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 Wadu Marshalo Anebo (BPharm) 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 Wadu Marshalo Anebo (BPharm) Submitted to the Graduate Studies of Addis Ababa University in partial fulfillment for the degree of Master of Public Health in Field Epidemiology Advisors Wondimu Ayele (MSc, PhD Candidate) Alemayehu Bekele (MPH, PhD) June 2017 Addis Ababa Compiled BOW final – Wadu Marshalo/June 2017 Page II ADDIS ABABA UNIVERSITY School of Graduate Studies Compiled Body of Works in Field Epidemiology By Wadu Marshalo Anebo 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 Acknowledgments I would like to thank my mentors Dr Alemayehu Bekele from Ethiopia Public Health Association and Mr. Wondimu Ayele from Addis Ababa University College of Health Science School of Public Health for spending their time mentoring at each outputs and providing constructive comments for each output in this document. I would like to acknowledge Addis Ababa University, School of public health, Ethiopia Field Epidemiology Program coordinators, EFETP directors, resident advisors and Supervisors Dr Adamu Addissie, Dr Tatek Anbessie, Dr Zegeye Hailemariam, Mr. Abdulnasir Abagero, Ms. Abigya Wondimagegn and Mr. Endashaw Shibru for their memorable supervision, material support and comments in the class and practical attachment sessions. I also thank all individuals, organizations and the community who provided me their support during all field investigation and program evaluation activities. At the last but not the least, I acknowledge CDC, MOH, SNNPR PHEM staffs, Bench Maji, Wolaita, South Omo zones health departments and Konta special district health office that they support me friendly in the duration of the field attachment in the regional health bureau and health departments. Compiled BOW final – Wadu Marshalo/June 2017 Page i Table of Contents Acknowledgments............................................................................................................................ i Table of Contents ............................................................................................................................ ii List of Tables ................................................................................................................................. iv List of Figures .............................................................................................................................. viii List of Annexes ............................................................................................................................... x Abbreviation and Acronyms .......................................................................................................... xi Executive Summary ......................................................................................................................... i Chapter I- Outbreak/Epidemic Investigations ................................................................................ 5 1.1 Measles Outbreak in Konta special district, Southern Nation Nationalities and Peoples Region, Ethiopia, 2016 – Case-control study ................................................................................. 5 1.2 An epidemic of Leg Swelling of Unknown Etiology in Mizan prison, Bench Maji Zone, Southwestern Ethiopia, 2016 ........................................................................................................ 31 Chapter II-Surveillance Data Analysis Report ............................................................................. 64 2.1 Measles Surveillance Data Analysis Report of South Nations, Nationalities and Peoples’ Region, 2012-2016, Ethiopia ........................................................................................................ 64 Chapter III-Evaluation of Surveillance System ............................................................................ 83 3.1 Evaluation of Maternal death, Measles and AFP Surveillance System of Wolaita zone, SNNPR, 2017 ................................................................................................................................ 83 Chapter IV-Health Profile Description Report ........................................................................... 114 4.1 Health Profile Description of Kindo Didaye district, Wolaita Zone, SNNPR – Ethiopia 2016 114 Chapter V- Scientific Manuscripts for Peer reviewed Journals .................................................. 143 5.1. An epidemic of Leg Swelling of Unknown Etiology in Prison, Southern Ethiopia, 2016 .. 143 Compiled BOW final – Wadu Marshalo/June 2017 Page ii Chapter VI – Abstracts for Scientific Presentation 6.1. Measles outbreak investigation of Konta special district, Southern Nations, Nationalities and Peoples’ Region, Ethiopia - 2016 .............................................................................................................. 162 6.2. An Epidemic of Leg Swelling of Unknown Etiology in Prison, Southern Nations, Nationalities and Peoples’ Region, Ethiopia, October 2016...................................................... 164 Chapter VII – Narrative Summary of Disaster Situation Visited ............................................... 166 7.1 (Belg) Humanitarian, Health and Nutrition Need Assessment, SNNPR June, 2016 ............ 166 7.2. Rapid Need Assessment and Humanitarian Health Action following Landslide Disaster in SNNPR, May 2016 ..................................................................................................................... 170 Chapter VIII – Protocol/Proposal for Epidemiologic Research Project ..................................... 183 8.1 Describing Maternal Death and Exploring Factors Affecting Implementation of Maternal Death Surveillance and Response in Wolaita Zone, Ethiopia 2017 ........................................... 183 Chapter IX - Other Additional Output Reports........................................................................... 208 9.1 Acute Febrile Illness Outbreak Investigation in South Omo Zone, SNNPR, Ethiopia - 2016 208 9.2. Summary of training on Public health surveillance and Diseases of Public Health Intelligence – at Tembaro/Mudula primary hospital from December 13 – 17, 2016 ................. 221 9.3. Weekly PHEM Bulletin Preparation .................................................................................... 224 Annexes....................................................................................................................................... 237 Compiled BOW final – Wadu Marshalo/June 2017 Page iii List of Tables Table 1 Summary of Number of Measles Cases and deaths in each kebeles of Konta Special district in SNNPR, Ethiopia – 2016....................................................................................... 16 Table 2 Number of Measles cases and deaths by age groups of Konta Special district, SNNPR – Ethiopia, March 2016 ............................................................................................................ 17 Table 3 Comparison of reports of district and Kebeles Annual Measles vaccination coverage, Konta special district, SNNPR, Ethiopia – 2016 ................................................................... 20 Table 4 EPI data quality checking for 2014/15, Albe Agare Kebele of Konta special district, SNNPR, Ethiopia, 2016 ......................................................................................................... 20 Table 5 Socio-demographic characteristics of Case-control study of Measles, Konta, SNNPR, Ethiopia, 2016 ........................................................................................................................ 24 Table 6 Bivariate Analysis and Adjusted Odds Ratio for Associated risk factors for Measles outbreak, Konta, SNNPR, Ethiopia – 2016 ........................................................................... 26 Table 7 Number of Cases by ethnic group present in each dormitory as of 03 November 2016, Mizan prison, SNNPR - Ethiopia .......................................................................................... 41 Table 8 Measure of 6 rooms of prisoners to know area and volume of each room, Mizan prison in SNNPR, Ethiopia - 2016 ................................................................................................... 48 Table 9 Socio-demographic characteristics of Case (N=103) and Controls (N’=206) of Mizan prison, SNNPR, Ethiopia - 2016 ........................................................................................... 50 Table 10 Socio-demographic characteristics continued from Table 4 .......................................... 51 Table 11 Personal hygiene related variable of cases (N=103) and controls (N’=206) in Mizan prison,