ETHIOPIAN FIELD EPIDEMIOLOGY ANDLABORATORY TRAINING PROGRAM (EFLTP) COMPILED BODY OF WORKS IN FIELD EPIDEMIOLOGY

Abstract

Executive Summary This body of works is the summary of all outputs produced and core competences accomplished during a two years and half field residency in the Field Epidemiology and Laboratory Training Program. These include outbreak investigation, surveillance data analysis, surveillance system evaluation, district health profile description, thesis development, scientific writing and communication (abstracts, manuscripts, and articles) development of laboratory standard procedures and manual. Investigation of acute watery diarrhea outbreak in Segeg district, Nogob zone of Somali region Ethiopia, from 10th March to 15th April 2017 was done. This investigation was conducted as part of public health response for the outbreak. The outbreak was described by person, place and time characteristics, possible causes or risk factors and sources of the outbreak were identified. Public health interventions appropriate for the outbreak were recommended, and timely control and prevention measures were implemented following the investigations. Analysis of ten years (January, 2006-Janury, 2015) routine public health surveillance data of under five measles reported from southern nations, nationalities and peoples region was conducted. In this study the incidence of under-5 measles was assessed. The Proportion of epidemiologically linked, confirmed and suspected cases was identified. The proportion of confirmed measles cases was described. Vaccination status and distribution of cases by age and sex was determined. Moreover, description by place, person, and time was performed. Evaluation of a health facilities based malaria surveillance system of Kedida Gamela woreda of kembata Tembaro zone, SNNPR was conducted with the objective of assessing the performance and operation of core and supportive functions and the system attributes, and identifying possible gaps in the system for improvement. The woreda disease surveillance officers and surveillance focal persons from selected health facilities were involved in the evaluation. Data analysis, interpretation, management, epidemic preparedness plan, timeliness of report and malaria monitoring chart were major deficiencies in the malaria surveillance system. Discussions were also conducted with woreda health officials on the identified gaps and recommendations were forwarded for all stakeholders. District health profile description of Damboya woreda of Kembata Tembaro zone, SNNPR region was conducted. The objective of the assessment was to describe the district health system and the health status of the population, provide broad overview of the social, economic, demographic and geographic determinants of health, identify priority public health problems of the woreda and produce a baseline health profile document for possible intervention programs on the identified health problems and further studies. AFI &AURTI were the leading causes of morbidity in adults and under- five respectively in the woreda. Coverage of basic health services like immunization, ANC family planning and PNC is higher than the average for the zone as well as the region. But the coverage of skill birth attendants and Tuberculosis detection rate were low. Data management and retention needs due attention in the woreda. A copy of the health profile document was shared with district and regional health officials and other stakeholders. Scientific manuscript for peer reviewed journals and abstracts for scientific presentations were prepared. A research paper was developed on the prevalence and associated risk factors of Hepatitis B and hepatitis C viruses among women following antenatal care in Durame general hospital, southern Ethiopia. In the study the prevalence of hepatitis B and C viruses was determined and risk factors associated with both viruses infection were identified. Blood transfusion, family history of liver disease and multiple sexual exposures were potential factors for hepatitis B and history of previous surgery and family history of liver disease were risk factors for hepatitis C virus infection. Laboratory quality manual of Durame general hospital was developed with the aim of improving the provision of quality of laboratory activities. Standard Operating Procedures (SOPs) for the detection of salmonella typhi and blood film for blood parasites examination were developed. Additionally the way forward was given to develop SOP for other tests being performed without SOP.Other activities such as provision of training for public health emergency management (PHEM) officers working at different levels (regional to health facility level) on public health surveillance and response were also undertaken.