Browsing by Author "Addissie, Adamu(PhD)"

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    Assessment of the Magnitude of Glycemic Controland its Associated Factors Among Patients with Type 2 Diabetes at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2015
    (Addis Ababa University, 2015-06) Tekalegn, Yohannes; Addissie, Adamu(PhD); Ayele, Wondimu; Kebede, Tedla
    Back ground: Diabetes is increasing at an alarming rate throughout the world and about 80% of diabetics‟ lives in low and middle income countries. Glycemic control is the most important predictor of diabetes related complications and death. Identifying factors associated with glycemic control will help health care providers to design programs which improve quality of services provided to diabetic patients. Objectives: The aim of this study was to assess the magnitude and factors associated with glycemic control among type 2 diabetic patients at Tikur Anbessa Specialized hospital, Addis Ababa, Ethiopia. From march to April, 2015. Methods: Facility based cross sectional study was conducted on a sample of 412 type 2 diabetic patients attending diabetic clinic of Tikur Anbessa Specialized Hospital. The study subjects were selected using systematic random sampling technique from March to April, 2015. Quantitative data were collected on demographic, fasting blood sugar, self reported adherence to diabetes self care and diabetic distress scales using structured questionnaires. The data was entered and analyzed on SPSS V20. Descriptive statistics were used to determine magnitude of glycemic control among type 2 diabetes patients. Logistic regression was used to identify factors associated with outcome variables. Result: A total of 412 type 2 diabetic patients were interviewed. Median age of participants was 52 years (IQR= 40-60 years). 51.7% of the respondents were females. Median duration of diabetes is 10 years (IQR: 5-16 years). About 80% had uncontrolled fasting glycemic level. The factors which are significantly associated with poor glycemic control were longer duration of diabetes (AOR: 2.72 95%CI [1.16, 6.32]) and being on insulin therapy (AOR= 3.01 95% CI: 1.5- 5.9). Conclusion: proportion of patients with poor glycemic control is high. Longer duration of the disease and being on drug regimen insulin is was associated with poor glycemic control. Appropriate attention should be given to patient with longer duration of disease and those on insulin therapy
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    Ethiopia Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology
    (Addis Ababa University, 2015-05) Abebe, Wake; Addissie, Adamu(PhD); Deti, Tesfaye
    The Ethiopia Field Epidemiology Training Program (EFETP) is a two year an in-service training program in field epidemiology adapted from the United States Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Service (EIS) program. The program is designed to assist the Ministry of Health in building or strengthening health systems by recruiting promising health workers and building their competencies through on-the-job mentorship and training. Because trainees work in active public health teams that are tackling the most serious and acute problems of the population, their work is exciting and leads to improvements in program implementation even as the trainees are learning. The EFETP program has two main components, each of which contributes to the award of the Masters degree (MPH) in Field Epieemiology. A classroom-teaching component (25%) and practical attachment or field placement component (75%) consisting of disease investigations, surveillance evaluations, surveys, and applied research on national health problems. Residents have the opportunity for public health practice in the real world. From the beginning of second week of October 2013 up to the end of May 2015, I stayed in Field Epidemiology Training Program, School of Public Health-Addis Ababa University, Oromia Regional Health Bureau (ORHB) field base and Ethiopia Public Helath Intitute (EPHI) field base. This body of work has nine chapters, including reports of two outbreak investigations, one surveillance data analysis, one evaluation of surveillance system, and one Woreda health profile description, two abstracts for scientific conference, one meher assessment, one research proposal, as an additional output Weekly bulletin and assessment on Hospitals preparedness towards Ebola Virus Diseases (EVD). Chapter one: Two outreak investigations were conducted. Descriptive and Analytic Epidemiology was used during investigations. These are: measles outbreak investigation in Abun Gindeberet District of West Shewa Zone, Oromia, May-2014; another measles outbreak investigation in Nedjo District, West Wellega Zone, Oromia, February, 2015. We identified several factors that contributed to measles outbreak in both districts. Chapter two: Four years Addis Ababa University, College of Health Science, School of Public Health XIV AAU-CHS-SPH-EFETP Compiled Body of Works by: Wake Abebe, May-2015 (2010 to 2013) relapsing fever surveillance data was analyszed, East Shewa Zone, Oromia, March, 2014. In Chapter three: Evaluation of surveillance system was conducted in Jimma Zone, Oromia-June, 2014. Chapter four: Health profile description of Boset District of East Shewa Zone, Oromia-February, 2014. Chapter five: Scientific Manuscript for Peer Reviewed Journals was done on Measles outbreak investigation in Abuna Gindeberet District, Oromia, Ethiopia-May, 2014. Chapter six: Two abstracts were submitted for scientific conference (TEPHINET conference that will be held in Mexico-June, 2015). These include: 1) Measles Outbreak Investigation and response in Abuna Gindeberet District, West Shewa Zone, Oromia, Ethiopia-May ,2014. 