A Master of Apartment Epidemiology: Field Epidemiology during the COVID-19 pandemic

Abstract

Burnet Institute is a medical research institute and non-governmental organisation that aims to achieve better health for vulnerable communities across the world through global health and development programming and research. I undertook my field epidemiology placement with Burnet during 2020-2021. This coincided with the start of the COVID-19 pandemic, one of the worst pandemics in history. This thesis presents the projects and activities completed during this placement.

In March 2020 I seconded to the Victorian Department of Health and Human Services (DHHS) during the acute stage of the COVID-19 pandemic. During this period, I worked as a field epidemiologist on notable first wave outbreaks. This included an outbreak at a psychiatric healthcare facility, the investigation of which, through a descriptive and cohort analysis, allowed me to fulfil several MAE competency requirements. This was one of the first detailed descriptions of a COVID-19 outbreak and cohort study in a healthcare setting in Victoria, Australia. Reviewing and further investigating this outbreak added to our understanding of transmission dynamics and patient exposure characteristics associated with SARS-CoV-2 infection in a sensitive setting. It also informed control measures and policy for the Victorian COVID-19 response related to outbreaks in similar settings.

I conducted an epidemiological study to measure the prevalence of, risks associated with, and knowledge and attitudes towards tuberculosis (TB) amongst healthcare workers (HCWs) in Yogyakarta, Indonesia. Due to the COVID-19 pandemic, the TB infection and disease screening amongst this population was delayed. However, the knowledge and attitudes survey amongst HCWs was completed and is one of very few such surveys and therefore has been drafted as a scientific manuscript. The study found participants had practical understanding of TB and positive attitudes towards the implementation of TB prevention programs in healthcare facilities. It also identified some key areas for TB education and engagement amongst the population of HCWs in Yogyakarta.

I investigated the public health rationale for establishing a TB infection surveillance system in high burden and low- and middle-income countries (LMICs). Through assessments of key surveillance criteria and parameters, I concluded that TB infection not only warrants the establishment of a surveillance system in these settings but is imperative to manage and eliminate TB. This chapter provides one of the first conceptual designs of such a system specifically for high burden and LMICs, and evidence and considerations that may guide adaption to different contexts.

The final sections of this thesis describe the teaching components and other field epidemiology, public health, and research activities I was involved in throughout my placement. Combined, these projects, activities and experiences demonstrate the competency requirements of the Master of Philosophy in Applied Epidemiology program at the Australian National University. Show more