time distribution 1

49. secular trend ， secular change Also known as long-term variation or long-term change, refers to a relatively long period of time , usually several years or decades, the clinical characteristics of the disease, distribution, epidemic intensity and other aspects of the change. China Health Statistics Yearbook, 1995-2005, adapted Time distribution 1

50. A comprehensive description of the population, region, and time distribution of disease population region Figure 2-9 Regional and age distribution of vitamin A deficiency rates in children aged 3-12 years in China in 2002 (Li Liming et al., 2005) Comprehensive description 1

51. migrant epidemiology Definition: A method of discussing the cause of a disease. It is to explore the relationship between the occurrence of diseases and genetic or environmental factors by observing the differences in morbidity or mortality among immigrants , local residents in the places of migration and the people in the places of origin . It is often used to investigate the etiology and epidemic factors of tumor, chronic disease and some genetic diseases. Comprehensive description 1

52. Principles to be followed in the epidemiological study of migration: If the difference in the incidence or mortality of a disease is mainly the result of environmental factors , the incidence or mortality of the disease in the immigrant population is different from the population in the country of origin (region), but close to the incidence or mortality of the local population in the country of immigration (region). If the difference in incidence or mortality of the disease is mainly related to genetic factors , the incidence or mortality of the immigrant population is similar to that of the population in the country of origin (region), and is different from that of the local population in the country of migration (region). Comprehensive description 1

53. Figure 2-10 Comparison of gastric cancer mortality rate between native population and American immigrants and white Americans (1/100,000) (Lilienfeld, 1972) Comprehensive description 1

54. Epidemic intensity *** Refers to the change in the incidence of a disease in a population in a certain area and the degree of connection between cases in a certain period of time. sporadic outbreak epidemic pandemic 1

55. sporadic Definition: means that the incidence rate is the average level of the past year , and there is no obvious correlation between cases in terms of time and place of onset. The local incidence of the disease in the last three years was compared when the distribution was determined. Epidemic intensity *** 1

56. outbreak Definition: refers to patients in a local area or collective unit, a sudden occurrence of many symptoms in a short period of time. Many have the same source or route of transmission. (e.g. food poisoning) Most patients often occur at the same time between the shortest and longest incubation periods of the disease. Epidemic intensity *** 1

57. e pidemic Definition: means that the incidence of a disease in a certain area significantly exceeds (3-10 times) the incidence level of the disease over the past three years. There were obvious temporal and spatial connections among the cases . There are common transmission factors . Epidemic intensity *** 1

58. pandemic Definition: The incidence of a disease significantly exceeds the incidence level of the disease in the past years, the disease spreads rapidly , involves a wide range of areas, and crosses provincial boundaries, national borders or even continents in a short period of time to form a worldwide epidemic. Epidemic intensity *** 1

59. Summary Calculation and application of common frequency index of disease; Epidemic intensity of the disease (4); Three distributions of the disease (time, region, population); Endemic diseases (category 3); The basis of determining endemic diseases (5 points) Comprehensive description of three distributions: Epidemiology of migration. 1

60. 1. China is one of the countries with high incidence of esophageal cancer. To study the relationship between the incidence of esophageal cancer and environmental factors and genetic factors in Chinese Canadians, and to describe the distribution of the disease comprehensively, the most appropriate epidemiological research method is : Cross-sectional study Genetic epidemiology Birth cohort studies Epidemiology of migration A B C D Case-control study E Single choice question 1 exercise

61. 2. A drug has been developed somewhere for a disease that can prolong the patient's life, but can not cure the disease and may cause it （） Decrease in prevalence Reduced incidence Increase in prevalence Increased incidence A B C D No effect on incidence and prevalence E Single choice question 1

62. 3 . Morbidity is not applicable （） Describe the distribution of the disease Look for clues to the cause Measure disease severity Evaluation of control effect A B C D Reflects the frequency of disease occurrence E Single choice question 1

63. 4 . A common measure used in outbreak surveys is （） I ncidence rate Prevalence rate Case fatality rate M ortality rate A B E D Attack rate C Single choice question 1

64. 5 . The tripartite distribution of the disease means （） Age distribution, sex distribution, occupation distribution Age distribution, sex distribution, seasonal distribution Seasonal distribution, population distribution , regional distribution Time distribution, regional distribution , population distribution A B D E Age distribution, sex distribution, regional distribution C Single choice question 1

65. 6 . The case fatality rate of a disease refers to （） Crude death rate per 100,000 population he proportion of all patients with a disease who have died from the disease in a given period of time (usually 1 year) The proportion of all deaths in a population due to a disease in a given period of time (usually one year) The death rate of a disease caused by a particular cause A B E The frequency of death from a disease in a given population over a given period of time Single choice question C D 1

66. "Epidemiology", Ed. Siyan Zhan, Human Health 8th edition, July 2017 Clinical Epidemiology, Siyan Zhan (Ed.), 2nd edition, June 2015 Chinese Journal of Epidemiology, http://www.cma.org.cn Chinese Journal of Public Health, http://www.zgggws.com National Bureau of Statistics of the PRC: http://www.stats.gov.cn/ Public health and health science data center: http://www.phsciencedata.cn/ Recommended books and websites 1

67. thank you 1