EEI Burden Estimate Cholera_Kenya

Burden Estimate for the Generic Clearance of Emergency Epidemic Investigation Data Collections

(0920-1011)

GenIC No.:	2015009-028
Title of Investigation:	Undetermined source, mode of transmission and risk factors for a Widespread Outbreak of Cholera among residents of multiple counties — Kenya, 2015

For each data collection instrument included with the GenIC, estimate the burden by completing the table below. Each data collection instrument should be included as a separate row.

Burden Table (insert rows for additional respondent types if needed)

Data Collection Instrument Name	Type of Respondent	Data Collection Mode	No. Respondents (A)	No. Responses per Respondent (B)	Burden per Response in Minutes (C)	Total Burden in Hours (A x B x C)/60*
Appendix 1. Cholera Response Community Questionnaire Knowledge, Attitudes and Practices	General public	Face to face	500	1	20	166
Appendix 2. Health Care Worker Questionnaire	Health care workers	Face to face	50	1	20	17

*Round up to the nearest whole number.

Return completed form with the GenIC request to EEI Information Collection Request Liaison or EIS program designee.

EEI Information Collection Request Liaison:

Danice Eaton, PhD, MPH

EIS Program Staff Epidemiologist

Epidemiology Workforce Branch

Division of Scientific Education and Professional Development

Centers for Disease Control and Prevention

2400 Century Center, MS E-92

Office: 404.498.6389
Deaton@cdc.gov

Page 2 of 2 Form Updated: 5/29/2014