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Addis Ababa University, College of Health Science, School of Public Health ADDIS ABABA UNIVERSITY, COLLEGE OF HEALTH SCIENCE, SCHOOL OF PUBLIC HEALTH Ethiopia Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology By Tasew Erena Duressa 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 June 2015 Addis Ababa i | P a g e ADDIS ABABA UNIVERSITY, COLLEGE OF HEALTH SCIENCE SCHOOL OF PUBLIC HEALTH Ethiopia Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology By Tasew Erena Duressa 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 Prof. Alemayehu Worku Dr. Lucy Boulanger June 2015 Addis Ababa ii | P a g e ADDIS ABABA UNIVERSITY, COLLEGE OF HEALTH SCIENCE, SCHOOL OF PUBLIC HEALTH Ethiopia Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology By Tasew Erena Duressa 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 Approval by Examining Board _________________________________ ______________________________ Chairman, School Graduate Committee _________________________________ ______________________________ Advisor _________________________________ ______________________________ Examiner _________________________________ ______________________________ Examiner iii | P a g e ACKNOWLEDGMENTS First of all, I would like to thank God for His Mercy and secrets of my success, my mentors Professor Alemayehu Worku, Dr.Lucy Boulanger and my supervisor Mr Abyot Bekele for the development of this document right from advice and guidance on investigation and assessment period to the final period. Also I would like to express my deep appreciation to AAU SPH for giving me this chance to exercise. Second, I would like to thank, Dr. Adamu Adisie, Dr. Zegeye Hailemariam and Mr. Alemayehu Bekele for their kind and constructive inputs. The comments and suggestions you all gave me during field base supervisions were give brightness for this document. Third, I would also like to thank my colleagues, Public Health Emergency Management staffs (PHEM), and my classmate cohort V Field Epidemiology Training Program Residents, for their input during my presentations for parts of this document. Forth, I would like to thank all study participants for their patience and hospitality to provide epidemiological information for outbreak investigation part of this document. Fifth, my gratitude goes to different regional health bureaus, zonal health departments, health facilities those were participated during investigation and assessment for their kind assistance and guidance. Sixth At last but not the least my gratitude goes to my beloved Wife w/o Amelework Tadesse and my Cute Daughter Thummim Tasew for their contribution and the fulfillments of this document, my beloved wife this was not successful without your support and encourage, you are really ” the secret of my achievement”. Finally, I would also extend my acknowledgement to Ethiopian Public Health Institute (EPHI), Ethiopian Public Health Association (EPHA), CDC and African Field Epidemiology Network (AFENET) for covering all the coasts used to conduct all separated papers indicated in this document. i | P a g e TABLE OF CONTENTS ACKNOWLEDGMENTS ............................................................................................................................. i TABLE OF CONTENTS .............................................................................................................................. ii LIST OF TABLES ....................................................................................................................................... iv LIST OF FIGURES ..................................................................................................................................... vi LISTS OF MAPS ....................................................................................................................................... viii LIST OF ANNEXES ................................................................................................................................... ix ACRONYMS ................................................................................................................................................ x EXECUTIVE SUMMARY ........................................................................................................................xiii CHAPTER I– OUTBREAK INVESTIGATION ......................................................................................... 1 1.1. Outbreak Investigation of Measles in Jimma Town, Oromia Region, Ethiopia 2014 .................. 1 CHAPTER II – SURVEILLANCE DATA ANALYSIS REPORT............................................................ 31 2.1 Analysis of Measles Surveillance Data in Ethiopia 2013 ........................................................... 31 Abstract ................................................................................................................................................... 31 CHAPTER III– EVALUATION OF SURVEILLANCE SYSTEM .......................................................... 65 3.1 Malaria Surveillance System Evaluation, Gidda Ayyana and Kiramu Woreda, East Wollega Zone, Oromia Region, Ethiopia 2014 ..................................................................................................... 65 CHAPTER IV – HEALTH PROFILE DISCRIPTION REPORT .............................................................. 87 4.1 Assessment of Health Profile Description of Dukem Town, Ethiopia 2014 .............................. 87 CHAPTER V – SCIENTIFIC MANUSCRIPTS ...................................................................................... 114 5.1 Outbreak investigation of Measles in Jimma Town, Oromia Region, Ethiopia, 2014 ............. 114 CHAPTER VI– ABSTRACT FOR SCIENTIFIC PRESENTATION ..................................................... 143 6.1 The Epidemiology of Measles in Ethiopia, 2013: A Retrospective Data Analysis .................. 143 6.2 Traveler Risk Assessment and Risk Management of Ebola Viral Disease in Ethiopia 2014 ... 145 CHAPTER VII – NARRATIVE SUMMARY OF DISASTER SITUATION ......................................... 147 7.1 Health and Nutrition Emergency Needs Assessment in Bale and Arsi Zones, May 2014 ........ 147 CHAPTER VIII –EPIDEMIOLOGIC RESEARCH PROJECT PROPOSALS ....................................... 166 8.1 Effectiveness of Cold Chain Management for Vaccines and factors contributing for poor cold chain management in Addis Ababa, 2015 ............................................................................................ 166 8.2 Post Outbreak Risk Assessment of Dengue Fever, and Opportunities for Integrated Control and Elimination in Dire Dawa Town, Ethiopia 2015. ................................................................................. 180 ii | P a g e 8.3 Level of Adherence to the Malaria Management Protocol among Health Workers Attending Under-Five Years Old Febrile Children at Weliso St. Lucas Catholic Hospital, South West Shewa, Oromia, Ethiopia 2015 .......................................................................................................................... 189 8.4 Assessment of Factors Associated with Full Immunization in Informal and Formal Settlements among Children 12-23 Months: Addis Ababa, Ethiopia 2014 .............................................................. 199 9.1 Outbreak Investigation and Response Training for Woreda, Zonal and Regional PHEM Officers, Adama, 2014 .......................................................................................................................... 207 CHAPTER X: EBOLA VIRUS DISEASE (EVD) PREVENTION AND CONTROL ACTIVITY ........ 214 10.1 Establishing EVD Screening Sites at Land Crossing ports in Gambella, 2014 ........................ 214 CHAPTER XI – EPIDEMIOLOGICAL BULLETIN .............................................................................. 227 11.1 Public Health Emergency Management Weekly Bulletin, Week 50, 2014 .............................. 227 11.2 Public Health Emergency Management Weekly Bulletin, Week 10, 2015 .................................. 230 iii | P a g e LIST OF TABLES TABLE 1: Demographic Characteristics of Measles Cases and Controls, Jimma, Oromia 2014 ................... 8 Table 2: Risk Factors for Contracting Measles Cases and Controls, Jimma, 2014 .............................................. 9 Table 3: Knowledge on Measles Cases and Controls, Jimma District, Oromia, 2014 ...................................... 11 Table 4: Independent Predictors of Measles in Jimma District, Oromia Region, 2014 .................................... 11 Table 5: Measles Cases Distribution by place and person, Dama Woreda, Oromia, Ethiopia 2015 ............ 23 Table 6: Socio Demographic Distribution, Dama Woreda, Guji Zone, Oromia, Ethiopia 2015 ................... 24 Table 7: Factors Associated With Measles, Dama Woreda, Guji Zone, Oromia, Ethiopia 2015 .................. 25 Table 8: Awareness On Measles, Guji Zone, Oromia, Ethiopia 2015 .................................................................... 25 Table 9: Independent Predictors of Measles Guji Zone, Oromia, Ethiopia 2015 ............................................... 26 Table 10: Distribution of Cases by Age Group,
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