Field Epidemiology Training Program

Last updated

Field Epidemiology involves the application of epidemiologic methods to unexpected health problems when a rapid, on-site investigation is necessary for timely intervention. [1] A more expansive definition is: The practice of epidemiology in the field, i.e., in the community, commonly in a public health service, i.e., a unit of government or a closely allied institution. Field epidemiology is how epidemics and outbreaks are investigated, and it is a tool for implementing measures to protect and improve the health of the public. Field epidemiologists must deal with unexpected, sometimes urgent problems that demand immediate solution. Its methods are designed to answer specific epidemiologic questions in order to plan, implement and/or evaluate public health interventions. These studies must consider the needs of those who will use the results. The task of a field epidemiologist is not complete until the results of a study have been clearly communicated in a timely manner to those who need to know, and an intervention made to improve the health of the people. [2]

Contents

Field Epidemiology Training Programs (FETPs) are two-year applied public health training programs modeled after the U.S. Centers for Disease Control and Prevention's (CDC) Epidemic Intelligence Service (EIS). FETPs are established within host country ministries of health to enhance the epidemiologic capacity of the public health workforce and increase the use of science and data to appropriately respond to public health threats. By developing the skills of the workers and reinforcing the health systems in which they work, FETPs also help countries to meet their core capacity requirements for surveillance and response under the revised International Health Regulations (IHR, 2005).

The guiding principle of the FETP training model is “learning through doing,” a concept that is analogous to a medical residency (in which physicians acquire on-the-job experience by learning and practicing the necessary skills to become capable clinicians); many FETP programs are however open to a wide range of health professional backgrounds, not only physicians. FETP trainees, or “residents,” spend approximately 25 percent of their time in the classroom, learning the principles of epidemiology, disease surveillance, outbreak investigation, and biostatistics. The other 75 percent of their time is spent in field placements, where residents "learn by doing," by participating in outbreak investigations, helping to establish and evaluate disease surveillance systems, designing and conducting studies on problems of public health concern in their country, and training other healthcare workers. Field work is typically conducted under the supervision and guidance of an experienced mentor.

FETP residents have been involved in initiatives to prevent and control infectious diseases of global health importance, including polio, cholera, tuberculosis, HIV, malaria, and emerging infectious diseases of animal origin (e.g., SARS, Nipah virus, and avian influenza). Many residents have also worked to reduce the burden of non-communicable diseases, such as heart disease, cancer, and diabetes, or environmental or occupational health problems.

Since launching the Epidemic Intelligence Service by the US Centers for Disease Control and Prevention in 1951, the development of field epidemiology has been promoted internationally and globally. [3] The first FETP outside of the United States was established by Canada in 1975. [4] In 1980, the government of Thailand requested CDC’s assistance to establish its own program, with funding initially contributed by the United States Agency for International Development (USAID). Since then, CDC has helped to establish FETPs in 41 countries worldwide, which have produced more than 2,500 graduates from 61 countries. [5] Over 80% of residents stay in their home countries, and many become leaders within their public health system.

FETP Networks

Many of the countries which participate in an FETP collaborate with the Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET), a global network of Field and Applied Epidemiology Training Programs, to share resources and best practices. Regional FETP networks also exist, including: the African Field Epidemiology Network (AFENET), the Eastern Mediterranean Public Health Network (EMPHNET), RedSur (the network of Latin American FETPs), and the South Asia Field Epidemiology and Technology Network (SAFETYNET).

The European Centre for Disease Prevention and Control (ECDC) has created the European Programme for Intervention Epidemiology Training (EPIET) in 1995. Its purpose was to create a network of highly trained field epidemiologists in the European Union, thereby strengthening the public health epidemiology workforce at EU Member States and EEA level. Current EPIET alumni are providing expertise in response activities and strengthening capacity for communicable disease surveillance and control inside and beyond the EU. In 2006 EPIET was integrated into the core activities of ECDC. The European Public Health Microbiology Training Programme (EUPHEM) was initiated by ECDC in 2008. The EUPHEM program a unique program. The objective of the public health microbiology path (EUPHEM) is to provide state-of-the-art training in public health microbiology enabling its fellows to apply microbiological and epidemiological methods to a wide range of public health problems in Europe.

