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Epidemiology for Global Health
Course Number UGPH-GU 9030
Instructor Details
Adolphina Addoley Addo-Lartey, PhD [email protected]; [email protected]+233(0)26 145 8709+233(0)54 413 2970Office: University of Ghana, School of Public Health, first floor (SPH Room 4)Office Hours: By appointment. Please allow at least 24 hours for your instructor to respond to your email.
Class Details Class Time: Thursdays, 2:00pm – 5:00pm Class Location: NYU Accra CampusAddress: No.8 3rd Norla Street, Labone
Prerequisites None
Class Description
Epidemiology is the study of the distribution and determinants of health and illness in human populations and the application of this study to control health problems. The purpose of this course is to introduce students to the basic principles and methods of epidemiology in a global context and to demonstrate their applicability in the field of public health. Topics covered in this course include history, background and different perspectives of epidemiology, measures of disease frequency; measures of association; epidemiologic study designs; public health surveillance; outbreak investigations; assessment of causality; and relationship between epidemiology and public health policies. In addition, students will develop the necessary skills to critically read, interpret and assess health information from published epidemiological studies and mass media sources.
The course will comprise three major segments:1. The epidemiologic approach to disease intervention2. Using epidemiology to identify the cause of disease3. The practice of epidemiology
The course structure will consist of readings, lectures, in-class case studies, discussions, exercises and student presentations, and in-class time to work on a research design. Each class will involve a lecture as well as exercises which are meant to complement and apply (as opposed to repeat) the material in the text. Hence completing the readings and homework on time is essential for success in the course. A field visit will be arranged to give students a glimpse of the public health surveillance system in Ghana. There will be one or two guest lecturers, who will introduce an area of public health epidemiology, reinforce epidemiological principles, and/or provide relevant examples to place epidemiological concepts in context. Additional reading materials will be provided as necessary.
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Desired Outcomes
The statements below describe the desired knowledge, skills, and behaviors that students should have obtained upon completing this course.
Explain the role of epidemiology in public health. Contrast the epidemiologic population-based approach with the clinical perspective. Provide the appropriate research question when presented with a public health problem that requires an epidemiologic investigation.
Identify sources of health-related data in order to describe the distribution of disease in populations. Generate hypotheses from descriptive data on disease frequency in relation to person, place and time. Interpret health status indices based on these data, example morbidity and mortality rates.
Explain the critical differences between epidemiologic descriptive and analytic study designs, the measures that can be estimated from each, as well as strengths and limitations of these designs. Describe how to select and appropriate study design for a specific research question or health problem.
Analyze data using the appropriate epidemiologic techniques (under the guidance of someone with more advanced training). Define, compute and interpret epidemiologic measures of prevalence, incidence, relative risk, attributable risk, mortality ratios.
Identify practical issues in conducting epidemiological studies e.g. the various forms of potential bias in epidemiological data and their potential for occurrence in specific study situations. Discuss the implications of study findings.
Evaluate the evidence in favor of and against the likelihood that an observed association in epidemiological studies is causal using a set of criteria.
Communicate the role of epidemiology in public health surveillance. Present the purpose and problems of data interpretation in surveillance and outbreak investigations.
Communicate epidemiological information to lay and professional audiences
Assessment Components
NYU Classes will be used extensively throughout the semester for assignments, posting of readings, and communication. NYU Classes is accessible through at https://home.nyu.edu/academics
In-class activities - ExercisesExercises and discussions: In class exercises will provide an application of the Gordis chapter readings, assigned readings, and lecture concepts and will also reflect the kinds of problems that could be posed in exams. Exercises will be graded on a 10-point scale and will count towards your final grade.
HomeworkChapter questions: The majority of chapters are followed by multiple choice type questions. Since the letter answers are provided at the back of the textbook, “satisfactory” homework answers will also require a written justification of why the letter answer was selected. Students are encouraged to work individually on homework assignments. Homework will be collected at the beginning of class on the day it is due and will be graded on a satisfactory/not satisfactory basis which will count towards your final grade. Solutions will be discussed in class.
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Problem setsFive practice problem sets will be distributed in class and will be due one week after distribution. Each problem set will emphasize important topics from lectures and assigned readings. Students are expected to work independently and should not discuss these assignments with others. These will be graded on a 100 point scale. Problem sets will be collected at the beginning of class on the day it is due. Solutions will be discussed in class.
Midterm examOne midterm exam will be organized based on the material covered in the first half of the course and may include multiple choice questions, computational, and short answer type questions. The exam will be graded on a 100 point scale. Students may bring ONE SHEET of paper with notes to this exam. The note sheet will be collected and returned with the exam.
