Address 17 : The Epidemiological Transition 1 Overview .


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Changes In Cause Of Death. In spite of the fact that Sweden and France have longer records on the quantities of passings, Britain has the longest record of the reason for death (1838).McKeown evaluated the commitment of distinctive illnesses to the change in future 1848-54 to 1971.
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Slide 1

Address 17 : The Epidemiological Transition (1) Overview CHANGES IN CAUSE OF DEATH POSSIBLE EXPLANATIONS 1. Changes In Host-Agent Relationship 2. Vaccination And Therapy

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Changes In Cause Of Death Although Sweden and France have longer records on the quantities of passings, Britain has the longest record of the reason for death (1838). McKeown evaluated the commitment of various infections to the change in future 1848-54 to 1971. ¾ of all enhancements were specifically because of a lessening in passings from irresistible ailments. Be that as it may, a significant number of the rest of the ¼ were additionally most likely because of decreases in irresistible infections.

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Contributions To Improvements AIRBORNE INFECTIOUS DISEASES 40.3% Tuberculosis 17.5% Bronchitis, pneumonia, influenza 9.9% Scarlet fever, diphtheria 6.2% Measles 2.1% Smallpox 1.6% WATERBORNE/FOODBORNE INFECTIONS 21.4% Cholera, looseness of the bowels, dysentry 10.8% Typhoid (+typhus) 6.0% Non-respiratory tuberculosis 4.6% OTHER INFECTIONS 12.6% Convulsions and teething 8.0% OTHER CAUSES 25.6% Old age 8.7% Prematurity, adolescence, infancy 6.2% Other 8.9%

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Possible Reasons For Improvements Overall around 5/6 of change was likely because of decrease in contaminations. Why did they decrease? McKeown proposed 4 conceivable clarifications: Changes In Host-Agent Relationship Immunization And Therapy Reduced Exposure To Infections Increased Resistance To Infections

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1. Changes In The Host-Agent Relationship Diseases can "spontanously" turn out to be more harmful or less destructive for no undeniable reason. The decrease in passings from red fever might be an illustration. May perhaps have been a consider the decrease of diphtheria. Generally speaking, such changes are most likely just a minor component.

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2. Inoculation And Therapy The late 19 th and 20 th century saw significant advances in the capacity of the therapeutic calling to treat irresistible sicknesses. McKeown proposes the effect of these advances was less essential than is by and large accepted. Diphtheria, polio and smallpox give cases of where medicinal intercessions made an effect.

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Airborne Diseases The confirmation for most airborne illnesses recommend the majority of the change happened before compelling therapeutic treatment: e.g. Tuberculosis Measles Whooping Cough Pneumonia Scarlet Fever

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Water-And Food-Borne Diseases Much similar conclusions apply to water-and sustenance borne illnesses: e.g. Cholera Diarrhoeal ailments Non-repiratory tuberculosis Typhoid

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Other Infections Evidence recommends comparative conclusions for: Typhus Tetanus However, therapeutic science would seem legitimized in asserting credit for lessened passings from: Puerperal fever

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US Evidence McKinley and McKinley announced comparable discoveries for the USA. Medicinal science can guarantee credit for at most 20 for every penny of the expansion in future in the US in the 20 th century. Therapeutic science can guarantee for all intents and purposes no credit for changes in the 19 th century.

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Summary Therapeutic pharmaceutical has assumed a valuable part in the control of irresistible sicknesses, yet it didn\'t generally start until the presentation of sulphonamides and anti-infection agents around 1935. At that point mortality from most diseases had officially tumbled to a little portion of their level in the mid-nineteenth century. McKeown claims that e ven after the presentation of chemotherapy, with the imperative exemption of tuberculosis, it is most likely safe to reason that inoculation and treatment were not the fundamental impacts on the further decay of the demise rate.

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