1
|
Bakiika H, Obuku EA, Bukirwa J, Nakiire L, Robert A, Nabatanzi M, Robert M, Moses M, Achan MI, Kibanga JB, Nakanwagi A, Makumbi I, Nabukenya I, Lamorde M. Contribution of the one health approach to strengthening health security in Uganda: a case study. BMC Public Health 2023; 23:1498. [PMID: 37550671 PMCID: PMC10408150 DOI: 10.1186/s12889-023-15670-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/13/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND The One Health approach is key in implementing International Health Regulations (IHR, 2005) and the Global Health Security Agenda (GHSA). Uganda is signatory to the IHR 2005 and in 2017, the country conducted a Joint External Evaluation (JEE) that guided development of the National Action Plan for Health Security (NAPHS) 2019-2023. AIM This study assessed the contribution of the One Health approach to strengthening health security in Uganda. METHODS A process evaluation between 25th September and 5th October 2020, using a mixed-methods case study. Participants were Subject Matter Experts (SMEs) from government ministries, departments, agencies and implementing partners. Focus group discussions were conducted for five technical areas (workforce development, real-time surveillance, zoonotic diseases, national laboratory systems and emergency response operations), spanning 18 indicators and 96 activities. Funding and implementation status from the NAPHS launch in August 2019 to October 2020 was assessed with a One Health lens. RESULTS Full funding was available for 36.5% of activities while 40.6% were partially funded and 22.9% were not funded at all. Majority (65%) of the activities were still in progress, whereas 8.6% were fully implemented and14.2% were not yet done. In workforce development, several multisectoral trainings were conducted including the frontline public health fellowship program, the One Health fellowship and residency program, advanced field epidemiology training program, in-service veterinary trainings and 21 district One Health teams' trainings. Real Time Surveillance was achieved through incorporating animal health events reporting in the electronic integrated disease surveillance and response platform. The national and ten regional veterinary laboratories were assessed for capacity to conduct zoonotic disease diagnostics, two of which were integrated into the national specimen referral and transportation network. Multisectoral planning for emergency response and the actual response to prioritized zoonotic disease outbreaks was done jointly. CONCLUSIONS This study demonstrates the contribution of 'One Health' implementation in strengthening Uganda's health security. Investment in the funding gaps will reinforce Uganda's health security to achieve the IHR 2005. Future studies could examine the impacts and cost-effectiveness of One Health in curbing prioritized zoonotic disease outbreaks.
Collapse
Affiliation(s)
- Herbert Bakiika
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda.
| | - Ekwaro A Obuku
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Justine Bukirwa
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Lydia Nakiire
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Aruho Robert
- Uganda Wildlife Authority, P.O Box 3530, Kampala, Uganda
| | - Maureen Nabatanzi
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Mwebe Robert
- Ministry of Agriculture and Animal Industry and Fisheries, P.O Box 102, Entebbe, Uganda
| | - Mwanja Moses
- Ministry of Agriculture and Animal Industry and Fisheries, P.O Box 102, Entebbe, Uganda
| | | | - John Baptist Kibanga
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Aisha Nakanwagi
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Issa Makumbi
- Public Health Emergency Operation Centre, Ministry of Health, P.O. Box 7272, Kampala, Uganda
| | - Immaculate Nabukenya
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Mohammed Lamorde
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| |
Collapse
|
2
|
Bochner AF, Makumbi I, Aderinola O, Abayneh A, Jetoh R, Yemanaberhan RL, Danjuma JS, Lazaro FT, Mahmoud HJ, Yeabah TO, Nakiire L, Yahaya AK, Teixeira RA, Lamorde M, Nabukenya I, Oladejo J, Adetifa IMO, Oliveira W, McClelland A, Lee CT. Implementation of the 7-1-7 target for detection, notification, and response to public health threats in five countries: a retrospective, observational study. Lancet Glob Health 2023; 11:e871-e879. [PMID: 37060911 PMCID: PMC10156425 DOI: 10.1016/s2214-109x(23)00133-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/17/2023] [Accepted: 02/27/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Suboptimal detection and response to recent outbreaks, including COVID-19 and mpox (formerly known as monkeypox), have shown that the world is insufficiently prepared for public health threats. Routine monitoring of detection and response performance of health emergency systems through timeliness metrics has been proposed to evaluate and improve outbreak preparedness and contain health threats early. We implemented 7-1-7 to measure the timeliness of detection (target