Ethiopian Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology
Creators: name: Ayele, Tsehay
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2016

description: The current health service policy of Ethiopia gives emphasis to health promotion and prevention focusing on communicable diseases, nutritional disorders and environmental health problems without neglecting essential curative activities. In order to achieve this government of Ethiopia has outlined major strategies that include human resource development. Ethiopian Field Epidemiology Training Program, adapted from the United States Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Service (EIS) was established in 2009 with the aim of producing skilled public health professionals who provide in-service assistance to advance and prevent public health problems and contribute to evidence-based decision-making. Since its inception the program has played a significant role in investigation of outbreaks of unknown causes, priority disease surveillance activities, strengthening of surveillance system and prevention and control measures of prioritized diseases. From November, 2014 to May, 2016 I have stayed in Field Epidemiology Training Program, School of Public Health-AAU and at South Nations Nationalities Peoples (SNNP) Regional Health Bureau field bases. During my stay I have learnt a lot and carried out many public health activities. I have carried out two outbreak investigations, two surveillance data analysis, one surveillance system evaluation, one district health profile description; two scientific manuscript for peer reviewed journal, three abstracts for scientific conference, one blelg health need assessment and one epidemiological research proposals. In addition I have provided training for district and zonal surveillance focal persons and prepared six weekly epidemiologic bulletins of SNNP regions. We have investigated two Measles outbreaks during field base residency. The investigations were performed by descriptive and analytical epidemiology methods to describe magnitude of the diseases and identify risk factors associated with diseases. Over the period of outbreak in East Badewacho woreda a total of 158 measles cases and 0 deaths were detected. The overall attack rate was 75.7/100,000 and the case fatality rate was 0%. Having contact with a person suspected to have measles, presence of measles case patient in the family and malnutrition were independent risk factors, and not-vaccinated for measles dependent risk factors and for contracting measles infection. We recommend enhanced routine immunization service, strengthened of surveillance and early reporting system and awareness creation to the community on mode of transmission, prevention and health seeking behavior. In Shashogo woreda a total of 44 measles cases with no deaths were identified. The overall attack rate of this outbreak was 3.5/100,000 population with the highest attack rate were Ethiopian Field Epidemiology Training Prograram shayeayele@yahoo.com Page xv observed at Shamisa missie kebele with the attack rate of 288/100,000, Pop. 24 (54.5%) measles cases were not received measles vaccine, and 4 (9.1%) measles cases had unknown vaccination history. We recommend, ensuring that the vaccine efficacy is maintained at the kebele level, there should be a refrigerator at the health post. The measles vaccination coverage of the woreda must be improved. We analyzed five years (2011 – 2015) suspected Measles surveillance data in South, Nations, Nationality, Peoples (SNNP) region to know the burden and trends of the disease. In the five years there were 13,270 suspected Measles cases in SNNP Region with a mean annual incidence of 15.2 suspected patients per 100,000 and 66 suspected deaths with case fatality rate of 0.4%. The magnitude of suspected measles in SNNPR region showed an increasing trend during the past five years except in 2015. We recommended the surveillance activities need improvement in early detection of cases, for the completeness of variables and specificity of reporting suspected measles cases especially during outbreaks. We analyzed nine years (2007 – 2015) suspected AFP surveillance data in South, Nations, Nationality, Peoples (SNNP) region to know the burden and trends of the disease. In the nine years there were 2,108 suspected AFP cases in SNNP Region, Out of the total cases, 2074 (98.4%) AFP cases were under 15 years old. The magnitude of suspected AFP in SNNPR region showed the highest attack rate in less than five years age group. We recommended active surveillance of all AFP cases is mandatory to get the Polio eradicated by health facilities, and districts, and improving data recording, and reporting system by health centers, woredas, and zones. We conducted evaluation of surveillance system from March, 15-31, 2016 in Hadiya Zone, SNNP, and Region. The surveillance system of the zone was simple, flexible, useful and acceptable. However, attributes like; data quality, timeliness, and representative require attention for improvement of surveillance process. The system needs to be improved through including timeliness measurement indicators and incorporating all private and NGO health facilities in surveillance reporting units. We have collected and summarized health and other health related events, demographic, socioeconomic, political and cultural aspect of Kedida- Gamela woreda of West Kambata Tambaro Zone from February, 11-18, 2016. The leading cause for both, adult and less than 5 years children outpatient (OPD) and inpatient visit was malaria. Ethiopian Field Epidemiology Training Prograram shayeayele@yahoo.com Page xvi We have also prepared scientific manuscript for peer reviewed journals on measles outbreak investigation and response in East Badewacho woreda , Hadiya zone, SNNP Region ,Surveillance data analysis of suspected measles cases in SNNP, region, from 2011 to 2015, Surveillance data analysis of suspected AFP cases in SNNP, region, from 2007 to 2015, four abstracts were prepared for scientific conference on measles outbreak investigation and response in East Badewacho woreda , Hadiya zone, SNNP Region ,Surveillance data analysis of suspected measles cases in SNNP, region, from 2011 to 2015, Surveillance data analysis of suspected AFP cases in SNNP, region, from 2007 to 2015 . Blelg Season need assessment was conducted in tow zones of South Nations Nationalities People Region (SNNPR), Sidama and Gedeo zones, south Ethiopia, to identify humanitarian needs including Health emergencies like disease outbreaks or wide spread malnutrition, that usually follow after emergency events due to natural or manmade disasters. We identified lack of emergency preparedness, shortage of emergency drugs and therapeutic feedings and medical equipment at both zonal level and many districts of these zones. Epidemiological research project proposal on Assessment of Prevalence and associated risk factors for malaria in Shashogo woreda, Hadiya zone, SNNP region was prepared. A Cross-sectional descriptive study will be used for this study and Multi-stage sampling technique will be used to get study subjects. The total of 766 households will be assessed in this study. The aim of this study could help to get reliable information to determine the effectiveness of the malaria control program and factors associated with the high malaria prevalence in the district. The total estimated budget required for the study is 11,730.USA Dollar. Additionally ten Weekly surveillance bulletin of SNNP region PHEM was also prepared. The bulletin serves to provide feedback on surveillance activities, and summarizes weekly surveillance data and performance of SNNPRHB/PHEM on epidemic prone diseases and other public health emergencies. Health and Nutrition emergency prevention and Response, Command Post ,activities were undertake in Hadiya, Kambata Tambaro zones and Halaba special woreda to coordinate, organize and strengthen the surveillances system of the zone, In South, Nations Nationality Peoples, Region /SNNPR/August- October 2015.