PENGANTAR EPIDMIOLOGI PENYKIT MENULAR 1

Epidemiologi Definisi 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 Penyakitamenular Definisi : Epidemiologi penyakit menular terfokus dalam mempelajari distribusi dan determinan penyakit menular dalam populasi.

Epidemiologi Penyakitamenular Klasifikasi Penyakit Berdasarkan etiologi (kausa)  Penyakit infeksi  Penyakit non infeksi  Etiologi (organism) : Tuberkulosis, Campak, Malaria, dsb  Manifestasi klinik : Meningitis, Encefalitis, Rinitis, Diare ??, dsb

Epidemiologi Penyakitamenular Berdasarkan Durasi :  Penyakit akut  Penyakit kronik Peak symptoms within 3 months (acute) or longer than 3 months (chronic)

Epidemiologi Penyakitamenular Acute 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

6/24/2016 Acute Diseases MENULAR TIDAK MENULAR Chronic Diseases MENULAR TIDAK MENULAR Common 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 liver Types of Diseases Examples

Definition of communicable diseases A 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 diseases Epidemiology The study of the transmission of disease Communicable 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 another Noncommunicable Disease A disease that is not transmitted from one individual to another

Definition of communicable diseases Communicable 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 disease Disease 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

12 EtiologiDurasi AkutKronis Infeksi Common cold Pneumonia Campak Gondongan Pertusis Typhoid Kolera Kusta TBC AIDS Demam rheumatik Hepatitis B Non Infeksi Keracunan (intoksikasi insektisida dan logam, dsb) Trauma Penyakit Jantung Koroner Diabetes Mellitus Kanker Stroke

Classification of Diseases & Health Problems Organ or Organ System –i.e., heart disease, kidney disease, respiratory infection Causative Agent –Biological Agents –Chemical Agents –Physical Agents Communicable vs Non communicable Acute vs Chronic –Peak symptoms within 3 months (acute) or longer than 3 months (chronic)

Chap 4: Prevention and Control Causative Agents for Diseases & Injuries Biological Agents Chemical Agents Physical Agents Viruses Rickettsiae Bacteria Fungi Protozoa Metazoa Pesticides Food additives Pharmacologics Industrial chemicals Air pollutants Cigarette smoke Heat Light Radiation Noise Vibration Speeding objects

DEFINITIONS INFECTION -The entry, development or multiplication of an infectious agent in the body tissues of man or animals INFECTIOUS DISEASE -A 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 Triangle Model

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

Communicable Disease Model Agent Host Any susceptible organism invaded by an infectious agent

Communicable Disease Model Agent Host Environment All other factors that inhibit or 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 Infection The habitat in which an infectious agent normally lives and grows –Human: Anthroponoses, symptomatic or asymptomatic –Animal: Zoonoses –Environmental: Plants, soil, and water Pathogen Reservoir

Chain of Infection The path by which an agent leaves the source host Pathogen Reservoir Portal of exit

Chain of Infection Modes of Transmission Direct: Immediate transfer - Direct contact - Droplet spread Indirect - Airborne - Vehicleborne - Vectorborne Pathogen How pathogens are passed Reservoir Portal of 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. 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. Modes of transmission can be classified as direct or indirect.

Routes of transmission Direct  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 (www)www

Chain of Infection Pathogen Reservoir Portal of exit Trans- mission - Agent enters susceptible host Portal of entry Respiratory Oral Skin Intravenous Gastrointestinal

Chain of Infection Pathogen Reservoir Portal of exit Trans- mission - Final link is a susceptible host Portal of entryNewhost

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

Pencegahan primer Adl Upaya pencegahan yg dilakukan saat proses penyakit belum mulai (pd periode pre-patogenesis) dengan tujuan agar tidak terjadi proses penyakit T.a: 1. Promosi kesehatan 2. Perlindungan khusus Riwayat Alamiah Penyakit31

Pencegahan sekunder Adl Upaya pencegahan yg dilakukan saat proses penyakit sudah berlangsung namun belum timbul tanda/gejala sakit (patogenesis awal) dengan tujuan proses penyakit tidak berlanjut T.a: 1. Early diagnosis & prompt treatment 2. Disability limitation Riwayat Alamiah Penyakit32

Tingkat pencegahan tertier Riwayat Alamiah Penyakit33 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 Pathogen –Pasteurization –Chlorination –Antibiotics –Antivirals –Disinfectants

Prevention of Communicable Diseases Human Reservoir –Isolation –Surveillance –Quarantine –Drug treatment

Prevention of Communicable Diseases Portal of Exit –Gowns –Masks –Condoms –Hair nets –Insect repellents

Prevention of Communicable Diseases Transmission –Isolation –Hand washing –Vector control –Sanitary engineering –Sneeze glass –Sexual abstinence –Safer sex

Prevention of Communicable Diseases Portal of Entry –Masks –Condoms –Safety glasses –Insect repellents

Prevention of Communicable Diseases Establishment of Disease in New Host –Immunizations –Health education –Nutrition promotion –Sexual abstinence

Noncommunicable Disease Model Your genetic endowment

Noncommunicable Disease Model Your genetic endowment Personality Beliefs Behavioralchoices Environment Health Care System Water Quality AirPollution Economics

Diseases of the Heart and Blood Coronary 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.

Cancer Malignant neoplasm: Occurs when cells lose control over their growth and division. As these cells continue to grow they eventually develop a “new growth”—a tumor Metastasis: Parts of the tumor break off and travel to the rest of the body’s organs and continue their growth.

Other Top Noncommunicable Diseases 1.Chronic obstructive pulmonary disease 2.Diabetes mellitus 3.Chronic liver disease and cirrhosis

Prevention of Noncommunicable Diseases Primary Prevention –Adequate food intake –Good opportunities for education, employment, and housing –Efficient community services –Health promotion –Access to medical services –Protection from the environment –Protection from occupational hazards –Empowerment for one’s own health

Prevention of Noncommunicable Diseases Secondary Prevention –Mass screenings –Case-finding measures –Adequate health personnel, equipment, and facilities –Personal screening (self breast or testes exams) –Hemoccult tests –Pap tests

Prevention of Noncommunicable Diseases Tertiary Prevention –Adequate emergency medical personnel, services, and facilities –Understand unmodifiable risk factors –Significant behavioral or lifestyle changes (Modifiable risk factors) –Support groups –Counseling