Klaus Krickeberg's research while affiliated with Bielefeld University and other places

Publications (37)

Article
Modern epidemiology can boast of a precise definition, clearly formulated basic concepts, and well elaborated methods, all of them described elsewhere in this handbook. These are in principle the same in developing and in developed countries. What is different is the framework, the choice of topics and of applications to be treated given local nece...
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The two previous lessons have shown us the ways in which most data arise in Public Health. The first way passes through systematic recording in registers. There, data are usually measured and recorded for all units of the target population, for example for all consultations in the outpatient ward of the District Hospital of the district of Quynh Ph...
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It is not easy to present the essential features of the descriptive epidemiology of cardiovascular diseases succinctly and clearly. The exposition that follows will necessarily be rather cursory. There are two reasons for that. Firstly, several categories of these diseases exist whose epidemiology is quite different. Secondly, in many countries, in...
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Diarrhoeal diseases display several specific features. Firstly, they may be due to a very large variety of pathogens. Secondly, whilst the clinical diagnosis of the symptom “diarrhoea” is easy and standardized diagnostic decision schemes exist, for the majority of cases in Vietnam there is no laboratory confirmation of such and such agent. The perc...
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Dengue fever shares with malaria two important traits. Firstly, its pathogen is transmitted from man to man by mosquitoes that bite and suck blood. Secondly, no vaccine exists as yet. However, from the point of view of case management there are two essential differences between the two diseases. Dengue is an acute infection; hence, follow-up plays...
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“Hepatitis” means “inflammation of the liver”. Those inflammations caused by a virus present a serious problem to public health. As we have seen in Sect. 4.2, acute viral hepatitis in Vietnam had in 2007 an incidence of 10.62 cases per 100,000 inhabitants. This may not appear very high. In fact, among acute infectious diseases viral hepatitis had a...
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In Sect. 1.5 we have listed the main categories of risk factors. The “classical” factors age, sex, time and place are the subject of purely descriptive epidemiology, which is a century-old area that started with registries of causes of death. The other categories of the list were studied systematically only in a more recent past, and that was the b...
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Sampling from medical records is a classical technique in medical and epidemiologic research. Let us look at a fictitious example. Suppose Dr. Q. wants to find the frequency of a risk factor A among all patients who were treated in a given ward of his hospital during the period 2000–2009. There had been N=9,850 such patients, and for every one of t...
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Many concepts of epidemiology such as incidence or prevalence of a disease, mortality and risk factors have already appeared in previous lessons. Their meaning was sufficiently clear to allow a preliminary discussion of the basic principles of epidemiology, of their role in public health and of the main issues in the epidemiology of infectious dise...
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On the 23rd February 2009, Dao Duy Anh, born on 24 September 1992, consulted the Thaí Bình General Hospital because of bad stomach pains. A physician recorded the anamnesis, examined him, diagnosed an acutely inflamed stomach and wrote prescriptions for amoxiclin, rekalate, smecta and omeprazole. Anh was cured within a few days and no follow-up by...
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We will be using the following definition of an infectious disease, which is short and focuses on the essential: An infectious disease is a disease caused by a microorganism. Sometimes, the term “communicable” is used as a synonym for “infectious” but we will avoid it because there is no general agreement about its meaning.By a microorganism we mea...
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Traditional curricula in Public Health contain courses on “Nutrition and Food Safety” and “Environmental Health”. We will therefore be very brief in this lesson and stress the modern aspects but not dwell on technicalities. In particular we want to show that these two fields are largely based on epidemiological concepts.
Chapter
The purpose of this book was to convey to the reader the fundamental ideas of epidemiology. Obviously, not every essential aspect could be covered but basically all topics in epidemiology are extensions or generalizations of those treated here. We are going to give a short overview of the “missing” topics; they can be found in more advanced texts.
Chapter
Why treating tuberculosis and malaria within the same lesson? After all, they are quite different diseases, one of them being caused by a bacterium and the other one by a parasite (see Sect. 4.1). These pathogens do not attack the same organs. The clinical manifestations and diagnostic methods of the two diseases are not the same. Their dynamics of...
