Tutorial_Epidemiologi 1

Overview
Epidemiological principles and methods are used to describe the frequency and the
determinants of disease, injury and death occurrence. In this chapter you will learn about the
epidemiological measures that are used to quantify the frequency of morbidity and mortality in
a population.

Objective
After this session, students were expected to better able to:
1. define the basic measurement including proportion, rate and ratio
2. define and calculate define and calculate a range of measures of frequency of disease,
including prevalence, risk, odds and rates
3. define and calculate crude and specific mortality (morbidity) rates
4. explain the limitations of comparing crude rates between populations and the methods to
overcome these limitations.

Activity 1.
Determine whether each of the following statements is ratio, proportion or rate
a. Person with diabetic family history has 1.6 higher risk compare to those who did not have
family history of diabetes
b. Occurrence of measles cases in Palebo City for male to female is 1:3
c. The incidence of dengue in Huji City is 65/100.000 population per year
d. 90% of measles cases in Bali have previous contact history with confirmed measles cases

Based on information provide in the table above, answer the questions below
a. What is the ratio of operating room deliveries to delivery room deliveries neonatal listeriosis
in General Hospital A, Costarica?
b. What proportion of infants lived?
Activity 2
One thousand men who 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 (no one had died or was lost to follow-up).

1. What is the prevalence of HIV in men working in factory A on 1 January 2002, and on 1
January 2003?
2. What is the annual risk of developing HIV infection in men working in factory A in 2002?

One thousand men from factory B were screened for HIV on 1 January 2002 and 50 men were
found to be HIV-positive. All the men were tested for HIV once a month until 31 December 2002.
Twelve men became HIV-positive during these 12 months. Figure below shows when these 12
men became HIV-positive. Tests were always carried out at the end of the month. The remaining
938 men were still HIV-negative by 31 December 2002. No one died or was lost to follow-up
during this period.

1. What were the odds of becoming infected with HIV in the first 6 months of 2002 in the
12 men who became HIV-positive that year?
2. What is the total number of person-months at risk of HIV infection observed in this
study?
3. What is the incidence rate of HIV infection in men working in factory B?
Activity 3
A total of 1,176,453 deaths (all causes in the whole population) were reported in country X in
2003. The mid-year population in 2003 was estimated to be 198,812,000. HIV-related deaths
and mid-year population by age group are given in below table

Calculate the crude death rate (from all causes) in country X in 2003.

Now complete above table by answering the following questions:

1. Calculate the crude HIV-related death rate in country X in 2003 in the whole population.
2. Calculate the age-specific HIV-related death rate among 5–14-year-olds and among 35–
44-year-olds.

HIV-related deaths and mid-year population by age group in Country Y in 2003 are given in table
below

a. Calculate the age-specific HIV-related death rates for country Y in 2003, and complete table
above
b. The HIV-specific death rate for country Y in 2003 was 4.5 per 100,000 populations. Your
calculation for Question 2 should have given you the HIV-specific death rate in country X in
2002 as 5.5 per 100,000 populations.
c. Can you conclude that a person living in country X has a risk of dying from HIV that is 1.2
times (5.5/4.5 = 1.2) as high as a person living in country Y?
d. Discuss the limitations of the comparison in Question c above and outline two ways to
overcome them.