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Use of epidemiologic methods in disaster management. Dr AA Abubakar Dept of Community Medicine Ahmadu Bello University Zaria Nigeria. Learning objectives. Define disaster epidemiology Give historical overview of disaster epidemiology
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Use of epidemiologic methods in disaster management Dr AA Abubakar Dept of Community Medicine Ahmadu Bello University Zaria Nigeria
Learning objectives • Define disaster epidemiology • Give historical overview of disaster epidemiology • Discuss applications of epidemiologic methods to disasters ( before, during & after the events)
Epidemiology • The study of the distribution & determinants of health related events in human populations and the application of the study to the control of health problems Host Agent Environment Epidemiologic triad
Study designs in epidemiology • Observational study • Descriptive study: Description of the occurrence of a disease in a population • Usually described in person, place & time • Analytical study: Analyses relationships between health status & other variables • Case control study • Cohort study • Experimental study or intervention study
Disaster epidemiology • Use of epidemiology in disaster situations • Epidemiologic methods can be used to measure & describe the adverse effects of natural and man made disasters
Types of studies in disaster epidemiology • Surveillance • Ongoing systematic collection, collation & analysis of data & the timely transmission of information to those who need to know for action to be taken • Public Health impact evaluation • Natural history evaluation • Analytic studies of risk factors
Types of studies in disaster epidemiology 2 • Clinical investigation • Population based study • Study of the psychological effects of disasters
Historical development of disaster epidemiology • 1950- Early review of role of epidemiology during disasters • Late 1960 Civil war in Nigeria: Practical application of epidemiology in disaster management • Early 1970 Establishment of Center for Research on Epidemiology of Disasters
Historical development of disaster epidemiology 2 • 1976 Earthquake in Guatemala important epidemiologic studies carried out • 1980 Eruption of Mount St Helena was a major milestone in shaping governments response to disasters
Before a disaster • Conducting hazard & vulnerability analyses of the population • Hazard analysis: Collecting & assessing data on the nature, causes, frequency, distribution and effects of past events in order to make predictions about future events • Vulnerability analysis: analysis of a population risk when a hazard of a given magnitude occurs
Before a disaster 2 • Modeling/ Simulating disaster scenarios • Conducting drills • Designing emergency protocols • Assessing level of Emergency preparedness • Assessing flexibility of surveillance systems • Training health & safety personnel
During a disaster • Conducting disaster damage assessment • Conducting rapid field investigations • Identifying urgent needs & matching resources • Prioritizing relief efforts • Conducting disaster surveillance • Conducting epidemic investigations
After a disaster • Conducting post disaster epidemiologic follow up studies • Identifying risk factors for death & injury • Planning strategies to reduce impact-related morbidity & mortality • Developing specific interventions based on the nature of the disaster
After a disaster 2 • Evaluating effectiveness of interventions • Conducting descriptive & analytical studies • Planning medical & public health responses to future disasters • Conducting long term follow-up of rehabilitation & reconstruction activities
Challenges to applying epidemiologic methods • Extent of physical destruction • Public fear • Social disruption • Lack of infrastructure for data collection • Time urgency for results • Movement of populations • Lack of local support or expertise
Challenges for selecting study designs • Cross sectional: Studies of frequencies of deaths, illnesses, injuries and adverse health effects • Limited by absence of population counts • Analytical study: Case control study is the best study to determine risk factors & study interactions among multiple factors • Limited by definition of specific outcomes & issues of selecting cases & controls
Conclusion • Epidemiology can provide much needed information on which a rational, effective & flexible policy for the management of disaster is based • Epidemiology provides the tools for rapid & effective problem solving during public health emergencies like natural & man made disasters