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Addis Ababa University, College of Health Sciences 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 Elsabetee Megrssa 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 2014 Addis Ababa 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 Elsabetee Megrssa 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 Dr.Ayele Belachew Dr. John Fogarty May 2014 Addis Ababa ii Addis Ababa University School of Graduate Studies Compiled Body of Works in Field Epidemiology By Elsabetee Megrssa Ethiopia Field Epidemiology Training Program (EFETP) School of Public Health, College of Health Sciences Addis Ababa University Approval by Examining Board _________________________ ___________________ Chairman, School Graduate Committee _________________________ ___________________ Advisor _________________________ ___________________ Examiner _________________________ ___________________ Examiner iii Acknowledgments First of all I would like to thank my mentors Dr Ayele Belachew and Dr.John Fogarty for their guidance, support and inputs in my work. Secondly, I would like to thank Dr. Lucy Boulanger, Dr.Getahun Aynalem, Dr.Desalegn Dalecha, Dr. Adamu Addis, Dr. Zegeye Hailemariam, Ms. Abigail Greenleaf, Mr. Alemayehu Bekele and Mr. Abyot Bekele for their constructive comments and contribution during field base supervisions. Third, I would like to thank Dr. Daddi Jimma; he is a deputy director general of Ethiopian Public health Institute and all PHEM staff for their cooperation and contribution during my study period. Fourth, I also would like to thank different regional health bureau, zonal health department, Woreda health offices, community members and other related sector for their coordination, collaboration and contribution during outbreak investigation. At the last but not the least I would like to thank Ethiopian Public Health Association for its financial and logistic support provided to me. iv Table of Contents Table of Contents ............................................................................................................................ v List of Tables ................................................................................................................................ vii List of Figures ................................................................................................................................ ix List of Map ...................................................................................................................................... x List of Abbreviations .................................................................................................................... xii Executive Summary ..................................................................................................................... xvi Chapter I – Outbreak Investigation ................................................................................................. 1 1.1. Meningitis Outbreak, Hababo Guduru Woreda-Oromia Region, Ethiopia-2013 ................ 1 1.2. Measles Outbreak in Kechene Medhanialem Orphanage, Addis Ababa, Ethiopia-2014 .. 14 1.3 Dengue Fever Outbreak Investigation in Adaar Woreda, Afar Region, Ethiopia-2014 ..... 26 Chapter II – Surveillance Data Analysis ....................................................................................... 38 Epidemiology of Meningococcal Meningitis-Ethiopia, 2005-2012 .......................................... 38 +Chapter III – Evaluation of Surveillance System ....................................................................... 47 Evaluation of Measles Surveillance System in Afar Region, Ethiopia, 2013 ........................... 47 Chapter IV – Health Profile Description Report........................................................................... 58 Health Profile of Awash Fentale Woreda, Afar Region-2013 .................................................. 58 Chapter V – Scientific Manuscript for Peer Reviewed Journal .................................................... 82 5.1 Measles Outbreak in Kechene Medhanialem Orphanage, Addis Ababa, Ethiopia-2014 ... 82 5.2 Dengue Fever Outbreak Investigation in Adaar Woreda, Afar Region, Ethiopia-2014 ..... 89 Chapter VI – Abstract for Scientific Presentation ........................................................................ 97 v 6.1 Meningitis Outbreak, Hababo Guduru Woreda-Oromia Region, Ethiopia-2013 ............... 97 6.2. Measles Outbreak in Kechene Medhanialem Orphanage, Addis Ababa, Ethiopia-2014 .. 99 6.3. Dengue Fever Outbreak Investigation in Adaar Woreda, Afar Region, Ethiopia-2014 .. 