Compiled Body of Works in Field Epidemiology
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Date
2019-06
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Addis Abeba University
Abstract
Despite many intervention activities undertaking prevention of communicable diseases remain a public health problem globally. The Ethiopian Government Policy gives more emphasis on prevention measures of communicable diseases. Many strategies and programs were also set to enhance disease prevention activities. Ethiopian Field Epidemiology Training Program, adapted from the United States Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Service (EIS) is one of the programs focusing on capacity building of public health practitioners. The training enables trainers to conduct disease surveillance and implement prevention and control measures of prioritized diseases.
I stayed in the Addis Ababa University, School of Public Health- Field Epidemiology Training Program and at the Oromia Regional Health Bureau Field Base from October 2017 to June 2019.During my stay, I carried out two outbreak investigations, one surveillance data analysis, one surveillance system evaluation, one district health profile description, prepared two abstracts, one scientific manuscript for peer reviewed journals and one disaster situation analysis. I was also engaged in one epidemiological research proposal, one training and preparation of three weekly epidemiologic bulletins for this residency outputs. However, I included only one weekly bulletin in this Document.
We investigated two outbreaks (Measles and scabies) during this field base Residency. Additionally, we investigated also two outbreaks (Measles and food poising) which were not included in this Document. We did not include the two additional outbreaks due to similarity with previous measles investigation and food poising outbreak where I served as co-investigator with other staff. Descriptive and analytical epidemiology methods were used to describe magnitude of the diseases and identify risk factors associated with diseases. A total of 34 measles cases were reported from Goro Woreda of Bale Zone, Oromia Region in 2018. We identified that low vaccine coverage, lack of awareness, lack of belief in modern medicine and poor cold chain management for measles outbreak in the woreda. We recommended increasing community awareness on vaccination, additional second dose of
measles vaccine and proper cold chain management.
There were also scabies outbreaks in three Medresa/religious education sites of Ginnir Woreda,Bale Zone of Oromia Region that we investigated in February 2019. During this outbreak, a total of 102 scabies cases and no deaths were reported from January 2019 to February 2019. Lack of safe water, overcrowding, long duration contact and students movements from one Medresa to others might be attributed factors for scabies outbreak. We recommended provision of safe and adequate water, avoiding contact with someone with symptoms, active case search and early treatment and separate rooms for students/deresa.Surveillance data analysis of Severe Acute Malnutrition (SAM) for consecutive four years (2006– 2009 E.C) was conducted in Bale Zone of Oromia Region. The cases were increasing
throughout those years especially during 2008 E.C due to ElNino with decreasing deaths. We identified that strong screening and case management contributed for the increasing number of cases and declining deaths.
I conducted surveillance system evaluation in Akaki Woreda, Finfinne Special Surrounding Zoneof Oromia Region in 2018. During this evaluation, the overall surveillance system and selected disease (malaria) was assessed. The system was simple, flexible, useful, sensitive and complete but, not timely, stable and representative. Health profile description was carried out in Sinana district, Bale Zone, Oromia Region from February to March 2018. Low coverage of infrastructures, high prevalence of communicable diseases such as diarrhea and acute upper respiratory infections and low maternal health serviceswere noted. prepared scientific manuscript for peer reviewed journals on measles outbreak investigation and response in Goro Woreda, Bale Zone of Oromia Region.Two abstracts were prepared for scientific conference submission; Measles Outbreak Investigation and Intervention in Goro Woreda of Bale Zone and Severe Acute Malnutrition(SAM) data analysis in Bale Zone, Oromia Region. Disaster situation analysis was conducted at IDP sites in Begi woreda of West Wellega Zone,Oromia Region in July 2018 to assess situation, identify humanitarian needs and give public health intervention. Diarrhea and other communicable diseases were anticipated to be a major public health concerns in Begi District. We identified shortage of food and non food items, drugs and medical equipment at zonal, Woreda and Health facilities levels.
Epidemiological research project proposal on assessment of sanitary condition of food and drinking establishments in Bishoftu Town, Oromia Region was prepared. Cross-sectional study will be used for this study. A total of 422 food and drinking establishments will be selected from total establishments based on stratification followed simple random sampling. Data on building, water, latrine and waste management facilities will be collected from owners whereas data on knowledge and practice will be from food handlers. Water sample also will be taken from common source for bacteriological test. The rest activities of study other than proposal will be expected to be finished in the next year. The total estimated budget required for the study is 46,220.21 ETB.
Training was given to zonal and woreda PHEM focal persons from five Woredas and one town at Dambi Dollo Town of Kellem Wellega on Community based surveillance. Topic covered in this training were, establishing community-based surveillance, role and responsibility of focal person, major indicators of early warning system, IDSR versus PHEM report, standard and community case definition and monitor and evaluation. The evaluation training objectives was measured by reflection of idea and posttest. Based on evaluation, the training was successful and meets its objectives. Additionally, I was participated on workshop on Non communicable diseases that held at Addis Ababa University with collaboration of School of Public Health and University of German.
I prepared weekly bulletin on PHEM report of Oromia Regional Health Bureau for WHO Epidemiologic week 51 of 2018. The health facilities report completeness and timeliness for that week was 88.2% and 86.8% respectively. Report completeness and timeliness were above the expected national level (80%). Suspected measles cases were increasing during week 51 of 2018.
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Epidemiology