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Background. Chikungunya virus is a ribonucleic acid (RNA) virus transmitted by a mosquito bite. Chikungunya virus outbreaks are characterized by rapid spread, and the disease manifests as acute fever. This study aimed at determining risk factors for chikungunya virus outbreak to apply appropriate prevention and control measures. Methods. Unmatched case-control study was performed to identify risk factors of chikungunya outbreak in Somali region of Ethiopia in 2019. Cases and controls were enrolled with 1 : 2 ratio. All cases during the study period (74 cases) and 148 controls were included in the study. Bivariate and multivariable analyses were implemented. The serum samples were tested by real-time polymerase chain reaction at Ethiopian Public Health Institute Laboratory. Results. A total of 74 chikungunya fever cases were reported starting from 19th May 2019 to 8th June 2019. Not using bed net at daytime sleeping (adjusted odds ratio (AOR): 20.8; 95% confidence interval (CI): 6.4–66.7), presence of open water holding container (AOR: 4.0; CI: 1.2–3.5), presence of larvae in water holding container (AOR: 4.8; CI: 1.4–16.8), ill person with similar signs and symptoms in the family or neighbors (AOR: 27.9; CI: 6.5–120.4), and not wearing full body cover clothes (AOR: 8.1; CI: 2.2–30.1) were significant risk factors. Conclusion. Not using bed net at daytime sleeping, presence of open water holding container, presence of larvae in water holding container, ill person with similar signs and symptoms in the family or neighbors, and not wearing full body cover clothes are risk factors for chikungunya virus outbreak.

Background; Malaria is caused by one or more of the five species of plasmodium species that can infect by the bite of female Anopheles. In Ethiopia, about 68% of the total population resides in areas with high malaria risk and 2,174,707 cases and 662 deaths due to malaria were reported in 2014–2015 with case fatality rate of 0.03%. The outbreak was reported on April 22/2019 (WHO week 17) then we investigate the outbreak to describe the magnitude of morbidity and mortality due to malaria outbreak, identify the etiologic agent and investigate factors associated with an occurrence of malaria outbreak.Methods; we conducted case control study in Bolosso Sore woreda. We used outbreak investigation questionnaire to asses’ risk factor for both cases and controls of patients. We collected 75 cases and 150 controls by face to face interview by administered questionnaire. We analysed the data with Epi Info.Version7.2.0.1 and SPSS.V 23 and the statistical we used 95% CI. Result; the overall attack rate of the woreda was 36.4 per 1000. From the cases Males are slightly more affected than females (38: 37) .The most affected age group is >15 years, 54 (72%) followed by 5-14, 17(22.7%). Plasmodium falcifarem is the highest proportion of malaria in the wereda. Having impregnated treated net have no problem but impregnated treated net who have used sometimes (AOR 10.214; 95% CI) was identified as a risk factor for malaria or more likely affected by malaria ten times each respectively than those impregnated treated net used always. Conclusion; Presence of intermittent rivers nearest to the community, open deep well near to their home and usage of impregnated treated net (those impregnated treated net use sometimes and never use impregnated treated net) were risk factors for onset/occurrence of the outbreak of malaria. We recommend all malarias area insecticide treated bed net should be distributed for all households according to their family member. Beside this, utilization of bed net should be monitored and optimized.

Background In 2010–2017, meningococcal serogroup A conjugate vaccine (MACV) was introduced in 21 African meningitis belt countries. Neisseria meningitidis A epidemics have been eliminated here; however, non-A serogroup epidemics continue. Methods We reviewed epidemiological and laboratory World Health Organization data after MACV introduction in 20 countries. Information from the International Coordinating Group documented reactive vaccination. Results In 2011–2017, 17 outbreaks were reported (31 786 suspected cases from 8 countries, 1–6 outbreaks/year). Outbreaks were of 18–14 542 cases in 113 districts (median 3 districts/outbreak). The most affected countries were Nigeria (17 375 cases) and Niger (9343 cases). Cumulative average attack rates per outbreak were 37–203 cases/100 000 population (median 112). Serogroup C accounted for 11 outbreaks and W for 6. The median proportion of laboratory confirmed cases was 20%. Reactive vaccination was conducted during 14 outbreaks (5.7 million people vaccinated, median response time 36 days). Conclusion Outbreaks due to non-A serogroup meningococci continue to be a significant burden in this region. Until an affordable multivalent conjugate vaccine becomes available, the need for timely reactive vaccination and an emergency vaccine stockpile remains high. Countries must continue to strengthen detection, confirmation, and timeliness of outbreak control measures.

Rabies infection is almost always a 100% lethal viral disease in all mammals, including humans. Although rabies is vaccine preventable disease, more than 60,000 people worldwide, and 2,700 people in Ethiopia die of fatal human rabies annually. The aim of this study was to generate strategic information on the extent of the burden of rabies and the existing major response strategies, in order to overcome and bring attention to the management of rabies outbreaks. Cross - sectional study design was used to assess the current situation of rabies burden in the Southern Nations, Nationalities, and Peoples' Regional States of Ethiopia. Data analysis revealed a total of 16 fatal human rabies and 287 suspected rabies exposures. The highest attack rate of 116.3 cases per 100,000 human subjects was reported in Tembaro woreda. As a result, 48 animal deaths of rabies have been reported, while cattle (28) have been more affected than other animal species. The lack of dog immunization, lack of community awareness of dog management, and inaccessibility and inefficiency of anti - rabies vaccines were major risk factors associated with the spread of rabies exposure between humans and animals. In conclusion, this study has clearly shown that both the existence and the high magnitude of fatal human and animal rabies are significant in the area. Multidisciplinary approach interventions to increase community awareness of dog vaccination, effective and immediate treatment of exposed individuals is recommended as a method of disease control and prevention.

