Compiled Body of Works in Field Epidemiology

Abstract

Executive Summary In spite of many intervention activities undertaking recurrent and emerging public health diseases are remain a public health problem globally especially in developing countries. The Ethiopian government policy is more emphasis on prevention measures of communicable and non communicable diseases. Ethiopian Field Epidemiology Training Program that adapted from the United States Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Service (EIS) is one of the programs focusing on capacity building public health practitioners. The training enables trainers to conduct disease surveillance and implement prevention and control measures of prioritized diseases. I stayed from October 2015 to March 2018 in St. Paul‘s Hospital Millennium Medical College, Department of Public Health- Field Epidemiology Training Program and at Oromia Public Health Research Capacity Building and Quality Assurance Laboratory Field Base. During my stay; I carried out one outbreak investigation; one surveillance data analysis; one surveillance system evaluation; one Woreda health profile description; two Standard Operating Procedures; one Lab Manual; submission of two abstracts for scientific conference and a research. Chapter I: Mumps outbreak investigation in Dano woreda, western Ethiopia was conducted during my stay at the field base. Descriptive and Analytic Epidemiology was used during investigations to describe magnitude of the diseases and identify risk factors associated with diseases. We used 40 cases and 120 controls 1 to 3 ratio. The outbreak was occurred within two kebeles of Dano Woreda which were Dire Hujuba 28(70%) and Dano Shenen 12(30%). We identified that Mother‘s level of education and contact with mumps cases were contributed for mumps outbreak in the woreda. We recommend National vaccination campaign of Mumps vaccination should be initiated to avoid further occurrence of sporadic Mumps outbreak and further complication. Chapter II: Surveillance data analysis of Measles was conducted at East Shewa zone health office that was reported from September 2011 up to March 2016 which contains all measles case. A total of 955 Measles cases and 2 deaths with a Case Fatality Rate of 0.21% were reported from September 2011 up to March 2016 in East Shewa Zone. We recommend Measles vaccine campaign and health education for the community should be addressed in all areas of East Shewa Zone. Chapter III: Evaluation of surveillance system was conducted at Boset Woreda, East Shewa Zone, Oromia Regional State from 13-25 February 2017. During this evaluation, surveillance of malaria was assessed. The system is useful, simple, acceptable, flexible, but system attributes such as; Data quality, positive predictive value, and stability at woreda level still need great attention and improvement. Providing of updated guideline and training should be mandatory. Chapter IV: - Health profile description of Boset Woreda of East Shewa Zone of Oromia region was collected, analyzed and interpreted accordingly from April - May, 2016. Diarrhea and Helminthiais are still in the lists of top 10 leading causes of morbidity in both adults and under 5 children which suggest that, there were no proper utilizations of latrine and low awareness of sanitation and Hygiene practices, therefore the Woreda health office with stakeholder have to promote hygiene and sanitation for the community. Chapter V:-two abstracts were submitted for scientific conference .This includes: 1. Health Profile Description of Boset Woreda, East Shewa Zone, Oromia Region, Ethiopia, 2015/16 2. Measles Surveillance Data Analysis Report of East Shewa Zone, Oromia Region from 2011 to 2016. Chapter VI: two Standard operating procedures for Oromia Public Health Research Capacity Building and Quality Assurance Laboratory, this includes: 1. Procedure for Quanti-FERON IFN- γ test using ELISA 2. Procedure for Quanti-FERON-TB Gold incubation of blood and harvesting of plasma Chapter VII: Laboratory quality manual for Mojo Hospital, East Shewa Zone, Oromia, Ethiopia. Chapter VIII: a thesis of ―Determinants of pulmonary tuberculosis in public health facilities of Dire Dawa city administration, Eastern Ethiopia, case control study‖ Was conducted from October to December 2017. This study showed Gender, Educational status, Monthly income, Housing affordability, Smoking cigarette, Contact history, Body Mass Index, HIV status, and having separated kitchen were significantly associated with being infected with Pulmonary TB among patients aged 15 years or older in all governmental public health facilities of Dire Dawa city administration, Eastern Ethiopia. Health education on pulmonary TB should be given exhaustively by Dire Dawa health office through health extension workers for the community especially who had no formal education