of ≤7 days from emergence), notification (target of ≤1 day from detection), and completion of seven early response actions (target of ≤7 days from notification), and we identified bottlenecks to and enablers of system performance. METHODS In this retrospective, observational study, we conducted reviews of public health events in Brazil, Ethiopia, Liberia, Nigeria, and Uganda with staff from ministries of health and national public health institutes. For selected public health events occurring from Jan 1, 2018, to Dec 31, 2022, we calculated timeliness intervals for detection, notification, and early response actions, and synthesised identified bottlenecks and enablers. We mapped bottlenecks and enablers to Joint External Evaluation (second edition) indicators. FINDINGS Of 41 public health events assessed, 22 (54%) met a target of 7 days to detect (median 6 days [range 0-157]), 29 (71%) met a target of 1 day to notify (0 days [0-24]), and 20 (49%) met a target of 7 days to complete all early response actions (8 days [0-72]). 11 (27%) events met the complete 7-1-7 target, with variation among event types. 25 (61%) of 41 bottlenecks to and 27 (51%) of 53 enablers of detection were at the health facility level, with delays to notification (14 [44%] of 32 bottlenecks) and response (22 [39%] of 56 bottlenecks) most often at an intermediate public health (ie, municipal, district, county, state, or province) level. Rapid resource mobilisation for responses (six [9%] of 65 enablers) from the national level enabled faster responses. INTERPRETATION The 7-1-7 target is feasible to measure and to achieve, and assessment with this framework can identify areas for performance improvement and help prioritise national planning. Increased investments must be made at the health facility and intermediate public health levels for improved systems to detect, notify, and rapidly respond to emerging public health threats. FUNDING Bill & Melinda Gates Foundation.
Collapse
Affiliation(s)
| | - Issa Makumbi
- Republic of Uganda Ministry of Health, Kampala, Uganda
| | - Olaolu Aderinola
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | | | - Ralph Jetoh
- National Public Health Institute of Liberia, Monrovia, Liberia
| | | | | | | | | | - Trokon O Yeabah
- National Public Health Institute of Liberia, Monrovia, Liberia
| | - Lydia Nakiire
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | - Aperki K Yahaya
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | | | - Mohammed Lamorde
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | | | - John Oladejo
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | | | - Wanderson Oliveira
- Vital Strategies, São Paulo, Brazil; Ministry of Defense Hospital of the Armed Forces, Brasília, Brazil
| | | | | |
Collapse
|
3
|
Achan MI, Nabukenya I, Mitanda S, Nakacwa J, Bakiika H, Nabatanzi M, Bukirwa J, Nakanwagi A, Nakiire L, Aperce C, Schwid A, Okware S, Obuku EA, Lamorde M, Luswata B, Makumbi I, Muruta A, Mwebesa HG, Aceng Ocero JR. COVID-19 and the law in Uganda: a case study on development and application of the public health act from 2020 to 2021. BMC Public Health 2023; 23:761. [PMID: 37098568 PMCID: PMC10126532 DOI: 10.1186/s12889-023-15555-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 03/29/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Despite the discovery of vaccines, the control, and prevention of Coronavirus disease 2019 (COVID-19) relied on non-pharmaceutical interventions (NPIs). This article describes the development and application of the Public Health Act to implement NPIs for COVID-19 pandemic control in Uganda. METHODS This is a case study of Uganda's experience with enacting COVID-19 Rules under the Public Health Act Cap. 281. The study assessed how and what Rules were developed, their influence on the outbreak progress, and litigation. The data sources reviewed were applicable laws and policies, Presidential speeches, Cabinet resolutions, statutory instruments, COVID-19 situation reports, and the registry of court cases that contributed to a triangulated analysis. RESULTS Uganda applied four COVID-19 broad Rules for the period March 2020 to October 2021. The Minister of Health enacted the Rules, which response teams, enforcement agencies, and the general population followed. The Presidential speeches, their expiry period and progress of the pandemic curve led to amendment of the Rules twenty one (21) times. The Uganda Peoples Defense Forces Act No. 7 of 2005, the Public Finance Management Act No. 3 of 2015, and the National Policy for Disaster Preparedness and Management supplemented the enacted COVID-19 Rules. However, these Rules attracted specific litigation due to perceived infringement on certain human rights provisions. CONCLUSIONS Countries can enact supportive legislation within the course of an outbreak. The balance of enforcing public health interventions and human rights infringements is an important consideration in future. We recommend public sensitization about legislative provisions and reforms to guide public health responses in future outbreaks or pandemics.
