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Case study

Investigation of a haemorrhagic disease with unknown origin in Kyrandia, 2005: a teaching case-study

Investigation of a haemorrhagic disease with unknown origin in Kyrandia, 2005: a teaching case-study

Nassma Mohy Eldeen Altayeb1,&, Andrey Kuznetsov2, Wessam Mankoula3, Erasmus Gidimadjor4, Mageda Kihulya5, Dina Ramadan Lithy6, Barbara Maria Buerkin7,8


1Federal Ministry of Health, Khartoum, Osman digna street with Nile avenue PO Box 303 Zip code 1111, Sudan, 2Kazakh Scientific Center for Quarantine and Zoonotic Diseases, Almaty, Kazakhstan, 3Africa CDC, African Union, 4Disease Control and surveillance unit, Ghana, 5Social sector of Simiyu region, Tanzania, 6Ministry of Health, Egypt, 7Swiss Tropical and Public Health Institute, Switzerland, 8Global Partnership Initiated Biosecurity Academia for Controlling Health Threats (GIBACHT), Basel, Switzerland



&Corresponding author
Nassma Mohy Eldeen Altayeb, Federal Ministry of Health, Khartoum,Osman digna street with Nile avenue PO Box 303 Zip code 1111, Sudan




A number of diseases are classified as haemorrhagic disease and differences between them relate to etiologic factors, being infectious or non-infectious, geographic distribution, incidence, reservoir, transmission method, and clinical symptoms. In Kyrandia, cases of a human haemorrhagic disease have been reported since 1940, yet recently, the reported cases have been increasing in number due to several factors. In October 2005, the Ministry of Health (MOH) reported fatal laboratory-confirmed cases in the State of Shanta in Kyrandia, where a total of 605 cases of outbreak-related illness were reported during that period.

The goal of this case study is to build the capacity of trainees to investigate haemorrhagic disease outbreaks of an unknown origin. This case study is based on real events with some fictitious elements. Details from the original outbreak investigation have been modified to enhance the learning objectives and support the instructional goals. This case study aims to stimulate students to identify the source of a disease outbreak, analyse surveillance data, eliminate the outbreak, and develop strategies to prevent future outbreaks. The case study also aims at training students to evaluate existing prevention strategies, describe newly emerging infections, learn more about known diseases, and appropriately address public concern. This case study is designed for the training of basic level field epidemiology trainees or any other health care workers working in public health-related fields. The case study can be administered in 2-3 hours. Used as adjunct training material, the case study provides the trainees with competencies in analysing available data in order to identify triggering factors for viral haemorrhagic disease outbreak.



How to use this case study    Down

General instructions: this case study should be used as adjunct training material for novice epidemiology trainees to reinforce the concepts taught in prior lectures. The case study is ideally taught by a facilitator in groups of about 20 participants. Participants are to take turns reading the case study, usually a paragraph per student. The facilitator guides the discussion on possible responses to questions. The facilitator may make use of flip charts to illustrate certain points. Additional instructor´s notes for facilitation are coupled with each question in the instructor´s guide to aid facilitation.

Audience: This case study was developed for novice field epidemiology students. These participants are commonly health care workers working in the county departments of health whose background may be as medical doctors, nurses, environmental health officers or laboratory scientists who work in public health-related fields. Most have a health science or biology background.

Prerequisites: before using this case study, participants should have received lectures on disease surveillance and outbreak investigation.

Materials needed: Flash drive, flip charts, markers, calculators, computers with MS Excel, Annex 2 of the International Health Regulations 2005.

Level of training and associated public health activity: Novice - Outbreak Investigation

Time required: 2-3 hours

Language: English



Case study material Up    Down



Competing interest Up    Down

The authors declare no competing interests.



Acknowledgement Up    Down

We wish to acknowledge the Global Partnership Initiated Academia for Controlling Health Threats (GIBACHT) and the Eastern Mediterranean Public Health Network (EMPHNET) for their support in developing this case study.



Annexes Up    Down

Annex 1: the triple package layers (figure provided by IATA, Montreal, Canada)

Annex 2: International Health Regulations IHR (2005)



References Up    Down

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