Ethiopia Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology

Debele, Getachew Demissie (2017) Ethiopia Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology. Masters thesis, Addis Ababa University.

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The Ethiopian government policy emphasis on prevention measures of communicable and noncommunicable diseases. In addition, many strategies and programs were set to enhance disease prevention activities. Ethiopian Field Epidemiology Training Program that adopted from the United States Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Service (EIS) is one of the programs focusing on capacity building of public health practitioners. The training enables trainers to conduct disease surveillance and implement prevention and control measures of prioritized diseases. I stayed from October 2015 to May 2017 in Addis Ababa University School of Public HealthField Epidemiology Training Program and at Oromia Regional Health Bureau Field Base. During my stay, I carried out two outbreak investigations, one surveillance data analysis, one surveillance system evaluation, one district health profile description, submission of three abstracts, one scientific manuscript for peer reviewed journals, one Meher assessment, one epidemiological research proposal, and two weekly epidemiologic bulletin for residency outputs. Even though I included only two weekly bulletins in this document, I produced totally 7 weekly bulletins during stay at field base. We investigated two outbreaks (Human Cutanous Anthrax and Influenza Like illness (H1N1) during field base residency. Descriptive and analytical epidemiology methods used to describe magnitude of the diseases and identify risk factors associated with diseases. Ten (10) cases of Influenza Like illness (H1N1) reported from Sire woreda of Arsi Zone, Oromia Region in 2016. We identified that low Livestock vaccination, low surveillance system activities (not timely reported), and shortage of emergency drugs supply, were contributed for anthrax outbreak in the woreda. We recommended routine vaccination of livestock in the area , Coordinated effort of both Health and livestock Development Offices at the Zone and Woreda should strength the surveillance system and conduct active surveillance regularly, Regional Livestock Development Office should access the vaccines support with supplies to such vulnerable areas. Additionally, there was Influenza Like illness (H1N1) outbreaks in Robe Woreda, Arsi zone, Oromiya Region that we had investigate in February 2016. During this outbreak, 16 H1N1 cases and no deaths reported. Overcrowding, poor ventilation, and weak awareness of prison’s community attributed for Influenza Like illness (H1N1) in this Prison. We recommended that the H1N1 vaccine should have been provided to the community in accordance with Government distributions guidelines, and increase prison’s community awareness on H1N1 prevention and control measures. Surveillance data analysis of Severe Acute Malnutrition (SAM) for consecutive three years (2005 – 2007 E.C) conducted in Arsi Zone of Oromia Region. The cases decreased throughout the first two years, and increased at 2007 with decreasing death rate. We identified that strong screening and case management contributed for increased number of cases and declining deaths respectively. We conducted surveillance system evaluation at Bale Zone of Oromia Region, (highlight) and in 2017. During this evaluation, surveillance of selected diseases (malaria and measles) assessed. The surveillance system activities at Zonal, Woreda and Health facility level were low. Poor data management, infrequent supportive supervision, absence of well-organized feedback, poor utilization of manuals and guidelines contributed for unsatisfactory of the system. Health profile description carried in Akaki Woreda, Special Zone Surrounding Finfinne, and Oromia Region from February to March 2016. Low community awareness and less number of Health Centers were the contributing factors for low coverage. Enrolment of female students increased in primary school during 2015/16. We prepared scientific manuscript for peer reviewed journals on Human Cutanous Anthrax and Influenza Like illness (H1N1) outbreak investigation and response in Sire Woreda, and Robe Woreda Prison, Arsi Zone, Oromia Region. Two abstracts were done for scientific conference submission; Human Coetaneous Anthrax Outbreak Investigation in Sire Woreda of Arsi Zone and Surveillance Data Analysis of Severe Acute Malnutrition and Response in Arsi Zone, Oromia Region. Meher assessment was conducted in selected woredas of Arsi and Bale zones in Oromia Region during 2016 to identify humanitarian needs following emergency occurrence. Malnutrition anticipated being a major public health concern in Bale zone. There were measles outbreak in Bale Zone and AWD outbreaks in some districts of Arsi and Bale zones. We identified shortage of drugs and medical equipment at both zonal level and many districts of these zones.Epidemiological research project proposal on assessment of Factors Affecting Utilization of Latrine, Berbere Woreda, Bale Zone, Oromia Region, was prepared. Unmatched case control study will be employed for this study. Cases will be those household, which have latrine but not using it yet, or households, which do not have latrine. Controls will be model households currently using latrine. One to two ratios of cases and controls will be selected. A total of 840- study subjects will be selected from rural kebeles, while the rest 44-study subjects will be selected from suburban kebeles. Knowledge of residents of selected kebeles socio demographic characteristics of the respondent, latrine condition, culture barriers against utilization of latrine and issues concerning the role of utilization of latrine in acute watery diarrhea transmission will be assessed using questionnaire adopted from different similar studies. The overall activities of study will be expected to finish in two months (June - July 2017). The total estimated budget required for the study is 89,200.00 ETH Birr. I Conducted Report of AWD Rapid Assessment from February 10/2017 to April 9/2017 of Berbere woreda of Bale Zone, Oromia Region. The numbers of AWD by sex were Male 224(51.4%) and Females 212(48.6%) respectively. Male cases were higher than Female cases in the Woreda. The majority of cases were children of age under 15 years and adults of age above 35 years. Sixteen (16) kebeles were affected by AWD. High number of cases were admitted from Hambela kebele of Berbere Woreda which accounts 189(43.3%), followed by Haro Nanno 43(10%), and Gebe 36(8.3%) kebeles respectively. I prepared seven weekly bulletins on PHEM report of Oromia Regional Health Bureau for WHO Epidemiologic week 25, 37, of 2016 and week 3, 4,5,18 and 19 of 2017. However, I included only two (week 25 of 2016 and week 3 of 2017) in this output. The health facilities report completeness for week 25 of 2016 was 92% and for week 3 of 2017 was 90% above the expected national level (80%). Suspected measles cases and confirmed malaria cases were increasing during week 25 of 2016, both confirmed malaria, and suspected cases of measles were decreasing.

Item Type: Thesis (Masters)
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Africana
Depositing User: Emmanuel Ndorimana
Date Deposited: 29 Jun 2018 07:46
Last Modified: 29 Jun 2018 07:46

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