100 6.4 Epidemiology of Meningococcal Meningitis-Ethiopia, 2005-2012 .................................. 102 6.5. Evaluation of Measles Surveillance System in Afar Region, Ethiopia, 2013 .................. 103 Chapter VII – Narrative Summary of Disaster Situation Visited ............................................... 104 Meher Human Health and Nutrition Emergency Need Assessment- Gedio, Kenbata Tenbaro, and Sidama Zone of SNNP Region-2013 ............................................................................... 104 Chapter VIII – Protocol/Proposal for Epidemiologic Research Project ..................................... 125 Assessment of Knowledge, Attitude and Practice of Bed Net use to Prevent Malaria Infection among Rural Community, Wolyita Zone, Southern Ethiopia-2014........................................ 125 Chapter IX – Other Additional Output Report ........................................................................... 141 Public Health Emergency Management Week 07 Bulletin-2013 ........................................... 141 vi List of Tables TABLE 1: CLINICAL PRESENTATION OF MENINGITIS, HABABU GUDURU WOREDA, OROMIA REGION, 2013 ........................................................................................................................... 7 TABLE 2: BIVARIATE ANALYSIS OF DIFFERENT EXPOSURES, HABABU GUDURU WOREDA, OROMIA REGION, 2013 ........................................................................................................................... 8 TABLE 3: CLINICAL PRESENTATION OF MEASLES IN KECHENA MEDHANIALEM ORPHANAGE, ADDIS ABABA, 2014 .......................................................................................................................... 19 TABLE 4: SOCIO-DEMOGRAPHIC INFORMATION OF CASES AND CONTROLS, KECHENA MEDHANIALEM ORPHANAGE, ADDIS ABABA, 2014 ............................................................... 19 TABLE 5: BIVARATE ANALYSIS FOR DIFFERENT EXPOSURES, KECHENE MEDHANIALEM ORPHANAGE, ADDIS ABABA, 2014 ......................................................................................... 20 TABLE 6: SOCIO-DEMOGRAPHIC INFORMATION OF CASES& CONTROLS, ADAAR WOREDA, AFAR REGION-2014 ......................................................................................................................... 31 TABLE 7: BIVARATE ANALYSIS FOR DIFFERENT EXPOSURE ADAAR WOREDA, AFAR REGION-2014 ............................................................................................................................................... 32 TABLE 8: CASES AND DEATHS OF MENINGITIS BY REGION-ETHIOPIA, 2005-2012. ....................... 41 TABLE 9: INCIDENCE AND CFR OF MENINGITIS BY AGE GROUP-ETHIOPIA, 2005-2012 ................ 42 TABLE 10: POPULATION BY SEX AND KEBELE, AWASH FENTALE WOREDA, AFAR REGION, 2005 EFY ........................................................................................................................................ 60 TABLE 11: POPULATION IN DIFFERENT GROUPS, AWASH FENTALE WOREDA, AFAR REGION, 2005 EFY ........................................................................................................................................ 61 TABLE 12: VITAL STASTIC OF AWASH FENTALE WOREDA, AFAR REGION, 2004 EFY ................... 62 TABLE 13: HEALTH FACILITY LIST BY KEBELE, AWASH FENTALE WOREDA, AFAR REGION, 2005 EFY ........................................................................................................................................ 62 TABLE 14: PROFESSIONAL TO POPULATION RATIO, AWASH FENTALE WOREDA, AFAR REGION, 2005 EFY ............................................................................................................................... 63 TABLE 15: DESCRIPTION OF EPI COVERAGE, AWASH FENTALE WOREDA, AFAR REGION, 2004 EFY ............................................................................................................................................... 64 TABLE 16: TOP TEN LEADING CAUSES OF OPD VISIT, AWASH FENTALE WOREDA, AFAR REGION, 2003 EFY ............................................................................................................................... 65 vii TABLE 17: TOP TEN LEADING CAUSE OF OUTPATIENT VISIT IN THE HEALTH CENTER OF AWASH, AFAR REGION, 2004 EFY ....................................................................................................... 66 TABLE 18: MALARIA CASE BY PARASITIC SPECIOUS AWASH FENTALE WOREDA, AFAR REGION, 2004 EFY ..............................................................................................................................
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