Epidemiology constitutes Descriptive, Analytical, and Interventional studies. One obtains knowledge in specific aspects on studying these aspects, defining a relationship between the disease outbreak, cause, and intervention.
Descriptive studies give information about the distribution of the disease under study, its occurrence, and pervasiveness. That is, it aims at describing the disease.
Analytical studies include analyzing the cause of chronic or infectious diseases and their associated risk factors or complications.
Interventional epidemiology studies the effectiveness of the approaches undertaken to control and prevent the disease.
The epidemiologic triad
The epidemiologic triad or epi-triad aims at establishing a relationship between the cause, occurrence, distribution, and effects of the disease on the host. Epidemiologists used the triad, traditionally, to analyze infectious diseases alone. Nevertheless, of late, they have expanded it to non-infectious chronic disorders and accidents, as well. The epi-triad takes three aspects into consideration- the agent, host, and the environment and studies the interaction between them. These three constituents, as shown in the diagram, are placed at the vertices of the triangle.
The first component or the agent is a disease-causing pathogen. It can either be a virus, or microbes like bacteria, fungi, protozoa, or helminths, which can cause several diseases. They can either be parasitic or non-parasitic. However, to expand the definition of host beyond infectious diseases, agents also include certain physical and chemicals factors. These may be asbestos, heavy metals, cigarette smoke, and others that cause non-infectious, chronic disorders.
The second component, or the host, refers to a human who has contracted a particular infection. However, the person might not develop disease even on contracting the pathogen. Infected hosts can be either non-permissive or dead-end, reservoir host and amplifying host. A reservoir host carries the infectious organism for long periods without manifesting any symptoms, whereas the amplifying hosts allow the pathogen to multiply within it. When the host does not permit either, it is called a non-permissive host. However, the severity of infectious disease and its prognosis depends on the host’s age, sex, comorbidities, genetic abnormalities, or any predisposition to other chronic disorders.
The environment is the third component that consists of all the factors external to the host. It includes physical factors like geographical location, climate, and socio-economic factors like sanitation conditions, resources and healthcare facilities, and others.
The fourth component, called a vector, is incorporated either as a part of the host or individually as a vector-borne disease. In such a case, controlling the multiplication of vectors can stop the disease outbreak because the chain of infection in vector-borne diseases largely depends on the availability of vectors.
Types of epidemiological studies
Epidemiological studies are of 4 types, namely, cross-sectional, case-control, cohort, and interventional studies. Of these, the application of cross-sectional and case-control studies is more widespread.
Cross-sectional studies analyze the conditions prevailing in a population at a particular period. Either the epidemiologist subjects the entire population under study or considers a group of individuals representing a population. For instance, Coggon et al. established vitamin status as a causal factor in cataracts through cross-sectional studies.
Case-control studies find a relationship between cases and control groups. The former is a term for addressing people’s symptoms of a particular disease, whereas the latter consists of people not exhibiting any conditions related to it. A thorough comparison between the two groups helps to determine the causal factor of the disease. For instance, Herbst and Scully reported an unusual cancer development in a group of adolescent girls through case-control studies. They concluded that the mothers who underwent hormone therapy during pregnancy gave birth to girls having a predisposition to cancer.
Cohort studies check for a relationship between the development of a particular disease in a population and the people’s behavior under study. For instance, such a study shows smokers are more prone to lung cancer than non-smokers.
Intervention studies include observational analysis on a particular population followed by random sampling into two separate groups. One of the groups acts as a control while the scientists intervene with the other. For instance, during drug trials, the drug is administered to only one out of the two groups.
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