Browsing by Author "Dagnachew Alemu"

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    Compiled Body of Works in Field Epidemiology.
    (Addis Ababa University, 2017-06) Tarekegn Disasa; Ayele Belachew; Dagnachew Alemu
    Ethiopia has been giving special attention to the control of epidemic prone diseases, of international concern and diseases on eradication and elimination programs, through surveillance activities. The role of public health practitioners include ensuring effective health promotion, disease prevention and control activities, conducting surveillance on emerging public health threats and providing relevant information to policy makers and public health officials. From October, 2015 to end of April, 2017 I have stayed in Field Epidemiology Training Program, School of Public Health-AAU and Oromia Regional Health Bureau field base. We carried out two outbreak investigations, one surveillance data analysis, one evaluation of public health surveillance system, one woreda health profile description, two abstracts for scientific conference, one Maher assessment, one research proposal and other activities as additional outputs. Chapter I: We conducted epidemiological investigations of two outbreaks. We used descriptive and analytic epidemiology during investigations. We identified several factors that contributed to AWD outbreak in Limmu Woreda and found that lack of knowledge about the disease and lack of purifying water they used were attributed for the outbreak. We recommended awareness creation and use of treated water to stop outbreak in the community. We also confirmed measles outbreak in Limmu Seka Woreda. Being unvaccinated and having poor awareness on the mode of transmission for measles infection were found to be risk factors for developing the disease. We recommended improved routine and campaign measles immunization targeting less than 15 years, and also health education on means of transmissions, treatment and prevention of measles infection has to be enhanced. Chapter II: We did measles surveillance data analysis of five years (2011-2015 G.C) of Guji Zone to describe by person, place and time. Approximately equal numbers of cases were reported by gender and the most and the least affected age groups were 1-4 and ≥15 years respectively. Majority of cases were either not vaccinated or their vaccination status were unknown. Enhancing routine and campaign measles immunization targeting less than 15 years of age would prevent future risk. Addis Ababa University, College of Health Sciences, School of Public Health, 2017. Chapter III: We conducted evaluation of surveillance system in South West Shoa Zone from February 7-22, 2017. The overall surveillance system of the zone was weak. Regular monitoring of program specific supportive supervision and continuous feedback system should be strengthened for more improvement of the completeness and timeliness and/or surveillance system as whole. Chapter IV: We did health profile description, health and health related data, of Tiyo Woreda during 01/28/2016- 02/08/2016 G.C. Acute febrile illness was a top leading cause of outpatient morbidity in the woreda. Acute upper respiratory infection, Typhoid fever, whereas Pneumonia are among top ten diseases that cause outpatient morbidity in adult and Pneumonia, Non-bloody diarrhea, Dysentery and Diarrhea with dehydration were the commonest diseases that cause morbidity in under-five children in the woreda. Typhoid fever, Malaria all cases, Urinary tract infection and Non-bloody diarrhea were among top ten diseases that cause inpatient admission. Chapter V: We did scientific manuscript for peer reviewed journals on Measles outbreak in Limmu Seka, Jimma Zone. Chapter VI: We prepared two abstracts for submission to scientific conference during residency time. These are;  Five years (2011-2015)-Measles surveillance data analysis, Guji Zone Oromia Region, Ethiopia, 2016.  Measles Outbreak-Limmu Seka Woreda, Jimma Zone, Oromia Region, Ethiopia, 2017. Chapter VII: We conducted Meher assessment (Narrative summary of disaster situation) in Oromia Region to identify humanitarian needs in drought affected areas from November 20 to December 14, 2016 in selected woredas of Guji, Borena and West Guji Zones. Cholera outbreaks were occurred in all three zones. Malaria, cholera and measles are the most anticipated risk in the zones. Malnutrition was a major problem in all visited woredas. Chapter VIII: We prepared one epidemiological research project proposal on assessment of prevalence and determinant factors associated with childhood measles vaccination status in Limmu Seka Woreda, Jimma Zone, Oromia Region. Descriptive cross-sectional study will be used for the study. A total of 865 mothers/caretakers with 12-23 months age child will be selected by systematic random sampling from randomly selected five kebeles of the woreda. Socio-demographic status of mothers/caretakers, knowledge of mothers/caretakers on Addis Ababa University, College of Health Sciences, School of Public Health, 2017 immunization service, place of delivery will be assessed using questionnaire adopted from EDHS and different similar studies. Chapter IX: I participated on post malaria epidemic need assessment and supporting mitigation activities conducted in Abaya Woreda, Borena Zone, Oromia Region during May/2016. Objective of the assessment were verifying reported data, identify potential risk factors and support mitigation activities in the woreda. About 7,762 malaria cases were reported from the woreda though there were data discrepancies at some health posts. Health posts reported 46% of cases. Guangua HC reported 30% of cases and Odo Mique HP reported 7% of cases during the epidemic period. Malaria cases reached peak during WHO week 17 in the woreda. Presence of different ponds, intermittent water and false banana for mosquito breeding sites and accumulation of malnutrition in the woreda identified as risks. Distribution of LLINs, Mass fever treatment, conducting spray and source reduction were major activities performed to control the epidemic. I participated on different trainings and review meetings given by ORHB and partners. Topics: Cholera epidemic prevention and control and case management protocol, Training on Maternal death surveillance and response (MDSR), PHEM review meeting six months and ten months activities report and performance evaluation, Vulnerability Risk Assessment and Mapping (VRAM) given by EPHI. I participated on cholera epidemic prevention and control activities in Sebeta, Burayu, Sululta, Laga Tafo and Bishoftu Towns and other four zones (support by distribution of Medicals supplies, receive report and give feedback). I prepared weekly bulletin on PHEM report of Oromia Regional Health Bureau for WHO Epidemiologic week 34 of 2016. The health facilities report completeness for that week was 87% and above the expected national level (80%). Suspected measles cases, confirmed malaria cases and cholera cases were kept increasing and SAM were decreasing during week 34 of 2016.
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    Compiled Body of Works in Field Epidemiology.
    (Addis Abeba Universty, 2014-06) Dagnachew Alemu; Wakgari Deressa
    Introduction: Measles is a leading vaccine preventable contagious disease caused by a virus genus Morbilli. According to the official report, an outbreak of measles is occurring throughout the regions of Ethiopia. Didesa was one of the measles outbreak affected woreda in Oromia Region in 2014.We conducted this study to determine the magnitude of morbidity and mortality due to measles infection and risk factors associated with outbreak. Methods: We used descriptive cross-sectional followed by unmatched case-control study, 50 cases with 100 controls. We collected the data using measles line lists, observation of cold chain, key informant interviews and using structured questionnaires. Results: A total of 84 measles cases with no death were reported during the outbreak. The outbreak was confirmed for measles IgM antibody. The index case was in Mede-Misoma Kebele. Age specific attack rate was higher in age groups of 5-14 year (9.9/1000person). The overall attack rate was5.8/1000person. Seventy percent of the cases were unvaccinated. Being vaccinated and having awareness on the mode of transmission for measles infection were protective factor for developing the disease and statically significant with OR 0.13 [95% CI = 0.05-0.37] and OR 0.33 [95%= 0.12-0.89] respectively. Case management, active case searching and health education was conducted during the outbreak. Recommendations: Improved routine and campaign measles immunization targeting less than 15 years, and health education on means of transmissions, treatment and prevention of measles infection should be enhanced.