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MARASMUS 1. This disease is caused by deficiency of protein as well as energy nutrients (that is carbohydrates and fats) in the diet. 2. Marasmus occurs in children below the age of 1 year. 3. This disease is more common in towns and cities where breast-feeding in discontinued quite early. 4. No swelling of body takes place in Marasmus. 5. In Marasmus, wasting of muscles is quite evident. The child is reduced to skin and bones. 6. Skin does not change color and does not break.

Community and Public Health (Week 2&3)

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Page 1: Community and Public Health (Week 2&3)

MARASMUS1. This disease is caused by deficiency of

protein as well as energy nutrients (that is carbohydrates and fats) in the diet.

2. Marasmus occurs in children below the age of 1 year.

3. This disease is more common in towns and cities where breast-feeding in discontinued quite early.

4. No swelling of body takes place in Marasmus.

5. In Marasmus, wasting of muscles is quite evident. The child is reduced to skin and bones.

6. Skin does not change color and does not break.

Page 2: Community and Public Health (Week 2&3)

Kwashiorkor1. This disease is caused by the

deficiency of protein in the diet of child.

2. Kwashiorkor occurs in children in the age group 1-5 years.

3. The disease is more common in villages where there is small gap period between successive pregnancies.

4. In this disease, swelling of body is observed due to retention of fluids.

5. Wasting of muscles is not evident.6. Skin changes color and become

broken and scaly.

Page 3: Community and Public Health (Week 2&3)

Introduction to Statisticsand Demography

Ma. Jenna Paje-Andres, RMT, MPH

Page 4: Community and Public Health (Week 2&3)

INTRODUCTION TO STATISTICS

Overview of Session

The students are introduced to basic concepts in statistics and analysis and presentation of public health data, using a non-mathematical approach. Sources of routine data and their interpretation will be likewise discussed.

The session will also provide students with basic tools needed to manage, analyze and interpret information and statistics.

Page 5: Community and Public Health (Week 2&3)

Objectives

At the end of the session the student should be able to:

• Apply statistical principles to specific area to study within the public health

• Recognize and utilize appropriate statistical procedure and tools.

Page 6: Community and Public Health (Week 2&3)

Statistics can be regarded in two ways:

• As a Method

• As Data

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• As a METHOD it refers to orderly processes of data collection, organization, presentation and interpretation (tabulation of data, computation of rates and frequency distribution, graphic presentation)

• As a DATA it refers to quantitative data affected to a marked extent by a multiplicity of causes. Data are collected in order to measure something (number of deaths, births, specific diseases, hospital admissions)

Page 8: Community and Public Health (Week 2&3)

Uses of Statistics

–Problems of estimates

–Problems of comparison

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Classification of Statistical Data1. Demographic- ex. Population

size, age, sex, geographic distribution, mortality, morbidity, growth rate

2. Health Status- ex. Causes and distribution of mortality and morbidity as to residence, place of occurrence, age, sex

3. Health Resources- ex. Number and distribution of health facilities, health manpower, health expenditures

4. Health-related Socio-economic Environmental Factors- ex. Water supply, excreta disposal, school enrollment, food establishment, transports, food intake/habits

Page 10: Community and Public Health (Week 2&3)

Uses of Statistics1. Problems of estimates2. Problems of comparison3. Health need identification4. Analysis of problem and trends5. Epidemiologic evaluation6. Program planning7. Budget preparation and justification8. Administrative decision making9. Health education

Page 11: Community and Public Health (Week 2&3)

Organization of Data• Tabulation- it refers to the

arrangement of any data in an orderly sequence, so that they can be presented concisely and compactly and so that they can be understood easily.

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Types of Data for Tabulation1. Frequency Distribution- data are grouped

according to some scale of classification, where the sum of the entries is equal to the total. The figures may either be in actual numbers, in percent or in both. The scales used may be qualitative, quantitative or both.

2. Correlation data- used to compare two or more frequencies

3. Time series data- some variables changes over a period of time is the one being presented

Page 13: Community and Public Health (Week 2&3)

Parts of a Table1. Title- Should states the objective of the table. It

should state clearly, briefly, and comprehensively what the figures in the body of the table stand for, how the data are classified, where and when obtained.

2. Stubs- indicate the basis of classification of the rows or horizontal series of figures

3. Column heading- indicates the basis of classification of columns or vertical series of figures.

4. Body of the Table- This is made up of the figures filing the cells or compartments brought about by the coordinates of the rows and columns.

5. Marginal totals- refer to the column totals and row totals

6. Footnote- indicates the source of information.

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Page 15: Community and Public Health (Week 2&3)

TabulationExample:A paper was submitted discussing the cases and a death

due to cholera in 2002 with the purpose of showing the case fatality rate was higher in a Muslem province (Lanaodel Sur), than in a Christian procince (Zamboanga del Norte) in all ages.

