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

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

Tsitsi Juru1,&, Nsiande Lema2, Daniel Chirundu3, Rayyan Muhammad Garba4, Joseph Asamoah rimpong5


1Zimbabwe Field Epidemiology Training Program, Harare, Zimbabwe, 2Tanzania Field Epidemiology training program, Dar es Salaam, Tanzania, 3Kadoma City Health Department, Kadoma, Zimbabwe, 4Department of Community Medicine, Aminu Kano Teaching Hospital, Nigeria, 5African Field Epidemiology Network, Accra, Ghana



&Corresponding author
Tsitsi Juru, Zimbabwe Field Epidemiology Training Program, Harare, Zimbabwe




Globally, it is estimated that foodborne-associated illness accounts for 2.2 million deaths. This is caused by contamination of food with toxins, parasites, bacteria or viruses that can lead to increased levels of morbidity and mortality. Although steps to conducting an outbreak investigation have been outlined in most epidemiology textbooks, identifying the causative agent for a foodborne illness outbreak can be complex based on the setting. In view of that, this case study was developed based on a foodborne illness outbreak at agirls’ boarding school to model the steps of an investigation. This case study will reinforce skills and theoretical knowledge attained by public health trainees, to be able to build competences in foodborne outbreak investigation. The target audiences are intermediate and advanced public health trainees. Estimated time of facilitation is 3 hours with a class size of 10-20 students.



How to use this case study    Down

General instructions: ideally, 1 to 2 instructors facilitate the case study for 10 to 20 students in a classroom or conference room. The instructor should direct participants to read a paragraph out loud, going around the room to give each participant a chance to read. When the participant reads a question, the instructor directs all participants to perform calculations, construct graphs, or engage in discussions. The instructor may split the class to play different roles or take different sides in answering a question. As a result, participants learn from each other, not just from the instructors.


Audience: postgraduate students in public healthand others who may be interested.


Prerequisite: lectures on outbreak investigation, study design and measures of association and impact.


Materials needed: laptop with Microsoft Excel or graph paper, flipchart or white board with markers, scientific calculator.


Level of training: advanced-outbreak investigation.


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

This case study is based on an unpublished investigation conducted in 2015-16 by Eliot Chikati, a graduate of the Zimbabwe Field Epidemiology Training Program. We acknowledge the African Field Epidemiology Network and Emory University for organizing a case study development workshop through which this output was developed. We also wish to thank the Zimbabwe Field Epidemiology Program for allowing us to use their data for this case study and the Zimbabwe program Director Professor Mufuta Tshimanga for nominating and supporting the training of the two Zimbabwean participants who authored this case study. We acknowledge TuyaNakale, Emmanuel Hikufe, Wilson Rubanzana, Mark Obonyo, Lazarus, Alice Manjate, Senesia Sitao, Hussein Muhammed, Joseph Ntaganira, Junaidu, Yusuf, Mikayla Farr, Desta Hiko, Herbert Brian Kazoora, MaleyMcleod, Yusuf Oyindamola, Junaid Kabir, Casey Daniel, Sorie Dumbuya, Evelyn Kamgang, Calbeth Alaribe, Ghada Farhat, and Richard Dicker for critiquing the initial write-up during the Case Study Development Course held at Emory University in May 2017.



References Up    Down

  1. WHO. Foodborne disease outbreaks: guidelines for investigation and control. 2008. Accessed 2 Jun 2017.

  2. CDC. Principles of Epidemiology: Home|Self-Study Course SS1978|CDC. 2008. Accessed 2 Jun 2017

  3. Chikati Eliot, Simukai Tirivanhu Zizhou, Donewell Bangure et al. Salmonellosis at a Private Girls High School in Marondera District of Mashonaland East Province, Zimbabwe, 2015: Retrospective Cohort study. Unpublished.

  4. Vander Weele TJ. Confounding and effect modification: distribution and measure. Epidemiol Methods. 2012;1(1):55-82. PubMed | Google Scholar

  5. Hosmer DW, Lemeshow S. Model-Building Strategies and Methods for Logistic Regression, in: Applied Logistic Regression. John Wiley & Sons, Inc. 2000; 91-142.






























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