Disaster epidemiology

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Disaster epidemiology

• Professor Vilius Grabauskas
• Kaunas University of Medicine, Kaunas, Lithuania

NATO supported advanced research workshop,
Kaunas, Lithuania, 8-10 August 2005
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Task of the presentation

• To overview basic principles of epidemiology in
  disasters

Vilius Grabauskas
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The key concepts

• Definitions
• Disaster epidemiology vs epidemiology in
  disasters

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Definitions

• A disaster is a destructive event that causes a
  discrepancy between the number of casualties and
  their treatment capacity.

In health and medical care, disaster means a
situation in which the need of medical care
exceeds the immediately available resources and
in which extraordinary and coordinated measures
are necessary if normal quality standards are to
be maintained
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To maintain the normal quality standards

• we need to
• attend to and treat injured persons within a
  injury area
• transport the injured and give treatment during
  transport
• attend to and treat injured persons in hospital
• take preventive measures against psychological
  sequelae in the injured, relativesand staff
  involved in rescue work.

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How we reache our goals?

• Epidemiology is the study of the causes and
  distribution of disease in human populations
• Disaster epidemiology the use of epidemiology
  in disaster situations.
• Epidemiologic methods can be used to measure and
  describe the adverse health effects of natural
  and human-caused disasters.

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Phases of a Disaster

• PREIMPACT
• disaster prevention and education
• IMPACT
• information collection and disaster mitigation
• POSTIMPACT
• rehabillitation

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Epidemiology of disasters

• Disasters

Natural (35 of all disasters and 94 of all
deaths in the last 15 years)
Man made
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Role of Epidemiology in Disasters

• To identify the priority health problems in the
  affected community.
• To determine the extent of disease existing
  within a community.
• To identify the causes of disease and the risk
  factors.
• To determine the priority health interventions.
• To determine the extent of damage and the
  capacity of the local infrastructure.
• To monitor health trends of the community.
• To evaluate the impact of health programs.

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Constraints of Epidemiology in Emergencies

• Poor understanding of basic epidemiological
  principles and measurement techniques.
• Rapid turnover of skilled staff.
• Lack of access to a significant fraction of the
  affected population due to chaos or insecurity.
• Limited resources for processing information.
• Difficulty in estimating the population size.
• Survey samples may not represent the total
  affected population.

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Key Epidemiological Indicators

• Awareness of the value of immunisation
• Compliance to universal precautions against
  HIV/AIDS
• Equity in distribution of resources

• Incidence
• Prevalence
• Morbidity rate
• Mortality rate

• access
• coverage
• quality of services
• availability

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Rapid Needs Assessment

• To determine the magnitude of the emergency.
• To define the specific health needs of the
  affected population.
• To establish priorities and objectives for
  action.
• To identify existing and potential public health
  problems.
• To evaluate the capacity of the local response
  including resources and logistics.
• To determine external resource needs for priority
  actions.
• To set up the basis for a health information
  system.

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Surveillance

• To monitor the health of a population and
  identify the priority health needs
• To follow disease trends for early detection and
  control of outbreaks
• To assist in planning and implementing health
  programs
• To ensure resources are targeted to the most
  vulnerable groups
• To monitor the quality of health care
• To evaluate the coverage and effectiveness of
  program interventions

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Outbreak Investigation
Reportable Diseases Diseases of Public Health Importance
Measles Cholera Meningitis Hepatitis Tuberculosis Yellow fever Haemorrhagic fever Rabies Tetanus Sexually transmitted infections (gonorrhoea, syphilis, chlamydia, genital ulcer disease, chancroid) HIV/AIDS
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Data Analysis

• To identify the possible root causes of problems.
• To investigate further to verify the actual
  causes of a problem.
• To define needs that have not been met.
• To develop an action plan for dealing with
  problems.
• To improve the quality of programs.

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Conclusions

• It is necessary
• It is useful
• It is helpful
• as any tool if used
• professionally

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