ADDIS ABABA UNIVERSITY, SCHOOL OF PUBLIC HEALTH Ethiopian Field Epidemiology Training Program (EFETP) Compiled Body of Works in field Epidemiology By ALIY ENDRISS AHMED 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 7-2017 Addis Ababa ALIY ENDRISS AHMED [email protected] EFETP,2017 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 ALIY ENDRISS 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 Mr. Teklehaymanot G/Hiwot Dr. Niguse deyessa June 2017 Addis Ababa ALIY ENDRISS AHMED [email protected] EFETP,2017 2 ADDIS ABABA UNIVERSITY School of Graduate Studies Compiled Body of Works in Field Epidemiology By ALIY ENDRISS 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 _________________________ ___________ Examiner _________________________ _____________ Examiner ALIY ENDRISS AHMED [email protected] EFETP,2017 3 ACKNOWLEDGMENT First and for most my deepest thank goes to almighty Allah for his priceless and unlimited support and gift throughout my life. I want to express my deepest appreciation to Mr. Teklehaymanot Gebrehiwot and DR. NIGUSE, EFETP mentors for their kind and constructive review of my works. I would like to express my grateful appreciation to the Ethiopian Field Epidemiology Trainin g program director Dr. Zegeye Hailemariam, Academic coordinator of the program Dr. Adamu Addisse and Ms. abigiya abtow and Dr. Alemayehu Bekele program coordinator from the Ethiopian public health association for their unreserved technical and administrative support. I would like to put across my grateful appreciation to the organizations: Addis Ababa University , Federal Ministry of Health, Amhara national regional state Health Bureau, CDC/Ethiopia, Ethiopian Public Health Association, District Health Offices, Health facilities and all other sectors who supported me in any aspect of my work during my all residency time. Finally, I would like to thank healthcare providers, health extension workers and the community who supported me during data collection time. ALIY ENDRISS AHMED [email protected] EFETP,2017 4 Table of Contents ACKNOWLEDGMENT ..................................................................................................................................... 4 LIST OF TABLE ................................................................................................................................................ 6 LIST OF FIGURES ............................................................................................................................................ 7 LIST OF ANNEX .............................................................................................................................................. 8 LIST OF ABRIVAITION .................................................................................................................................... 9 EXCUTIVE SUMMARY .................................................................................................................................. 11 CHAPTER I: OUT BREAK INVESTIGATION.................................................................................................... 12 Chapter II—surveillance data analysis ........................................................................................................ 52 Chapter III—surveillance system evaluation .............................................................................................. 69 Chapter IV – Health Profile Description Report .......................................................................................... 86 Chapter V—Scientific Manuscript for peer reviewed journals ................................................................. 106 Chapter VII – Narrative Summary of Disaster situation visited ................................................................ 122 CHAPTER VIII –Protocol/Proposal for Epidemiologic Research Project .................................................... 135 ALIY ENDRISS AHMED [email protected] EFETP,2017 5 LIST OF TABLE Table 1: Distribution of scabies cases and attack rate by age group in bati woreda, oromia zone, Amhara Region, Ethiopia, 2016 ................................................................................................................................ 26 Table 2: Distribution of scabies cases and attack rate by sex in bati woreda, oromia zone, Amhara Region, Ethiopia, 2016: ............................................................................................................................... 26 Table 3: Summary of bivariate analysis of risk factor for scabies outbreak, bati district oromia zone Amhara, Ethiopia, 2016 .............................................................................................................................. 27 Table 4: Distribution of AWD cases by age group attack rate in jile tumuga district, oromia zone, Amhara Region, Ethiopia, 2016. ............................................................................................................................... 45 Table 5:Multi-variate analysis of factors associated with AWD in cases and controls in Jile tumuga district, oromia zone, Amhara region, Ethiopia, 2016. ............................................................................... 47 Table 6: The comparison of the study results zonal summary with international Standards, July 2011- June2016, oromia zone Amhara region, North West Ethiopia. .................................................................. 65 Table 7: Budget allocation of kemissie town, Amhara region, 2014/2015 . ............................................... 95 Table 8: number of health facilities and the ratio to the population in kemissie town, 2014/2015 . ........ 96 Table 9: The health professional to population ratio in kemissie town, 2014/2015 . ................................ 96 Table 10: The comparison of the study results zonal summary with international Standards, June/2011- June/2016, oromia zone Amhara region, North West Ethiopia ............................................................... 116 Table 11: Population distribution of rapid meher needs assessed districts, oromia zone, Amhara Region, June, 2016. ................................................................................................................................................ 126 Table 12: Top five cause of morbidity by district, oromia zone Amhara, 2016. ....................................... 128 Table 13: Case/death trend of outbreak prone diseases by month, meher season assessed districts, oromia zone, Amhara Region, sep/2016 .................................................................................................. 130 Table 14: Anticipated epidemics in oromia zones Amhara Region, 2016 G.C . ........................................ 131 Table 15: Budget break down for EPI project ........................................................................................... 143 Table 16: project implementation for EPI project ................................................................................... 144 ALIY ENDRISS AHMED [email protected] EFETP,2017 6 LIST OF FIGURES Figure 1: map of bati district, Amhara region, 2016 ................................................................................... 17 Figure 2: frequency of parts of body affected by scabies lesion among the scabies cases of bat district, Amhara, 2016 .............................................................................................................................................. 22 Figure 3: frequency of parts of body affected by skin sores among the scabies cases of bat district, Amhara, 2016 .............................................................................................................................................. 23 Figure 4: Number of scabies cases by date of onset of disease, bati district, Amhara, 2016 .................... 24 Figure 5: numbers cholera cases by kebeles of Bati district, Amhara, Ethiopia, 2016 ............................... 25 Figure 6: Map of jile tumuga districts, Amhara region, 2016 ..................................................................... 36 Figure 7: Frequency of sign and symptom among the AWD cases of jile tumuga districts, Amhara, 201642 Figure 8: AWD cases by kebele, Jile tumuga district, Amhara region, 2016 ............................................... 43 Figure 9: Number of AWD cases by date of onset of disease, Jile Tumuga, 2016 ...................................... 44 Figure 10: number of AWD case by age and sex of Jile tumuga, Amhara, 2016 ........................................ 46 Figure 11: Map of oromia zone, Amhara region, 2016 ............................................................................... 56 Figure 12: Number SAM cases by district and year in under–five children in Oromia zone Amhara region, July/2011-june/2016. .................................................................................................................................