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 Dessalew Shitu 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 2019 Addis Ababa, Ethiopia 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 Dessalew Shitu 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 1. Dr. Abiy Girmay 2. Dr. Fikru Regassa May, 2019 Addis Ababa, Ethiopia Addis Ababa University School of Public Health Compiled Body of Work in Field Epidemiology By Dessalew Shitu Ethiopian Field Epidemiology Training Program (EFETP) School of Public Health, College of Health Science Addis Ababa University Approved by examining board ______________________________ ____________ Chairman, school graduate committee ______________________________ _____________ Advisor _______________________________ ____________ Examiner _______________________________ ____________ Examiner I. Acknowledgments I express my sincere and deepest gratitude to my academic mentors Dr Abiy Girmay and Dr Fikru Regassa who provided me unreserved support right from guidance on investigation and assessment phase to the final and as well as some technical issues of this document. I would also extend my thanks to field coordinator and resident advisor Mr.Zewdu Assefa and Ms. Wobayehu Kassa respectively who worked tirelessly in field related issues and sometimes in providing constructive ideas for the document. I also extend my great appreciations to all academic and program coordinating staffs for their work in all academic issues, technical support and program related issues. My special thank goes to the Federal Ministry of Health, Ethiopian Public Health Institute and CDC for their respective roles played throughout residency periods. My gratitude also goes to Benishangul-Gumuz Regional Health Bureaus, Zonal Health Departments, Woreda Health Offices, Health Facilities and others for their kind assistance and cooperation in investigations and assessments conducted. I II: Table of contents Contents I. Acknowledgments…………………………………………………………………………….……I II. Table of contents………………………………………………………………………………….II III. List of tables…………………..…………………………………………………………………IV IV. List of figures……………………………………………………………………………………VI V. List of annexes…………………………………………………………………………………..VIII VI. Abbreviations and acronyms.........................................................................................................IX VI. Summary foreword………………………………………………………………………………XI Chapter 1 : Outbreak investigation ..........................................................................................1 1.1. Rotavirus Outbreak investigation in Kurmuk district of Benishangul-Gumuz Region, Ethiopia Feb 2019. ..................................................................................................................1 1.2. Suspected Anthrax outbreak investigation in Homosha woreda, Assosa zone of Benishangul-Gumuz region, April, 2019. .............................................................................. 22 Chapter 2 : Surveillance data analysis report ........................................................................ 40 Surveillance data analysis report on Meningococcal meningitis in South Nations, Nationalities and Peoples’ Region from 2013-20177. ................................................................................. 40 Chapter 3 : Surveillance System Evaluation .......................................................................... 63 Meningococcal Meningitis Surveillance System Evaluation in Kolfe Keranio Sub-City, Addis Ababa, 2018 .......................................................................................................................... 63 Chapter 4 : Health profile ....................................................................................................... 89 Health Profile Assessment Report of Ginir Woreda, Bale Zone of Oromia Region, Ethiopia, 2018 ...................................................................................................................................... 89 Chapter 5 : Scientific Manuscript for Peer Reviewed Journals .......................................... 116 Rotavirus outbreak investigation in Kurmuk district, Assosa zone of Benishangul-Gumuz region, Feb, 2019................................................................................................................. 116 Chapter 6 : Abstracts for scientific presentation ................................................................ 132 Rotavirus outbreak investigation in Kurmuk district, Assosa zone of Benishangul-Gumuz region, Feb, 2019................................................................................................................. 132 Surveillance data analysis report on Meningococcal meningitis in South Nations, Nationalities and Peoples’ Region from 2013-2017 .................................................................................. 133 II Chapter 7 : Narrative Summary of Disaster Situation ........................................................ 134 Loss and damage assessment in IDPs affected due to conflict between Ethnic Oromos and Somalis in Bale zone, Oromia regional state, Ethiopia, 2018. .............................................. 134 Chapter 8 : Proposal for epidemiologic research project .................................................... 149 Mapping the risk of anthrax outbreaks both in humans and animals in Waghimra and South Gondar zones of Amhara regional state ............................................................................... 149 III III. List of tables Table 1.1: Distribution of Rotavirus cases by sex and age group in Kurmuk district, 2019. ..........8 Table 1.2: AR/1000 and CFR by sex and age group in Kurmuk district, BGR, Ethiopia, 2019. ....9 Table 1.3: AR/1000 and CFR by reporting Kebeles of Kurmuk district, Benishangul-Gumuz, 2019. ................................................................................................................................ 10 Table 1.4: Demographic characteristics of participants for case-control study, Kurmuk, BGR, 2019......................................................................................................................... 12 Table 1.5: Bivariate and multivariate logistic regression for Rotavirus outbreak in Kurmuk district, BGR, 2019. .............................................................................................................. 13 Table 1.6: Distribution of suspected GIT anthrax by sex and age group in Homosha woreda, April, 2019......................................................................................................................... 31 Table 1.7: AR/1000 of suspected anthrax by sex and place in Homosha woreda, Assosa zone, BG, 2019......................................................................................................................... 31 Table 1.8: 2018/2019 EFY livestock population and anthrax vaccination coverage by woreda in Assosa zone, April 2019. ......................................................................................... 32 Table 1.9: Demographic characteristics of participants for case-control study, Homosha woreda, BGR, April 2019. ..................................................................................................... 34 Table 1.10: Bivariate and multivariate logistic regression for anthrax outbreak in Homosha woreda, BGR, 2019. ................................................................................................ 34 Table 2.1: Data of phase I and II Meningitis "A" campaign in 2013 and 2014. .......................... 46 Table 2.2: Number of suspected meningitis reported cases, deaths and CFR by zones, SNNPR from 2013-2017. ...................................................................................................... 55 Table 2.3: Suspected meningitis cases, deaths, IR/100000 and CFR from 2013-2017 in SNNPR. ................................................................................................................................ 55 Table 3.1: List of Immediately and Weekly reportable diseases. ................................................ 73 Table 3.2 : Availability of guide lines, case definitions, reporting formats and clinical registers in visited health institutions in Kolfe Keranio Sub city, 2018. ...................................... 74 Table 3.3: Reporting sites, their completeness and timeliness in Kolfe Keranio sub city, 2018. 75 Table 3.4: Availability of epidemic preparedness and response resource in visited sites, Kolfe Keranio Sub city, 2018............................................................................................. 79 Table 3.5: Availability of resources for PHEM activates in visited health systems levels in Kolfe Keranio sub city, 2018. ............................................................................................ 81 Table 4.1: Number of health facility in Ginir district, Bale, Oromia Region, 2016/2017 .......... 101 Table 4.2: Number and type of health professionals in Ginir woreda, Bale zone, Oromia region, 2016/17. ................................................................................................................