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EPIDEMIOLOGIC TRANSITION

EPIDEMIOLOGIC TRANSITION. Epidemiologic Transition: Changes of fertility and mortality with modernization. Imhotep , the "father of medicine". The word "Imhotep" means "he who comes in peace'. Prevention in Egypt.

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EPIDEMIOLOGIC TRANSITION

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  1. EPIDEMIOLOGIC TRANSITION

  2. Epidemiologic Transition:Changes of fertility and mortality with modernization

  3. Imhotep, the "father of medicine". The word "Imhotep" means "he who comes in peace'

  4. Prevention in Egypt Herodotus, after his visit to Egypt in the 5th century B.C., stated that Egyptians were, with the Libyans, the healthiest people. This must have implied a good deal of sanitation. Cleanliness, was religious as well a hygienic obligation.

  5. Medicine is a science from which one learns the states of the human body with respect to what is healthy and what is not, in order to preserve good health when it exists and restore it when it is lacking Ibn Sina

  6. Abdel Omran Evolution of Disease Charles Darwin Evolution of Species

  7. The Theory Of Epidemiologic Transition (Abdel Omran) The Age of Pestilence and Famine The Age of Receding Pandemics The Age of Degenerative and Man-Made Diseases

  8. The Age of Pestilence and Famine Characterized by high mortality rates, wide swings in the mortality rate, little population growth and very low life expectancy, vacillating betweeen 20 and 40 years

  9. Age of Receding Pandemics Epidemics become less frequent, infectious diseases in general become less frequent, a slow rise in degenerative diseases begin to appear, Average life expectancy increases steadily from about 30 to 50 years

  10. The Age of Degenerative and Man-Made Diseases Mortality continues to decline and eventually approaches stability at a relatively low level.

  11. Instead at looking at individual diseases, we need to look at the patterns of diseases

  12. Mortality is the fundamental factor in the dynamics of population growth Mortality has no fixed upper limits. Thus if fertility approached its upper maximum, depopulation would still occur.

  13. During the epidemiologic transition, a long-term shift occurs in mortality and disease patterns whereby pandemics of infection are replaced by degenerative and man-made diseases...

  14. The shifts in disease patterns in the 19th century were primarily related to changing SES (Developed Countries)With the 20th Century more related with disease control activities independent of SES (Developing Countries)

  15. Death Rates for TB in England and Wales

  16. Death Rates for TB in England and Wales TB Bacillus Identified Chemotherapy BCG Vaccination

  17. Death Rates for Measles in Children in England and Wales

  18. Death Rates for Measles in Children in England and Wales Immunization begun

  19. Epidemiologic Transition in Developing and DevelopedCountries

  20. High Incidence of NCDs in Developing Countries • Possible Infectious Etiology Macronodular Cirrhosis Hepatocellular Carcinoma Rheumatic Heart Disease Iron deficiency anemia • Related to Nutrition Deficiency Endemic Goiter Malnutrition Related Diabetes.

  21. High Incidence of NCDs in Developed Countries • Cardiovascular CHD Deep Vein Thrombosis • Respiratory Emphysema Lung CA • Female Genital Endometriosis Endometrial CA • Breast Breast CA Fibrocystic Disease • Male Genital Prostrate CA • Metabolic NIDDM

  22. Age 15-44 Accidents CA CHD Age 45-54 CHD CA Accidents Age 15-44 Accidents CHD CA Age 45-54 CHD CA Accidents Causes of Death Developed Developing

  23. 14 years 35 years

  24. 5 yrs 20 yrs Changing Life Expectancies

  25. Increasing Life Expectancy and Causes of Death 100 Other 80 60 Violence CHD 40 CA 20 Infection 0 40 44 48 52 56 60 64 68 72 76 Population Life Expectancy

  26. Incidence of Stomach CAMales

  27. Breast Cancer IncidenceFemales

  28. CHD Death RatesMales, aged 45-54

  29. Infectious Diseases NCD Mortality Rates Epidemiologic Transition

  30. NIDDM CHD Trauma CA Mortality Rates Epidemiologic Transition

  31. Transisi Epidemiologi di Indonesia

  32. OMRAN THEORY The Age of Pestilence and Famine The Age of Receding Pandemics The Age of Degenerative and Man-Made Diseases DEVELOPED COUNTRIES DEVELOPING COUNTRIES The Age of Pestilence and Famine The Age of Receding Pandemics The age of triple health burden

  33. The Age of Triple Health Burden (Tiga Beban Ganda Kesehatan) Masih tingginya angka kesakitan penyakit menular “klasik”. Tingginya angka kesakitan dan kematian akibat Penyakit Tidak Menular (Non-Communicable Disease). Munculnya penyakit baru (new emerging Infectious Disease)

  34. Beban Penyakit 1 Penyakit ini merupakan masalah kesehatan yang besar di hampir semua Negara berkembang apalagi negara tersebut berada pada daerah tropis dan sub-tropis Angka kesakitan dan kematian relatif cukup tinggi dan berlangsung sangat cepat menjadi masalahnya ex :Tuberkulosis (TB), Kusta, Diare, DBD, Filariasis, Malaria, Leptospirosis

  35. Beban Penyakit 2 Masalah utamanya adalah angka kematian akibat penyakit tidak menular (PTM) di Indonesia sudah lebih tinggi daripada kematian akibat penyakit menular Pada tahun 1995 kematian akibat penyakit tidak menular sebesar 41,7 persen dan tahun 2007 meningkat menjadi 59,5 persen, ini yang tercatat di pelayanan kesehatan bagaimana dengan yang tidak tercatat ? Ex :Hipertensi, Diabetes Mellitus, Penyakit Cardiovaskuler (CVD), Ischemic Heart Disease, PPOK, Kanker

  36. Beban Penyakit 3 Penyakit ini rata-rata disebabkan oleh virus lama yang berganti baju (bermutasi) Angka kesakitan dan kematian pada penyakit ini sangat tinggi dan berlangsung sangat cepat Ex : HIV (1983), SARS (2003), Avian Influenza (2004), H1N1 (2009)

  37. Let' s We Make That Dream ComeTrue What ‘Dream" To Make Indonesian Health

  38. Back to Nature • Improved Physical activity • A Healthier Diet, less saturated fats, more fiber • Less Stress

  39. FINISHTHANK YOU

  40. Importance of Geographic Patterns

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