Mekonnen, Mikiyas (2016) Ethiopian Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology. Masters thesis, Addis Ababa University.
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Abstract
This document contains two years Field Epidemiology Training Program outputs, to be submitted to school of public health for fulfillment of Masters Degree in Field Epidemiology. This Compiled Body of Work has eight chapters and eight annexes. Reports of diseases outbreak investigations, public health surveillance data analysis, surveillance system evaluation, narrative summary of disaster situation report, manuscript and abstracts presented in eight chapters. Chapter One: This chapter contains findings of two outbreak investigations. The first outbreak investigation was conducted on an outbreak of psychogenic disorder in primary school of Sululta district, Oromia Regional State. The objective of the investigation was to verify the outbreak and asses the distribution and risk factors of the outbreak to implement control measures. We used a descriptive analysis of the line list followed by a sex matched case-control study; we identified 183 case of psychogenic disorder (conversion disorder) with female dominance (62%). The outbreak was controlled mainly by giving health education to students, teachers and families of cases. We recommend provision of health education to community of the locality on psychogenic disorders. On a bigger scale, we recommend primary schools in the country to have a school Psychologist to help on overall psychological problems of students including in a possible incidences of mass psychogenic disorders. The second outbreak investigation was on Measles outbreak in Telalake district of Afar. We used a descriptive analysis of the line list followed by a sex matched case-control study; we identified 21 cases of Measles (the first five cases were lab confirmed). Eighty-one percent of the cases were not vaccinated for measles. The outbreak was controlled by providing mass vaccination and health education activities. We recommend strengthening health education and routine and catch up immunization programs activities by the district health office to prevent similar outbreaks. Chapter Two: Presents report of surveillance data analysis conducted on maternal death. We retrospectively analyzed national surveillance report collected from October 2013 to September 2015 to describe the distribution and determinate of maternal death in Ethiopia. The summary of the findings has shown that the overall maternal mortality ratio is 28.9 per 100,000 live birth with big disparity among regions the maximum being at Dire Dawa 94 deaths per 100,00 livebirth and the minimum being at addis Ababa 2.7 deaths per 100,000 live births. The top three causes of maternal deaths found to be hemorrhage followed by sepsis and hypertensive disease of pregnancy. We recommend much focus should be given to the top three common causes of maternal deaths (hemorrhage, sepsis and hypertensive disease of pregnancy) to reduce and improve maternal outcomes. The number of reported maternal mortality is far below the local and international estimates, which needs an evaluation of the overall maternal mortality surveillance system (based on this result, we conducted evaluation of MDSR system in Tigray region which presented in the next chapter). Chapter Three: Addresses surveillance system evaluation conducted on “Maternal Death Surveillance and Response System in Tigray Region, North Ethiopia”. This chapter aims to answer the systemic reasons of the major gaps identified from the data analysis of maternal death surveillance presented at chapter two of this document. The chapter clearly presents the purpose and objectives of maternal death surveillance its progress towards its objectives. The proposal of this study was sent to Training in Epidemiology and Public Health Intervention Network (TEPHINET)) for a mini grant and it was accepted and funded to be conducted. The surveillance attributes: simplicity, flexibility, acceptability, representativeness, timeliness, data quality, sensitivity, cost, predictive value positive and usefulness of the surveillance system were also assessed and presented in the chapter. The findings indicated that, that the implementation process of the surveillance system at facility level is not uniform in terms of reporting system and formats utilized. The simplicity (scored 3.6 out of 5), acceptability (scored 3.2 out of 5), timeliness (scored 3.64 out of 5) and the usefulness to identify cause of death (scored 3.3 out of 5) are major attributes of the surveillance system, which identified as areas demanding improvement. The Federal Public Health Emergency Management Unit (PHEM) and Tigray Health Office, should give a clear guidance on data collection, case definition, reporting system and response process to health facilities and health extension workers. Chapter Four: Describes assessment of Health Profile Description of Kirkose Sub city, Addis Ababa City Administration. In the chapter health and health related data of the sub city populations were evidently presented which is helpful for prioritizing high-flying problems andimplement strategies against the major public health problems of the sub city. The findings showed that lower performance was observed on overall vaccination coverage and implementation of PMTCT services. A detail action plan showing identified problems and with proposed interventions was developed and submitted to the Sub city health office (it is also annexed in this document). Chapter Five: Presents Scientific Manuscript for Peer reviewed Journals. The manuscript was prepared according to BMC manuscript guidelines. The manuscripts are on “Outbreak of Psychogenic Disorder in Primary School Students of Central Ethiopia”, “Investigation of Measles Outbreak in Remote District of Eastern Ethiopia” and “Estimating the Magnitude and Causes of Maternal Death in Ethiopia: Using Maternal Death Surveillance Report”. Chapter Six: Presents Abstracts on “Outbreak of Psychogenic Disorder in Primary School Students of Central Ethiopia”, “Investigation of Measles Outbreak in Remote District of Eastern Ethiopia”, “Estimating the Magnitude and Causes of Maternal Death in Ethiopia: Using Maternal Death Surveillance Report and “Evaluation of Maternal Death Surveillance and Response System in Tigray Region, North Ethiopia”. Chapter Seven: includes the narrative disaster situation report. As part of early warning and vulnerability assessment, the government of Ethiopia has been conducting nationwide human health and nutrition emergency need assessment twice a year in collaboration with different government sectors and development partners. The assessment was conducted to identify potential problems, which need humanitarian assistance. Based on the report from the assessment humanitarian requirement document was developed and shared with potential partners for response. This chapter clearly presents pre harvest (Belege scission) human health and nutrition need assessment conducted in selected districts of Hadiya and Kembata Tembaro Zones of SNNP Region. The assessment showed that the assessed areas have a risk of seasonal malaria outbreak and both mild and severe malnutrition is increasing sharply which needs a multisectoral intervention.Chapter Eight: Contain an epidemiological protocol entitled “Prevalence of Common Mental Disorders and Substance Use Among Taxi drivers of Addis Ababa and Relation with Road Traffic Incidences”. This project bases from my personal observation and it is not conducted in Ethiopian set up. This study focuses on assessing the safety of public transport specifically “Taxis” from the view point of mental health conditions of the drivers and the associated impact on road safety in Addis Ababa. Generally in low income set up specifically in Ethiopia the prevalence of mental disorders and substance uses and their impact on road traffic accident is not a well studied event. The study will use a cross sectional study design using drivers of all registered Taxis that currently giving transportation services as a study population. The findings of the study will share to all stakeholders for possible policy interventions.
| 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: | 01 Nov 2018 11:13 |
| Last Modified: | 01 Nov 2018 11:13 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/7525 |
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