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We have recognized that epidemiology is a subfield of Public Health; the basic theme is always the community. It is, however, not only a subfield; it is more: In the present section, we shall sketch the role of epidemiology in shaping the structure of the health system. In the following sections, we will describe how epidemiology determines the mai...
Chapter
It has been observed for centuries that a patient who survives an episode of certain infectious diseases such as smallpox or measles becomes immune for live against a further infection. For smallpox, the idea therefore arose to infect persons artificially by a “mild” form of the disease. This practice seems to have originated very early in China wh...
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They exist in many countries. The oldest one started operating in Denmark in 1943. The Vietnamese Cancer Registry is being built up gradually from regional registries that now function in Hanoi and Ho Chi Minh-City and in many municipal or provincial hospitals. Before the existence of cancer registries Ministries of Health relied on reported data f...
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Let us go back to Lesson 1 and in particular to Sect. 1.2 and have another look at the Register of Consultations of a Commune Health Station. In order to explain the basic ideas we reproduce below, as Table 11.1, a very simplified version of a page of this register. The columns “Insured or free of charge”, “Profession”, “Ethnicity”, “Place of treat...
Chapter
Cross-sectional studies are related to sample surveys. In both types of studies a sample S is taken from the target population U, for example by one of the sampling plans presented in Sect. 12.2. The basic difference between the two studies resides in their purpose and, consequently, in the way they are being evaluated. As remarked in Sect. 12.4, t...
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Up to now we have almost exclusively dealt with “person-based” studies. By this we mean that both the risk factor and the health outcome are variables that are defined for individual persons. The target population consisted of human beings. Typical factors were age, nicotine consumption, housing standard, a diagnosis and a medical treatment receive...
Chapter
We start by recalling some facts from previous lessons. There, many examples of exposures have appeared such as genetic disposition, smoking, lack of education, poor hygiene, polluted water, crowded housing, malnutrition, use of contaminated needles by drug addicts, and unprotected sex; many more will be treated in later lessons. They all exist ind...
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We have said in Sect. 1.1 that in the twentieth century the term “epidemiology” took a much wider meaning than before when it concerned only infectious diseases. This semantic transition reflected a transition of the “disease spectrum”; non-infectious ailments and injuries played now an increasing role. In Vietnam, we may indeed very well speak of...
Chapter
Many histograms evoke the shape of a bell, for example the histogram of the variable “diastolic blood pressure” in Practical Work 2 of Sect. 13.6. There is a theorem in the theory of probabilities that explains this observation; it is called the “central limit theorem”. As said before, knowledge of probability theory is not assumed here, so we desc...
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Up to now we have been studying the influence of a single factor on the distribution of a disease or on other health-related characteristics. This allowed us to concentrate on the essential ideas. Most diseases are “multi-factorial”, though; many factors exert their influence together. In this course we will not deal with general methods that have...
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The disease called AIDS (Acquired Immunodeficiency Syndrome) results from an infection with either of two retroviruses, HIV-1 or HIV-2 where HIV stands for “Human Immunodeficiency Virus”. The first one is by far more frequent and has caused a pandemic. For simplicity, we will restrict ourselves to looking at the epidemiology of this infection only,...
Chapter
Epidemiologic studies need to be carefully planned beforehand. This is true for any kind of study, be it a simple sample survey, a study of one of the types defined in Lesson 15, or a community study. The plan for the study, which is also called the “study protocol”, must cover all its aspects and stages. A classical mistake that is still being mad...
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A consultation in a Commune Health Station generally runs like this: Sometimes there will be a follow-up or a transfer to another medical service. This process is reflected by the layout of the Register of Consultations; see Sect. 11.1. It is the basic form of case-management. Normally the diagnosis is purely clinical and the resulting treatment is...
