Module 2 - Computer tools for outbreak investigation.

The second module was jointly organized by MediPIET and the National Institute of Public Health “Dr Milan Jovanovic Batut”, in Belgrade, Serbia, from 23rd to 27th September 2019.

This 1-week training course focused on the application of epidemiological principles in time, place, and person using epidemiological computer software to address urgent or emergency public health problems with a special attention to outbreak investigation of food and waterborne diseases (FWD).

The approach was very practical; it involved both lectures from experts with a wealth of experience in the field of FWD and in the use of specific epidemiological computer software and also, hands-on sessions (i.e. problem exercises and case study) to practice what participants have learnt.

With a focus on FWD, the course also reviewed basic principles of epidemiology and applied biostatistics, and addressed surveillance and outbreak investigation including laboratory methods, design of questionnaires, statistical analysis and last, communication of the findings.

Dr Iro Evlampidou and Dr Angeliki Lambrou as MediPIET Scientific Coordinators, supported by Dr Isabel Noguer, ISCIII Leader for MediPIET Consortium, in collaboration with Assoc. Prof Dr Verica Jovanovic, Director of the National Public Health Institute “Dr Milan Jovanovic Batut” put together the contents and mobilised a group of senior experts, with a lot of teaching and work experience in FWD, the specific statistical software, laboratory methods and outbreak communication.

A total of 27 participants attended the course, including fifteen fellows of the Third MediPIET Cohort from eleven current training sites: Albania, Armenia, Georgia, Kosovo1, Lebanon, Moldova, North Macedonia, Palestine, Serbia, Tunisia and Ukraine. In addition, there were six external participants, two from Bosnia-Herzegovina and one from each of the following countries: Algeria, Egypt, Montenegro and Morocco. Moreover, five local participants from Serbia and one observer from Israel attended the course.

At the end of the course, participants were able to:

  • Become familiar with outbreak investigation steps and toolsDiscuss the specificities of FWD (outbreak investigation, epidemiological surveillance, laboratory methods)
  • Get acquainted with computer tools for the various steps of an outbreak investigation and different epidemiological calculators
  • Create a data entry file from a paper questionnaire and epidemiological maps using Epi Info 7
  • Manage datasets, including data entry, validation and cleaning
  • Gain experience in using statistical software STATA and perform descriptive analysis
  • Get knowledge and skills in univariate analyses and calculate Odd Ratios (ORs) and Relative Risks (RRs)
  • Perform different statistical tests (chi-square test, Fisher’s test, Mann-Whitney, etc.)
  • Conduct analysis for cohort and case-control studies including stratified analysis
  • Understand the principles of international outbreak coordination
  • Communicate effectively the results of an outbreak investigation to various audiences (media, colleagues, scientific community)

Although intensive and time-constrained and for some too advanced, the course was much appreciated and very successful in most of its aspects and participants would have liked to spend more time practicing the new software.

MediPIET team is very grateful to the UK FETP/Public Health England and the Norwegian Institute of Public Health for their selfless collaboration in this module. Their contribution was outstanding and the participation of their professionals along the whole duration of the module is acknowledged and highly appreciated. Special gratefulness as well, to all the staff of Dr Milan Jovanovic Batut Institute of Public Health for their kindness and hospitality that eased the implementation of the activity.

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