Addis Ababa University College of public health science school of public health Ethiopia Field Epidemiology Training Program (EFELP) Compiled Body of Works in Field Epidemiology By Zemedkn Astatke Chekole 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 Ethiopia I Addis Ababa University College of public health science school of public health Ethiopia Field Epidemiology Training Program (EFELP) Compiled Body of Works in Field Epidemiology By Zemedkn Astatke Mentors’ Dr Wakgary Deressa Mr. Afework Tamiru F. Epidemiologist May 2016 II ADDIS ABABA UNIVERSITY School of Graduate Studies Compiled Body of Works in Field Epidemiology By: Zemedkun Astatke 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 Contents Acronyms ................................................................................................................................................... VIII Acknowledgement ........................................................................................................................................ X Executive Summary ...................................................................................................................................... XI Chapter One Outbreak Investigation......................................................................................................... - 1 - Chapter tow Evaluation of surveillance system .......................................................................................... 31 Chapter three Health profile description ..................................................................................................... 52 Chapter four Surveillance data analysis .................................................................................................... 81 Chapter five Protocol/proposal for epidemiologic research project .......................................................... 98 Chapter six abstract for scientific presentation ......................................................................................... 114 Chapter seven Borena field report ........................................................................................................... 117 Chapter eight Scientific Manuscript for .................................................................................................... 129 Chapter nine Scientific Manuscript for ..................................................................................................... 130 Bulletin & others ....................................................................................................................................... 136 IV List of figure Figure 1:-Distribution of measles case by date of onset chinaxsen district 2015 ......................................... 7 Figure 2:-Distribution of measles case by age and sex chinaksen District 2015 .......................................... 8 Figure 3:-Distribution of measles case by vaccination status 2015 .............................................................. 8 Figure 4:-picture of active scabies cases in anchar district 201 .................................................................. 24 Figure 5:-Line listed scabies cases during investigation 2016 anchar distric ............................................. 25 Figure 6:-Distribution of scabies case in anchar by age & sexdistrict 2016 ............................................... 25 Figure 7:-Distribution of scabies cases by sex in anchar woreda 2016 ...................................................... 26 Figure 8:-Epidemic curve of scabies cases in anchar district 2016 ............................................................ 26 Figure 9:- Data and information flow for public health activity ................................................................. 33 Figure 10:-Weakly report timelines by district 2015 .................................................................................. 42 Figure 11:-Weekly report completeness 2015 ............................................................................................ 43 Figure 12:- Top ten diseases in 2015 siraro district .................................................................................... 64 Figure 13:-Top ten causes morbidity of U 5years children in siraro district 2015 ..................................... 65 Figure 14:- Delivery attendant b/n skilled & safe delivery 2010-14 in siraro district ................................ 67 Figure 15:-Siraro district confirmed malaria cases 2005-2006 EPY .......................................................... 68 Figure 16:-Trends of TB case detection & treatment cure rate 2002-2006 EPY ........................................ 70 Figure 17:- Trends of OTP new admission in siraro district 2004-2007-EPY ............................................ 73 Figure 18:-Monthly new SC admission in siraro district 2004-2007 EPY ................................................. 74 Figure 19:- New admission of SC cases during supervision 2015 .............................................................. 74 Figure 20:- Traditional ambulance for caring laboring mother in siraro district 2015 ............................... 77 Figure 21:- Contributed serials from the community for mothers in weighting room after delivery 2015 77 Figure 22; _ CTC established in moyale district of Borena zone oromia 2015 ........................................ 122 Figure 23:- Picture to demonstrate shortage of water is moyale district 2015 .......................................... 128 Figure 24:-Borena zonal task force meeting ever other days during disaster period 2015 ....................... 128 V List of Table Table 1:- Chinaxsen district measles case by kebele 2015 ........................................................................... 9 Table 2:-Cases & death in chinaxen district 2015 ...................................................................................... 10 Table 3:-Socio demographic characterstic cases & control in chinaxen district 2015 ................................ 12 Table 4:-Identified risk factors for measles case in chinaxen district 2015 ................................................ 13 Table 5:-Population under surveillance in West Arsi zone 2015 ................................................................ 36 Table 6:-Immediately & weekly reportable disease list .............................................................................. 38 Table 7:- material used for PHEM department ........................................................................................... 41 Table 8:-Non AFP case detection & stool adequacy rat 2008-13 GC ........................................................ 44 Table 9:-West Arsi zone Measles case detection from 2008-13 GC .......................................................... 45 Table 10:-District & H.C PHEM focal person training need assessment Wst Arsi zone 2015 .................. 46 Table 11:- Target population in siraro district 2015 ................................................................................... 57 Table 12:- Distribution of schools in siraro district 2015 EPY ................................................................... 59 Table 13:- Distribution of school enrolment in siraro district 2015 ............................................................ 59 Table 14:-Drinking water in siraro district 2015......................................................................................... 60 Table 15:- Wash activity in siraro district 2015 .......................................................................................... 60 Table 16:- Siraro district Health profession & supporting staff 2015 ......................................................... 62 Table 17:-Siraro district Human power in Health facility 2015 ................................................................. 63 Table 18:-Family Health activity in siraro district 2015 ............................................................................. 66 Table 19: Malaria activity in 2015 .............................................................................................................. 69 Table 20:- Tuberculosis activity 2015 ........................................................................................................ 69 Table 21: Hive activity 2015 ....................................................................................................................... 71 Table 22:- Active case search activity in siraro district 2015 ..................................................................... 73 Table 23:- Financial activity 2015 .............................................................................................................. 75 Table 24:- Giant chart of the EPi project activity in west hareghe zone 2016 .......................................... 107 Table 25:- Cost breakdown for epi project 2015 ...................................................................................... 108 Table 27:- latrine coverage 2015 in borena zone 2015 ............................................................................