LECTURE 6

Epidemiological
Profiles of diseases
 TOPICS

DIMENSION OF DISEASES
DETERMINANTS OF DISEASES
SPECTRUM OF DISEASES
MASS PHENOMENA OF
DISEASE
CLASSIFICATION OF DISEASES
 DISEASE
• Disease is a state of departure from
health; a deviation from condition of
physical, mental and social well-being.
Disease is a product imbalance between
the three components of epidemiological
triad: agent, host and environment.
 DIMENSION OF DISEASES

• Physical dimension of a disease

comprises its clinical manifestations and
physiological alterations associated with
changes resulting from disease process.
 SOCIAL DIMENSION

• Social dimension: While diseases can

originate from social causes, they can also
give rise to social consequences.
Diseases can result in family disturbances,
family tension and economic burden.
Stigmatic diseases may lead to
disownment and abandonment of patients.
 MENTAL DIMENSION

• In addition to psychiatric illnesses, some

somatic diseases can lead to mental
problems. Diseases that are incurable
disabling or disfiguring cause anxiety,
depression and even suicidal tendencies.
Stigmatization can cause feelings of guilt,
loneliness, anger, frustration and
depression.
 MORAL DIMENSION

• A disease should be conceived as an

outcome of a natural process, and not as
a punishment for sins. Patients suffering
from diseases, liable to cause stigma,
should be treated with care, concern and
compression. Provision of health care
facility to people is the moral responsibility
of government.
 ECONOMIC DIMENSION

• Direct cost estimates the expenditure

incurred on the treatment of a disease,
whereas indirect cost estimates the loss of
income suffered by a patient during the
period of illness; it also estimates the
disturbance, disruption and inconvenience
caused by the disease to others
connected with the patient, either within
the family setting or elsewhere.
 DETERMINANTS OF DISEASES

• Causal factors bear a cause and effect

association with diseases, no disease can
appear without a causal factor. Causal
factor may be physical, chemical,
biological, psychological or nutritional.
Elimination of causal factors leads to
elimination of the corresponding diseases.
 CONTRIBUTING FACTORS

• Contributing factors promote disease

process; they may have a predisposing or
precipitating effect on the course of
diseases. For example, a patient with
deformed chest is prone to suffer from
chest infections.
 SOCIOECONOMIC FACTORS

• Socioeconomic factors prepare the

ground for the onset and continuance of
diseases. These factors include poverty,
unemployment, poor governance,
unemployment, ignorance, superstitious
beliefs and overpopulation.
 TYPICAL CASEES
• Typical cases possess a textbook clinical
profile. They pose no problem in diagnosis
because they are easily identified on the
basis of their clinical presentation and
laboratory findings. In case of a typical
communicable disease, appropriate
control measures can be instituted quickly
and easily.
 PRECLINICAL CASES
• Preclinical cases show no sign or
symptom; hence diagnosis is missed and
delayed. However, they can be diagnosed
by employing relevant diagnostic test. For
example, HIV, diabetes and hypertension
can be diagnosed in preclinical state when
the patients are asymptomatic.
 LATENT CASES
• Latent cases: the disease is in preclinical
state, but without any confirmatory
evidence. The microbial agent lies in a
dormant state. Infection caused by
Mycobacterium tuberculosis is a case in
point. Latent cases of infectious diseases,
therefore, pose no threat to public health.
 EPIDEMIC
• An epidemic is defined as the occurrence
of a disease in an area, clearly in excess
of the normal expectations. It is the excess
over the expected number, rather than the
absolute number of cases, that determines
the occurrence of an epidemic.
 ENDEMIC

• An endemic is defined as the occurrence

of a disease round the year, in a
population inhabiting a geographic area.
The disease agent is constantly present in
the endemic areas, and not imported from
outside.
 HERD IMMUNITY

• It is the level of resistance of a community

or group of people to a particular disease.
 PANDEMIC

• A pandemic is defined as occurrence of an

epidemic over a wide geographic region,
beyond the borders of a nation, a country
or a continent.