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 Serawit Elias 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/2017 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 Serawit Elias 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 Mentors: Professor, Alemayehu Werku (PhD) Yeshitila Mogessie (BSc, Mph) Compiled Body of Works in Field Epidemiology [email protected] Page ii 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 Serawit Elias 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 Approved by Examining Board ______________________________________ ___________________________ Chairman, School Graduate Committee ______________________________________ ___________________________ Mentors ______________________________________ __________________________ Examiner1 _______________________________________ __________________________ Examiner2 Compiled Body of Works in Field Epidemiology [email protected] Page iii Acknowledgements I am very grateful for Professor Alemayehu Werku, Lecturer, Addis Ababa university, College of Health Sciences, School of Public Health and M/r Yeshitila Mogessie, Public Health Emergency Management (PHEM) officer, Southern Nation, Nationalities and People’s Region (SNNPR) Health Bureau for their invaluable support in the development of this document and they have played a good mentorship role. Secondly, my gratitude goes to M/r Endashaw Shibiru, Regional Health Bureau Public health emergency management core process owner for his supervisory role and facilitation of field activities by availing logistics including financial resources. Thirdly, I would like to thank my colleagues, cohort 7 field epidemiology training program residents who were assigned with me in Hawassa field base for their suggestions throughout residency. Specially, Degu Belachew and Abriham Lere need appreciation for their hard work in the field as coinvestigators of outbreaks. Finally, I would like to thank wholeheartedly the following individuals and institutions that have directly or indirectly involved in the process. Without them this body of work won’t be meaningful. Zonal and Woreda level PHEM officers, IDSR focal persons, data collectors, health centers, primary hospitals, health offices, SNNPR Health Bureau, Addis Ababa university school of public health, Ethiopian Public Health Association, CDC and Ministry of Health. Compiled Body of Works in Field Epidemiology [email protected] Page iv Table of Contents Acknowledgements ...................................................................................................................................... iv Table of Contents .......................................................................................................................................... v List of tables .................................................................................................................................................. 1 List of Figures ............................................................................................................................................... 2 List of Annexes ............................................................................................................................................. 4 List of abbreviations and acronyms .............................................................................................................. 5 Executive Summary ...................................................................................................................................... 9 Chapter 1: Outbreak/Epidemic Investigations ............................................................................................ 10 1.1 Investigation of scabies outbreak in Halaba special woreda, SNNPR, October/2016 ...................... 11 1.1.1 Abstract ...................................................................................................................................... 11 1.1.2 Introduction ................................................................................................................................ 12 1.1.3 Objectives .................................................................................................................................. 14 1.1.4 Material and Methods ................................................................................................................ 15 1.1.5 Results ........................................................................................................................................ 19 1.1.6 Discussion .................................................................................................................................. 25 1.1.7 Conclusions ................................................................................................................................ 27 1.1.8 Recommendations ...................................................................................................................... 27 1.1.9 References .................................................................................................................................. 28 1.2 Rubella outbreak investigation Chena district, Keffa zone, SNNPR, March/2016 .......................... 29 1.2.1 Abstract ...................................................................................................................................... 29 1.2.2 Introduction ................................................................................................................................ 30 1.2.3 Objectives .................................................................................................................................. 32 1.2.4 Methods ...................................................................................................................................... 32 1.2.5 Result ......................................................................................................................................... 35 1.2.6 Discussion .................................................................................................................................. 38 1.2.6 Conclusion ................................................................................................................................. 39 1.2.7 Recommendation ....................................................................................................................... 39 1.2.8 References .................................................................................................................................. 40 Chapter 2: Surveillance Data Analysis Report ........................................................................................... 41 2.1 Report of 5 year’s (2011-2015) Surveillance Data Analysis on Malnutrition, SNNPR, Nov/2016 . 42 2.1.1 Abstract .......................................................................................................................................... 42 2.1.2 Introduction .................................................................................................................................... 43 2.1.3 Objectives ...................................................................................................................................... 45 Compiled Body of Works in Field Epidemiology [email protected] Page v 2.1.4 Methods and materials ................................................................................................................... 45 2.1.5 Result ............................................................................................................................................. 46 2.1.6 Discussion ...................................................................................................................................... 54 2.1.7 Conclusion ..................................................................................................................................... 55 2.1.8 Recommendations .......................................................................................................................... 56 2.1.9 References ...................................................................................................................................... 57 Chapter 3: Evaluation of Surveillance System............................................................................................ 58 3.1 Report of Typhoid Fever Surveillance System Evaluation, Gedeo Zone, SNNPR, March/2017 ..... 59 3.1.1 Summary ........................................................................................................................................ 59 3.1.2 Introduction .................................................................................................................................... 60 3.1.3 Description of