Chapter
A cohort study operates with several independent samples, one for each combination of levels of the exposure variables. Again we will restrict ourselves to the simplest situation where we have only one binary exposure variable that differentiates between “exposed” (1) and “non-exposed” (0) and one binary outcome variable with the values “diseased”...
Article
This book is meant for adoption in first courses on epidemiology in Medical Schools and Faculties of Public Health in developing and transition countries and in workshops in these countries, taught for example by members of international organizations. It is also suitable for parallel or second reading within curricula in developed countries and fo...
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Until now we have mainly treated cohort studies. This was true for analytic studies conducted by following up certain cohorts in order to investigate the influence of a risk factor on health. It was equally true for clinical trials. It also holds for the estimation of the predictive values of a diagnostic test where we start from two “cohorts”, nam...
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Full-text available
Among risk factors for infectious diseases, social ones present a particular challenge due to the increasing importance of old and new infections on the one hand, and the complexity of social reality on the other. This is not a new phenomenon.
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Not every topic admits a precise definition but ours does: Epidemiologic surveillance is the collection, transfer, analysis, and interpretation of information related to cases of diseases, which is done systematically and routinely.
Article
The setting of this article is an all-embracing Health Information System (HIS)* of the type that exists mainly in developing and transition countries. It was inspired by work in Vietnam and other places. The article discusses the basic principles on which a well-functioning HIS needs to rest regardless of the technical means employed (paper, elect...
Chapter
Full-text available
Various disciplines contribute to the investigation of determinants of human health and disease, to the improvement of health care, and to the prevention of illness. These contributing disciplines stem from three major scientific areas, first from basic biomedical sciences such as biology, physiology, biochemistry, molecular genetics, and pathology...
Chapter
Modern epidemiology can boast of a precise definition, clearly formulated basic concepts, and well elaborated methods, all of them described elsewhere in this handbook. These are in principle the same in developing and in developed countries. What is different is the framework, the choice of topics and of applications to be treated given local nece...
Chapter
Various disciplines contribute to the investigation of determinants of human health and disease, to the improvement of health care, and to the prevention of illness. These contributing disciplines stem from three major scientific areas, first from basic biomedical sciences such as biology, physiology, biochemistry, molecular genetics, and pathology...

Citations

... Moreover, epidemiology is multidisciplinary in nature: it includes unifying and organizing frameworks for conceptualizing, modeling, and explaining variability, as well as facilitating causal analysis and understanding (Ahrens, Krickeberg, & Pigeot, 2005) and generating plausible hypotheses (Stroup, Goodman, Cordell, & Scheaffer, 2004). Such models operate as intuitive theories, which Tenenbaum, Griffiths, & Kemp (2006, p. 309) define as: ...
... This was a comparative cross-sectional study design which compared mean serum zinc levels of 15 preeclamptic and non-preeclamptic pregnant women. The study was conducted at the Maternity Clinic of the University Teaching Hospital (UTH). ...
... Reliable estimates of the populations affected by inherited diseases have become increasingly important to guide efficient allocation of public health resources in each country, region, and city [7, 9, 10]. The lack of epidemiologic studies of inherited disorders is particularly true for developing countries with limited resources [11][12][13]. Most epidemiologic researches have been conducted with individuals from Europe and North America, who represent only a fraction of the global population [11, 12]. ...
... Proposed Study 2: Multi-location Cohort Study Long-term health and longevity studies can be designed (e.g., cohort) or observational (e.g., retroactive study). The six-community study previously described is similar to a retroactive epidemiological study on human health (Ahrens et al. 2014). In addition to epidemiology, medical researchers and public policy analysts (mindful of many of the issues noted here) sometimes design and conduct long-term cohort studies to test the impacts of various treatments, behaviors , or external factors on a group of subjects over time. ...
... Heeks discusses how the 'bottom billion' of the world's population can be socially, politically, economically and psychologically excluded and that ICTs can assist in decreasing this exclusion [14]. However despite the proliferation of different community based information systems the majority of routine national HIS have data from the health facilities as the lowest level of data collected [15,16]. Consequently, data is not captured on those not accessing formal health services. ...