ADDIS ABABA UNIVERSITY COLLEGE OF HEALTH SCIENCE SCHOOL OF PUBLIC HEALTH ETHIOPIAN FIELD EPIDEMIOLOGY TRAINING PROGRAM Compiled Body of Works in Field Epidemiology By Kidist Jifar Thesis Submitted to Addis Ababa University, School of Public Health in Partial Fulfillment for the Degree of Master of Public Health in Field Epidemiology Advisors - 1. Prof. Alemayehu Worku 2. Dr. Fufa Abunna June, 2019 Addis Ababa, Ethiopia ADDIS ABABA UNIVERSITY COLLEGE OF HEALTH SCIENCE SCHOOL OF PUBLIC HEALTH ETHIOPIAN FIELD EPIDEMIOLOGY TRAINING PROGRAM Compiled Body of Works in Field Epidemiology By Kidist Jifar Thesis Submitted to Addis Ababa University, School of Public Health in Partial Fulfillment for the Degree of Master of Public Health in Field Epidemiology Advisors - 1. Prof. Alemayehu Worku 2. Dr. Fufa Abunna June, 2019 Addis Ababa, Ethiopia Addis Ababa University School of Graduate Studies Compiled Body of Works in Field Epidemiology By Kidist Jifar 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 ________________________ ______________________ Advisor _________________________ ___________________ Examiner _________________________ ___________________ Examiner Compiled body of work –AAU [email protected] , 2019 Page iii Acknowledgements I would like to acknowledge my mentors Prof. Alemayehu Worku and Dr. Fufa Abunna for their continuous support in reviewing my outputs. I wish to express my appreciation to Addis Ababa University School of Public Health, all instructors, program coordinators and resident advisors for their efforts in transferring their knowledge that enabled me to gain a practical knowledge in this field of study. I would like to thank FMoH, CDC and EFETP for financing and providing technical support for the program. I extend my gratitude to Mizan tepi University community, Hawassa city administration, South Omo zone, Sidama zone, Gedeo zone and Misrak badewacho district for their support and facilitation during my field stay. I would also like to thank SNNP Regional PHEM staffs and all my class mates for their constructive input and technical advice. Finally, am very humbled to thank my family for their unconditional love and support especially my husband, thank you for your continuous support and inspiration during my school stay. Compiled body of work –AAU [email protected] , 2019 Page iv Contents Acknowledgements ....................................................................................................................................... 2 List of tables ................................................................................................................................................ vii List of figures ................................................................................................................................................ ix Abbreviations/Acronyms .............................................................................................................................. x Chapter One- Outbreak Investigation ........................................................................................................... 1 1.1 Dysentery outbreak investigation in Mizan Tepi University, Bench-Maji Zone, SNNPR, Ethiopia 2019 .......................................................................................................................................................... 1 1.2 Suspected Anthrax Outbreak Investigation among pastoralists in Nyangatom Woreda of South Omo Zone, SNNPR, 2018 ........................................................................................................................ 21 Chapter two -Surveillance Data Analysis .................................................................................................... 32 2.1 Acute flaccid paralysis/polio surveillance data analysis from 2013-2017, SNNPR, Ethiopia 2018. .. 32 Chapter Three- Evaluation of surveillance system ..................................................................................... 47 3.1 Evaluation of Maternal Death Surveillance and Response (MDSR) System in Hawassa city administration, SNNPR Ethiopia ............................................................................................................. 47 Chapter Four- Health Profile Assessment ................................................................................................... 63 4.1. Health Profile Description of Misrak Badewacho District, Hadiya Zone, SNNPR, Ethiopia 2018 .... 63 Chapter Five- Scientific Manuscript ............................................................................................................ 84 5.1 Dysentery outbreak investigation in Mizan Tepi University, Bench-Maji Zone, SNNPR, Ethiopia 2019 ........................................................................................................................................................ 84 .Chapter six- Scientific Abstract .................................................................................................................. 95 6.1 Dysentery outbreak investigation in Mizan Tepi University, Bench-Maji Zone, SNNPR, Ethiopia 2019 ........................................................................................................................................................ 95 Chapter Seven- Narrative Description of Disaster Situation....................................................................... 96 7.1 Meher Season emergency health and nutrition needs assessment conducted in SIDAMA and GEDEO zones of SNNPR, Ethiopia ........................................................................................................... 96 Chapter eight-proposal of epidemiologic research project ...................................................................... 116 8.1 Assessment of Knowledge, Attitudes and Practices regarding Anthrax among community in Nyangatom Woreda, South omo zone, SNNPR Ethiopia 2019 ............................................................. 116 Chapter nine-Other Additional Output Reports ....................................................................................... 126 9.1 Weekly Bulletin of PHEM Report -Epidemiologic Week 12/2019, SNNP Regional Health Bureau. 126 Annexes ..................................................................................................................................................... 129 Annex 1: Dysentery Outbreak Investigation Questionnaire ................................................................. 129 Compiled body of work –AAU [email protected] , 2019 Page v Annex 2: Checklist for Evaluation of Maternal Death Surveillance and Response (MDSR) System in Hawassa city administration, SNNPR Ethiopia ...................................................................................... 132 Annex 3: Checklist for Health Profile Assessment of Misrak Badewacho District, Hadiya Zone, SNNPR, Ethiopia 2018 ........................................................................................................................................ 147 Annex 4: Rapid Meher Assessment- Health and Nutrition Sector: Region/Zone level Questionnaire. 154 Annex 5: questionnaire to assess knowledge, attitude and practice of anthrax in Nyangatom woreda south omo zone SNNPR ........................................................................................................................ 170 Compiled body of work –AAU [email protected] , 2019 Page vi List of tables Table 1: Clinical Symptoms of cases in Mizan Tepi University, Bench-Maji zone, SNNPR Ethiopia, 2019 Table 2: Bivariate Analysis of Risk and Protective Factors for Dysentery Outbreak, Mizan Tepi University Bench-Maji zone, SNNPR Ethiopia, 2019 .................................................................................... Table 3: Multivariate Analysis of Risk and Protective Factors for Dysentery Outbreak, Mizan Tepi University Bench-Maji zone, SNNPR Ethiopia, 2019 .................................................................................... Table 4: Acute Flaccid Paralysis age specific attack rate by age group SNNPR, Ethiopia, 2013-2017. Table 5: Reported AFP cases by zone and special districts by year, SNNPR, Ethiopia 2018. Table 6: Expected AFP cases by zone and district by year, SNNPR, Ethiopia 2018. Table 7: expected reported and non AFP rates by zones and special districts SNNPR, Ethiopia, 2018. Table 8: population under surveillance in selected health facilities, Hawassa city administration, SNNPR 2019. Table 9: Human resource of health institutions in the district, in 2009 E.C Table 10: vital statistics and health indicators of the District in 2009 E.C. Table 11: Immunization coverage of the District in children under one years of age in 2009 E.C Table 12: Top ten causes of morbidity (OPD visit) in adults in Misrak Badewacho district in 2009 E.C. Table 13: Top five causes of morbidity (OPD visit) in pediatrics in Misrak Badewacho district in 2009 E.C. Table 14: Demographic characteristics of Sidama zone, Loka abaya, bona Zuria and Aroressa District in, 2017/18 Table 15: The top five Causes of Morbidity in Loka abaya, Bona Zuria and Aroressa Districts in Sidama zone, 2017/18 Table 16: Malaria cases in Loka abaya, Bona zuria and Aroressa District 2017 Vs 2018 Table 17: Facilities with SAM management in Loka abaya, Bona Zuria and Aroressa