BackgroundYellow Fever (YF) is a viral hemorrhagic disease transmitted by aedes mosquito species. Approximately, 200,000 cases and 30,000 deaths occur worldwide every year. In Ethiopia, the last outbreak was reported in 1966 with 2200 cases and 450 deaths. A number of cases with deaths from unknown febrile illness reported from South Ari district starting from November 2012. This investigation was conducted to identify the causative agent, source of the outbreak and recommend appropriate interventions.MethodsMedical records were reviewed and Patients and clinicians involved in managing the case were interviewed. Descriptive data analysis was done by time, person and place. Serum samples were collected for serological analysis it was done using Enzyme-linked Immunosorbent Assay for initial screening and confirmatory tests were done using Plaque Reduction and Neutralization Test. Breteau and container indices were used for the entomological investigation to determine the risk of epidemic.ResultsA total of 141 Suspected YF cases with 43 deaths (CFR = 30.5%) were reported from November 2012 to October 2013 from South Omo Zone. All age groups were affected (mean 27.5, Range 1–75 Years). Of the total cases, 85.1% cases had jaundice and 56.7% cases had fever. Seven of the 21 samples were IgM positive for YF virus. Aedes bromeliae and Aedes aegypti were identified as responsible vectors of YF in affected area. The Breteau indices of Arkisha and Aykamer Kebeles were 44.4% and 33.3%, whereas the container indices were 12.9% and 22.2%, respectively.ConclusionThe investigation revealed that YF outbreak was reemerged after 50 years in Ethiopia. Vaccination should be given for the affected and neighboring districts and Case based surveillance should be initiated to detect every case.
Declaration of the novel coronavirus disease as a Public Health Emergency of International Concern necessitated countries to get ready to respond. Here, we describe key achievements, challenges and lessons learnt during the readiness and early response to COVID-19 in Ethiopia. Readiness activities commenced as early as January 2020 with the activation of a national Public Health Emergency Operations Centre and COVID-19 Incident Management System (IMS) by the Ethiopian Public Health Institute. The COVID-19 IMS conducted rapid risk assessments, developed scenario-based contingency plans, national COVID-19 guidelines and facilitated the enhancement of early warning and monitoring mechanisms. Early activation of a coordination mechanism and strengthening of detection and response capacities contributed to getting the country ready on time and mounting an effective early response. High-level political leadership and commitment led to focused efforts in coordination of response interventions. Health screening, mandatory 14-day quarantine and testing established for all international travellers arriving into the country slowed down the influx of travellers. The International Health Regulations (IHR) capacities in the country served as a good foundation for timely readiness and response. Leveraging on existing IHR capacities in the country built prior to COVID-19 helped slow down the importation and mitigated uncontrolled spread of the disease in the country. Challenges experienced included late operationalisation of a multisectoral coordination platform, shortage of personal protective equipment resulting from global disruption of importation and the huge influx of over 10 000 returnees from different COVID-19-affected countries over a short period of time with resultant constrain on response resources.
Background: Coordinating outbreak investigations requires effective interagency communication.Important tasks include making the initial notifications, establishing roles and responsibilities for each jurisdiction, providing updates on the progress of the investigations, revising priorities for the investigation, and establishing the next steps. The major goal of surveillance activities is to identify and eliminate preventable causes of morbidity and mortality. Outbreak response basically entails preparedness which helps to establish arrangements in advance to enable timely, effective and appropriate responses to specific potential hazardous events or emerging disaster situations that might threaten society/environment Objective: To review lessons learned from the October 2018 Wolayta Zone yellow fever outbreak management in SNNPR, Ethiopia.Methods: Qualitative research approach, with Thematic Analysis. Purposive sampling method was used. Data were collected through FGDs, in-depth interviews, observation and document reviews Results : Among the main findings of the review is the weakness of the surveillance to detect case; the surveillance system was not that much effective for early detection of viral hemorrhagic fevers and there was knowledge gap to detect in the existing. The Review found out further that preparedness plan was weak, failing to consider the outbreak for VRAM. However, it is worth-noting that the Review showed that despite late detection, a rapid response team was set up and was able to save the lives of many during the outbreak. The findings further showed there was good coordination among various stakeholders at different levels and with satisfying sharing of roles and responsibilities.Conclusion: Based on the major findings, it may be concluded that the surveillance system was weak to detect yellow fever outbreak occurrence in Wolaita Zone. A major gap is therefore the inability to include the case to the IDSR weekly report. Once the case was confirmed, the response to the crisis was fairly commendable. Even though there was a confusion on identifying the first case, after the confirmation of the first case, the case management went as per the standard guideline and SOPs, helping save so many lives through availing the service free of charge 4The importance of experiential learning is highlighted when the situation is getting more multifaceted as in the yellow fever (Carroll, 1995). One method used to establish and promote mindfulness and safety in an organization is the after-action review (Allen et al., 2010). An After-Action Review (AAR), is a discussion of an event that enables health professionals and colleagues with similar or shared interests to discover what happened, why it happened, and how to sustain strengths and improve on weaknesses for future incidents (USAID, 2006).Researchers emphasize the importance of post-incident discussion (i.e., AARs) that highlights strengths, weaknesses, and near failures and describe the findings as a key feature of safety cultures for future actions...
Hepatitis A virus is a non-enveloped, single-stranded, linear ribonucleic acid (RNA) virus Hepatovirus from the Picornaviridae. It is transmitted by ingestion of food contaminated by fecal matter. Gastrointestinal symptoms with Fever, fatigue, yellowing of the skin or eyes, light-colored feces and dark-colored urine are among symptoms. It is a cause of death for 15 000 annually around the globe. The objective of this study is to describe hepatitis A outbreak in in terms of person, place and time. We investigated the outbreak to describe the cases and to identify the etiology. Medical records and line list were reviewed and descriptive data analysis was performed. Serum samples were tested by Immunoglobulin M (IgM) enzyme linked Immunosorbent assay (ELISA) and real time polymerase chain reaction (PCR) methods. We included all 81 cases with acute jaundice syndrome diagnosis and analyzed the data using Microsoft Excel. A total of 81 persons were affected with the acute jaundice syndrome. Among those, 37 (46%) were females and 44 (54%) were males. The median age of patients was 7 years with range 1-40 years old. The overall attack rate of the outbreak was 27 per 100,000. The age of patients ranged from 1 to 40 years. Out of 18 tested samples, 11 (61%) were positive for Hepatitis A. From the total cases listed, 44 (45%) were from the local community and 37 (46%) were from the internally displaced people (IDP). The outbreak lasted from February to August 2017. Hepatitis A was confirmed affecting people below 40 years of ages in Dolo zone, Somali region, Ethiopia in 2017 and there will be no way that it cannot cause illness again.
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