Investigating a foodborne illness outbreak at a private girls’ school in Mashonaland East Province, Zimbabwe, 2015
Tsitsi Juru, Nsiande Lema, Daniel Chirundu, Rayyan Muhammad Garba, Joseph Asamoah Frimpong
The Pan African Medical Journal. 2018;30 (Supp 1):11. doi:10.11604/pamj.supp.2018.30.1.15271

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Case study

Investigating a foodborne illness outbreak at a private girls’ school in Mashonaland East Province, Zimbabwe, 2015

Cite this: The Pan African Medical Journal. 2018;30 (Supp 1):11. doi:10.11604/pamj.supp.2018.30.1.15271

Received: 21/02/2018 - Accepted: 05/04/2018 - Published: 18/05/2018

Key words: Outbreak investigation, foodborne illness, Zimbabwe

© Tsitsi Juru et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at:

Corresponding author: Tsitsi Juru, Zimbabwe Field Epidemiology Training Program, Harare, Zimbabwe (

This article is published as part of the supplement “African Case Studies for Public Health Volume 2” sponsored by African Field Epidemiology Network, (Case Study Design and Development, Rollins School of Public Health, Emory University

Guest editors: Scott JN McNabb, Ghada N Farhat, Casey Daniel Hall, Joseph Asamoah Frimpong, Richard Dicker

Investigation of anthrax in an endemic region in Kenya: a mixed methods approach

Mark Odhiambo Obonyo1,&, Mikayla Farr2, Emmanuel Hikufe Hikufe3, Wilson Rubanzana4, Maurice Omondi Owiny1, Zeinab Gura Roka1


1Kenya Field Epidemiology and Laboratory Training Program, Kenya, 2Rollins School of Public Health, Emory University, USA, 3Nambia Field Epidemiology and Laboratory Training Program, Nambia, 4School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Rwanda



&Corresponding author
Mark Odhiambo Obonyo, Kenya Field Epidemiology and Laboratory Training Program, Kenya




In Kenya, human anthrax cases most often occur linked to animal anthrax. In most cases, human behaviors, especially slaughter and consumption of meat from animal anthrax cases, has been implicated. This case study is based on an anthrax outbreak investigation conducted in an endemic region in Kenya in May 2016.The case study simulates how a mixed methods approach can be used in epidemiologic research.To fully benefit from this case study, participants should have had prior lectures or other instruction in quantitative and qualitative study designs and sampling approachesused in epidemiologic research. The case study is ideally suited for trainees at intermediate or advance level training in field epidemiology who should be able to complete the case study in approximately 3 hours.



How to use this case study    Down

General instructions: the case study is suited for a class of up to 20 trainees per session. Ideally, 1 to 2 instructors can facilitate the case study in a classroom or conference room. The instructor facilitating the session should direct participants to read a paragraph out aloud, going around the room to give each participant a chance to read. When a participant reads a question, the instructor may choose to engage the class in large group discussion of the answer, randomly identify a participant to respond to the question, or divide the class into smaller groups for exercises, depending on the type of question. The role of the instructor is largely to coordinate the session such that participants learn more from each other, and not just from the instructor.


Audience: intermediate and advance level trainees in the Field Epidemiology and Laboratory Training Program (FELTP).


Prerequisites: for this case study, participants should have received lectures or other instructions in; Study designs in epidemiologic research; Survey and sampling in epidemiologic research; Ethics in Research: Writing an Informed Consent Form.


Materials needed: flipcharts or white board with markers.


Level of training: intermediate and advanced level training in epidemiology.


Time required: approximately 3 hours


Language: English



Case study material Up    Down

  • Download the case study student guide;
  • Request the case study facilitator guide.



Competing interests Up    Down

The authors declare no competing interests.



Acknowledgments Up    Down

The authors wish to thank the residents of the Kenya field epidemiology and laboratory training program who carried out the investigations. We wish also to thank AFENET and organizers of the case study design and development course at Emory University School of Public Health for logistical and technical support during development of the case study.



References Up    Down

  1. Opare C, Nsiire A, Awumbilla B, Akanmori BD. Human behavioural factors implicated in outbreaks of human anthrax in the Tamale municipality of northern Ghana. Acta Tropica. 2000 Jul 21;76(1):49-52. PubMed | Google Scholar

  2. Doreen Chilolo Sitali, Chisoni Mumba, Eystein Skjerve, Oliver Mweemba, Consolata Kabonesa, Mwinyi Omary Mwinyi, Luke Nyakarahuka and John Bwalya Muma. Awareness and attitudes towards anthrax and meat consumption practices among affected communities in Zambia: a mixed methods approach. PLoS Negl Trop Dis. 2017 May; 11(5): e0005580. PubMed | Google Scholar

  3. Janice Blanchard C, Yolanda Haywood, Bradley Stein D, Terri Tanielian L, Michael Stoto, Nicole Lurie. In their own words: lessons learned from those exposed to anthrax. American Journal of Public Health. 2005; 95(3): 489-495. PubMed | Google Scholar

  4. Chikerema SM, Matope G, Pfukenyi DM. Awareness and attitude toward zoonoses with particular reference to anthrax among cattle owners in selected rural communities of Zimbabwe. Vector Borne Zoonotic Dis. 2013 Apr; 13(4): 243-9. PubMed | Google Scholar






























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