Field Epidemiology in the Pacific

Abstract

In this thesis, I present the projects and activities that I undertook to fulfil the competencies required for completion of the MAE Program 2019 - 2020.

During my candidature, I was based at Hunter New England (HNE) Population Health in Newcastle, NSW. During this time I completed three major international projects, contributed to the Regional investigation and response to the COVID-19 pandemic, and was involved in a range of other public health investigations and capacity building opportunities both locally in HNE and in the Pacific.

I conducted an Epidemiological study to explore the translation of knowledge into action of graduates of the Field Epidemiology Training Program in Papua New Guinea (FETPNG). Whilst many Field Epidemiology Training Programs (FETPs) have conducted quantitative outcome evaluations of their respective Programs, this study aimed to qualitatively explore the impact that graduates have had on the public health system and their communities, and critical success factors and challenges in practically applying skills in the field after training. The results will be used to strengthen the FETPNG curriculum, advocate for greater support of the Program, and provide the basis for an evaluation tool to be used to evaluate the impact of FETPs in other contexts.

At the request of Atoifi Adventist Hospital (AAH) in East Kwaio, Solomon Islands, I analysed the routine passive malaria surveillance data from 1 January 2018 - 31 August 2019. Malaria is an important public health issue in Solomon Islands, and laboratory staff had anecdotally noticed an increase in overall case detection, proportion of Plasmodium falciparum infections, and number of people being confirmed with malaria multiple times. This study described current epidemiology of malaria in East Kwaio for the study period in order to support evidence-based clinical and public health decision-making. In-field dissemination of initial results to AAH staff and community leaders resulted in the recommendation of an electronic malaria surveillance system which would provide data to support malaria planning and decision-making of both Hospital and community members.

Following this recommendation, I worked with the AAH team and an Australian developer to develop a pilot electronic surveillance system for malaria for AAH. The system was developed to prioritise usefulness, simplicity, acceptability, data quality, stability, flexibility and timeliness. The system facilitates information management of clinically complex malaria cases, informs the Hospital team of the current epidemiological situation in the region to enable appropriate public health planning, and engages community members as active participants in data utilisation for malaria prevention and control.

In February 2020 I was deployed to the World Health Organization Western Pacific Regional Office, Philippines, as an Epidemiologist in the Incident Management Support Team (IMST) in responding to the emerging COVID-19 pandemic. I worked with a team of Epidemiologists to collect, descriptively analyse, interpret and present data from Member States to the IMST on a daily basis. We assessed the current level of transmission in each respective country and area, examining the data in relation to enhanced and routine surveillance data and preparedness assessments, and provided recommendations to the IMST on appropriate public health preparedness and response measures. I also present a range of other public health response experiences, highlighting the imperative to centre the human experience in response work.

Finally, I present a selection of teaching and capacity building activities that I conducted. This includes presentation of a Lessons from the Field (LFF) on COVID-19 contact tracing in a remote, resource limited, cross-cultural setting, a combined teaching session to First Year MAE Scholars based on my LFF, and additional capacity building activities in HNE, PNG and Solomon Islands. Show more