Introduction Suspected cholera cases were reported to the city administration health bureau in Addis-Ababa, Ethiopia on June 5, 2016 and it was laboratory confirmed by culture on 7 June 2016. The outbreak was declared by the government on June 8, 2016. The aim of this study was to rapidly investigate the outbreak epidemiologically and guide response activities in the affected Sub cities of Addis Ababa city administration. Methods An unmatched 1:2 case-control study was conducted in six selected sub-cities of the city administration. Different laboratory tests were also done from suspected possible risk factors identified to support the epidemiological findings. A case was a patient greater than 5 years old, who developed acute watery diarrhea with or without Vomiting. Control was an individual greater than 5 years' old who stayed in the same township and did not suffer from cholera. A structured questionnaire was used to select cases and controls. Epi InfoTM statistical software was used to analyze the data. Results were presented in narratives, figures and tables. Results The present study found that, the study participants who used street-vended water (Odds Ratio (OR)=10.4; 95% CI: 1.20-90.9), those who reported holy water sources use (OR=2.7, 95% CI: 1.45-5.04), eating raw meat (OR=7.75; 95% CI: 3.86-15.54) or roasted meat (OR=2.16; 95% CI: 1.19-3.93) and vegetable salad (OR=2.07; 95% CI: 1.14-3.76) were associated with contracting cholera infection. The likelihood of contracting cholera was significantly higher among those who ate food from street vendor sources (OR=5.32; 95% CI: 1.82-15.56) and those who practiced open defecation (OR=8.12; 95% CI (2.20-29.81). Having a latrine (OR=0.29; 95% CI: 0.12-0.69) and proper hand hygiene practice (OR=0.22; 95% CI: 0.14-0.38) were found to be protective against cholera infection. Conclusion Improving awareness of the community by intensifying social mobilization activities through community participation in proper hygienic practice, proper waste disposal and latrine facility construction and utilization. Provision of safe water for the community by strictly conducting end-point assessment of water points and conducting a KAP assessment among food handlers to explore their knowledge and practices regarding safe food/drink handling and water treatment as well as initiate appropriate PH actions based on the findings which will be necessary for prevention of similar cholera outbreaks in the future.

Background: Dengue fever is a rapidly emerging vector born infectious disease caused by Dengue virus and it is now one of WHO reportable diseases. About 50 -200 million cases, 20,000 deaths occur annually. In Ethiopia the first outbreak of Dengue fever appeared in Dire Dawa city in 2013, where 9441 cases were recorded. The second Dengue fever outbreak occurred in Afar Region. Third and fourth was in Somali Region in Godey town, 2014 and 2015. In Godey town acute febrile illness cases of unknown cause become increased started from May 27, 2015. We investigated to identify risk factors of Dengue fever outbreak and commence control measures. Methods: A case-control study was conducted in Godey town, Ethiopia from 8-22 July 2015. Cases were defined according to the WHO guideline and controls were individuals with no sign and symptoms living in the same town with cases. We recruited 50 cases and 100 controls in the study. Medical records and line lists were reviewed. Data were collected at household level using structured questionnaires. Twenty-four serum samples collected from cases. Data was analyzed using SPSS 20 software. Result: We identified 223 cases with 0 death, 116 (52%) were male. The mean age of cases was 25.8 years. Ten cases were positive for Dengue fever by PCR at national laboratory. Lack of formal education (AOR=3.1; 95%CI: 1.30-7.49), living with ill person (AOR=2.8; 95%CI: 1.22-6.52), open containers in household (AOR=3.6; 95%CI: 1.34-9.38) and presence of larvae in the water containers (AOR=5.4; 95%CI: 2.33-12.44) were risk factors for the outbreak. Conclusion: Poor household water handling, living with ill person and lack of formal education contributes for occurrence of Dengue fever outbreak in Godey town. Health education and all other interventions associated with use of water and sanitation needs to be part of long-term control of Dengue.

Introduction: Influenza is a respiratory illness caused by influenza virus that can spread very easily from person to person. The virus is spread through the air by the exchange of fluid droplets from the mouth or nose of one person to another person due to sneezing and coughing. The manifestations of illness (fever, cough, sore throat) caused by the influenza virus are usually mild to moderate but for some it could be severe, leading to hospitalization and even death. In Ethiopia, influenza sentinel surveillance has been launched in 2008 with one ILI sentinel site (Shiromeda Health Center) and one SARI sentinel site (Yekatit 12 Hosp). Ongoing analysis of surveillance data is important for detecting outbreaks and unexpected increases or decreases in disease occurrence, monitoring disease trends, and evaluating the effectiveness of disease control programs and policies. This trend analysis was conducted to characterize ILI cases in person, place and time, determine the positivity rate of the sentinel site and put possible recommendations based on the findings. Methods: We reviewed five years Influenza (2013 to 2017) data of Shiro meda health center. Data was cleaned prior to analysis. Descriptive analysis by person, place and time was done using Microsoft excel 2013. Results displayed using narration, graphs and tables. Results: A total of 1,489 cases of Influenza like illness reported from Shiro meda health center for the last five years, of which 950 (64%0 were females and the remaining 539 (46%) were males. Out of the total reported cases, 98% were from Gullele sub-city. The most affected age group was 15-44 (49%) followed by 5-14 (32%). The positivity rate of the site was 30.31%. Of those positive cases for Influenza, 20% were Influenza type A and the remaining were Influenza type B. Some important characteristics of patients are missing. Conclusion: Almost all of the cases were reported from Gullele sub-city. The most affected age group was 15-44 followed by 5-14. Influenza type A and B are circulating in the sentinnel site. Regular data analysis and supevision is required to improve the quality of data produced in the sentinnel site.