In 2016, EPIET and EUPHEM became the ECDC Fellowship Programme, consolidating in this way the alignment of administrative processes and core curricular aspects.

EPIET has a very active alumni network (the EPIET Alumni Network; EAN) that was created in 2000 to help develop and maintain a network of European public health epidemiologists that have participated in the European Programme for Intervention Epidemiology Training (EPIET); it now also includes alumni from the European Programme for Public Health Microbiology Training (EUPHEM) and other European Field Epidemiology Training Programmes (FETP). As well as alumni of training programmes, the EAN also has some ‘external’ members who, through their work, meet similar objectives to the EAN. As the regular member surveys show, "having a network of professionals that know each other, speak the same 'language', and can easily access each other's expertise, represents an important resource for European and global public health, which should be nurtured by encouraging more collaborations devoted to professional development." [6]

Related Research Articles

Centers for Disease Control and Prevention United States government public health agency

The Centers for Disease Control and Prevention (CDC) is the leading national public health institute of the United States. The CDC is a United States federal agency under the Department of Health and Human Services and is headquartered in Atlanta, Georgia.

Epidemiology is the study and analysis of the distribution, patterns and determinants of health and disease conditions in defined populations.

James (Jim) Chin is a public health epidemiologist. He works in public health surveillance and prevention of communicable diseases, particularly AIDS.

The Council of State and Territorial Epidemiologists (CSTE) is a 501(c)(6) non-profit organization originally organized in 1955, founded in 1992, and based in Atlanta, Georgia. CSTE works to advance public health policy and workforce capacity for applied public health epidemiologists in all localities, states, and territories in the United States.

The Epidemic Intelligence Service (EIS) is a program of the U.S. Centers for Disease Control and Prevention (CDC). Established in 1951 by Alexander Langmuir, it arose from biological warfare concerns relating to the Korean War. The modern EIS is a two-year, hands-on post-doctoral training program in epidemiology, with a focus on field work.

European Centre for Disease Prevention and Control Agency of the European Union

The European Centre for Disease Prevention and Control (ECDC) is an independent agency of the European Union (EU) whose mission is to strengthen Europe's defences against infectious diseases. The Centre was established in 2004 and is located in Solna, Sweden.

The European Programme for Intervention Epidemiology Training (EPIET) Fellowship provides training and practical experience in intervention epidemiology at the national centres for surveillance and control of communicable diseases in the European Union. The fellowship is aimed at EU medical practitioners, public-health nurses, microbiologists, veterinarians and other health professionals with previous experience in public health and a keen interest in epidemiology.

The Health Threat Unit of the Directorate-General for Health and Consumer Protection, is responsible for terrorism surveillance and early warning of biological, chemical, and radiological threats within the European Union. The Health Threat Unit runs the Rapid Alert System, which conducts surveillance on communicable diseases and diseases caused by acts of bioterrorism. The surveillance data are coordinated and evaluated by the Health Emergency Operations Facility. Health threat information and warnings are sent to the member states by the Communication and Crisis Center (BICHAT) and the Security Office in Brussels, Belgium.

The following is a timeline of events relating to the Centers for Disease Control and Prevention.

Tele-epidemiology is the application of telecommunications to epidemiological research and application, including space-based and internet-based systems.

Umeå Centre for Global Health Research


The Umeå Centre for Global Health Research (UCGHR) is a Centre of Excellence within Umeå University in Northern Sweden. The Centre operates within the university’s Division of Epidemiology and Public Health Sciences, and is led by a steering group chaired by a principal investigator.

National Centre for Disease Control

National Centre for Disease Control (NCDC) is an institute under the Indian Directorate General of Health Services, Ministry of Health and Family Welfare. It was established in July 1963 for research in epidemiology and control of communicable diseases and to reorganize the activities of the Malaria Institute of India (MII). Currently it has eight branches at Alwar, Bengaluru, Trivandrum, Calicut, Coonoor, Jagdalpur, Patna, Rajahmundry and Varanasi to advise the respective state governments on public health. The headquarters are in Sham Nath Marg in New Delhi.