“Of the 930 cases reported in Lanao del Sur, 388 or 41.7% died as against 191 cases reported in Zamboanga del Norte of which 26 or 13.6% died. On closer study, it was observed that while the relative positions of each age group in terms of CFR (Case Fatality Rate) is the same both provinces it was noted that CFRs in Lanao del Sur were more than twice the values obtained in Zamboangadel Norte.

Page 16: Community and Public Health (Week 2&3)

There are 107 cases and 54 deaths under 10 years in Lanao del Sur with a CFR of 50.5% as against 55 cases and 12 deaths in Zamboangadel Norte, with a CFR% of 21.8%. In the age group 10-24, there were 156 cases and 30 deaths reported in Lanao del Sur with 19.2% CFR while cases and 3 deaths were recorded in Zamboanga del Norte with a CFR of 7.6%. In the last age group of 25 years and over, 667 cases and 304 deaths were recorded for Lanaodel Sur, with a CFR of 45.6% while in Zamboanga del Norte, there were 97 cases and 11 deaths with a CFR of 11.3%.”

Page 17: Community and Public Health (Week 2&3)

Cases and Deaths, Cholera El Tor

Lanao del Sur and Zamboanga del Norte, 2002

Age Group

Lanao del Sur Zamboanga del Norte

Cases Deaths CFR Cases Deaths CFR

under 10 years 107 54 50.5 55 12 21.8

10-24 years 156 30 19.2 39 3 7.6

25 years & over 667 304 45.6 97 11 11.3

Total 930 388 41.7 191 28 13.6

Page 18: Community and Public Health (Week 2&3)

Graphing - The purpose is to convey a simpler idea of what the statistical table contains.

- A statistical graph is either a series of lines joined together, or bars or enclosed areas, drawn to represent certain statistical information under consideration.

- Primary tools for presentation and analysis.

Page 19: Community and Public Health (Week 2&3)

Parts of a Graph1. Title- indicate clearly and briefly what the figures in the body

of the graph stand for, how the data were classified, and where and when obtained. This is placed at the bottom of the graph, preceded by a number for easy reference.

2. Axis- a graph has 2 axes, the vertical and the horizontal. One of the axes is always quantitative scale while the other is either qualitative or quantitative scales.1. X axis- horizontal2. Y axis- vertical

3. Legend- this is needed when one is drawing more than one graph in a graphing space. This clarifies to what particular item each of the graph refers. It is placed either at the bottom of the graph or as close as possible to the figures being identified.

4. Body of the graph- these are the lines, bars or figures drawn within the graphing space.

Page 20: Community and Public Health (Week 2&3)

Types of data commonly represented by graphs

• Frequency distribution- there are two kinds of scales used, the qualitative and the quantitative which may discontinuous variety (counts) or continuous (measurement)

• Trends- numbers (counts) or raters (measurements) plotted over a given time period

• Correlation data- maybe either of the two

Page 21: Community and Public Health (Week 2&3)

Different Types of Graphs

1. Line graph- this is used to graph time series data to depict trends or changes with time with respect to some other variables

2. Histogram- used to graph continuous variables

3. Polygon- used to graph continuous variables

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4. Bar or Stick graph- this is used to graph qualitative variables and discontinuous variables of the quantitative variety.

5. Pictorial Diagram- this is usually in the form of rectangles, squares or circles (pie), used to depict the distribution of a whole, with different segments representing different segments representing different frequencies.

6. Scatter point diagram- this is used to show relationship of simultaneous measurements.

Page 23: Community and Public Health (Week 2&3)

DEMOGRAPHY• Statistical study of human

population• It encompasses the study of the

size, structure and distribution of these populations, and spatial and/or temporal changes in them in response to birth, migration, aging and death.

Page 24: Community and Public Health (Week 2&3)

POPULATION• Population is the study of the

character, number, and distribution of living organisms residing in or migrating through particular places.

• Study of population is closely associated with social and biological sciences and it examines the relative size of a breeding group with respect to the age structure, number of viable offspring, survival rates, and longevity among separate aggregations.

Page 25: Community and Public Health (Week 2&3)

There are three principal uses of population data in health administration, and these are for:

1. The computation of vital and health statistics rates and ratios

2. Setting up coverage of activities

3. Setting up norms for assignment of health facilities, staff and funds

Page 26: Community and Public Health (Week 2&3)

Estimates of population Size1. Continuous Population Registration

– Consist of registering births, deaths, emigration and immigration, making necessary additions and subtractions to the existing population

2. Surveys– Simple way of estimating the number of

population in a smaller area. One ay is to count the number of houses and for every ten houses, conduct a census. Based on the censusedhousehold, estimate the average occupant per house and then multiply this figure by the number of household.

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3. Mathematical Estimates• Arithmetic Increase Method- it is assumed

that the population increases at a constant amount per year. The difference between the last two censuses is taken and then divided by the number of year between them to get the average amount of population increase per year.

• Geometric Increase Method- assume that population increases at a constant rate per year. The principle mathematical operation therefore is the determination of annual rate of population change.