In class evaluation of a published studyThis assessment provides an opportunity to apply the concepts from the course by reviewing a published journal article. A pdf copy of the article will be made available for students to review and discuss with colleagues outside class hours. One week later, there will be an in-class assessment following the “pyramid exam” structure. This is explained as follows: For the first part of the assessment, students will be given a clean hard copy of the same paper and asked to answer multiple choice questions about the reviewed article independently. After submitting their answers for part 1, students will be given a chance to discuss the questions within small groups and submit a new group answer sheet. The final grade of the assessment will be based on both the individual answers (75%) and group answers (25%).
Media Project/PresentationThis project addresses how epidemiological findings are filtered through the media. What do media reports convey correctly and what are conveyed incorrectly? Students will be asked to choose a health-related statement form the popular press (e.g. from a newspaper, magazine, or on a cereal box, wine bottle, billboard, general websites, etc.) Students will then find an epidemiologic journal article (e.g. medical or public health journal) which relates to this statement. In a brief, structured oral presentation, the student will compare the journal article’s conclusions with those from the media report. Further instructions including length of presentation time will be given in class. The presentation will be graded on a 100 point scale. The grade will be based two-thirds on content: collection and analysis of literature, critical thinking, and application of course concepts; and one-third on form clear organization, well prepared and delivered presentation. Students should submit their presentations to NYU Classes or via email to the instructor before the day of their presentation.
Design a study – Final take home examThe purpose of this project is to pull together the concepts conveyed in the course using a real-life epidemiologic problem. The project will simulate a situation faced by a team of working epidemiologists. The aim of the project is for students to apply the concepts covered in lectures to address important aspects of designing an epidemiological study (e.g., defining the population of interest, choosing a data source, understanding the strengths and limitations of the chosen study design). Students will work in groups and at least one class session will be reserved for groups to meet. The exam/project will be distributed in class and will be graded on a 100 point scale. The grade will be based two-thirds on content and one-third on form.
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Note: Unless otherwise specified, all written work must be submitted as a hard copy. All assignments must be typed (1” margins, Times New Roman, Calibri, Arial, Font size 11 or 12). Your full name(s) must be on the top of each page. All in-class presentations must be completed during class time.
Assessment Expectations
Students are expected to complete all assigned readings prior to each synchronous class. Students are also encouraged to read/explore any additional resources pertinent for each class and share during the lectures. The final grades for the course will be based on the following:
Homework/Chapter Questions = 10%Class Exercises = 10%Practice Problem sets = 15%Midterm exam = 20%In class evaluation of a published study = 10%Media project = 15%Design a study- Final take home exam = 20%
Grade conversion
For this course your total numerical score, calculated from the components listed above, correspond to the following letter grades: A=94-100; A-=90-93; B+=87-89; B=84-86; B-=80-83; C+=77-79; C=74-76 C-=70-73; D+=67-69; D=65-66; F=below 65
Grading Policy All assignments should reflect independent work with the exception of group projects which should reflect the contributions of each member of the group.
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Attendance Policy
Attend class on time and participate in all class sessions. If you cannot attend a certain session, it is your responsibility to email the instructor prior to the start of the class, or in the case of an emergency, immediately upon return. Unexcused absences and continuing lateness will impact your attendance grade.
Late Submission of Work
Academic Accommodations for Students with Disabilities
Late homework without prior permission will not be accepted. Late problem sets will not be accepted and no make-up problem sets will be given. Late media projects will not be accepted and no make-up in class exams will be given.
Please feel free to tell me about any physical or learning disability that can threaten your success in this course. I will do my best to help minimize any difficulties that you may have. Kindly share these concerns with me no later than the second week of this class (February 9, 2017). Students with disabilities should also inform the Academic director and school administrator to determine what classroom accommodations should be made available.
Plagiarism Policy The university policy concerning academic honesty should be followed at all times. An excerpt
may be found below. The full text can be found in the student handbook or at http://www.nyu.edu/about/policies-guidelines-compliance/policies-and-guidelines/academic-integrity-for-students-at-nyu.html
At NYU, a commitment to excellence, fairness, honesty, and respect within and outside the classroom is essential to maintaining the integrity of our community. By accepting membership in this community, students take responsibility for demonstrating these values in their own conduct and for recognizing and supporting these values in others. In turn, these values will create a campus climate that encourages the free exchange of ideas, promotes scholarly excellence through active and creative thought, and allows community members to achieve and be recognized for achieving their highest potential.
In pursuing these goals, NYU expects and requires its students to adhere to the highest standards of scholarship, research and academic conduct. Essential to the process of teaching and learning is the periodic assessment of students' academic progress through measures
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such as papers, examinations, presentations, and other projects. Academic dishonesty compromises the validity of these assessments as well as the relationship of trust within the community. Students who engage in such behavior will be subject to review and the possible imposition of penalties in accordance with the standards, practices, and procedures of NYU and its colleges and schools. Violations may result in failure on a particular assignment, failure in a course, suspension or expulsion from the University, or other penalties.
