A look at the work of the National Institute of Epidemiology, Chennai.
A layman may take epidemiology as the study of how common diseases are, who gets them, and why some people get them but others do not. More precisely, it is a branch of medical science that deals with the incidence, distribution and control of disease in a population. Epidemiology studies the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems.
There are different ways for epidemiological investigations. Surveillance can be used to study distribution. Analytical studies handle determinants. In a vast country like India with limited health facilities, epidemiology has a major role to play. It develops the health profile of the population through specific data collection. It is a helpful tool in developing priority areas in health care.
One method of identifying priority areas is the study of mortality rates, which reflect the number of deaths in a population by a particular cause in a given duration. Fine health care will increase life expectancy; but it will cause an aging population thereby shifting priority to old-age care and geriatrics.
There is ample scope for research in epidemiology in India, since reliable data are not available in respect of the incidence of different diseases. Visual disability is a case in point. Information from patients coming to our hospitals cannot substitute population-based studies. In the case of visual disabilities, studies cannot be done by ophthalmologists alone. The studies will need the services of epidemiologists, biostatisticians, sociologists, anthropologists and economists. This reveals the spread of research in epidemiology.
To implement an effective public health policy, several disciplines such as epidemiology, medical sciences, social sciences, economics and ethics will have to join hands.
There is a committed institution that focusses on epidemiology, under the control of the Indian Council of Medical Research (ICMR): the National Institute of Epidemiology (NIE), Ayapakkam, near Ambattur, Chennai – 600 077; Website: www.nie.gov.in.
The NIE was established in 1999 by merging the Central JALMA Institute for Leprosy (CJIL Field Unit), Avadi, with the Institute for Research in Medical Statistics, Chennai. The institute covers development of human resources in epidemiology and biostatistics, networking of the various ICMR and non-ICMR institutes at the national level for epidemiological purposes, and consultancy. It is a World Health Organisation (WHO) collaborating centre for leprosy research and epidemiology and a technical resource group for epidemiology of HIV, approved by the National AIDS Control Organisation. It carries out research activities including interventional studies, disease modelling, health systems research, evaluation of health schemes and disease control programmes, issues of statistical methodology, epidemiological investigations, and clinical trials of traditional remedies.
The institute is recognised by the Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, for a two-year Master’s programme in Epidemiology. The University of Madras has recognised the NIE for research leading to Ph.D. in the areas of Epidemiology and Biostatistics.
The institute functions as a catalyst for a vibrant national health system through responsive research, education and training in epidemiology and public health. The NIE is an instrument for enhancing the quality of life of our citizens. It influences public health practice and policies.
The NIE has a multi-pronged approach in its working. It works with national and international partners in health research and uses innovative state-of-the-art technologies. The institute aligns its research with key stakeholders to generate and implement strategies for an effective and efficient national health system. It helps in setting standards in public health education. Most important, the NIE strengthens human resources for national public health services through education and training, as also by building bridges between educational and research institutions. It coordinates work in the Department of Health Research and ICMR multi-centric studies.
The work in the institute is divided into different divisions such as Epidemiology, Biostatistics, Training, Health Systems Research and Bio-ethics, and Social and Behavioural Sciences.
Let us have a quick look at some of the completed and ongoing research programmes, which offers an indication of the nature of work handled.
Prevalence of cardiovascular disease risk factors in industrial workers.
Prevalence of HIV and other sexually transmitted infections and associated risk factors among wives of truck drivers.
Epidemiological profile of dengue and chikungunya.
Monitoring compliance with the tobacco-free law.
Hospital-based sentinel surveillance for bacterial meningitis.
Social acceptance of leprosy and leprosy patients.
The NIE has collaboration with a number of international and national institutions of repute. Some of these are the WHO, UNICEF, the Food and Agricultural Organisation, the International AIDS Vaccine Initiative, Boston University, and Bill and Melinda Gates Foundation.