Measuring Morbidity, and mortality .pptx

Measuring Morbidity, and mortality

1. قياس المراضة والوفيات Measuring Morbidity, and Mortality Dr. Hadi Al- Hamzi MBBS, MSC Faculty of Medicine Department of community Amran University

2. الاهمية Importance Summarizing Data تلخيص البيانات Enable us to compare events تمكننا من مقارنة الاحداث Reflect the real size of a problem تعكس الحجم الحقيقي للمشكل

3. انواع القياسات Types of Measures In dichotomous variables we use three types of measures, these are:- في المتغيرات الثنائية ( التي لها قيمتين فقط ) نستخدم ثلاثة انواع من القياسات هي: - Rate المعدل Ratio التناسب Proportion النسب

4. المتغيرات الثنائية Dichotomous variables المتغيرات الثنائية في الوبائيات ، هي تلك المتغيرات الاسمية تمتلك فقط فئتين من القيم ( صنفين ) :- ابيض / اسود ، ليل / نهار ، مريض / غير مريض ( صحيح ) ، حي / ميت ، معرض للإصابة / غير معرض للإصابة ، منيع / غير منيع ،الخ . In epidemiology dichotomous variables are those nominal variables have only tow categories :- alive / dead ; white / black ; sick / healthy ; exposed / non-exposed ; immune / non- immune

5. الصيغة العامة للقياسات General Formula of Measures جميع انواع القياسات تعتمد على نفس الصيغة ، ولكنها تختلف بمحتوى التعويض عن كل رمز X Rate , Ratio , Proportion = ------------ X 10ⁿ Y X X 10ⁿ ------------- = المعدل ، التناسب ، النسبة Y

6. الصيغة العامة للقياسات General Formula of Measures The size of 10ⁿ may equal 1; 10; 100; and so on depending upon the value of n . ان حجم 10n يمكن ان يساوي 1 ، 10 ، 100 ، وهكذا، ويعتمد على قيمة n 10° = 1 10¹ = 10 10² = 100 10³ = 1000

7. المعدل Rate المعدل هو قياس تواتر ( تكرار ) حدوث الظاهرة . Rate is a measure of the frequency of occurrence of a phenomenon . • Rate may be -: المعدل يمكن ان يكون Crude خام - General عام - Specific نوعي -

8. Rate ( cont.) ( المعدل ( تبع المعدل في الغالب هو نسبة مضاف اليها توجه معين يقيس حدوث شيء ”حادثة معينة“ في مجتمع معين وفي زمن معين . Rate is mainly a proportion with specific trend It measures the occurrence of event in a specified population in a specified time. يمكن ان يظهر الاختلاف مع مرور الزمن . It can present the change over the time.

9. Ratio التناس ب ،(Variables - التناسب هو التعبير عن العلاقة بين موضوعين (متغيرين او ظاهرتين قد تكون هاتان الظاهرتان او الموضوعان / المتغيران مدمجان مع بعضهما او مستقلان . Ratio is an expression of the relationship between tow things/ variables or phenomena they may be distinct or included in each other .

10. التناسب Ratio في التناسب البسط لا يدخل في المقام . In a ratio the numerator is not included in the denominator . Male ------------- or Male : Female Female كلا العددان يؤخذان خلال فاصلة زمنية واحدة Both quantities are considered at the same time . يتم النظر في كلا الكميتين في نفس الوقت .

11. النسبة Proportion النسبة هي التعبير عن علاقة جزء بالمجموع الكلي ، وعليه فان البسط مشمول في المقام . Proportion is the expression of a part to the whole, so the numerator is included in the denominator يمكن ان يعبر عنها كنسبة مئوية او كجزء ( 50 % او 0,5 او ½) Can expressed as a percentage or fraction.

