Addis Ababa University, College of Health Sciences, School of Public Health Ethiopia Field Epidemiology Training Program (EFELP) Compiled Body of Works in Field Epidemiology By: Wake Abebe Lemma 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, 2015 Addis Ababa, Ethiopia Addis Ababa University, College of Health Science, School of Public Health 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: Wake Abebe Lemma 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: Dr. Adamu Addissie Mr. Tesfaye Deti May 2015 Addis Ababa II AAU-CHS-SPH-EFETP Compiled Body of Works by: Wake Abebe, May-2015 Addis Ababa University, College of Health Science, School of Public Health ADDIS ABABA UNIVERSITY School of Graduate Studies Compiled Body of Works in Field Epidemiology By: Wake Abebe Lemma 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 AAU-CHS-SPH-EFETP Compiled Body of Works by: Wake Abebe, May-2015 Addis Ababa University, College of Health Science, School of Public Health Acknowledgements My deepest gratitiude goes to my mentors; Dr. Adamu Addissie; at AAU-SPH and Mr. Tesfaye Deti who is Oromia Health Bureau PHEM core process Owner for the constructive and valuable suggestions and comments given to me. Next I will give my heartfelt thanks to Centers for Disease Control and Prevention (CDC), EFETP and Ethiopian Public Health Association (EPHA) for providing technical and financial support. My appreciation also goes to dedicated Residents Advisor Dr. Lucy Boulanger, Academic Coordinators of Field Epidemiology Training Program Dr Zegeye H/Mariam and Mr. Alemayehu Bekele for their unreserved mentoring, advice and guidance for the completion of this document. I would like to thank all instructors of the School of Public Health-AAU for their efforts in sharing their knowledge. Finally, I would like to acknowledge staffs of Oromia Public Health Emergency Management core process and Ethiopia Public Health Instutute for their valuable support during the residency period. IV AAU-CHS-SPH-EFETP Compiled Body of Works by: Wake Abebe, May-2015 Addis Ababa University, College of Health Science, School of Public Health Table of Contents Acknowledgements ...................................................................................................................................... IV Lists of Figures ............................................................................................................................................ VI Lists of Tables ............................................................................................................................................. VII Lists of Maps................................................................................................................................................ IX Lists of Annexs .............................................................................................................................................. X List of Abbreviations ................................................................................................................................... XI Executive Summary ................................................................................................................................... XIII CHAPTER-I Outbreak Investigations .......................................................................................................... 1 1.1 Measles Outbreak Investigation in Abuna Gindeberet District, West Shewa Zone, Oromia Region, Ethiopia-May, 2014 ........................................................................................................................................ 2 1.2. Measles Outbreak Investigation in Nedjo District, West Wellega Zone, Oromia Region, Ethiopia- February, 2015 .............................................................................................................................................. 22 CHAPTER-II Surveillance Data Analysis Report ...................................................................................... 41 2.1. Relapsing Fever Surveillance Data Analysis Report, East Shewa Zone, 2010-2013 ....................... 42 CHAPTER-III Evaluation of Surveillance System ..................................................................................... 57 3.1. Evaluation of Surveillance System for Malaria and Measles in Jimma Zone,2014................... 58 CHAPTER-IV Health Profile Description Report ...................................................................................... 83 CHAPTER-V Scientific Manuscript for Peer Reviewed Journals ............................................................ 110 5.1. Measles Outbreak Investigation in Abuna Gindeberet District, West Shewa Zone, 2014 ............. 111 CHAPTER-VI Abstracts for Scientific Presentations ............................................................................... 127 6.1. Measles Outbreak Investigation in Abuna Gindeberet District, West Shewa Zone, 2014 ............. 128 6.2. Assessment of Hospitals Preparedness towards Ebola Virus Diseases in Addis Ababa, 2015 ....... 130 CHAPTER-VII Narrative Summary of Disaster Situation ..................................................................... 132 7.1. Narrative Summary Report on Meher Assessment in Borena, Guji and West Arsi zones, 2014 ... 133 CHAPTER-VIII Protocol/Proposal for Epidemiologic Research Project ................................................ 155 8.1. Assessment of magnitude of vaccination status and factors related among Children Age 12-23 Months of age in Abuna Gindeberet District, Oromia, Ethiopia-2015 ....................................................... 156 CHAPTER-IX Other Additional Outputs ................................................................................................. 172 9.1. Assessment of Hospitals Preparedness towards Ebola Virus Diseases in Addis Ababa, 2015 ....... 173 9.2. Weekly Bulltetin –ORHB-PHEM-2014 ......................................................................................... 191 V AAU-CHS-SPH-EFETP Compiled Body of Works by: Wake Abebe, May-2015 Addis Ababa University, College of Health Science, School of Public Health Lists of Figures Figure 1: Distributions of measles cases by age group in Abuna Gindeberet District,May-2014 ............. 11 Figure 2: Age specific Attack rate in Abuna Gindeberet District, West Shewa, Oromia, May-2014 ........ 11 Figure 3: Distributions of measles suspected cases Abuna Gindeberet District, West Shewa,May-2014 .. 11 Figure 4: Cumulative Attack Rate of measles by Kebele in Abuna Gindeberet District, May-2014 ......... 12 Figure 5: Epi-curve based on date of onset of rash Abuna Gindeberet District, West Shewa, May-2014 . 13 Figure 6: Previous vaccination status of measles cases in Abuna Gindeberet District, May-2014 ............ 14 Figure 7: Distributions of cases by age in Nedjo District, Oromia, Ethiopia, Feb, 2015............................ 30 Figure 8: cases and cumulative Attack Rate of measles by Kebele in Nedjo District, Feb, 2015. ............. 31 Figure 9: Epi-curve based on date onset of rash Nedjo District, West Wellega, Oromia, Feb, 2015. ........ 32 Figure 10: Previous vaccination status of measles cases in Nedjo District, Feb, 2015. ............................. 33 Figure 11: The average five years adminstrative coverage of measles affected Kebeles, Nedjo, 2015 ..... 34 Figure 12: Trends of relapsing fever cases by year in East Shewa Zone, Oromia, from 2010-2013 .......... 48 Figure 13: Trends of relapsing fever cases by months East Shewa Zone, Oromia, from 2010-2013 ......... 49 Figure 14: Distributions of relapsing fever cases by districts, East Shewa Zone, Oromia 2010-2013 ....... 50 Figure 15: Incidence of relapsing fever cases by districts East Shewa Zone, Oromia from 2010-2012..... 51 Figure 16: Distribution of relapsing fever cases by District, East Shewa Zone, Oromia, 2010-2013 ........ 53 Figure 17: Data and Information flow in IDSR indicating varying cycles , Ethiopia, 2012) ..................... 62 Figure 18: Trends of malaria cases reported from January to June in Jimma Zone, Oromia, 2014 ........... 72 Figure 19: trends of measles cases by week in Oromia from 8/04/2013 - 1/07/2013 ................................. 72 Figure 20: The Average percentage of weekly PHEM report completeness, Jimma, Oromia-2006 EFY.. 79 Figure 21: Population pyramid of Boset District, Ethiopia, 2012/13.......................................................... 91 Figure 22: Organo-gram of Boset District, Ethiopia, 2012/13 .................................................................... 94 Figure 23: Trends of immunization status of Boset District, Ethiopia, 2010/11-2012/13 .......................... 96 Figure 24: Status of mothers’ health services in Boset District, Ethiopia, 2010/11-2012/13 ..................... 97 Figure 25: