An epidemiology supervision can be presented as a permanent dynamic and multidimensional track system after the epidemic process of concrete infectious or parasite disease, and also after an epidemiology situation on the whole on certain territory in a concrete period of time for rationalization and increase of efficiency of prophylactic and противоэпидемической work.
Epidemiology and socio-economic meaningfulness of infectious diseases determine the necessity of the continuous looking after an often changing epidemiology situation (supervision) with the purpose of timely development of measures, providing liquidation, reduction or inhibition at certain level of infectious diseases (control).
Epidemiology meaningfulness of illnesses is determined prevalence, frequency of registration, among a population estimated on the indexes of morbidity.
Economic meaningfulness is estimated direct and indirect harm.
Direct harm is expenses on an ambulatory and stationary inspection and treatment of disease, payment on temporal disability, disability, pension, for help in the case of death of bread-winner. Expenses on противоэпидемические measures, scientific development of methods and methods of fight against an infection.
Indirect harm is a cost of the products received less society as a result of disability on illness (to the care after to the patients, disability, death).
Thus, эпиднадзор and эпидконтроль are components of the general system, determined as epidemic process control.
An object of эпиднадзора is an epidemiology situation in its intercommunication with the socially-ecological environment of dwelling of people.
Epidkontrol' – actually system of prophylactic and ïðîòèâîýïèäåìèîëîãè÷åñêèõ measures.
Tasks of эпиднадзора:
- estimation of scales, character of prevalence and socio-economic meaningfulness of infectious diseases.
- an exposure of tendencies and estimation of rates of dynamics of эпидпроцесса is in time. Determination of risk time – that того period of time, when real or potential неблагополучие takes place on this infection.
- Districting of territory taking into account the degree of real and potential epidemiology неблагополучия on this infection (that determination of risk territory).
- Exposure of contingents of population, subject to the promoted risk of disease by virtue of features of their production-domestic or other terms of life (that exposure of risk groups)
- Exposure of reasons and terms, determining an origin and looked after character of displays of epidemic process of this infection – risk factor
- Determination of the adequate system of prophylactic and противоэпидемических measures, planning of sequence and terms of their realization.
- Control of scales, quality and efficiency of the carried out prophylactic and противоэпидемических measures.
- Development of переодических prognoses of эпидситуации.
The functional structure of the system of epidemiology supervision can be presented as a successive chain of measures:
- supervision in place, collection and registration of information
- stage-by-stage communication of data «on a vertical line», or from a «top» to the bottom, that от district in areas, regional and further in republican establishments of the system of эпиднадзора.
- Exchange by information on a horizontal line (that at the level of districts, cities, areas, republics of country)
- эпиданализ and estimation of information on the programs, to specific for every level of эпиднадзора
- estimation of epidemiology situation, that raising of epidemiology diagnosis.
- Exchange by information on principle of feed-back, that «from top to bottom» от higher in the нижестоящии levels of the system of эпиднадзора
- Development of administrative decisions, that recommendations on planning and adjustment of the carried out measures.
- Development of prognosis of development of epidemiology situation.
Epidnadzor is carried out in accordance with the complex-having a special purpose programs, developed specially for every нозоформы.
Any program includes:
- purpose and tasks of the planned supervision, territory of эпиднадзора
- group of population, undertaking under a supervision, and also duration of forthcoming period of supervision
- character and volume of information, subject collection, sources of receipt of information (ЛПУ, clinical, microbiological, virologies, parasitology laboratories and other)
- methods and переодичность collection of primary information, переодичность analysis of information, method of analysis of information, primary and final forms of tables and accounting, methods of presentation of reports.
An analysis of information is analytical methods of research
Purpose – to expose причинно-следственные connections in an epidemic process.
An epidemiology method is an aggregate of methodical receptions, allowing to estimate the structure of morbidity of population on the groups of diseases and нозоформам, and in regard to separate diseases – on territory, among the different groups of population, in time in order to unseal причинно-следственные connections in development and display of morbidity and ground of measures on the prophylaxis of morbidity and estimation of their efficiency..
Structure of epidemiology method – hypotheses about причинно-следственных connections are formulated and estimated with посмощью of methods (дескриптивных) of descriptive-evaluations and аналитеческих, estimated about proved by the analytical, experimental methods of research and mathematical design.
A purpose of descriptive-evaluation reception is a study of problems of medicine and prophylaxis on the forms of nosologies of diseases, and in regard to separate diseases – on territory, to the groups of population and in time.
Basic data get are documents of registrations and current, results of selective researches.
Infectious diseases are registered is a magazine of account of infectious morbidity, form 60. The infections of quarantines, tuberculosis, лепра and дерматовенерологические diseases, are subject a separate account.
Dvaosnovnykh analytical research method –
3) A case is control – based on comparison of information about the cases of hit under the action of the studied factor of patients and people, unbeing ill this disease.
4) Kogortnyy research method – the intensive indexes of morbidity are studied in cohorts which get and непопадают under the action of the studied factor.
An epidemiology diagnosis is a logical formula, containing the estimation of epidemiology situation and its determinant (reasons) on concrete territory, among the certain groups of population.
It is a section of epidemiology, reflecting the stages of estimation of epidemiology situation, directed on the exposure of причинно-следственных connections in an epidemic process.
At raising of epidemiology diagnosis explored:
– indexes of morbidity, transmitter, death rate in time, among the different groups of population, prevalence of diseases on territory
– properties of exciter, ways and factors of his transmission, immunological layer (structure) of population, are studied
– natural and social factors are explored, providing saving and circulation of exciter in a period between epidemics, that in the period of his reservation, and in the period of origin of epidemic hearths.
– efficiency of the carried out prophylactic and противоэпидемических measures is estimated.
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Stages of epidemiology diagnostics:
- collection of information
- formulation of working диагностичской hypothesis about причинно- connections of consequences in an epidemic process
- statistical verification of working hypothesis
- verification of accordance of working diagnostic hypothesis information of retrospective epidemiology analysis
- formulation of final epidemiology diagnosis
- development of recommendations on optimization of prophylactic and противоэпидемических measures.
- development of prognosis of epidemiology situation.
A retrospective epidemiology analysis is an estimation of epidemiology situation for one or another last period of time taking into account time of risk, risk groups, territory of risk and risk factors..
An epidemiology prognosis is a foresight of epidemiology situation in one or another period of time taking into account the groups of risk, risk territory, time of risk and risk factors.