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Addis Ababa University, College of Health Sciences Addis Ababa University, College of Health Sciences, School of Public Health Ethiopian Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology By Getachew Abebe (BSc) 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 Addis Ababa University College of Health Sciences School of Public Health Ethiopian Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology By Getachew Abebe 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. Jemal Haeider Mr. Teklehymanot Gebrehiwot June 2015 Addis Ababa ADDIS ABABA UNIVERSITY School of Graduate Studies Compiled Body of Works in Field Epidemiology By Getachew Abebe Ethiopian 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 ________________ ________ Examine _________________ ________ Examiner Acknowledgments First of all, my deepest thank goes to almighty God for his generous and limitless hold and concern throughout my life and achievement in career. I want to express my heart full appreciation to Dr. Jemal Haidaer and Mr. Teklehymanot Gebrehiwot, mentors for their kind and constructive review of this document. I would like to express my grateful to the Ethiopian Field Epidemiology Training Program Resident advisor Dr. Lucy Boulanger and Dr. Getahun Aynalem, program director Dr. Zegeye Hailemariam and Dr. Adamu Addisse, Dr. Desalegn Dalecha Academic coordinators of the program for their unreserved technical and administrative support, guidance and motivation in achieving this output. My recognition also goes to Mr. Alemayehu Bekelle program coordinator from Ethiopian public health association and again to Mr. Teklehymanot Gebrehiwot and Getinet Abie field supervisors from Amhara regional health bureau PHEM core process for their support during all field attachment activities. I like to pay my great full appreciation to the organizations: Addis Ababa University, Federal Ministry of Health, CDC/Ethiopia, Ethiopian Public Health Association, Amhara Regional Health Bureau, District Health Offices, Health facilities and all other sectors who gave me all technical as well as financial support during my all residency time. The last but not the least, I extend my thanks to my co workers (cohort-5 residents), who helped me directly or indirectly during the residency time. Getachew Abebe, [email protected], EFETP-Residency output-2015 Page i Table of contents Page Acknowledgments............................................................................................................................ i Table of contents ............................................................................................................................. ii List of Tables ................................................................................................................................. iii List of Figures ................................................................................................................................ iv List of Maps ................................................................................................................................... vi List of Annexes .............................................................................................................................. vi List of Abbreviations ..................................................................................................................... vi Executive Summary ........................................................................................................................ 1 Chapter I – Outbreak/Epidemic Investigations ............................................................................... 3 Chapter II – Surveillance Data Analysis Report ........................................................................... 42 Chapter III – Evaluation of Surveillance System ......................................................................... 56 Chapter IV – Health Profile Description Report........................................................................... 90 Chapter V – Scientific Manuscripts for Peer reviewed Journals ................................................ 112 Chapter VI – Abstracts for Scientific Presentation ..................................................................... 136 Chapter VII – Narrative Summary of Disaster Situation Visited ............................................... 138 Chapter VIII – Protocol/Proposal for Epidemiologic Research Project............................ 155 Chapter IX – Other Additional Output Reports (If any) ...................................................... 171 Annexes....................................................................................................................................... 173 Getachew Abebe, [email protected], EFETP-Residency output-2015 Page ii List of Tables Table 1: Measles cases and controls by age group and vaccination status, Fogera, south Gondar zone, Amhara, 2014 ................................................................................................................................ 12 Table 2: Measles cases, attack rates and case-fatality rates by kebeles, Fogera, South Gondar Zone, ANRS, 2014............................................................................................................................................... 14 Table 3: Frequency of symptoms among measles cases, Fogera, South Gondar zone, Amhara, 2014 17 Table 4: Summary of bivariate and multivariate analysis of independent variables during Fogera measles outbreak risk factor analysis, Amhara, North West Ethiopia, 2014 ............................................. 17 Table 5: Measles cases and controls by age group and vaccination status, Chewaka, Illu-Aba-Bora zone, Oromyia, 2014 .............................................................................................................................. 32 Table 6: Measles cases, attack rates and case-fatality rates by kebeles, Chewaka, Illu-Aba-Bora Zone, Oromyia region, 2014 ................................................................................................................... 33 Table 7: Frequency of symptoms among cases, Chewaka, Illu-Aba-Bora zone, Oromyia, 2014 35 Table 8: Summary of bivariate and multivariate analysis of independent variables during Chewaka measles outbreak risk factor analysis, Oromyia, South West Ethiopia, 2014 ............................................ 36 Table 9: Distribution of TB types by year, Amhara region, North West Ethiopia, 2010-2013 .... 50 Table 9: List of PHEM immediately and weekly reportable diseases .......................................... 71 Table 10: The population under surveillance in the assessed district and cluster health centers . 72 Table 11: Number of health facilities in the study areas expected to report, Jawi, ANRS, July-June, 2013/2014 ..................................................................................................................................... 73 Table 12: Reporting rates of health facilities of Jawi district in 10 weeks (week 16- 25)/2014) . 74 Table 13: Measles cases and deaths by place and outbreak start date in Jawi, Awi, ANRS, February- May/2014 ...................................................................................................................................... 78 Table 14: Population data by age and sex, Jawi, Amhara, 2013 .................................................. 96 Table 15: Population by kebele and distance from woreda town ................................................. 99 Table 16: Type of water by source in Jawi woreda in 2005 E.C/2013 ....................................... 100 Table 17: Number of health facilities by type in Jawi woreda, 2014 ......................................... 101 Table 18: Number of health professionals by educational level in health facilities of Jawi woreda in 2014 ..................................................................................................................................................... 102 Table 19: Man power in Jawi woreda health office, 2014 ........................................................ 102 Table 20: Vital statistics data of Jawi woreda health office, 2014 ............................................ 104 Table 21: Top ten causes of morbidity/OPD visit/ in Jawi district, Amhara region, 2013 ......... 106 Table 22: Measles cases, attack rates and case-fatality cases by kebeles, Fogera, South Gondar Zone, ANRS, 2014 ................................................................................................................................ 117 Getachew Abebe, [email protected], EFETP-Residency output-2015 Page iii Table 23: Measles cases, attack rates and case-fatality r by kebeles, Chewaka, Illu-Aba-Bora Zone, Oromyia region, 2014 ................................................................................................................. 129 Table 24: Assessed zones and woredas, Amhara, Ethiopia, 2014 .............................................. 138 Table 25: Team Members during the assessment time, Amhara,
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