The International Association of National Public Health Institutes (IANPHI) is a member organization of government agencies working to improve national disease prevention and response. IANPHI is made up of 100+ members, located in approximately 90 countries. An important goal of IANPHI is to improve health outcomes by strengthening or creating NPHIs.

Mekong Basin Disease Surveillance

The Mekong Basin Disease Surveillance (MBDS) consortium is a self-organised and sub-regional co-operation spearheaded by health ministries from member countries to collaborate on infectious disease surveillance and control. The co-operation focuses on cross-border co-operation at selected sites and has matured through several phases of work. PRO/MBDS is a component of the outbreak reporting system ProMED-mail.

Sanitary epidemiological reconnaissance, synonym epidemiological reconnaissance is a literal name of a concept and routine of finding out disease potential on a territory of arrival of major contingent. Russian: санитарно-эпидемиологическая разведка, син. эпидемиологическая разведка. This is a kind of medical reconnaissance, process of information gathering on possible infectious diseases' origin-sources, the ways and factors of the infection transfer and determining all conditions that could have promoted the spread of infestation among army service personnel. In 1939 Academician E.N.Pavlovsky announced his "doctrine of nidality", so called by Soviet biologists. People can acquire zoonoses and insect-borne diseases when they occupy at certain times of the year natural habitat of a certain pathogen (plague, tularemia, leptospirosis, arboviruses, tick-borne relapsing fever. The WHO Expert Committee on Zoonoses listed over 100 such diseases. About natural focality of the diseases is known elsewhere.

Stephen S. Morse is an American epidemiologist, influenza researcher and specialist on emerging infectious diseases, who has served as an adviser on the epidemiology of infectious diseases and on improving disease early warning systems to numerous government and international organizations. As of 2016, he is Professor of Epidemiology at the Mailman School of Public Health of Columbia University. His seminal book Emerging Viruses (1993) was selected by American Scientist for its list of "100 Top Science Books of the 20th Century".

The Integrated Disease Surveillance program (IDSP) is a disease surveillance scheme under the Ministry of Health and Family Affairs in India, assisted by the World Bank. The scheme aims to strengthen disease surveillance for infectious diseases to detect and respond to outbreaks quickly. The scheme seeks to set up a Central Disease Surveillance Unit and a State Surveillance Unit in each State where data is collected and analyzed. A large amount of data on disease reports are collected in order to be able to identify the outbreak of a disease, identify its causes and take corresponding preventive and responsive measures. An early warning system has been put into place in order to take timely preventive steps.

The Health Protection Surveillance Centre (HPSC) is part of the Irish Health Service Executive. HPSC was set up in 1998 and was formerly known as the National Disease Surveillance Centre (NDSC).

Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET) is a global professional network of field epidemiology training programs (FETPs). As of August 2019, TEPHINET comprises 71 member FETPs working across more than 100 countries. TEPHINET's mission is to empower and mobilize a competent field epidemiology workforce to serve all people through standardized training, experiential learning, training program quality improvement, mentoring, and knowledge exchanges in order to connect epidemiologists better, faster, and with quality across the globe. As a network, TEPHINET member programs share technical expertise for improving disease surveillance, public health emergency response, and health promotion programs and collaborate with multinational outbreak response teams sponsored by the World Health Organization and other organizations.

References

  1. Gregg MB, ed. Field Epidemiology. Oxford University Press. New York. 1996.
  2. Last JM. A Dictionary of Epidemiology. Fourth Edition. Oxford University Press. New York. 2001
  3. White, Mark; Sharon M. McDonnell; Denise H.Werker; Victor M. Cardenas; Stephen B. Thacker (2001). "Partnerships in International Applied Epidemiology Training and Service". American Journal of Epidemiology. 154 (11): 993–999. doi:10.1093/aje/154.11.993. PMID   11724714.
  4. White FMM, A Perspective on the control of communicable diseases in Canada, Editorial. Can J Public Health 1976, 67: 449-53.
  5. "Field Epidemiology Training Program (FETP)". CDC.Division of Public Health Systems and Workforce Development.
  6. "Time, place, and people: composition of the EPIET Alumni Network and its contribution to the European public health resource in 2013." Pezolli et al. Epidemiol Infect. 2015

Further reading

Public Health