Morbidity Rates

1. Morbidity Rates Dr.NouraAbouammoh Dr. AfnanYounis

2. Learning Objectives • Define and calculate measure of frequency of disease (Prevalence, Incidence, Attack rate) • Be able to decide when to use them • Be able to interpret the results

3. Reminder-The epidemiological approach • 5 Ws. • So what? - Prevention and control

4. Case vs. Episode • Distinguish between case and an episode - Case e.g. Poliomyelitis. - Episode e.g. an asthma attack requiring admission.

5. Size of population • If 75 cases of TB in village A and 25 cases in village B, is TB commoner in village A?

6. Prevalence • The total number of cases of a disease in a given population at a specific time.

7. Prevalence • Prevalence =No. of cases with the disease at a point in time/Total no. of people in defined pop. at same point in time X 10n • Point vs. period

8. Exercise (1) 1000 men were working in factory A were screened for HIV on 1 January 2002 and 50 of them were found to be positive for HIV antibodies. The screening was repeated in the same 1000 men on 1 January 2003 and this time 62 men were positive, including the 50 men who were positive on the first screening. What is the prevalence of HIV in men working in factory A on 1 January 2002 and 1 Jan 2003?

9. Answer No. of prevalent cases at 1 January 2002= 50 No. persons in the pop. In January 2002=1000 Therefore, the prevalence at January 2002= 50 / 1000 X 1000 = 50/1000

10. No. of prevalent cases at January 2003= 62 No. of persons in the population at 1 January 2003= 1000 Therefore, the prevalence at 1 January 2003= 62/1000 X 1000 = 62/1000

11. Exercise (2) • Parents of 700 children in village A were asked if their children have developed diarrhoea during the past 3 weeks. 200 children had a positive history of diarrhoea. • Calculate the prevalence.

12. Answer • No. of cases = 200 • No. of population = 700 • Prevalence = 200/700 X 1000 = 285/1000

13. Incidence • Frequency of new cases of disease in a defined pop. during a specified time period

14. Incidence • Incidence= No. of new cases with disease in a specified time period/ No. of disease free people at the start of the time period X 10n • Disease free people = pop. at risk

15. Uses of frequency measure • Prevalence: - Useful in health care settings e.g. estimate services required. - Cannot study cases that got better or died. • Incidence: - Useful for investigating causal relationships and risk factors.

16. Exercise (3) • 1000 men were working in factory A were screened for HIV on 1 January 2002 and 50 of them were found to be positive for HIV antibodies. The screening was repeated in the same 1000 men on1 January 2003 and this time 62 men were positive, including the 50 men who were positive on the first screening. • What is the incidence of HIV infection in men working in factory A in 2003?

17. Answer No. of new cases in 2003= 12 No. of persons at risk of HIV infection in January 2003 = 1000 – 50 = 950 The incidence of developing HIV infection = 12/950 X 1000= 12.6/1000

18. Attack Rate • An attack rate is a variant of an incidence rate, applied to a narrowly defined population observed for a limited time, such as during an epidemic. • The attack rate is usually expressed as % percent.

19. Attack Rate

20. Exercise (4) • Of 100 persons who attended a dinner party, 35 subsequently developed gastroenteritis. • Calculate the attack rate of gastroenteritis

21. Answer Attendees = 100 ILL = 35 Attack rate = (35 ÷ 100) X 100 = 35%

22. Exercise (5) • In a university student has got H1N1 flu. She attended a class of 80 students, of which 12 students got the flu 5 days later. • Calculate the attack rate of the flu.

23. Answer Class = 80 ILL : • new cases= 12 • old case = 1 • At risk students= 80 - 1 = 79 Attack rate = (12 ÷ 79) X 100 = 15%

24. Thank You