ETHIOPIA FIELD EPIDEMIOLOGY TRAINING PROGRAM (EFETP) COMPILED BODY OF WORKS IN FIELD EPIDEMIOLOGY

Abstract

Executive summary This body of works is the summary of all outputs produced, core competences accomplished and thesis during two years class & field residency in Field Epidemiology Training Program. These include outbreak investigations, surveillance data analysis, surveillance system evaluation, woreda health profile description, and conducted a research. The first chapter contains outbreak investigations of acute watery diarrhea in Gulele sub city, Addis Ababa, Ethiopia, in May 2017. For the outbreak case control study was conducted. The study result revealed eating salad, outside at gathering and raw meat and using common latrine were found as risk factors of disease contraction. Regarding surveillance data analysis, four years typhus HMIS report/data of Gulele Sub City from 2012-2015 were taken retrospectively and descriptive analysis by person, place and time was performed. HMIS report is used to make the 4 years data uniform because the surveillance data was incomplete & couldn‘t be described by place & person. Trend revealed the overall prevalence rate of typhus fever in the Sub City was almost increasing from 2011/12-2014/15 and the increment was by far high in 2014/15 (22.1 per.1000pop. per year). Among the woredas of Gulele Sub City, wereda 5 showed high prevalence in all years except in 2012/13. Generally Wereda 8 and wereda 3 are the least prevalent weredas in Gulele Sub City, A.A, Ethiopia. A surveillance system evaluation was also conducted in Gulele sub city, in February 2017 in five of the ten woredas of the sub city for one of public health important diseases, typhoid fever which is weekly reportable and one of the twenty communicable diseases under surveillance which had a significant magnitude from the weekly surveillance reports of Gulele sub city. The study finding revealed trend analysis were not being done by health centers, therefore the system was not sensitive & useful to detect outbreak, to estimate magnitude of the morbidity and mortality of the disease and to take action and decision making. In Gulele sub city the system was not satisfactory and there was also report discrepancy with the laboratory document in typhoid fever. But the system was confirmed by the respondents as it was simple and flexible by all assessed sites. Woreda 9 health profile description of Gulele sub city, Addis Ababa was conducted in May 2016. It includes description of three years data (2013-2015). The objective of the assessment was to describe the woreda health system and the health status of the population, provide broad overview of the social, economic, demographic and geographic determinants of health, to 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. Overall in the three years, Acute Upper Respiratory Infection, Other or unspecified infectious & parasitic diseases and Diarrhea were the leading causes of Morbidity in the Woreda respectively. A research was conducted on utilization of integrated management of neonatal and childhood illness (IMNCI) algorithm and associated factors among health professionals assigned at under five unit in governmental health centers in Addis Ababa, Ethiopia, 2017. The study revealed that the proportion of IMNCI implementation by health workers in the study setting was (57%). In this study 75.7% of health workers respond who have attended IMNCI training as compared to WHO recommendation (60% of facility health workers). The study also identified lack of training and negative attitude of health workers had significant association towards low implementation of IMNCI strategy