Collapse
Affiliation(s)
| | - Immaculate Nabukenya
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Sarah Mitanda
- Ministry of Justice and Constitutional Affairs, P.O Box 7183, Kampala, Uganda
| | - Joanita Nakacwa
- Ministry of Justice and Constitutional Affairs, P.O Box 7183, Kampala, Uganda
| | - Herbert Bakiika
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Maureen Nabatanzi
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Justine Bukirwa
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Aisha Nakanwagi
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Lydia Nakiire
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Cedric Aperce
- Resolve to Save Lives, New York 100 Broadway, 4th Floor, New York, NY 10005 USA
| | - Aaron Schwid
- Vital Strategies, New York 100 Broadway, 4th Floor, New York, NY 10005 USA
| | - Solome Okware
- World Health Organization, Uganda Country Office, P. O. Box 24578, Kampala, Uganda
| | - Ekwaro A. Obuku
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | - Mohammed Lamorde
- Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda
| | | | - Issa Makumbi
- Ministry of Health, P.O. Box 7272, Kampala, Uganda
| | - Allan Muruta
- Ministry of Health, P.O. Box 7272, Kampala, Uganda
| | | | | |
Collapse
|
4
|
Nabatanzi M, Bakiika H, Nabukenya I, Lamorde M, Bukirwa J, Achan MI, Babigumira PA, Nakiire L, Lubanga T, Mbabazi E, Taremwa RB, Mayinja H, Nakinsige A, Makanga DK, Muruta A, Okware S, Komakech I, Makumbi I, Wetaka MM, Kayiwa J, Ocom F, Ario AR, Nabatanzi S, Ojwang J, Boore A, Yemanaberhan R, Lee CT, Obuku E, Stowell D. Building National Health Security Through a Rapid Self-Assessment and Annual Operational Plan in Uganda, May to September 2021. Health Secur 2023; 21:130-140. [PMID: 36940291 PMCID: PMC10701509 DOI: 10.1089/hs.2022.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 12/19/2022] [Accepted: 01/05/2023] [Indexed: 03/22/2023] Open
Abstract
Uganda established a National Action Plan for Health Security in 2019, following a Joint External Evaluation (JEE) of International Health Regulations (2005) capacities in 2017. The action plan enhanced national health security awareness, but implementation efforts were affected by limited funding, excess of activities, and challenges related to monitoring and evaluation. To improve implementation, Uganda conducted a multisectoral health security self-assessment in 2021 using the second edition of the JEE tool and developed a 1-year operational plan. From 2017 to 2021, Uganda's composite ReadyScore improved by 20%, with improvement in 13 of the 19 technical areas. Indicator scores showing limited capacity declined from 30% to 20%, and indicators with no capacity declined from 10% to 2%. More indicators had developed (47% vs 40%), demonstrated (29% vs 20%), and sustained (2% vs 0%) capacities in 2021 compared with 2017. Using the self-assessment JEE scores, 72 specific activities from the International Health Regulations (2005) benchmarks tool were selected for inclusion in a 1-year operational plan (2021-2022). In contrast to the 264 broad activities in the 5-year national action plan, the operational plan prioritized a small number of activities to enable sectors to focus limited resources on implementation. While certain capacities improved before and during implementation of the action plan, countries may benefit from using short-term operational planning to develop realistic and actionable health security plans to improve health security capacities.
