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

Kalore, Markos Gurmamo (2017) Ethiopia Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology. Masters thesis, Addis Ababa University.

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Abstract

The Ethiopian Field Epidemiology training program started in 2009. Field Epidemiology and Laboratory Training Program is an in-service training program in field epidemiology adapted from United States Center for Disease Control and prevention (CDC) Epidemic Intelligence Service (EIS) program. The EFETP has two main components, each of which contributes the award of the Master degree (a class-room teaching component and practical attachment or field placement component. During the field placement component I was engaged on Outbreak investigation, Surveillance Data Analysis, Surveillance system evaluation, District health profile development, participating in Disaster situation visiting including flood disaster, conflict Situation and Belg Assessment. The rest others are Project proposal development, Abstract writing for scientific conference, Peer review journal writing, Preparing Oral presentation in scientific conference, giving refreshment training for Zone and Woreda level PHEM officers and Trainings on Scabies out break Management and AWD outbreak management for Zonal PHEM Officers. By accomplishing these, I produced outputs that compiled in this Body of Work. Outbreak investigation I-1: Malaria disease Outbreak investigation in Le-Zembara Kebele, Tembaro Woreda, Kembata Tembaro Zone, SNNPR, Ethiopia, in January 2016. In this malaria out break investigation we found as a result a total of 659 confirmed malaria cases (Attack Rate: 106 per 1000) and zero death were reported from January to February 2016 with the peak in February. Slide positivity rate was 77.8 %. Above 4 years age group were more affected by malaria (Age specific attack rate of per population was 121). Using bed net every night was preventive effect for the disease (Odds Ratio: 0.6, 95%CI, and 0.7-1.4). Presence of stagnant water (Odds Ratio: 6.2, 95%CI 1.5-24.8). Outbreak investigation I-2:- Scabies disease outbreak investigation in Kacha Bira woreda, Kembata Tembaro Zone, SNNPR, Ethiopia, November 2016. We collected a total of 517 scabies suspected cases line list from 3 Kebeles with overall attack rate of 2.8/1,000 population with no scabies related death (CFR=0). Out of 517 total cases, 253(49%) of them were males and 263(51%) were females. The mean age was 12 year with which ranges from 1year to 65 years and most affected age group was 5-14 years with an attack rate of 1.6/1,000 populations. Majority of the cases were reported from Doreba kebele. On Multivariate analysis, contact history with scabies cases in past 2 months ,being age-group less than fifteen years were riskfactor for developing the scabies infestation and statistically significant with an AOR of 146 [95%CI=54.3-396.6 P= < 0.0001] and 2.355 [95%CI=1.36-4.03, P<0.0001] respectively. Surveillance Data Analysis Report II: Five years (2004-2008) Zonal data of Severe Acute Malnutrition in Kembata Tembaro Zone data was analyzed. In the zone a total of 18, 175 total admissions of Severe Acute Malnutrition (SAM) cases were reported at Outpatient Therapeutic Program (OTP) and Stabilization Center (SC) in the last analyzed consecutive five years (2004 - 2008 E.C). Children 6-59 months of age constituted almost all % of new admissions. Admissions from severe acute malnutrition were decreased from 2004 to 2008 E.C, but for the last consecutive 4 years it was increasing. The total highest is in 2004 EC but constantly increasing from 2005-2008 EC. From the past consecutive five-year's report of SAM in the Zone 32 deaths with a fatality rate of 0.18 to 0.42% were reported. Evaluation of surveillance system III: The completeness of the selected Health posts was 86%, health centers were 95.6% and selected woredas and Zone had 100% in 2016. The timeliness was difficult to know at health facility level due to absence of time of report. 5(28%) HEW in the health post did not get any training. 