2) Assessment of hospitals preparedness towards EVD in Addis Ababa, Ethiopia-January, 2015. Chapter seven: Narrative summary of disaster situation.Meher assessment was conducted in three zone of Oromia region. These include Borena, Guji and West Arsi zones in November, 2014. Chapter eight: Protocol/proposal for Epidemiologic Research Project was prepared on the title “Assessment of magnitude of immunization coverage and Associated Factors among children Age 12–23 Months in Abuna Gindeberet District, Oromia-July-2015. Finally, in chapter nine: additional outputs, Assessment of hospitals preparedness towards EVD in Addis Ababa, Ethiopia-January, 2015 and Weekly PHEM bulletin were prepared in public health priorty disease
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    Ethiopian Field Epidemiology and Laboratory Training Program (EFELTP) Compiled Body of Works in Field Epidemiology
    (Addis Ababa University, 2015-05-27) Tarekegn, Tessema; Addissie, Adamu(PhD); Taame, Haftom
    This body of work comprises of all my outputs that has been done during the two year stay. The components of my outputs were outbreak investigation, surveillance data analysis report, evaluation of surveillance system, health profile description report, scientific manuscripts for peer reviewed journals, abstracts for scientific presentation, narrative summary of disaster situation visited, protocol for epidemiologic research project, and other additional outputs like Ebola Virus disease (EVD) surveillance, and training report. Outbreak Investigation I-1. Measles outbreak investigation was conducted in Halaba Special Woreda, SNNPR, 2014. A total of 46 measles cases and zero deaths were identified in the line list. Out of the total 17 laboratory sent specimens, 14 were IgM positive. The attack rate was highest in infants (85.3/100,000). We conducted a 1:3 unmatched case-control study. Being vaccinated with measles (OR=0.0312, 95% CI, 0.0111-0.0878), knowing the modes of transmission of measles (OR= 0.2727, 95% CI, 0.1229-0.6052), and knowing the right age of the child for measles (OR= 0.2045, 95% CI, 0.0881-0.4748) was a protective factor. Children living with a family size of five and more than five household members were more likely to contract measles (OR= 3.833, 95% CI, 1.7098-8.594). Outbreak Investigation I-2. We conducted measles outbreak investigation in Kirara Health Center Catchment, Konta Special Woreda, SNNPR, 2014. A total of 333 measles cases and zero deaths were identified in the line list. Out of the total 6 laboratory sent specimens, 2 were IgM positive. For the rest samples the result was unknown. The attach rate was highest in infants (9.4/100). A total of 53 cases and 105 controls were employed into the case-control study. In multivariate analysis, Being vaccinated with measles (OR= 0.52, 95% CI (0.2693-0.9984), educational status (OR= 1.86, 95% CI (1.2836-2.6837), and history of travel to active measles area (OR= 2.2, 1.1183-4.3280) were significantly associated with contracting measles. Surveillance Data Analysis II. A total of 1648 AFP cases were identified from 2007-2013. We described the AFP cases by person, place and time and determined the magnitude of AFP cases among zones in the region. Out of the total, 1621 (98.4%) AFP cases were under 15 years old and 9 AFP cases were age greater than 15 years. The most affected age group was 1-4. A child should receive at least 4-polio doses at his childhood. More than 54% of the AFP cases received Ethiopian Field Epidemiology Training Program tessema2002@gmail.com less than 4-polio doses. The non-AFP rate of the region was 2.9, and the highest incidence was reported in 2012(3.4/100,000). Sheka was the most affected zone (4.7/100,000) and Masha was the most affected district (11.3/100,000) in the region. Evaluation of Surveillance System III. We evaluated a total of 41-surveillance units (3-woredas, 9-health centers, 27-health posts). The surveillance system should be evaluated periodically to improve quality, efficiency and usefulness. At 41(100%) evaluated surveillance units, standard case definition was used and available. Twenty (100%) health posts were using family folder for case registration. Except from zonal PHEM, no any evaluated reporting units were using the computer technology for data storage. Malaria surveillance data was no analyzed at Woreda, and health center level. Despite the presence of regular supportive supervision, a few surveillance units used epidemic preparedness plan, and no surveillance units used malaria monitoring chart. The malaria surveillance system in Kembata-Tembaro was, simple, acceptable, flexible, and stable, but not timely and not representative. Health Profile Description Report IV. We conducted a rapid assessment from March 10-17/2013 to describe health profile in Kedida-Gamela district. The annual administrative coverage of the Contraceptive Acceptance Rate (CAR), ANC, skilled delivery, PNC, polio-3 and penta-3 and measles was 78.6%, 84%, 24.2%, 114%, 106.6% and 104.6% respectively. The annual TB detection rate was 32% against the district target (70%). Malaria was the top cause of morbidity in both adults and children and the priority problem including severe acute malnutrition in the district. Scientific Manuscripts for Peer Reviewed Journals V. Scientific journals prepared to communicate findings help, and improve the health, safety, and well-being of the community. As a result we prepared to a peer reviewed