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Essentials of Epidemiology

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Course Type Course Code No. Of Credits
Foundation Core SPG2PH403 4

Semester and Year Offered: 1st Semester, 1st Year

Course Coordinator and Team:  N. Nakkeeran & Samik Chowdhury

Email of course coordinator: nakkeeran@aud.ac.in

Pre-requisites: None

Aim: This course introduces the student to the principles and basic methods of modern epidemiology. Epidemiology is defined as the study distribution and determinants of health related states and events in defined populations and the application of this to study to solving public health problems. This course is being offered with the objectives of familiarising students on science and approaches of epidemiology and to provide an understanding on the potential role of epidemiology in public health decision making.

This course will start with a brief discussion on historic evolution of epidemiology, its definitions, principles, scope, and functions. This module will further introduce students to disease epidemiology including disease occurrence, natural history and spectrum of disease, chain of infection, disease outbreaks of various extents, principles and concepts on disease surveillance and outbreak analysis. Subsequently, the course opens up a space for a debate on different approaches in epidemiology - traditional vs. modern; population level vs. individual level, as well to explore the principles of social epidemiology.

Course Outcomes:

  • Familiarity with historical debates in epidemiology
  • Knowledge of the science, principles and approaches of epidemiology
  • Appreciation of the role of epidemiology in public health decision making
  • Knowledge of epidemiological study designs, their strengths and weaknesses.
  • Use of epidemiological knowledge to raise critical questions

Brief description of modules/ Main modules:

  • Diseases biology: This module will cover elementary aspects of disease biology with select number diseases as illustrations to serve as a bridge module for students coming from non-medical (&para-medical) streams
  • Introduction to epidemiology: This module covers (1) definition and historical evolution of epidemiology, (2) epidemiology and public health, (3) epidemiologic functions and approach, (4) descriptive and analytic epidemiology, (4) concepts of disease occurrence and (5) achievements in epidemiology.
  • Early debates in epidemiology: This unit will cover the debate on 'traditional' vs. 'modern' epidemiology, largely covered in some of the issues in American Journal of Public Health in the middle of 1990s, with the gradual demise of population based epidemiology giving way to new public health and 'risk-factor' epidemiology, justified with the emergence of NCDs epidemics.
  • Measuring health and disease risk: This module covers (1) defining health and disease (2) measuring disease frequency, death rates and morbidity (3) comparing disease outcomes and (4) measures of public health impact.
  • Public health surveillance : This module covers (1) epidemic and endemic diseases (2) chain of infection, (3) investigation and control of epidemics, (4) purpose and characteristics of public health surveillance, (5) identifying health problems for surveillance (6) collecting, analyzing and interpreting data for surveillance
  • Epidemiology of prevention - non-communicable disease: This module covers (1) the scope of prevention, (2) levels of prevention, (3) primordial, primary, secondary and tertiary prevention and (4) screening
  • Clinical epidemiology: This module covers (1) definition of normality and abnormality, (2) diagnostic tests, (3) natural history and prognosis, (4) effectiveness of treatment (5) use of evidence based guidelines and (5) prevention in clinical practice
  • Environmental and occupational epidemiology: This module covers (1) environment and health, (2) exposure and dose, (3) assessing risks and impact, (4) injury epidemiology and (5) special features like safety standards, measuring past exposure and healthy worker effect.
  • Epidemiology, health policy and planning: This module elaborates on epidemiological knowledge as a key input for health policy and planning.
  • Social epidemiology: In this module key principles on social epidemiology will be discussed.
  • Introduction to epidemiological study designs: This module introduces students to some common study designs used in epidemiology such as longitudinal, experimental (randomized control trials / non-randomized experiments) and case control designs, and meta-analysis.

Assessment Details with weights:

  • Class exercise I - 20%
  • Class exercise II - 25%
  • Class exercise III - 25%
  • (These exercises themselves will be of various kinds - review of texts, poster making, data, reflections form field etc.)
  • End semester open book exam or assignment - 30%

Reading List:

Essential readings:

  • Saracci, R., Epidemiology: A Very Short Introduction, London: OUP, 2010
  • Bonita, Beaglehole and Kjellstrom, Basic Epidemiology, WHO. https://apps.who.int/iris/bitstream/handle/10665/43541/9241547073_eng.pdf?sequence=1&isAllowed=y
  • Berkman, LF., Kawachi, I., and Glymour, MM., (eds.) Social Epidemiology, (2nd Edition) OUP, Oxford, 2014, http://ndl.ethernet.edu.et/bitstream/123456789/27643/1/24.pdf
  • Rose and Barker, Epidemiology for the Uninitiated, Coggon, BMJ Books.
  • Pearce, N.," Traditional Epidemiology, Modern Epidemiology, and Public Health", American Journal of Public Health, May 1996, Vol. 86, No.5:678-83
  • Susser, M., "Choosing a Future for Epidemiology: I. Eras and Paradigms", American Journal of Public Health, May 1996, Vol. 86, No. 5:668:673
  • Susser, M., "Choosing a Future for Epidemiology: II. From Black Box to Chinese Boxes and Eco-Epidemiology", American Journal of Public Health, May 1996, Vol. 86, No. 5: 674-7
  • Weed, DL., "Epidemiology, the Humanities, and Public Health", American Journal of Public Health, July 1995, Vol. 85, No. 7:914-18
  • Wing, S., "Whose Epidemiology, Whose Health?" International Journal of Health Services, 1998, Vol. 28, No. 2 (1998), pp. 241-252
  • Brown, M., From Foetid Air to Filth: The Cultural Transformation of British Epidemiological Thought, ca. 1780-1848, Bull. Hist. Med., 2008, 82 : 515-544
  • Crawford, DH, Viruses: A very short introduction (2nd edn.) London: OUP, 2018.
  • Kreiger, N., "Theories for Social Epidemiology in the 21st Century: An Ecosocial perspective" International Journal of Epidemiology, Volume 30, Issue 4, August 2001, Pages 668-677, https://doi.org/10.1093/ije/30.4.668
  • McMillen, CW., Pandemics: A Very Short Introduction, London: OUP, 2016
  • Spassoff R.A. Epidemiologic Methods for Health Policy, Oxford University Press, 1999
  • Trostle, J. A. (2005). Epidemiology and Culture (Unit 1). New York: Cambridge University Press.
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