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Addis Ababa University, College of Health Sciences, School of Public Health Ethiopian Field Epidemiology Training Program (EFETP)

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Addis Ababa University, College of Health Sciences, School of Public Health Ethiopian Field Epidemiology Training Program (EFETP) 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 Equbay G/Egziabher (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 May 2016 Addis Ababa 1 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: Equbay G/Egziabher (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 Advisors Dr. Negussie Dayissa (MD, MPH, PHD) Mr.Muluken Gizaw (BSC, MPH) May 2016 Addis Ababa ADDIS ABABA UNIVERSITY School of Graduate Studies Compiled Body of Works in Field Epidemiology By: Equbay G/Egziabher (BSC) 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 _________________________ ___________________ Advisors Dr Negussie Dayissa (MD, MPH, PHD) ______________ Mr. Muluken Gizaw (BSC, MPH) ––––––––––––––––––– Examiner (External) Dr Abiy Hruy (MD, MPH) ___________________ Examiner Dr Ayele Belachew (PHD) ___________________ Acknowledgment On behalf of my works, I would like to thank my mentors (Dr Negussie Dayissa and Muluken Gizaw), instructors at AAU SPH, for their valuable support during the two years residency activities. My deepest gratitude goes to MOH, AAU, EPHA and CDC who may able me to have a knowledge and skill with their successful coordination and scientific management of the program. A special thank of mine goes to, TRHB and Mekelle Hospital, who made me a candidate for this special program. Next, I would like to thank all EFETP coordinators, AAU-SPH instructors for their efforts of continuous mentoring, sharing of their knowledge, advice and guidance during my residency time. Finally, but not the least my sincere thanks goes to Tigray regional health bureau PHEM officers, especially to Ato Yohanns G/Haweria field supervisor .At last I want to thank Ato Gbrekurstos Negash for his valuable comments. I Table of Contents Lists of Tables ............................................................................................................................................... III Lists of Figures ............................................................................................................................................... V Lists of Annexes........................................................................................................................................... VII List of Acronyms and Abbreviation ............................................................................................................ VIII Executive Summary ...................................................................................................................................... X Chapter I: Outbreak/Epidemic Investigations ........................................................................................... - 1 - 1.1. Malaria Outbreak Investigation in Asgede Tsimbla Woreda, Tigray, Ethiopia, Mar 1-10, 2016 ... - 1 - 1.2. Impetigo Outbreak Investigation, Wukro Klte Awlaelo, Eastern Zone of Tigray, Ethiopia, Jul, 2015 ................................................................................................................................................................ 24 1.3. Outbreak Investigation of Scabies, St.Goerge Church, Mekelle, Tigray, Ethiopia, 25-29 Sep, 2015. ................................................................................................................................................................ 41 Chapter II: Surveillance Data Analysis ....................................................................................................... 57 2.1. Measles Secondary Data Analysis of Tigray Region, Ethiopia Jul, 2011-Jun, 2015. ...................... 57 Chapter III: Surveillance System Evaluation .............................................................................................. 77 3.1. Surveillance System Evaluation of Measles and Malaria diseases in Kola Temben Wereda, Tigray, Ethiopia, Feb, 2016 ................................................................................................................................. 77 Chapter IV: Health Profile Description Report ......................................................................................... 132 4.1. Health profile description of kilte Awlaelo woreda, Tigray region, Ethiopia, Apr, 2015. ............ 132 Chapter V: Scientific Manuscripts for Peer Reviewed Journals ............................................................... 164 5.1. Malaria Outbreak Investigation in Asgede Tsimbla Woreda, Tigray, Ethiopia, Mar 1-10, 2016 .. 164 5.2. Impetigo Outbreak Investigation in Wukro Klte Awlaelo Woreda, Tigray, Ethiopia, 1-10, Jul, 2015. ..................................................................................................................................................... 176 Chapter VI: Abstracts for scientific presentations .................................................................................... 186 6.1. Malaria Outbreak Investigation in Asgede Tsimbla Woreda, Tigray, Ethiopia, Mar 1-10, 2016 .. 186 6.2. Impetigo Outbreak Investigation in Wukro Klte Awlaelo Woreda, Tigray, Ethiopia, 1-10, Jul, 2015. ..................................................................................................................................................... 187 6.3. Outbreak Investigation of Scabies in St.Goerge Church, Mekelle , Tigray, Ethiopia, Jul 25-Sep 29, 2015. ..................................................................................................................................................... 188 6.4. Measles Secondary Data Analysis of Tigray Region, Ethiopia Jul, 2011-Jun, 2015. .................... 189 II Chapter: VII Disaster Management Situation Report ............................................................................... 190 7.1.Narrative Summary of six Belg Beneficiary Woredas of South and South-Eastern Zones of Tigray, Jan-May, 2015....................................................................................................................................... 190 Chapter VIII: Protocol/Proposal for Epidemiological Research Project .................................................. 211 8.1. Prevalence of Asymptomatic Malaria and Associated Factors among School Children in Asgede Tsimbla District, Northern Ethiopia, 2016. ........................................................................................... 211 Chapter XV: Other Additional output reports ........................................................................................... 227 9.1. Surveillance data analysis of influenza, Mekelle Hospital sentinel site, Tigray , Ethiopia, Jun, 2013-Feb, 2015. .................................................................................................................................... 227 9.2. Emergency Health and Nutrition activities (EHN) ........................................................................ 241 9.3. Epidemiological Bulletins ......................................................................................................... 268 Lists of Tables Table 1.1.1 ASAR of malaria outbreak by each kebele and age group, Asgede Tsimbla, Tigray, Ethiopia, Jan 25-Feb 07, 2016. ............................................................................................................................... - 10 - Table 1.1.2 Demographic characteristics of the case-control study participants of malaria outbreak in A/Tsimbla district, Tigray, Mar 1-10, 2016------------------------------------------------------------------------12 Table 1.1.3 Bi-Variate analysis results of the risk factors of malaria outbreak with crude OR and level of significance, A/Tsimbla, Tigray, Ethiopia, Mar 1-10, 2016------------------------------------------------------13 Table 1.1.4 Shows Multi-Variate analysis result of the independent risk factors of malaria outbreak, A/Tsimbla, Tigray, Ethiopia Mar 1-10, 2016-----------------------------------------------------------------------14 Table 1.2.1 Analytic result of Impetigo outbreak, Klte Awlaelo, Tigray, Ethiopia, Jul, 2015 ................... 31 Table 1.2.2 DST results of the impetigo swabbed samples, Klte Awlaelo, Tigray, Ethiopia, Jul, 2015 .... 32 Table 1.2.3 Shows the socio-demographic characteristics of the ill and non-ill church students, Mekelle, Tigray, Ethiopia, Sep 25-29, 2015 .............................................................................................................. 46 Table 1.3.1 Shows Relative risk and 95% confidence interval of the independent factors of scabies outbreak, St.Goerge church, Mekelle, Tigray, Ethiopia, 25-29 Sep, 2015. ................................................ 48 Table 2.1 Age specific attack rate and number of measles cases by age group, Tigray, Ethiopia, Jul, 2011- Jun, 2015. .................................................................................................................................................... 66 Table 2.2 Shows annual incidence rate and number of measles cases by
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