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 Getachew Demissie Debele 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 AAU/SPH Page i Addis Ababa University College of Health SciencesSchool of Public Health Ethiopia Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology By Getachew Demissie Debele 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 Professor Ahmed Ali Mr. Gemechu Befa (MPHFE) June 2017 Addis Ababa ii Addis Ababa University School of Graduate Studies Compiled Body of Works in Field Epidemiology By Getachew Demissie Debele 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 Acknowledgments First, I would like to thank my mentors Professor Ahmed Ali and Mr.Gemechu Befa for their guidance, support and inputs in my work. Secondly, I would like to thank Dr. Adamu Addis, Ms. Abigiya Wondimagegnehu for their constructive comments and contribution during field base. Third, I would like to thank Mr Gemechu Shume; he is a core process owner of ORHB PHEM and all staff member of ORHB PHEM for their cooperation and contribution during my study period. Fourth, I also would like to thank ORHB, Different Zonal Health Department, Woreda health offices, community members and other related sector for their coordination, collaboration and contribution during outbreak investigation. Fifth, I would like to thank Ethiopian Public Health Association for its financial and logistic support provided to me. At the last but not the least, I would like to thank Gelan Town Health Office staff for their support. iv Table of Contents ACKNOWLEDGMENTS .......................................................................................................................................... IV LIST OF TABLES ......................................................................................................................................................... 1 LIST OF ABBREVIATIONS ........................................................................................................................................ 2 EXECUTIVE SUMMARY ........................................................................................................................................... 5 CHAPTER- I ................................................................................................................................................................ 8 OUTBREAK INVESTIGATION .................................................................................................................................. 8 1.1 INVESTIGATION OF INFLUENZA LIKE ILLNESS (H1N1) ......................................................................................... 9 1.2 INVESTIGATION OF HUMAN CUTANEOUS ANTHRAX OUTBREAK ........................................................................ 26 CHAPTER- II ............................................................................................................................................................ 47 SURVEILLANCE DATA ANALYSIS ...................................................................................................................... 47 2.1 SURVEILLANCE .................................................................................................................................................. 48 DATA ANALYSIS OF SEVERE ACUTE MALNUTRITION, ARSI ZONE, OROMIYA REGION, ETHIOPIA, 2005-2007 E.C . 48 CHAPTER- III ........................................................................................................................................................... 63 EVALUATION OF SURVEILLANCE SYSTEM ..................................................................................................... 63 3.1 EVALUATION OF PUBLIC HEALTH SURVEILLANCE SYSTEM OF BALE ZONE, OROMIA REGION, ETHIOPIA, 2017 ................................................................................................................................................................................. 64 CHAPTER – IV ....................................................................................................................................................... 102 HEALTH PROFILE .................................................................................................................................................. 102 4.1. HEALTH PROFILE DESCRIPTION OF AKAKI WOREDA, FINFINNE ZURIA OROMIA SPECIAL ZONE, OROMIA REGION ETHIOPIA, 2016 ...................................................................................................................................................... 103 CHAPTER- V .......................................................................................................................................................... 130 SCIENTIFIC MANUSCRIPT FOR PEER REVIEW JOURNAL ............................................................................ 130 5.1. SCIENTIFIC MANUSCRIPT FOR PEER REVIEWED JOURNALS ............................................................................. 131 CHAPTER- VI ......................................................................................................................................................... 143 ABSTRACTS FOR SCIENTIFIC PRESENTATION .............................................................................................. 143 6.1 INVESTIGATION OF HUMAN CUTANEOUS ANTHRAX OUTBREAK ..................................................................... 144 6.2 SURVEILLANCE DATA ANALYSIS OF SEVERE ACUTE MALNUTRITION ............................................................. 145 6.3 INVESTIGATION OF INFLUENZA LIKE ILLNESS (H1N1) OUTBREAK ................................................................... 146 CHAPTER – VII ...................................................................................................................................................... 147 NARRATIVE SUMMERY OF DISASTER SITUATION ....................................................................................... 147 7.1 NARRATIVE SUMMARY REPORT ON MEHER ASSESSMENT IN ARSI AND BALE ZONES, OROMIYA, ETHIOPIA, 2016 ............................................................................................................................................................................... 148 7.1.6. CONCLUSION ............................................................................................................................................... 160 CHAPTER- VIII ...................................................................................................................................................... 163 PROTOCOL/PROPOSAL FOR EPIDEMIOLOGIC RESEARCH PROJECT ........................................................ 163 v 8.1ASSESSMENT OF FACTORS AFFECTING UTILIZATION OF LATRINE, BERBERE WOREDA, BALE ZONE, OROMIA, ETHIOPIA, 2017 ...................................................................................................................................................... 165 CHAPTER – IX ....................................................................................................................................................... 178 OTHER ADDITIONAL OUTPUT REPORTS ......................................................................................................... 178 9.1. NARRATIVE SUMMARY REPORT OF AWD PREVENTION AND CONTROL ACTIVITIES DONE AT BERBERE WOREDA OF BALE ZONE, OROMIA REGION, FROM SEPTEMBER 2016- FEBRUARY ............................................... 179 9.2. BERBERE WOREDA AWD OUTBREAK PREVENTION AND CONTROL PREPAREDNESS RAPID ASSESSMENT REPORT, FEBRUARY 2017 G. C. ............................................................................................................................. 183 9.3. WEEKLY BULLETIN OF PHEM REPORT FOR WHO EPIDEMIOLOGIC WEEK 25/2016, AND WEEK 3/2017 OROMIA REGIONAL HEALTH BUREAU. ................................................................................................................................ 198 vi List of Tables 0.1 Table 1.1. Proportion Of Some Variables For Influenza (H1n1) Outbreaks In Robe Woreda Prison, Arsi Zone, Oromia Region, Ethiopia From 24/2/2016 --2/3/2016 ......................................................................................... 19 0.1table 1.3: Attack Rate Of Suspected Human Cutaneous Anthrax By Kebele, Sire Woreda Of Arsi Zone, Oromia Region, 2016 ........................................................................................................................................................ 34 0.1table 2.1:- Hot Spot Woredas, Arsi Zone, Oromia, Ethiopia, And 2008 E.C. ......................................................... 50 0.2table 2.2.Total New Admissions Of (Sam), Arsi Zone, Oromia, Ethiopia 2005 - 2007 E.C ................................... 54 0.3table 2.3:- Prevalence