The training of doctors in epidemiology is carried out at all faculties of higher medical educational institutions, but it varies significantly in content. The study of epidemiology helps future medical practitioners and pediatricians to acquire the skills of population thinking, knowledge of the principles of organizing and conducting epidemiological studies, which serve to obtain the evidence-based data in medicine. In addition, knowledge of the basics of epidemiology is necessary to perform certain preventive functions in medical institutions.
Epidemiology belongs to the rapidly developing disciplines, although the origins of epidemiology as a science go back to ancient times. In recent years, the ideas about its structure and content have undergone significant changes. Globalization and integration processes in science in recent years have determined a qualitatively new level of development of epidemiology and the expansion of its borders. Currently, epidemiology is considered as a fundamental medical science related to the field of preventive medicine. Epidemiology of infectious and non-infectious diseases represents two sections of a single science. They are identical in essence, have a common subject of study — morbidity (population level of pathology organization), a single scientific method (epidemiological) and a common goal — prevention of morbidity.
The modern period is characterized by the further development of the epidemiology of infectious diseases. It faces many unsolved tasks, the list of which increases both due to the classical diseases that have changed clinical and epidemiological manifestations, and new infections that have recently been discovered. In this regard the new coronavirus infection COVID-19 has to be mentioned, which has now become a pandemic. It is necessary to note a significant evolution of scientific views of the problem of global elimination of infections. In the 1950s and 1960s, the task of the World Health Organization (WHO) was to eliminate a wide list of diseases, but modern ideas on the patterns of the epidemic process, the ecology of pathogens, interactions of macro- and micro-organisms indicate not only the impossibility, but also the inexpediency of elimination of a large number of infections. Currently, the aim is to reduce the incidence of vaccine-controlled infections to a sporadic level, and only some of them must be eliminated if there are certain prerequisites.
At present, it is extremely important to establish the laws of the occurrence and development of mass non-infectious (oncological, endocrine, cardiovascular, psychiatric, etc.) diseases. At the same time, the epidemiology of most non-infectious diseases is mainly descriptive, while their causes and pathogenesis have not been sufficiently studied. Only for some groups of diseases, in particular cardiovascular diseases, general hypotheses have been proposed that explain the causes and mechanism of their spread, and some preventive programs have been developed.
In recent years, the widespread use of epidemiological methods has led to the formation of the so-called clinical epidemiology aimed at improving the therapeutic and diagnostic process. The methodological basis of clinical epidemiology and evidence-based medicine is epidemiological research. Only epidemiological research can provide reliable, verified information for decision-making in clinical and preventive medicine. The formation of a system of public health centers emphasizes the importance of training the specialists who know the basics of epidemiological diagnostics and prevention of a wide range of human pathologies. The main objectives of the currently existing health care system are to protect, strengthen and restore the health of the population, taking into account the factors affecting it.
This textbook examines the issues of the formation and development of epidemiology as a fundamental medical science, the main principles of general epidemiology, epidemiology and prevention of common infectious and non-infectious human diseases. This textbook is also focused on epidemiological diagnostics and methods of epidemiological investigations. Modern ideas about epidemiology, surveillance and prevention of diseases are presented with an emphasis on the pathologies that are most relevant for Russian healthcare due to their high prevalence, social and economic significance, and the tendency to deterioration of the epidemic situation. When preparing the textbook, we used our own materials, literature data, official regulatory and legislative and methodological documents (orders of the Ministry of Health of the Russian Federation and Rospotrebnadzor, methodological recommendations and instructions, WHO materials).
The authors will gratefully accept all comments and suggestions aimed at further improving the textbook.
As a result of studying the discipline, the student should know:
- the history of epidemiology, the main stages of the formation of epidemiology as a science;
- the subject of epidemiology;
- the types of epidemiological studies and their purpose;
- design and fundamentals of the organization of epidemiological studies;
- proof system and evidence-based approach in making informed decisions on preventive and curative measures;
- legal and ethical aspects of epidemiological investigations;
- the study of the epidemic process;
- preventive and anti-epidemic measures and organization of the anti-epidemic work;
- epidemiology and prevention of infections associated with the provision of medical care;
- epidemiology and prevention of the most common infectious diseases;
- epidemiology and prevention of the most common non-infectious diseases.