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A conversation with one of Somalia’s pioneer FETP residents

Somalia’s Sadia Hassan Hussein’s dream of becoming an epidemiologist can be traced to 2008 when she was due to travel to Sudan to study public health. “Unfortunately, I was not allowed by my mother,” she recounts without divulging details as to why she was stopped on the tracks.

However, Sadia’s dream was not shattered and her dream of practicing epidemiology came about eight years ago when she joined the federal ministry of health.

“I have been working on public health promotion and disease surveillance in different locations in the country,” she recounted recently on the sidelines of the 1st Somalia National Institute of Health Research conference.

When Sadia was enrolled into the Somalia FETP for a three-month frontline training, not even being a mother was going to stand in her way.

“I took on the FETP training alongside my master’s program which I completed in November 2021, while I was also on maternity leave,” she said. “After graduating in the first cohort as one of the best performing students, I wish I to quickly go through all the training levels of the FETP, to be able to contribute to the improvement of the surveillance system in my country.”

Sadia was so determined to achieve her goals that during the three-month training period, she also managed do her surveillance work, and continued with her routine health promotion work.

Reflections on responding to a measles outbreak in Daynile District

“I had the opportunity of presenting my abstract on a measles investigation at the 1st National Institute of Health Research conference held in Puntland from 30 January – 1 February 2022.

Somalia was among the top ten countries that reported the highest number of measles cases in 2021. I focused on the data referred to by the Early Warning, Alert and Response Network (EWARN) registered health facilities in Daynile district, Banadir region. I worked together with the district health officer, pediatrician, health facility in-charge, and lab personnel from Daynile District Hospital in November 2021. The objective was to confirm the existence of a measles outbreak in Daynile, and implement prevention and control measures.

Data was collected by using a line list and a semi-structured questionnaire using a modified case investigation format. Demographic information such as age, sex, resident, patient characteristics, including; date of onset, date of visit to health facilities, outcome, and vaccination status were coupled with data from health facilities, collected on cold chain management and patient management.

We also conducted house-to-house and community active case searches for unreported cases of measles. We made a distinction of suspected, confirmed, and laboratory confirmed measles outbreaks. 

Serum specimens were collected from eight suspected cases and sent to the national measles laboratory for IgM test and a test done as per the global and national guidelines.

From August 3rd, 2021 to October 17, 2021, a total of 96 suspected measles cases were epidemiologically linked to confirmed cases reported from Daynile district.

Seven (7.3%) cases were confirmed by laboratory investigation (IgM positive) with more than half of measles cases 51 (53.1%) having occurred in males. It was recorded that 83 (86.5%) of cases occurred in children below five years and the mean age of cases was 30 months (3-168 months). 

What stood out was that none of the reported suspected measles cases were vaccinated against measles. Only eight (8.3%) were not eligible for measles vaccination schedule (such as below nine months) and majority of the reported cases 72 (75%) had contact history with a similar case.

The outbreak occurred in six villages of the district with the higher proportion 68% (65) of cases residing in internally displaced persons’ camps.”