journals on Measles outbreak investigation in halaba special Woreda, SNNPR, 2014. Abstracts for Scientific Presentation VI. We prepared abstracts of measles outbreak investigation conducted in Halaba Special Woreda, and Acute Flaccid Paralysis data analysis conducted regionally (SNNPR). Narrative Summary of Disaster Situation Visited VII. We participated in Belg assessment which was conducted in Gamo-Gofa and Wolayta zone. Kamba woreda and Merab-Abaya was Ethiopian Field Epidemiology Training Program tessema2002@gmail.com selected in Gamo-Gofa zone and Humbo and Boloso-Sore Woredas were selected from Wolayta zone. Malaria and severe acute malnutrition was the identified problem in the assessment area. Proposal for Epidemiologic Research Project VIII. Malaria remains a serious public health problem, causing 1.2 million deaths and 300 to 660 million clinical cases in tropical and subtropical areas each year. We designed a cross-sectional community and health facility based study to assess the malaria prevalence and risk factors in Kedida-Gamela district. We will use three stage cluster sampling technique (kebele, Villages, and Household). A single population proportion formula with a 95% confidence interval and prevalence of 50% with a margin of error 5.0% with a power of 80% will be used to calculate the sample size. n = z2 pq/d2 = (1.96)2 *0.5(11-0.5)/ (0.05)2 = 384. Because of the clustering effect the sample size, n = 2*384 = 768. Other Additional Output Reports IX. During the residency period we conducted Ebola Virus Disease Surveillance in Lare Woreda, Pagak Land port entry, Gambella region, 2014. We also conducted public health emergency management (PHEM) officer and health facility focal persons training which was organized by SNNPR health bureau, and it an additional output
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    Ethiopian Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology
    (Addis Ababa University, 2014-11) Kassa, Woubayehu; Addissie, Adamu(PhD); Deyassu, Negussie(PhD)
    The Ethiopian Field Epidemiology Training program (EFETP) is a two year field based masters program. The school of public Health /Addis Ababa University, Federal Minister of Health, Ethiopia Public Health Institute(EPHI), Ethiopia Public Health Association (EPHA) and CDC Ethiopia are running the program together .the field work comprises seventy five (75%) of the program which called residence with the aim of learning by working in public health emergency management centre This Body of work contains my outputs for the two years stay in the program. It includes outbreak investigations, surveillance data analysis, surveillance system evaluation, description of health profile report, writing of scientific manuscript for peer review journal, abstracts submitted/presented in scientific conferences, writing protocol/proposal of epidemiologic research project and a summary of disaster situation in selected area. In the outbreak investigation chapter or section two outbreaks were investigated, one of the outbreak investigation done in Dire Dawa city administration “Dengue fever outbreak investigation “a case control study and the other one was a descriptive study was which was done among South Sudan refugees in Gambella regional state “suspected Hepatitis E outbreak investigation among the refugees“ Chapter two contains report of surveillance data analysis which was conducted on Acute flaccid paralysis in Ethiopia, A five year data were analyzed.Chapter three addresses surveillance system evaluation “An Evaluation of Ethiopian Paediatrics bacterial meningitis among 5 years children. This chapter include the purpose and objectives of the sentinel surveillance and its progress towards its objectives, challenges and gaps, the sentinel surveillance attributes: simplicity, flexibility, stability, acceptability, representativeness, timeliness, data quality, sensitivity and predictive positive value were also assessed in the chapter Chapter four contains assessment of West and East Harerega zone health profile. In the chapter health and health related data of the zone populations were presented Chapter five contains Scientific Manuscripts for Peer reviewed Journals. In his chapter two manuscripts are presented. The manuscripts were prepared according to Ethiopian journal of health development author’s guideline. xv Chapter six contains abstracts of outbreak investigations, surveillance data analysis, and surveillance system evaluation. The abstract entitled “Acute febrile illness outbreak with first report of dengue fever - Diredewa city administration, Ethiopia ,November/2013 was accepted for poster presentation at 63rd EIS conference in Atlanta /Georgia Similarly another abstract entitled “Acute Flaccid Paralysis in Ethiopia from 2008-2010 was accepted and presented on the 5th African Field Epidemiology Network conference in Addis Ababa.Chapter seven contains a report on Health and Nutrition need assessment (risk assessment) on selected districts of East and West Harerega zones of Oromia region, the report conducted in collaboration with other team members, WHO, UNCHEF, and Goal/Ethiopia. Chapter eight epidemiological research project in title “Prevalence and risk factors of Hepatitis B among pregnant women in Addis Ababa “were written and submitted Chapter nine include other outputs and in this chapter training conducted on influenza sentinel surveillance review meeting and it was a one day training focused on sample collection, storage and transportation for the diagnosis of Influenza in this chapter Public Health Emergency weekly bulletins were included