12. النسبة ( تابع Proportion ( cont.) ( كلا العددان يؤخذان خلال فاصلة زمنية واحدة Both quantities are considered at the same time يعبر عن النسبة بالصيغة التالية :- Male Male Proportion = --------- X 100 or ----------X100 All Male + Female

13. قياس المراضة Morbidity Measurement اهم قياسات المراضة هي :- -1 معدل الحدوث ( الوقوع ) 2- معدل الانتشار -3 معدل الهجمة 4- معدل الهجمة الثانوية • The most important morbidity measures are: 1- Incidence Rate 2- Prevalence Rate 3- Attack Rate 4- Secondary Attack Rate

14. معدل الحدوث ( الوقوع ) Incidence Rate يعتبر معدل الحدوث ( الوقوع ) اكثر الطرق استخدامًا لقياس ومقارنة تواتر المرض في مجتمع او سكان او جمهرة محددة في زمن محدد . Incidence rate is the most common way of measuring and comparing the frequency of diseases in a population in a specified time . استخدام المعدل افضل من استخدام الاعداد المطلقة لماذا ؟ The use of rate is better than the use of absolute numbers WHY ? as they allow you to make fair comparisons between different population sizes. This is because – generally – the number of crimes committed will increase as a population grows

15. الحدوث ( الوقوع ) Incidence incidence refers to the occurrence of new cases of disease or injury in a population over a specified period of time. Two types of incidence are commonly used — incidence proportion and incidence rate. Synonyms for incidence proportion Attack rate Risk Probability of developing disease Cumulative incidence

16. نسبة الحدوث ( الوقوع ) Incidence Proportion Incidence proportion is the proportion of an initially disease free population that develops disease, becomes injured, or dies during a specified (usually limited) period of time. Incidence proportion is a proportion because the persons in the numerator, those who develop disease, are all included in the denominator (the entire population).

17. نسبة الحدوث ( الوقوع ) Incidence Proportion ( cont. ) • Incidence proportion is calculated by the following formula :- Number of new cases during a specific period Incidence proportion = ----------------------------------------------------------- X 100 Size of Population at start of period

18. نسبة الحدوث ( الوقوع ) Incidence Proportion ( cont. ) • Properties and uses of incidence proportions It is a measure of the risk of disease or the probability of developing the disease during the specified period. It includes only new cases of disease in the numerator. The denominator is the number of persons in the population at the start of the observation period. Because all of the persons with new cases of disease ( numerator) are also represented in the denominator, a risk is also a proportion.

19. نسبة الحدوث ( الوقوع ) Incidence Proportion ( cont. ) Calculating Incidence Proportion (Risk) In the study of diabetics, 100 of the 189 diabetic men died during the 13-year follow-up period. Calculate the risk of death for these men. Numerator = 100 deaths among the diabetic men Denominator = 189 diabetic men Risk = (100 ⁄ 189) × 100 = 52.9% Prepared

20. معدل الحدوث ( الوقوع ) ” تابع “ Incidence Rate ( cont. ) يحسب معدل الحدوث بالمعادلة التالية :- Incidence rate is calculated by the following formula :- New cases during a giving time Incidence = ---------------- ------------------------------ X 100 Population at risk at the same time

21. معدل الهجمة Attack Rate In the outbreak setting, the term attack rate is often used as a synonym for risk. It is the risk of getting the disease during a specified period, such as the duration of an outbreak. A variety of attack rates can be calculated. Overall attack rate is the total number of new cases divided by the total population.

22. معدل الهجمة Attack Rate A food-specific attack rate is the number of persons who ate a specified food and became ill divided by the total number of persons who ate that food معدل الهجمة هو مرادف لمعدل الحدوث ، ويحسب بنفس الطريقة It is calculated by the same way as incidence rate يعبر عنه عادة بنسبة مئوية ، وأحيانا يطلق عنه بالتكرار النسبي It is expressed by percent, and some time it is named relative frequency

23. معدل الهجمة الثانوية Secondary Attack Rate هو عدد حالات العدوى التي تحدث لدى المخالطين خلال فترة الحضانة ، بعد التعرض لحالة اولية بالنسبة الى اجمالي عدد للمخالطين المعرضين للإصابة. The number of cases of an infection, that occur among contacts within the incubation period following exposure to a primary case, in relation to the total number of susceptible exposed contacts.