Faculty are expected to guide students in understanding other people's ideas, in developing and clarifying their own thinking, and in using and conscientiously acknowledging resources - an increasingly complex endeavor given the current environment of widely available and continually emerging electronic resources. In addition, students come to NYU from diverse educational contexts and may have understandings regarding academic expectations that differ from those at NYU. NYU values and respects all academic traditions; however, while at NYU, students are expected to adhere to the norms and standards of academic integrity espoused by the NYU community and will be assessed in accordance with these standards. Students should ask their professors for guidance regarding these standards as well as style guide preferences for citation of sources for assignments in their courses.
Following are examples of behaviors that compromise the academic and intellectual community of NYU. The list is not exhaustive. Students should consult the websites and guidelines of their individual schools for an extended list of examples and for further clarification.
1. Plagiarism: presenting others' work without adequate acknowledgement of its source, as though it were one’s own. Plagiarism is a form of fraud. We all stand on the shoulders of others, and we must give credit to the creators of the works that we incorporate into products that we call our own. Some examples of plagiarism:
A sequence of words incorporated without quotation marks An unacknowledged passage paraphrased from another's work The use of ideas, sound recordings, computer data or images created by others as
though it were one’s own
2. Cheating: deceiving a faculty member or other individual who assess student performance into believing that one’s mastery of a subject or discipline is greater than it is by a range of dishonest methods, including but not limited to:
Bringing or accessing unauthorized materials during an examination (e.g., notes, books, or other information accessed via cell phones, computers, other technology or any other means)
Providing assistance to acts of academic misconduct/dishonesty (e.g., sharing copies of exams via cell phones, computers, other technology or any other means, allowing others to copy answers on an exam)
Submitting the same or substantially similar work in multiple courses, either in the same semester or in a different semester, without the express approval of all instructors
Submitting work (papers, homework assignments, computer programs, experimental results, artwork, etc.) that was created by another, substantially or in whole, as one's own
Submitting answers on an exam that were obtained from the work of another person or providing answers or assistance to others during an exam when not explicitly
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permitted by the instructor Submitting evaluations of group members’ work for an assigned group project which
misrepresent the work that was performed by another group member Altering or forging academic documents, including but not limited to admissions
materials, academic records, grade reports, add/drop forms, course registration forms, etc.
3. Any behavior that violates the academic policies set forth by the student’s NYU School, department, or division.
Required Text(s)
Epidemiology: with STUDENT CONSULT Online Access, 4e (Gordis, Epidemiology) Author: Leon Gordis MD MPH DrPHPublisher: Saunders; 4th edition (May 28, 2008)ISBN-13: 978-1416040026ISBN-10: 1416040021
Supplemental Texts(s) (not required to purchase as copies are in NYU-L Library)
None
Internet Research Guidelines
Not applicable
Additional Required Equipment
Not applicable
Session 1
Feb 02, 2017
Syllabus, course overview
Lecture: Introduction to epidemiology and Epidemics
John Snow website (www. ph.ucla.edu/epi/snow.html)
Epi Monitor (www.epimonitor.net)
Homework: Read Gordis, Chapter 1 and 2. Prepare Chapter 2 questions.
Reading for next week:
CDC Surveillance Overview: https://www.cdc.gov/hiv/statistics/surveillance/
District Health Information Management System DHIMS II: The Data Challenge
For Ghana Health Service http://solutionscenter.nethope.org/case_studies/view/
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district-health-information-management-system-dhims-ii-the-data-challenge-f
Session 2
Feb 09, 2017
Lecture: Epidemics (Continued)
Case study “Ebola: The Plague Fighters”
Class Exercise 1 – Ebola
Lecture: History of epidemiology and outbreak investigation
Class Exercise 2 – Outbreak following charity luncheon
Homework: Read Gordis, Chap. 3. Chap. 4 (pp. 59-73) and Chap. 6 (pp. 111-112)
Prepare Chapter 3 questions. Prepare Chapter 4 questions 1,2,5 and 10
Due: Home work - Chapter 2 Questions
Session 3
Feb 16, 2017
Guest lecture: Disease Surveillance / Outbreak Investigation
Lecture: Disease frequency
Summary Sheet Disease Frequency
Class Exercise 3 – Disease frequency
“Your disease risk” (www. yourdiseaserisk.com)
Homework: Read Gordis, Chap. 4 (pp. 73-82). Review Chap. 4 questions 3,4,6-11.
Problem set #1 distributed
Due: Homework - Chapter 3 questions and Chapter 4 questions 1,2,5 and 10
Session 4
Feb 23, 2017
Lecture: Age adjustment
Class Exercise 4 – Age Adjustment
Homework: Read Gordis, Chap. 10, Chap. 14 Chap. 7 and Chap. 8 (pp. 152-162).
