Ethiopian Field Epidemiology and Laboratory Training Program (EFELTP) Compiled Body of Works in Field Epidemiology
Creators: name: Tarekegn, Tessema
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2015

description: 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