Epidemiological Methodology and Hygiene

Knowledge and Understanding

The course aims to provide students with a solid scientific and practical foundation and an in-depth understanding of applied epidemiology, health promotion and protection, and the specific prevention of infectious and chronic-degenerative diseases, at both individual and population levels.

By the end of the course, students will be able to understand the principles and methods of epidemiological investigation, the main study designs, measures of frequency, association and impact, the principles of causal inference, and the methodologies used to evaluate the effectiveness of preventive and therapeutic interventions.

Applying Knowledge and Understanding

By the end of the course, students will be able to apply epidemiological investigation methods to design studies, measure determinants of health, investigate cause-and-effect relationships, and evaluate the effectiveness of preventive and therapeutic interventions.

Students will also be able to calculate and interpret the main epidemiological measures and apply the knowledge acquired to address public health issues, including through data analysis and practical case studies.

Laboratory activities will enable students to consolidate their methodological skills through the study and application of specific protocols, with particular emphasis on the processing, analysis, and interpretation of epidemiological data.

Making Judgements

Students will be able to critically interpret the findings of epidemiological studies and scientific literature using an evidence-based approach, identifying the main methodological limitations, potential sources of bias and confounding, and the translational implications of scientific evidence.

These skills will be developed through practical exercises, laboratory activities aimed at fostering the critical evaluation of epidemiological data and analytical results, and critical appraisal of scientific literature.

Communication Skills

Students will be able to clearly and accurately communicate key epidemiological concepts using appropriate scientific terminology, describe and interpret study findings, and discuss their implications for disease prevention and health promotion.

These skills will be developed through classroom interaction, journal club activities, and discussions of the results obtained during laboratory exercises.

Learning Skills

Students will develop the ability to independently expand their knowledge, consult and critically appraise epidemiological scientific literature, and continuously update their competencies through the use of scientific sources and reference documents, including those published in English.

Epidemiological Methodology

Public Health for translating research findings into disease prevention and health promotion interventions and public health policies. Demography and biostatistics in the epidemiological approach. Data sources and methods of data collection. Case definition. Data processing and presentation.

Measuring health events: the importance of the denominator; proportions and rates; measures of frequency (prevalence, cumulative incidence or risk, and incidence rate or incidence density); crude and specific rates; direct and indirect rate standardization. Indicators of population health status: fertility, birth rate, life expectancy, mortality, infant, neonatal and perinatal mortality, case fatality rate, survival rate, and sentinel events.

Sampling: the significance of sample-based studies; sampling methods; introduction to statistical inference.

Investigating cause-and-effect relationships: conceptual foundations of epidemiological study design; pilot studies; planning an epidemiological study; investigation methods; descriptive studies; ecological studies; cross-sectional studies; cohort studies; case-control studies; measures of association.

Risk assessment: risk factors (genetic, environmental and behavioral components). Absolute, relative and attributable risk. Measures of association and cause-and-effect relationships. Causal inference and confounding factors. Measures of population impact. Multiple risk factors and interaction. Bias and confounding in analytical studies; adjusted odds ratios and introduction to multivariable analysis. Interpretation of the results of analytical studies; significance of associations between risk factors and diseases; measures of population impact (attributable risk, attributable fraction, etc.).

Experimental epidemiology: experimental studies; clinical efficacy; experimental study designs (preventive trials, field trials and community trials; clinical trials).

Screening: the concept of secondary prevention; screening models; assessment of test validity for screening purposes: sensitivity, specificity and predictive value. Assessment of the target population for screening. Calculation of the Number Needed to Treat (NNT) and Number Needed to Screen (NNS).

Outbreak investigation: investigation of an epidemic; data analysis methods; epidemic curves. Operational protocols. Outbreak management.

Investigation of clusters of health events: definitions and examples; cluster identification; limitations of health event cluster investigations; data analysis.

Questionnaires in epidemiology: questionnaire development; organization of data for data entry; validation of responses.

Epidemiology of vaccination: historical origins of the scientific foundations of vaccination. Experimental models in vaccinology. Surveillance of vaccination coverage rates. Potential objectives of vaccination programs: protection of at-risk individuals; disease control; elimination; eradication. Assessment of real-world vaccine effectiveness.

Journal club: critical appraisal of recent articles published in the international epidemiological literature.

Applied Epidemiology Laboratory.

Hygiene

Epidemiology and prevention of respiratory tract infections.

Epidemiology and prevention of parenterally and sexually transmitted infections.

Epidemiology and prevention of foodborne infections and zoonoses.