24. معدل الهجمة الثانوية ( تابع ) Secondary Attack Rate ( cont.) هو عدد الاصابات المرضية اجمالًا، منقوصًا منها عدد الاصابات البدئية . خلال فترة زمنية معينة ، مقسومًا على عدد الافراد المستجيبين في نفس المجموعة ، منقوصًا منه الاصابات البدئية It is the total number of, minus the number of primary cases. Over a given time period, divided by the number of responders in the same group, minus the initial. Total cases – primary cases SAR = -------------------------------------------------- X 100 Susceptible persons – primary cases

25. معدل الانتشار Prevalence Rate يعبر عنه بعدد الحالات الجديدة والقديمة لحدث ما ، خلال فترة زمنية في مجتمع محدد مقسومًا على السكان المعرضين للخطر خلال نفس الفترة وفي نفس المجتمع Is the number of new and old events, during certain time in a certain population , divided by the population at risk during the same of time.

26. معدل الانتشار ( تابع ) Prevalence Rate ( cont. ) New and old cases Prevalence = --------------------------------- X 100 Population at risk هناك نوعين من معدل الانتشار هما :- -1 معدل انتشار نقطي 2- معدل انتشار حقبي There are two types of prevalence : 1- Point prevalence 2- Period prevalence

27. Point and Period prevalence Point prevalence refers to the prevalence measured at a particular point in time. It is the proportion of persons with a particular disease or attribute on a particular date. Period prevalence refers to prevalence measured over an interval of time. It is the proportion of persons with a particular disease or attribute at any time during the interval.

28. Calculating Prevalence In a survey of 1,150 women who gave birth in Taiz in 2000, a total of 468 reported taking a multivitamin at least 4 times a week during the month before becoming pregnant. Calculate the prevalence of frequent multivitamin use in this group. Numerator = 468 multivitamin users Denominator = 1,150 women Prevalence = (468 ⁄ 1,150) × 100 = 0.407 × 100 = 40.7%

29. قياس الوفيات Mortality Measures معدل الوفيات : هو قياس تواتر حدوث الوفاة في مجتمع محدد خلال فترة زمنية محددة . Mortality rate : is a measure of the frequency of occurrence of death in a defined population during specified period of time.

30. صيغة معدل الوفيات Mortality Rate Formula Deaths occurring during a given time period Mortality Rate = ------------------------------------ X 10ⁿ population among which the deaths occurred

31. معدل الوفيات Mortality Rate اهم معدلات الوفيات هي : The most important death rates are : - معدل الوفات الخام - Crude Death Rate - معدلات الوفيات الخاصة - Specific Death Rates

32. معدلات الوفيات الخاصة Specific Death Rates معدلات الوفيات الخاصة بالعمر Age specific death rates معدلات الوفيات الخاصة بالنوع Sex specific death rates معدلات الوفيات الخاصة بالسبب Cause specific death rates

33. معدل الوفيات الخام Crude Death Rate ( CDR ) # of all deaths during a given period of time CDR = ------------------------------------------- X 1000 estimated mid-interval population

34. معدل الوفيات بسبب محدد Cause-specific Death Rate ( C-s DR ) # of deaths from a specific cause during a given period C-s DR = -------------------------------------------- X 1000 estimated mid- interval population

35. معدل الوفيات التناسبي Proportional Mortality Rate ( PMR ) # of deaths from a specific cause during a given period PMR = -------------------------------------------------- X 100 # of all deaths during that period

36. معدل هلاك الحالة Case fatality rate ( CFR ) # of deaths due to a specific disease CFR = -------------------------------------- X 100 # of cases of that disease

37. معدل وفيات حديثي الولادة Neonatal Mortality Rate ( NMR ) # of deaths under 28 days of age during a given period NMR = ------------------------------------------- X 1000 # of live births during that period

38. معدل وفيات الرضع Infant Mortality rate ( IMR ) # of deaths under 1 year during a given period IMR = -------------------------------------------- X 1000 # of live births during that period

39. معدل وفيات الامهات Maternal Mortality Rate (MMR) # of pregnancy-related deaths during a given period MMR = ----------------------------------- X 100.000 # of live births during that period

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