Ethiopian Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology
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Date
2017-06
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Addis Abeba Universty
Abstract
Introduction: Populations living in rural kebeles with inadequate water and sanitation
infrastructure are at risk of epidemic disease. Acute Watery Diarrhea is one of a diarrheal disease
caused by infection of the intestine with the bacterium Vibrio cholera, either type O1 or O139.
Suspected Acute Watery Diarrheal disease (AWD) was reported from Areba Minch Zuria
Woreda Health Office, GamoGofa Zone, SNNPR, Ethiopia on June 13 /2016. On June 17/2016
the regional health bureau deployed a team organized from WHO, UNICIEF and Public health
emergency management to conduct the investigation and to describe the magnitude of the
outbreak, identify risk factors, and implement control measures.
Methods: Descriptive followed by unmatched Case control (1:2) study was conducted on Areba
Minch Zuria Woreda Health Office, GamoGofa Zone from June 21 to 30 /2016 and our samples
are all eligible cases during study period. 50 active cases (40% of the total cases from the CTC
center) and 100 controls (that are neighbor to the cases) were selected. We defined suspected
cases and controls according to WHO guide line and the data were collected by principal and co
investigator in face-to-face interviews of cases in CTC Center and house to house based on line
list and controls were nearby living houses of the cases. Questionnaire included sociodemographics,
knowledge and risk factors for AWD transmissions and a pre-test will be
Complied BOW (dtdtamrat@ yahoo.com) Page 2
employed in ten household that nearest to the CTC center. The data were first cleaned then
entered and analyzed by epi-info version 7.2. Analytical and descriptive analysis was done and
the results were presented by epi curve, graphs, tables and map.
Results: A total of 125 cases were reported from June 13/2016 to July 27/2016. From the total
cases 89(71%) were male and 36(29%) were female. The mean age of cases was 24 with
standard deviation of ±12 respectively. Five Kebeles (Shelemela, Elego, Kolashele, Gentasira
and Wozeqa) were affected by the outbreak. Among the affected Kebeles Shelemela reported
40(32%) cases from the total reported cases. The overall attack rate was 5 per 1000 population.
The sex specific attack rate was 7 for male and 3 for females per 1000 population; the highest
AR was in Elego Kebele which is 7 per 1000 population. On multivariate analysis factors that
statistically significant association with AWD outbreak were Drinking of lake water (OR: 6.7;
95%CI: 1.2 – 23.7 ; P:< 0.04) , Drinking of Cheka (Local drink) (OR: 5.6; 95%CI: 2.4 – 13.2 ;
P:< 0.001) ,Using river water for washing utensils (OR: 4.1; 95%CI: 1.2-13.4; P: < 0.02). Water
specimen from Lake Chamo and Sego River showed fecal contamination. 30 stool specimen was
collected for laboratory investigation (2 positive for culture, 21 positive for RDT & 7 are
Negative) and Vibrio cholera sera group 01, sera type ogawa identified.
Conclusion: In the woreda attack rate of AWD related to insufficient access to safe water
therefore future epidemics will undoubtedly occur unless the Zonal and Woreda government
should properly addressed the basic water and sanitation deficiencies in the community. Also
woreda water office should provide continuously water treatment chemical to the community
especially who living along the sides of Lake Chamo and Sego River.
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Keywords
Ethiopian Field Epidemiology Training Program (EFETP)