Epidemiological aspects Epidemiological aspects of GIT disordersof GIT disorders

Dr. Wasantha GunathungaDr. Wasantha Gunathunga

objectivesobjectives

To describe occurrence of GIT To describe occurrence of GIT disordersdisorders

To discuss factors affecting GIT dis.To discuss factors affecting GIT dis. To discuss preventive aspectsTo discuss preventive aspects

Epidemiology Epidemiology

The study of distribution and determinants The study of distribution and determinants of health related states or events in of health related states or events in human populationshuman populations

GIT disordersGIT disorders Disorders that manifest predominantly in Disorders that manifest predominantly in

the gastro intestinal systemthe gastro intestinal system

GIT disordersGIT disorders

Communicable Communicable Non communicable Non communicable

Occurrence of GIT disorders-Occurrence of GIT disorders-communicablecommunicable

Parasitic Parasitic Helminths – Helminths – hook worm, round worm hook worm, round worm

whip worm, pin wormwhip worm, pin worm

Occurrence of GIT disorders-Occurrence of GIT disorders-communicablecommunicable

Parasitic Parasitic Amoebas – Amoebas – E.E.

histolitica histolitica Other Other

Occurrence of GIT disorders-Occurrence of GIT disorders-communicablecommunicable

Bacteria and viruses Bacteria and viruses Gastritis Gastritis Hepatitis Hepatitis EnteritisEnteritis Colitis Colitis Other Other

Occurrence of GIT disorders-Occurrence of GIT disorders-NonNon--communicablecommunicable

Gastritis, gastric Gastritis, gastric ulcersulcers

MalignanciesMalignancies Ulcerative colitis Ulcerative colitis Alcohol related Alcohol related

problems problems Other Other

In Sri Lanka In Sri Lanka

In Sri Lanka a community survey of seven In Sri Lanka a community survey of seven districts found 20 – 32 per cent current districts found 20 – 32 per cent current drinkers. In the rural area those who drink drinkers. In the rural area those who drink do so heavily. A survey in eight villages do so heavily. A survey in eight villages showed 71 per cent of respondents showed 71 per cent of respondents drinking daily. Use is higher among poor drinking daily. Use is higher among poor families. 93 per cent of respondents used families. 93 per cent of respondents used locally produced alcohol, which is not locally produced alcohol, which is not reflected in the per capita consumption.reflected in the per capita consumption.

http://www.ias.org.uk/publications/theglobe/01issue3,4/globe0103_04_p4.html

In Sri LankaIn Sri Lanka

Fifty-seven Sinhalese patients were Fifty-seven Sinhalese patients were investigated for the presence of investigated for the presence of Helicobacter pyloriHelicobacter pylori by PCR. A by PCR. A prevalence of 70.1%, was prevalence of 70.1%, was demonstrated. demonstrated.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=120560

Levels of preventionLevels of prevention

PrimaryPrimary

SecondarySecondary

Tertiary Tertiary

H- nutr, immH- nutr, imm

Primary prevention

Host Environment agent Eg. tuberculosis

Host Host

Age Age SexSex Poor nutritionPoor nutrition HabitsHabits HIVHIV Immunity - BCGImmunity - BCG

Host Host

Age Age SexSex Poor nutritionPoor nutrition HabitsHabits HIVHIV Immunity – Immunity –

BCG/OPVBCG/OPV

Age :Age : Old age (eg. TB)Old age (eg. TB) Infancy(eg.diarrhoeInfancy(eg.diarrhoe

a) a) Sex:Sex: Male Male femalefemale

HostHost

Age Age SexSex Poor nutritionPoor nutrition HabitsHabits HIVHIV Immunity - BCGImmunity - BCG

Poor nutritionPoor nutrition Proper infant and Proper infant and

child feedingchild feeding Nutrition during Nutrition during

illnessillness Nutrition in special Nutrition in special

groupsgroups Proper feeding of Proper feeding of

senior citizenssenior citizens

Host Host

Age Age SexSex Poor nutritionPoor nutrition HabitsHabits HIVHIV Immunity - BCGImmunity - BCG

HabitsHabits Prevention of Prevention of

substance abusesubstance abuse Hygiene (food, Hygiene (food,

dental)dental) Other Other

HostHost

Age Age SexSex Poor nutritionPoor nutrition HabitsHabits HIVHIV Immunity - BCGImmunity - BCG

Prevention of HIV Prevention of HIV will prevent many will prevent many other infectionsother infections

Immunity –by Immunity –by vaccinations – hep vaccinations – hep B, A, OPV, other.B, A, OPV, other.

Agent Agent

Prevent drug resistance –proper use Prevent drug resistance –proper use of antibioticsof antibiotics

Look for new forms – mutations, eg. Look for new forms – mutations, eg. New cholera strainsNew cholera strains

EnvironmentEnvironment

Recognize Recognize occupational occupational exposureexposure

Improve domestic Improve domestic water and food water and food supply supply

Prevent antibiotic Prevent antibiotic residues in foodresidues in food

secondary preventionsecondary prevention

Surveillance Surveillance ScreeningScreening Complete treatmentComplete treatment

Surveillance Surveillance

Epidemiological surveillance is the Epidemiological surveillance is the continuous scrutiny of factors that continuous scrutiny of factors that determine the occurrence and determine the occurrence and distribution of diseases or other distribution of diseases or other conditions of ill health. It includes conditions of ill health. It includes systematic collection, analysis, systematic collection, analysis, interpretation and distribution of interpretation and distribution of relevant data for action. relevant data for action.

Approaches of preventionApproaches of prevention

Population approachPopulation approach

High risk approach High risk approach