Compiled Body of Works 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 Ashenafi Ayalew Submitted to the school of Graduate Studies of Addis Ababa University in partial fulfillment for Degree of Masters of Public Health in Field Epidemiology May 1, 2015 Addis Ababa Ashenafi,[email protected] i Compiled Body of Works 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 Ashenafi Ayalew Worku 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 1-Dr Fikre Enquoselassie (Ph.D.) 2-Mr. Addisu Workineh (B.sc, M.P.H) May 1, 2015 Addis Ababa Ashenafi,[email protected] ii Compiled Body of Works ADDIS ABABA UNIVERSITY School of Graduate Studies Compiled Body of Works in Field Epidemiology By Ashenafi Ayalew Worku Field Epidemiology and Laboratory Training Program (EFELTP) School of Public Health, College of Health Sciences Addis Ababa University Approval by Examining Board _________________________ ___________________ Chairman, School Graduate Committee _________________________ ___________________ Advisor _________________________ ___________________ Examiner _________________________ ___________________ Examiner Ashenafi,[email protected] iii Compiled Body of Works Acknowledgement First and foremost, I am very grateful to the God for giving me the health, wellbeing and the strength that were very fundamental for the successful accomplishment of this venture. I am also grateful to my mentors Dr. Fikre Enquoselassie and Mr. Addisu Workineh for their support and guidance while I was working my outputs. I wish to express my earnest thanks for EFETP and CDC Ethiopia for launching such a vital field of study in the country. I am very proud to be part of this I am exceedingly grateful for field supervisors Mr. Belay Bezabih and Mr. Getinet Abie, who are PHEM core process owner and deputy core process owner at Amhara Regional State Health Bureau respectively, for permitting me to take part in numerous undertakings of PHEM so that I become competent epidemiologist. I am also exceedingly grateful for program coordinators and resident advisors: Dr. Adamu Addissie, Mr. Alemayehu Bekele, Dr. Lucy Boulanger and Dr. Zegeye Haile Mariam for their funding, guidance and encouragement they gave me during supportive supervision visits and at times whenever I demand ed them for assistance. I also wish to thank my mom and my siblings for their encouragement and support. I am also grateful to my fiancée, none of this would be possible without her love and support. The last but not the least that I want to place on record, my sense of gratitude to those health workers, health extension workers, officers, who are working (at regional, zonal and woreda level) and WHO EPI and surveillance officers (Dr. Solomon Wubie,Dr. Ayalineh Fanta and Dr. Kumie) who lent their had directly or indirectly, for the accomplishment of this venture . Ashenafi,[email protected] iv Compiled Body of Works Table of Contents ACKNOWLEDGEMENT ................................................................................................................................... IV LIST OF TABLES................................................................................................................................................ 5 LIST OF FIGURES .............................................................................................................................................. 6 LIST OF ABBREVIATIONS ............................................................................................................................... 7 EXECUTIVE SUMMARY ................................................................................................................................. 10 CHAPTER I – OUTBREAK/EPIDEMIC INVESTIGATIONS ....................................................................... 13 1.1 MEASLES OUTBREAK INVESTIGATION -BUGNA, ETHIOPIA, 2014 ................................................................... 13 1.2 MEASLES OUTBREAK IN GONJI KOLELA WOREDA, WEST GOJAM, AMHARA, 2015 ..................................... 31 CHAPTER II – SURVEILLANCE DATA ANALYSIS REPORT ................................................................... 47 CHAPTER III – EVALUATION OF SURVEILLANCE SYSTEM ................................................................. 67 CHAPTER IV – HEALTH PROFILE DESCRIPTION REPORT ................................................................... 90 CHAPTER V – SCIENTIFIC MANUSCRIPTS FOR PEER REVIEWED JOURNALS .............................. 119 CHAPTER VI – ABSTRACTS FOR SCIENTIFIC PRESENTATION ......................................................... 135 CHAPTER VII – NARRATIVE SUMMARY OF DISASTER SITUATION VISITED ................................ 139 CHAPTER VIII – PROTOCOL/PROPOSAL FOR EPIDEMIOLOGIC RESEARCH PROJECT .............. 148 CHAPTER IX – OTHER ADDITIONAL OUTPUT REPORTS .................................................................... 166 EBOLA VIRUS DISEASE PREPAREDNESS ............................................................................................................... 166 ANNEXES ........................................................................................................................................................ 186 OUTBREAK INVESTIGATION ................................................................................................................................. 186 1. Measles outbreak investigation Questionnaire ...................................................................................... 186 2. House to house rapid monitoring of measles vaccine coverage ............................................................ 188 SURVEILLANCE EVALUATION .............................................................................................................................. 189 4. Public Health Surveillance system Evaluation checklist (Woreda/Zone) ............................................. 189 5. Public Health Surveillance system Evaluation checklist (Health Facility)........................................... 194 HEALTH PROFILE ASSESSMENT CHECKLIST ........................................................................................................ 203 6. Checklist for Health profile assessment ................................................................................................. 203 PROPOSAL FOR EPIDEMIOLOGIC PROJECT ......................................................................................................... 222 7. Questionnaire for Households ................................................................................................................ 222 8. Dummy Tables ......................................................................................................................................... 226 EBOLA VIRUS DISEASE PREPAREDNESS .............................................................................................................. 229 9. EVD screening report format.................................................................................................................. 229 10. Tally Sheet for EVD screening ...................................................................................................... 229 List of tables Table 1 Diagnostic criteria for measles, Kuaro, Bugna, Amhara Regional State, Ethiopia, 2014 ........... 20 Table 2 Age-specific attack rate of measles in Kwaro, Bugna, Amhara, Ethiopia January 2014 ............ 23 Ashenafi,[email protected] 5 Compiled Body of Works Table 3 Diagnostic criteria for measles cases, Gonji Woreda, West Gojam, Amhara with onset February to April 2015 ............................................................................................................................................... 37 Table 4 Measles age specific attack rate, Gonji Kolela, West Gojam, Amhara 2015 ................................ 40 Table 5 Measles attack rate by kebele, Gunji Kolela Woreda, West Gojam, Amhara ........................ 42 Table 6: Suspected measles cases by age distribution, West Gojam, Amhara 2009 -2013 ........................ 52 Table 7: Number and proportion of susceptible individuals by woreda, West Gojam Zone, Amhara 2009- 2013 ............................................................................................................................................................ 60 Table 8: Vital statics, MDG targeted Health Indicators: .......................................................................... 101 Table 9: Indoor residual spray performance by targeted kebeles, Artuma Fursi, Ethiopia 2013 ............ 107 Table 10: Average staff requirement and gaps in selected professional categories to be filled at health center level, Artuma Fursi Woreda, Amhara Region, Ethiopia 2014 ....................................................... 111 Table 11: Plan of action after assessment ................................................................................................ 114 Table 12:Age-Specific Attack Rates In Kwaro, Bugna,Amhara, Ethiopia January, 2014 .. Error! Bookmark not defined. Table 13: List of trainings and conferences ............................................................................................