Review chap. 8 questions 1,3,5,8.
Problem set #2 distributed.
Due: Problem set #1
Session 5 Field Trip
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Mar 02, 2017
Session 6
Mar 09, 2017
Lecture: Descriptive epidemiology
Class Exercise 5 – Breast cancer and dietary fat
Lecture: Randomized trials
Class Exercise 6 – Antioxidants
Homework: Read Gordis, Chap. 9 and Chap. 10 (pp. 177-195). Chap. 13 and Chap. 20.
Prepare Chapter 9 and Chapter 10 questions.
Due: Problem set #1
Session 7
Mar 16, 2017
Lecture: Cohort Studies
Class Exercise 7 – Design a cohort study
Lecture: Case-Control Studies
Class Exercise 8 – Study design
Class Exercise 9 – Design a case-control study
Homework: Read Gordis, Chap. 11 and Chap. 12. Prepare Chapter 11 and Chapter 12 questions.
Media Project distributed
Due: Chapter 9 Questions Chapter 10 Questions
Mar 23, 2017 (SPRING BREAK WEEK – NO CLASS)
Session 8
Mar 30, 2017
Prepare for Midterm Exam (NEXT WEEK)
Lecture: Measures of Association
Class Exercise 10 – Association
Lecture: Attributable Risk
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Summary Sheet Attributable Risk
Class Exercise 11 – Attributable risk
Homework: Read Gordis, Chap. 15 (pp. 247-251), Chap. 8 (pp. 147-152).
Review Chap. 15 questions 2 and 7. Review Chap. 8 questions 2,4,6,7.
Problem set #3 distributed
Due: Chapter 11 and 12 Questions
Session 9
Apr 06, 2017
Midterm Exam: Covers material through Attributable Risk
Media project: Discussion on progress and challenges
Session 10
Apr 13, 2017
Lecture: Bias
Class Exercise 12 – Bias
Lecture: Chance
Class Exercise 13 – Chance
Homework: Read Gordis, Chap. 15 (pp. 251-262); Chap. 14 (pp. 230-245).
Prepare Chapter 14 questions. Prepare Chapter 15 questions 1 and 8.
Reading for next week: Abstract TBD
Due: Problem set #3
Session 11
Apr 20, 2017
Lecture: Confounding
Class Exercise 14 – Confounding
Lecture: Causality and External Validity
Class Exercise 15 – Challenges to Validity
Class Exercise 16 – Abstract critique
Reading for next week: Daling et al. Risk of breast cancer among young women: Relationship to induced abortion. J Natl Cancer Inst 86; 1584-92, 1994.
Problem set #4 distributed.
Due: Chapter 14 questions and chapter 15 questions 1&8
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Session 12
Apr 27, 2017
Lecture: Literature Critique
Class Exercise 17 – Literature Critique
Lecture: Screening
Class Exercise 18 – Screening
Homework: Group work on Media Project.
Groups allocated for Design a study (Take home exam)
Problem set #5 distributed.
Due: Problem set #4
Session 13
May 04, 2017
Media Project Presentations
Group work time- Design a study (Take home exam)
Due: Media Projects Outline
Session 14
May 11, 2017
Group work time
Journal Article for In class pyramid exam distributed or posted
Due: Problem set #5
Session 15
May 18, 2017
Pyramid exam: In class assessment of a published study.
Covers material from measures of association through literature critique
Due: Design a study – Take home exam
Classroom Etiquette
Cell phones must be turned off or put on silent during class. Laptops are allowed only for note-taking or course related.
Required Co-curricular Activities
Not applicable
Suggested Co- Not applicable
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curricular Activities
Your Instructor
Dr. Adolphina Addo-Lartey holds a BSc (Honors) from the University of Ghana in Biochemistry and Nutrition, an MS from Iowa State University in Human Nutrition, and a PhD in Public Health from the University of Massachusetts, Amherst, USA. Her research primarily focuses on epidemiological studies in women’s health and maternal/infant health care. She has done extensive research relating to nutritional factors influencing reproductive health outcomes and chronic disease risk, healthcare accessibility and the social support aspect of healthcare delivery as well as gender and health issues in Ghana. She is experienced in research and trial design, proposal development, data management and statistical analysis. Dr. Addo-Lartey is a lecturer at the University of Ghana’s School of Public Health, where she teaches undergraduate and postgraduate courses in the Department of Epidemiology and Disease Control. Dr. Addo-Lartey is also an adjunct faculty at the College of Global Public Health (NYU) and NYU Accra where she teaches “Assessing Community Health Needs and Resources” and “Epidemiology for Global Health”, respectively.
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