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

Abebe, Nigatu Tarekegn (2014) Ethiopia Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology. Masters thesis, Addis Ababa University.

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Abstract

During my field residency as EFETP resident I have conducted the following field activities in SNNPR Field Base. These were: Outbreak investigations, surveillance data analysis report, evaluation of surveillance system, District Health profile description report, Scientific manuscript for peer review journals, abstract for scientific presentation, narrative summary of disaster situation visited, writing protocol/proposal for epidemiologic research project and post epidemic assessment; in order to achieve all the above outputs of residency we have used different epidemiological study methods. In general, my outputs of the two years field residency in the EFETP are presented in a précised way as follow: Two outbreak investigations were investigated and well documented under chapter one; these are: 1. Malaria Outbreak Investigation, Chano-Mile kebele, Arbaminch Zuria Woreda, Gamogofa Zone, SNNPR The analysis of the study shown that people who are living near to breeding site within 1km radius were 5.5 times more likely to develop clinical malaria (OR =5.5, 95% CI= 2.30-13.15). Peoples in which their ITNs worn out, are 5.2 times more likely to develop malaria (OR=5.2, CI=2.28-11.82) 2. Measles Outbreak Investigation, Shay Bench Woreda, Bench Maji Zone, SNNPR There were 478 measles cases seen from 13 October 2013 to 28 Nov 2013 with 240 males and 238 females. Of these cases 3 deaths were registered (CFR 0.6%) and the attack rate was 331 per 100,000 populations. The finding reveals that measles cases who were vaccinated with less than 2 doses of measles antigen were more at risk of developing measles (OR = 2.569; 95% CI = 1.182, 5.733). The households who had family size with 5 persons and more were at risk for developing measles (OR = 12.27; 95% CI = 4.763, 35.68). Measles cases living with persons with symptoms of measles in the same households had more risk to develop measles (OR = 3.6; 95% CI = 1.5581, 8.2694). Chapter II - Ten Years Malaria Surveillance Data Analysis Report, SNNPR, 2003 – 2012 Total malaria suspected fever cases examined by RDT and/or microscopy was 15,722,005. Out of these numbers of cases positive for malaria parasites either by RDT or microscopy were 4,094,332 i.e. slide positivity rate was 26%. Total malaria cases (clinical + confirmed) treatedduring these periods were 12,065,332. From the total malaria cases 3,802,626 were <5 years of age. Total inpatients due to malaria were 171,701cases and 3,580 deaths were registered. Regarding the plasmodium species, from a total 4,094,332 confirmed cases 63% was P.falciparum & 37% was P.vivax. This descriptive analysis shows that the incidence of malaria starting from 7 cases/1000 to more than 500 cases/1000 population in 2012. Chapter III - Acute flaccid paralysis surveillance system evaluation report, Silte Zone, SNNPR, December 2013 Silte zone reported 10 AFP cases in 2013. Of these, 80% were <5years of age, and 50% were males and 50% were females. One case was confirmed for VDPV2. The zonal average annualized non-polio AFP detection rate were 2.8 non-polio AFP cases/100,000 children <15years in 2013. All performance indicators met the WHO-specified targets except the stool adequacy rate of 70 % (WHO target is ≥80%). The vaccination status of the cases were validated that 70% unknown. Chapter IV - Health Profile Description Report, Sodo district, Gurage Zone, SNNPR, 2012 The potential health service coverage of the district was more than 100%. Ratio of Health center to population 1:22197; and health post to population was 1:2877. Profession wise the ratio of health officer to population 1:15538, Nurse to population 1:1992, midwife to population 1:15539 and Health Extension worker to population 1:1653. The ten top causes of under 5 morbidity were acute respiratory tract infection(4213), diarrheal disease(2400), pneumonia(1719), malaria(1244), helimenthiasis(871), eye disease(631), trauma(572), skin infection(471), ottitis media(106) and severe acute malnutrition(47). Chapter V - Scientific manuscripts for peer reviewed journals Measles Outbreak Investigation conducted at Shay Bench Woreda, SNNPR is prepared for peer review journals as per the instructions and guidelines of CDC. Chapter VI - Abstracts for scientific presentations Two abstracts titled with "Chano Mile kebele malaria outbreak investigation report and AFP surveillance system evaluations" are prepared as abstract for the scientific presentations. Chapter VII - Narrative Summary of Disaster Situation Visited Major findings: There is multi-sectoral PHEM coordination forum at all level and different governmental and nongovernmental organizations including UN agencies are involved in the forum. At regional level the forum meet monthly however at Zonal and woreda level the forumnot meet regularly. From March to May, outbreak of Meningitis, measles and yellow fever were reported. Except yellow fever both measles and meningitis outbreak were contained. Epidemic preparedness and response plan is available in all visited zones and woredas as well as at regional level however; the plan is supported by budget only at regional level. Chapter VIII - Protocol/Proposal for Epidemiologic Research Project The title for epidemiologic research project is prevalence and associated risk factors of malaria among workers, Kuraz sugar factory project, Salamago district, South Omo zone, SNNPR, Ethiopia. Malaria is a major global public health problem and a leading cause of morbidity and mortality in many countries. Malaria caused an estimated 219 (range 154–289) million cases and 660 000 (range 490 000–836 000) deaths in 2010. Approximately 80% of the cases and 90% of the deaths occur in Africa while the remaining cases and deaths occur mainly in the South-East Asia and Eastern Mediterranean Regions. Approximately 68% of the population lives in malaria risk areas in Ethiopia, primarily at altitudes below 2,000 meters. The study will be conducted from April to June 2014. The total cost estimated to implement this project is ETB birr 89,748. Chapter IX - Yellow Fever Post Epidemic Assessment in South Omo Zone, SNNPR, Ethiopia, November, 2013 The presence of an emergency-response coordination mechanism among partners; availability of the national PHEM guide line (2012); availability of epidemic preparedness and response (EPR) plan; and existence of government financial contingency budget (though not ear marked for emergency response activities) at the SNNP region and south Omo zone level was promising. At the region level the staffing of PHEM structure is 100%. However at the onset of the recent yellow fever outbreak the proportion of PHEM officers assigned to the South Omo zone health department was 50%. In addition, the capacity of regional and zonal PHEM officers (knowledge and skills) on determination of thresholds for Yellow Fever outbreak was noticed to be encouraging (100%). At woreda level the coordination existed in 25%; PHEM guideline in 50%; EPRP in 50%; PHEM staffing was below 50% and no emergency financial access in the Woredas health offices visited. However, of the observed EPRP documents none identified population groups and areas at high risk/hazards for yellow fever outbreak. At woredas/town health office level three fourth of the PHEM officers had the capacity to determine the thresholds for yellow fever outbreak.Finally, the above reports or outputs are compiled in this volume (Body of Work document) as per the format provided by the program.

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:	27 Nov 2018 12:32
Last Modified:	27 Nov 2018 12:32
URI:	http://thesisbank.jhia.ac.ke/id/eprint/7770

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