28 (100%) of respondents were accepted the surveillance system and its data was helpful to detect cases early. Written epidemic preparedness and response plan was only at two woreda offices and at zonal level. The case definition was not available in some health post visited; this may lead to low detection of malaria, measles and AWD from the community. During the analyzed period, there was no outbreak of malaria, AWD, and measles in the evaluated kebeles and woreda. Scientific manuscript journal IV: Scientific journals prepared to communicate findings or present new ideas that help improve the health, safety and well being of the population. As a result a peer review journal was prepared on a disease entitled “Malaria disease Outbreak investigation in Le-Zembara Kebele, Tembaro Woreda, Kembata Tembaro Zone, SNNPR, Ethiopia, in January 2016". Abstracts for scientific Presentation V: Three abstracts were prepared. The three abstracts are " Scabies disease outbreak investigation in Kacha Bira woreda, Kembata Tembaro Zone, SNNPR, Ethiopia, November 2016", “Malaria disease Outbreak investigation in Le-Zembara Kebele, Tembaro Woreda, Kembata Tembaro Zone, SNNPR, Ethiopia, in January 2016” and “Surveillance Data analysis of five years (2004 -2008 EC) on Severe Acute Malnutrition (SAM) in zone of KT, SNNPR, Ethiopia.Disaster situation visited VI: I was participated in Belg Assessment in June 2016 at South Omo Zone and Segen area People’s Zone and 7 selected Woredas of the above Mentioned zones the assessment conducted mainly on health and nutrition disaster assessment and response. On the Belg Assessment some emergency decisions discussed with the regional concerned bureaus after field feedback and remedial actions taken based on it. And I also participated in Flood disaster situation need assessment and emergency response team member on in Halaba Special Woreda on May 2016. Because of flood disaster from Halaba special woreda of 36 flood affected kebeles, 13 deaths, 13,318 populations displaced from 2,673 Households. Based on the field disaster visited on site communications to the region, actions taken like emergency food supply, shelter management on refuges, road re-designing during flood time, evacuating the people from flooded sites to normal sites, temporary clinics for refuges arranged, potential health risks identified and planned for action. Besides to this I participated in Conflict Situation need assessment and management in Gedeo Zone, on October 2016. During this conflict disaster time from the Gedio Zone, 23 people died, 180 people injured, 14,787 people displaced from 3,241 Households. Temporary clinics at different prison sites and refuge sites established, prison hygiene and class adequacy for prisoners commented and corrected, re-putting on of the health system functionality supported by our team members. Proposal development for research VII: Double burden of communicable and non communicable chronic disease like hypertension are undergoing epidemiological transition worldwide. The problem is of special concern in sub Saharan Africa due to this double burden of disease and transition to a more Western lifestyle. Ethiopia is one of the Sub-Saharan Africa which shares the problem that needs intervention. The aim of this study is to assess prevalence and factors associated with hypertension among adults, Halaba Kulito Town residents, Southern Ethiopia, 2016. A community based cross sectional study will be conducted. The study will include 422 adults (age >30) residing in mentioned area. Data on risk factors will be collected by interview method using Questionnaire adapted from WHO STEP wise approach to Surveillance on non communicable disease. In-addition measurements on Blood pressure, height and weight will be taken by using standard mercury sphygmomanometer, tape meter and digital balance respectively. The data will be entered into SPSS or EPI-Info 7.1 & analyzed. Other additional outputs VIII: In the residency time additional outputs done were Conflict situation need assessment in Gedeo Zone on October 2016. It is mentioned above but counted asother outputs in this document. Besides to this we provided refresher training for Zonal and Woreda level PHERM officers on EPRP, AWD outbreak management in CTC sites and Scabies outbreak management in community level. Besides to these, I gave the training on Severe Acute Malnutrition Management in stabilization (SC) sites and OTP sites which is modular training for Zonal and Woreda and Health facility Health Workers in year 2016 and 2017.

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:	24 Oct 2018 07:41
Last Modified:	24 Oct 2018 07:41
URI:	http://thesisbank.jhia.ac.ke/id/eprint/7007

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