Epidemiology and prevention of emerging and vector-borne infections.

Epidemiology and prevention of vaccine-preventable infections.

Epidemiology and prevention of healthcare-associated infections (HAIs). Surveillance programs and national and European surveillance networks.

Epidemiology and prevention of cardiovascular diseases.

Epidemiology and prevention of diabetes mellitus and obesity.

Epidemiology and prevention of malignant neoplasms.

Preconception and prenatal prevention. Maternal health indicators. Mortality, morbidity and pregnancy loss.

Congenital malformations. Methodological approach: epidemiological study design. Impact of nutrition on the incidence of congenital defects (neural tube defects, spina bifida and orofacial clefts). Down syndrome. Genetic susceptibility. Preventive interventions.

Public Health Genomics. The four phases of translational research. Frameworks for evaluating genetic and genomic tests.

Recommended Textbooks

1. F. Faggiano, F. Donato, F. Barbone. Manuale di Epidemiologia per la Sanità Pubblica. Centro Scientifico Editore.

2. P.L. Lopalco, A.E. Tozzi. Epidemiologia facile. Il Pensiero Scientifico Editore.

3. L. Checcacci, C. Meloni, G. Pellissero. Igiene. Casa Editrice Ambrosiana.

4. S. Barbuti, G.M. Fara, G. Giammanco. Igiene, medicina di comunità e sanità pubblica. EDISES, 2014.

5. W. Ricciardi, S. Boccia. Igiene. Medicina Preventiva. Sanità Pubblica. Terza edizione. Edizioni Idelson-Gnocchi, 2021.

Supplementary and Further Reading Materials

During the course, additional textbooks and documents, primarily in English, will be recommended, including scientific articles, guidelines, and institutional documents, to support further study of the topics covered and critical appraisal of the scientific literature.

The oral examination aims to assess the achievement of the expected learning outcomes, with particular emphasis on knowledge and understanding of the topics covered, the ability to apply acquired knowledge, and the critical interpretation of epidemiological evidence.

The assessment will take into account the relevance and completeness of the answers, analytical and synthesis skills, the ability to establish connections between different topics of the course and provide practical examples, as well as clarity of presentation and appropriate use of scientific terminology.

The highest grade will be awarded to students who demonstrate a thorough command of the subject matter, the ability to integrate and relate acquired knowledge, effective communication skills, mastery of discipline-specific terminology, and independent judgement in interpreting epidemiological problems and scientific evidence.

The assessment of learning outcomes may also be conducted online, should circumstances require it.

To ensure equal opportunities and in compliance with current legislation, students with specific needs may request an individual meeting to arrange appropriate accommodations and/or exemptions, in accordance with the learning objectives and their individual requirements. Students may also contact the CInAP (Centre for Active and Participatory Integration – Services for Students with Disabilities and/or Specific Learning Disorders) representative of their Department (https://www.cinap.unict.it/content/referenti).

Grading Criteria

The final grade will be expressed on a 30-point scale, according to the following criteria:

- Fail (below 18/30): Insufficient knowledge of fundamental topics, difficulties in applying epidemiological concepts, limited analytical skills, and inadequate use of scientific terminology.

- 18–21/30: Basic knowledge of the topics, limited ability to apply acquired knowledge, modest analytical skills and ability to establish connections between topics, and sufficiently clear presentation.

- 22–25/30: Satisfactory knowledge of the topics, ability to apply the main epidemiological concepts and establish connections between them, clear presentation, and reasonably appropriate use of scientific terminology.

- 26–28/30: Good knowledge of the topics, ability to correctly apply acquired knowledge to epidemiological problems, good critical analysis and integration skills, clear presentation, and appropriate use of scientific terminology.

- 29–30/30 with honours: Thorough and comprehensive knowledge of the topics, excellent ability to apply and integrate acquired knowledge, independent judgement in interpreting epidemiological evidence, excellent communication skills, and mastery of scientific terminology. Honours may be awarded to students who demonstrate particularly in-depth knowledge, outstanding critical thinking skills, and an excellent ability to establish connections between different topics.

Cohort studies in epidemiology: description of their main characteristics.

Global cancer epidemiology. Screening programs.

Relative Risk (RR):

a) It is a measure that can only be obtained from experimental studies.

b) It is used to assess the increased risk of disease among individuals exposed to a risk factor compared with those who are not exposed.

c) It is used to assess the prevalence of disease among individuals exposed to a risk factor.

d) It is used to assess the increased risk of disease among non-exposed individuals compared with exposed individuals.

e) None of the above.