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

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

9. 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.
Vilius Grabauskas

10. 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.
Vilius Grabauskas

11. 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
Vilius Grabauskas

12. 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.
Vilius Grabauskas

13. 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
Vilius Grabauskas

14. 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
Vilius Grabauskas

15. 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.
Vilius Grabauskas

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