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Addis Ababa University, College of Health Sciences, School of Public Health Addis Ababa University College of Health Science School of Public Health Addis Ababa University, College of Health Sciences, School of Public Health Ethiopia Field pidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology By Addisalem Mesfin Submitted to the School of Graduate Studies of Addis Ababa University in Partial Fulfillment for the Degree of Master of Public Health in Field Epidemiology May, 2016 Addis Ababa, Ethiopia Cell phone: 0911243303 E-mail: [email protected] AAU/SPH/AM Addis Ababa University College of Health Science School of Public Health Addis Ababa University, College of Health Sciences, School of Public Health Ethiopia Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology By Addisalem Mesfin Submitted to the School of Graduate Studies of Addis Ababa University in Partial Fulfillment for the Degree of Master of Public Health in Field Epidemiology Advisors 1. Dr. Daddi Jimma 2. Dr. Alemayehu Bekele May 2016 Addis Ababa, Ethiopia AAU/SPH/AM Addis Ababa University College of Health Science School of Public Health ADDIS ABABA UNIVERSITY School of Graduate Studies Compiled Body of Works in Field Epidemiology By Addisalem Mesfin May 2016 Ethiopia Field Epidemiology Training Programme (EFETP) School of Public Health, College of Health Sciences Addis Ababa University Approved by Examining ____________________ _______________________ Chairman, School Graduate Committee _______________________________ ___________________________ Advisor ______________________ _____________________ Examiner __________________ __________________________ Examiner ii Addis Ababa University College of Health Science School of Public Health ACKNOWLEDGEMENTS I express my sincere and deepest gratitude to my mentors Dr. Daddi Jimma and Dr. Alemayehu Bekele – Deputy General Director of EPHI and project coordinator of EPHA, coordinator, Instructor of EFETP respectively, who worked with me hand in hand, tirlesly and friendly, right from guidance on investigation and assessment phase to the final and some times most technical phase of this document, they were with me all the time when evere I need them. I would extend my deepest gratitude also to the collaborating staff and Instructors of EFETP, especially Dr. Adamu Addisse who is senior instructorand program, to Dr. Zegeye Hailemarim and to Dr. Lucy Boulanger for their performance in conducting all academic issues, technical support and programmes related issues to run in the right way on behave of the CDC. My sincere thank and appreciation also goes to my instructor Professor Ahmed Ali who inspires me whenever he meets me to accomplish my objective with his valuable ideas in the light of his experience. My special thank goes to the Ethiopian Public Health Institute which hospitalized me as the field base during my stay for the last about two years and Ethiopian Public Health Association (EPHA) with CDC for covering all the costs used to conduct the different outputs indicated in this document. My gratitude also goes to different Regional Health Bureaus, Zonal Health Departments, Woreda Health Offices and Health Facilities who participated during investigations and assessments for their kind assistance and guidance.I also want to thank to my colleagues, Public Health Emergency Management staff, and my classmates, cohort VI Field Epidemiology Training Program Residents. AAU/SPH/AM Addis Ababa University College of Health Science School of Public Health Table of Content ACKNOWLEDGEMENTS ................................................................................................................................ iii Table of Content .......................................................................................................................................... iv List of Figures ............................................................................................................................................... ix List of Anexes .............................................................................................................................................. xii Chapter I: Outbreak/Epidemic Investigations .............................................................................................. 1 1.1 Outbreak Investigation of Diarrheal Disease in Addis Raey Training Centre, Amibara Woreda, Afar Region, Ethiopia, April 2016. ......................................................................................................................... 1 1.2 Influenza like Illness outbreak in rural and prison settings of south Gondar, northwest Ethiopia, February 2016. ............................................................................................................................................ 30 Chapter П: Surveillance Data Analysis ........................................................................................................ 52 Chapter III: Evaluation of Surveillance System ........................................................................................... 79 Evaluation of surveillance system in South East zone, Enderta Woreda Tigray regional sate, Ethiopia, 2015 ............................................................................................................................................................ 79 Chapter IV: Health Profile ........................................................................................................................... 99 Hintalo-Wajrat Woreda, Tigray Regional State, Health profile Assessment Report 2015.......................... 99 Chapter V: Scientific manuscript for peer reviewed Journal .................................................................... 121 Chapter VI: Abstracts for Scientific Presentation ..................................................................................... 168 Title.1 Outbreak Investigation of Diarrheal Disease in Addis Raey Training Centre, Amibara Woreda, Afar Region, Ethiopia, April 2016. ..................................................................................................................... 168 Chapter VII: Narrative Summary of Disaster Situation Visited ................................................................. 171 Meher Assessment Report conducted in Tigray Region, Ethiopia, 2015. ................................................. 171 Chapter VIII: Protocol/Proposal for Epidemiologic Research Project ....................................................... 241 .................................................................................................................................................................. 266 AAU/SPH/AM Page iv Addis Ababa University College of Health Science School of Public Health List of Tables Table 1: Case distribution by age and the majority case are under age group of15-24 years. ..... 12 Table 2: Shows result of drinking water test taken from storage tanker and point of use. ........... 16 Table 3: Mixed cause diarrheal distribution by Microscopic stool analysis findings, Addis Raey training center, Afar, Ethiopia-July 2015 ..................................................................................... 17 Table 4: Socio-demographic characteristics of diarrheal disease in Addis Raye Camp, Afar 2015 ....................................................................................................................................................... 18 Table 5: Risk Factors among visiting diarrheal disease patients in Addis Raye Camp, Afar 2015 ....................................................................................................................................................... 18 Table 6: Independent predictors of diarrhea, in Addis Raye Camp, Afar, 2015 .......................... 20 Table 7: Influenza like Illness cases distribution by age group and sex, Debretabor Town Prison Center and Some Megendi Kebele Villages of Farta Woreda, South Gonder Zone, Amhara regional state, Ethiopia, Feb.2016................................................................................................. 42 Table 8:Throat swab test result of suspected, Influenza like Illness among patients who were tested positive for influenza A(H1N1) pdm09 at EPHI, Addis Ababa, Ethiopia Feb, 2016. ....... 43 Table 9 : Socio-demographic characteristics of Influenza like Ilness in rural and prison settings of South Gondar, northwest Ethiopia, February- 2016. ................................................................ 44 Table 10: Risk Factors among visiting Influenza like Ilness patients in rural and prison settings of South Gondar, northwest Ethiopia, February, 2016. ............................................................... 45 Table 11: Independent predictors of Influenza like Illness outbreak in rural and prison settings of South Gondar, northwest Ethiopia, and February, 2016. .............................................................. 46 Table 12: Meningococcal meningitis Cases and Deaths – Ethiopia: 2010 -2014......................... 64 Table 13: Meningococcal meningitis Cases and Deaths by Age groups, Ethiopia, 2013. ........... 66 Table 14: Five year reported case of malaria by month Enderta woreda Tigray, 2008 EC .......... 87 Table 15: Mygenet HP Five year malaria cases report by month Enderta woreda Tigray, 2008 EC ....................................................................................................................................................... 93 Table 16: Demographic data by Kebeles,
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