1 Disaster epidemiology Professor Vilius Grabauskas Kaunas University of Medicine, Kaunas, Lithuania NATO supported advanced research workshop, Kaunas, Lithuania, 8-10 August 2005

2 Task of the presentation  To overview basic principles of epidemiology in disasters Vilius Grabauskas

3 The key concepts:  Definitions  Disaster epidemiology vs epidemiology in disasters Vilius Grabauskas

4 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 Vilius Grabauskas

5 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, relatives and staff involved in rescue work. Vilius Grabauskas

6 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. Vilius Grabauskas

7  PREIMPACT  disaster prevention and education  IMPACT  information collection and disaster mitigation  POSTIMPACT  rehabillitation Phases of a Disaster Vilius Grabauskas

8  Disasters: Epidemiology of disasters Natural (35% of all disasters and 94% of all deaths in the last 15 years) Man made Vilius Grabauskas

9  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. Role of Epidemiology in Disasters Vilius Grabauskas

10  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. Constraints of Epidemiology in Emergencies Vilius Grabauskas

11  Incidence  Prevalence  Morbidity rate  Mortality rate Key Epidemiological Indicators  Awareness of the value of immunisation  Compliance to universal precautions against HIV/AIDS  Equity in distribution of resources  access  coverage  quality of services  availability Vilius Grabauskas

12  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. Rapid Needs Assessment Vilius Grabauskas

13  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 Surveillance Vilius Grabauskas

14 Outbreak Investigation Reportable DiseasesDiseases 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 Vilius Grabauskas

15  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. Data Analysis Vilius Grabauskas

16  It is necessary…  It is useful…  It is helpful… as any tool if used professionally Conclusions Vilius Grabauskas