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Concept of disease causation

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Rizwan S A
Rizwan S A

This document discusses key concepts in epidemiology including definitions of disease, illness, and sickness. It describes the spectrum and "iceberg phenomenon" of disease, where most cases remain undiagnosed. Theories of disease causation are outlined, from older theories to modern concepts like the epidemiological triad/tetrad involving agents, hosts, and environments over time. Examples of risk factors, risk groups, and models of causation like the web and wheel of causation are provided. The natural history of disease progression is also addressed. Tuberculosis is used as an example to illustrate the interplay between infectious agents, human hosts, and social/environmental determinants of disease.

Health & Medicine
1 of 16
Concept of disease Dr. Rizwan S A, M.D., Assistant Professor, Department of Community Medicine, VMCH&RI, Madurai. 24.10.2014
Outline • Definition of disease – Distinction between disease, illness, sickness • Spectrum of disease • Iceberg phenomenon • Theories of causation • Natural history of disease First MBBS – Epidemiology series 2
Spectrum of disease 3First MBBS – Epidemiology series
Iceberg phenomenon – 1/2 First MBBS – Epidemiology series 4
Iceberg phenomenon – 2/2 1 Diseased, diagnosed & controlled 2 Diagnosed, uncontrolled 3 Undiagnosed or wrongly diagnosed disease 4 Risk factors for disease 5 Free of risk factors Diagnosed disease Undiagnosed or wrongly diagnosed disease 5First MBBS – Epidemiology series
Theories of causation • Old theories • Modern theories – germ theory – multifactorial causation – socioeconomic, cultural, genetic, psychological – epidemiological triad (tetrad) – web of causation – wheel of causation 6First MBBS – Epidemiology series
Epidemiological triad/tetrad – 1/4 Agent EnvironmentHost Time 7First MBBS – Epidemiology series
Epidemiological triad – 2/4 • Agents – Biological – Physical – Chemical – Mechanical – Insufficiency or excess of factors, hormones, nutrients, parts, structural defects, chromosomal factors, immunological factors – Social 8First MBBS – Epidemiology series
Epidemiological triad – 3/4 • Host – Demographic – Biological – genetic, biochemical, immunological, physio functions – Social and economic – Lifestyle 9First MBBS – Epidemiology series
Epidemiological triad – 4/4 • Environment – Physical, – Biological, – Psychosocial 10First MBBS – Epidemiology series
Risk factors and risk groups • Risk factors – Modifiable, non-modifiable – Examples for CVD • Risk groups – Target groups – Risk approach First MBBS – Epidemiology series 11
Web of causation 12First MBBS – Epidemiology series
Wheel of causation 13First MBBS – Epidemiology series
Natural history of disease 14First MBBS – Epidemiology series
Example - TB • Agent – types, sources, communicability • Host – age, sex, genetics, nutrition, immunity • Environment – urban slum, rural, overcrowding, poor ventilation • Other social factors – ignorance, stigma, health facilities, health habits, beliefs and customs First MBBS – Epidemiology series 15
Thank You sarizwan1986@outlook.com

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Concept of disease causation

  • 1. Concept of disease Dr. Rizwan S A, M.D., Assistant Professor, Department of Community Medicine, VMCH&RI, Madurai. 24.10.2014
  • 2. Outline • Definition of disease – Distinction between disease, illness, sickness • Spectrum of disease • Iceberg phenomenon • Theories of causation • Natural history of disease First MBBS – Epidemiology series 2
  • 3. Spectrum of disease 3First MBBS – Epidemiology series
  • 4. Iceberg phenomenon – 1/2 First MBBS – Epidemiology series 4
  • 5. Iceberg phenomenon – 2/2 1 Diseased, diagnosed & controlled 2 Diagnosed, uncontrolled 3 Undiagnosed or wrongly diagnosed disease 4 Risk factors for disease 5 Free of risk factors Diagnosed disease Undiagnosed or wrongly diagnosed disease 5First MBBS – Epidemiology series
  • 6. Theories of causation • Old theories • Modern theories – germ theory – multifactorial causation – socioeconomic, cultural, genetic, psychological – epidemiological triad (tetrad) – web of causation – wheel of causation 6First MBBS – Epidemiology series
  • 7. Epidemiological triad/tetrad – 1/4 Agent EnvironmentHost Time 7First MBBS – Epidemiology series
  • 8. Epidemiological triad – 2/4 • Agents – Biological – Physical – Chemical – Mechanical – Insufficiency or excess of factors, hormones, nutrients, parts, structural defects, chromosomal factors, immunological factors – Social 8First MBBS – Epidemiology series
  • 9. Epidemiological triad – 3/4 • Host – Demographic – Biological – genetic, biochemical, immunological, physio functions – Social and economic – Lifestyle 9First MBBS – Epidemiology series
  • 10. Epidemiological triad – 4/4 • Environment – Physical, – Biological, – Psychosocial 10First MBBS – Epidemiology series
  • 11. Risk factors and risk groups • Risk factors – Modifiable, non-modifiable – Examples for CVD • Risk groups – Target groups – Risk approach First MBBS – Epidemiology series 11
  • 12. Web of causation 12First MBBS – Epidemiology series
  • 13. Wheel of causation 13First MBBS – Epidemiology series
  • 14. Natural history of disease 14First MBBS – Epidemiology series
  • 15. Example - TB • Agent – types, sources, communicability • Host – age, sex, genetics, nutrition, immunity • Environment – urban slum, rural, overcrowding, poor ventilation • Other social factors – ignorance, stigma, health facilities, health habits, beliefs and customs First MBBS – Epidemiology series 15
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