Browsing by Author "Belay Bezabih"

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    Compiled Body of Works in Field Epidemiology
    (Addis Ababa University, 2011-03) Belay Bezabih; Richard Luce; Adamu Addissie,
    Background: Diarrheal diseases are a global problem, but are especially prevalent in developing countries in conditions of poor environmental sanitation, inadequate water supplies, poverty and limited education. Objective: The study was conducted to investigate the outbreak epidemiologically & provide guidance on interventions to be taken in the control & prevention of the disease. Methods: 58 cases were selected conveniently & interviewed with structured questionnaire. All clinic pharmacy prescriptions from 10/05/2009-16/05/2009 were reviwed & duplicate prescriptions were excluded. Student cafeterias, latrines, water supply, & cooking rooms were observed. Stool & drinking water samples were also collected to verify the etiologic agent. Then data were analyzed using Epinfo version3.3.2 & Microsoft Excel. Results: A total of 538 cases were identified during the outbreak and 482 (89.6%) of them were males. The median & rang of age of cases was 20 & 31 years respectively. The attack rate and case fatality rate was 49% and <1% respectively. 69.0% (40), 22.4 %( 13), & 8.6 %( 5) of the interviewed cases had >6, 4 to 6 & <4 episodes of diarrhea per 24 hrs respectively. Only 22.4 % (13) of the interviewed cases practiced hand washing with soap after latrine while 89.7 % (52) of them made hand washing with soap before any meal. 57.9% (n=58) of cases had also contact history to an individual with similar illness, i.e. either they cared the case or sharing of drinking & eating utensils. Piped water source was used for cooking, cleaning utensils and hand washing. There was no bath room latrine for food handlers who were working in student cafeterias. No pathogen could have been isolated from stool samples which were analyzed in the microbiology laboratory. Conclusions & recommendations :The overall attack rate was high (49%) and based on the case definition and characteristics observed on antibiotic treatment the cause of the outbreak could be shigellosis however the etiology was not confirmed by laboratory. But other agents lik Enterotoxigenic Escherchia coli (ETEC) could not be excluded. Hand washing & other hygienic practices were inconsistent among students & college food handlers & it needs continuous follow up and health education on sanitation issues should be strengthened. Training of health workers on recording and reporting of cases especially during outbreak is necessary. Responsible bodies (like local or regional health bureaus) should also offer training for health workers on epidemic diseases, supervise & monitor the college clinic regularly.
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    Compiled Body of Works in Field Epidemiology
    (Addis Abeba Universty, 2015-06) Misganaw Ayalew; Belay Bezabih
    Background: Measles is the leading causes of death among young children. Though a safe and cost-effective vaccine is available measles occur as outbreak. In 2013, there were 145,700 measles deaths globally. In Africa, about 13 million cases and 650,000 deaths occur annually, with sub-Saharan Africa having the highest morbidity and mortality. Due to an increase in vaccination coverage in developing countries there has been a significant change in the epidemiology of measles such as higher incidence in older children and young adults. The aim of investigation was to assess risk factors and institute doable intervention measures. Methods: We applied the case definition, a maculopapular rash and fever with coryza, conjunctivitis or cough, to select cases of measles. We conducted 1:2 unmatched case-control study from May 2-10 /2015. Data was collected using structured questionnaire. Analysis was done using Epi Info 7 and SPSS software. Then, Odds Ratio with 95% CI and P-value were used to measure the significance of association in bivariate and multivariate analysis. Results: Of 143 reported cases, half of them were females. The median age of cases was10 (Q1=4, Q3=19) years while that of controls was 9 (Q1=5, Q3=15) years. The overall attack rate (AR) was 218/100,000. It was higher among 15-44 years (471/100,000). No death reported throughout the outbreak. Being vaccinated against measles was 85% less likely contracting measles [AOR: 0.15, (95% CI: 0.06, 0.38, P< 0.0001)], contact history with cases [AOR: 7.1, (95% CI: 2.4, 12.6, P < 0.0001)]. Conclusion: Adults and children greater 15 years old were more affected. Absence of vaccination and contact with cases were found to be risk factors. We searched cases house to house and provided case management to stop the epidemic. Strengthening the routine surveillance activity and EPI program were recommended to the district health office.
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    Compiled Body of Works in Field Epidemiology.
    (Addis Ababa University, 2015-06) Yirdaw Emiru; Ahmed Ali; Belay Bezabih
    The Ethiopia Field Epidemiology Training Program (EFETP) is a two years competency based masters program adapted from the United States Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Service (EIS) Program. The School of Public Health/Addis Ababa University, the Federal Ministry of Health of Ethiopia/Ethiopian Public Health Institute (EPHI), the Ethiopian Public Health Association (EPHA), and CDC Ethiopia are running the Program jointly. The field work comprises of 75% of the Program which is called residency; learning by working in public health emergency and other health related priority issues. 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. Ethiopia adopted the Field Epidemiology Training Program to help improve leadership within Public Health Emergency Management. The Ethiopian Field Epidemiology Training Program (EFETP) provides residents a Master of Public Health Degree in Field Epidemiology after they complete two years of supervised work in applied or Field Epidemiology. This compiled body of works has nine main sections or chapters accomplished during the residency time of the Program. The first eight sections are expected outputs during the residency time; comprising of outbreak investigation, surveillance data analysis, evaluation of the surveillance system, health profile description report, writing of finalized scientific manuscript for peer review journals, abstracts submitted to scientific conferences, writing protocol/proposal of epidemiologic research project, summary of disaster situation visited/risk assessment and other additional works. The overall outputs of the two years Field Residency Program are presented in a summarized way; in the outbreak investigations chapter or section, two outbreaks were investigated and documented. Those included measles outbreak in Bure Zuria District, West Gojjam Zone, Amhara Region, April 2015 and unmatched case control outbreak investigation of relapsing fever in Debre Markos Town, Amhara Region, Ethiopia, December 2014. Health profile description report was done in Bure Zuria District in March 2014 and Surveillance system evaluation was also done in Bure Town & Bure Zuria Districts, Amhara Region, in July 2014. One finalized scientific manuscript was prepared for peer reviewed journal. Two abstracts were also prepared for scientific conferences. A report on need assessment (risk assessment) on prioritized Districts of Amhara Regional State was also conducted with other team members from food security center, WHO, UNICEF and EPHI. Under other additional works/outputs section (last chapter) activities like provision of training for public health emergency management (PHEM) officers working at different levels (regional to health facility level) in the Amhara Regional Health Bureau were also undertaken.