疾病的分布 （ distribution of disease ）
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疾病的分布 （ Distribution of Disease ）. 基本概念 任何疾病（或健康状态）在一定范围人群中有无发生以及发生例数的多少是时时都在变动的，有时表现为流行，有时表现为不流行，呈现一个连续的动态过程。疾病分布是疾病的群体表现。 研究疾病（或健康状态）的分布，就是要求我们不断地或经常地收集资料，分析描述这种连续的动态过程，即不同地区，不同人群和不同时间中发生的姿态（或态势）。 何处发病（死亡）率高 / 低？ 何时发病（死亡）率高 / 低？ 何种人群发病（死亡）率高 / 低？. 主要内容. 疾病频率测量指标 - PowerPoint PPT PresentationTRANSCRIPT
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Distribution of Disease
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/ / /
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incidence rateattack rateprevalence rate (infection rate) (secondary attack rate SAR)
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(
K= 100%1000/ 10000/
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attack rate
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prevalence rate
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K= 100% 1000/ 10000/
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()
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()()
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( Baker 1998)
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2-1
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P I D
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(infection rate)
K=100%
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(secondary attack rate SAR) () SAR
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mortality rate fatality rate (survival rate) (cumulative mortality rate)
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mortality rate K= 100% 1000/ 10000/
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= (crude death rate)
(specific death rate)
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fatality rate K= 100% 1000/ 10000/
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K= 100% 1000/ 10000/
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(survival rate) 13 5
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(cumulative mortality rate )
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() K= 100% 1000/ 10000/
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() potential years of life lost,PYLL
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e() i-() ai- ai= e-(i+0.5),() e0.5 di-
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YPLL
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YPLL
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1974PYLL PYLL(170) (170) PYLL() % % 1312675.0 100.0 77440 100.0 239238.5 18.2 5864 8.0 198327.5 15.1 19205 26.2 165264.5 12.6 4795 6.5 84195.0 6.4 2716 3.7 56667.0 4.3 5186 7.1 50264.0 3.8 3425 4.7 48079.5 3.7 4444 6.1 45418.0 3.5 4068 5.5 37954.0 2.7 2204 3.0 30919.0 2.4 2108 2.9 29634.0 2.3 1119 1.5 (Frerichs,1986)
1974PYLL PYLL(170) (170) PYLL() % % 1312675.0 100.0 77440 100.0 239238.5 18.2 5864 8.0 198327.5 15.1 19205 26.2 165264.5 12.6 4795 6.5 84195.0 6.4 2716 3.7 56667.0 4.3 5186 7.1 50264.0 3.8 3425 4.7 48079.5 3.7 4444 6.1 45418.0 3.5 4068 5.5 37954.0 2.7 2204 3.0 30919.0 2.4 2108 2.9 29634.0 2.3 1119 1.5 (Frerichs,1986)
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()disability adjusted life year, DALY
(YLL) (YLD)
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DALY
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( sporadic)
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(epidemic)
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(outbreak)
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2015105 22 24 2 4 6 8 10 12 14 910
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()
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1964-1965
1964-1965
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Adults and children estimated to be living with HIV/AIDS - end of 2003
Total: 34 46 million
Western Europe520 000 680 000North Africa & Middle East470 000 730 000Sub-Saharan Africa25.0 28.2 millionEastern Europe & Central Asia1.2 1.8 millionSouth & South-East Asia4.6 8.2 millionAustralia & New Zealand12 000 18 000 North America790 000 1.2 millionCaribbean350 000 590 000Latin America1.3 1.9 millionEast Asia & Pacific700 000 1.3 million
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2000AIDS
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HIV1985 2001.6HIV1-5051-100101-500501-10001001-5000>5000
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()
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(endemic)
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(rapid fluctuation)
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() (seasonal variation) : : ---
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1996
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2000O157:H7
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()periodicity) (
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19501988(1991 )
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secular trendsecular change
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(19001973)(Beaglehole R,1993)
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()
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(JS Mausner,1985) `
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Schottenfeld D, 1982,1996 1/10
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(1) (cross sectional analysis)
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(2) (birth cohort analysis) birth cohort)
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Massachusetts188019101930 (LH Roth1982)
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Massachusetts
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Frost Massachusetts 19305060 2040 19305060
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() /
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HIV1985 2001.6
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()
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()
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AIDS----
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()
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()
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90-97
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Haenszel W 19681/10
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2-11 1964-19652-12 1964-1965
map in the back of epi update
2-13 Haenszel W 1968 1995