Collapse
Affiliation(s)
- Maureen Nabatanzi
- Maureen Nabatanzi, MPHN, FETP, is an Epidemiologist, Global Health Security Department, Infectious Diseases Institute, Kampala, Uganda
| | - Herbert Bakiika
- Herbert Bakiika MPH, is a One Health Specialist, Global Health Security Department, Infectious Diseases Institute, Kampala, Uganda
| | - Immaculate Nabukenya
- Immaculate Nabukenya, PhD, is an Epidemiologist, Global Health Security Department, Infectious Diseases Institute, Kampala, Uganda
| | - Mohammed Lamorde
- Mohammed Lamorde, MD, PhD, is Head of Department, Global Health Security Department, Infectious Diseases Institute, Kampala, Uganda
| | - Justine Bukirwa
- Justine Bukirwa is a Technical Officer, Laboratory Systems, Global Health Security Department, Infectious Diseases Institute, Kampala, Uganda
| | - Martha I. Achan
- Martha I. Achan, LLB, LLM, is a Legal Advisor, Global Health Security Department, Infectious Diseases Institute, Kampala, Uganda
| | - Peter A. Babigumira
- Peter A. Babigumira, BPharm, is Technical Advisor, Emergency Preparedness and Response, Global Health Security Department, Infectious Diseases Institute, Kampala, Uganda
| | - Lydia Nakiire
- Lydia Nakiire, MPH, FETP, is an Epidemiologist, Global Health Security Department, Infectious Diseases Institute, Kampala, Uganda
| | - Timothy Lubanga
- Timothy Lubanga is Commissioner, Monitoring and Evaluation Department, Office of the Prime Minister, Kampala, Uganda
| | - Enid Mbabazi
- Enid Mbabazi, MD, is a Medical Officer, Office of the Prime Minister, Kampala, Uganda
| | - Roland B. Taremwa
- Roland B. Taremwa is a Monitoring and Evaluation Specialist, Office of the Prime Minister, Kampala, Uganda
| | - Harriet Mayinja
- Harriet Mayinja is a Research Officer, Integrated Epidemiology, Surveillance and Public Health Emergencies Department, Ministry of Health, Kampala, Uganda
| | - Anne Nakinsige
- Anne Nakinsige, MD, is Principal Epidemiologist, Integrated Epidemiology, Surveillance and Public Health Emergencies Department, Ministry of Health, Kampala, Uganda
| | - Douglas K. Makanga
- Douglas K. Makanga, MD, is a Medical Officer, Integrated Epidemiology, Surveillance and Public Health Emergencies Department, Ministry of Health, Kampala, Uganda
| | - Allan Muruta
- Allan Muruta, MD, MPH, is Commissioner, Integrated Epidemiology, Surveillance and Public Health Emergencies Department, Ministry of Health, Kampala, Uganda
| | - Solome Okware
- Solome Okware, MD, MPH, is an Epidemiologist, World Health Emergencies Cluster, World Health Organization, Uganda Country Office, Kampala, Uganda
| | - Innocent Komakech
- Innocent Komakech, MD, MPH, is an Emergency Readiness Officer, World Health Emergencies Cluster, World Health Organization, Uganda Country Office, Kampala, Uganda
| | - Issa Makumbi
- Issa Makumbi, MD, MSc, is Director, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Milton M. Wetaka
- Milton M. Wetaka is a Laboratory and Logistics Specialist, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Joshua Kayiwa
- Joshua Kayiwa, MSc, is a Data Analyst, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Felix Ocom
- Felix Ocom, MD, is Deputy Manager, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Alex R. Ario
- Alex R. Ario, MD, PhD, is Managing Director, Uganda National Institute for Public Health, Ministry of Health, Kampala, Uganda
| | - Sandra Nabatanzi
- Sandra Nabatanzi, MSC, is an Emergency Management and Response Specialist and Outbreak Coordinator, Division of Global Health Protection, US Centers for Disease Control and Prevention Uganda Country Office, Kampala, Uganda
| | - Joseph Ojwang
- Joseph Ojwang, MD, MPH, is a Public Health Specialist, Division of Global Health Protection, US Centers for Disease Control and Prevention Uganda Country Office, Kampala, Uganda
| | - Amy Boore
- Amy Boore, MD, PhD, is Director, Division of Global Health Protection, US Centers for Disease Control and Prevention Uganda Country Office, Kampala, Uganda
| | - Rahel Yemanaberhan
- Rahel Yemanaberhan, MSc, is Regional Technical Advisor (East Africa), Resolve to Save Lives Ethiopia Country Office, Addis Ababa, Ethiopia
| | - Christopher T. Lee
- Christopher T. Lee, MD, MPH, is Director of Global Preparedness and Response, Resolve to Save Lives, New York, NY
| | - Ekwaro Obuku
- Ekwaro Obuku, MD, PhD, is Senior Technical Advisor, Data and Policy, Global Health Security Department, Infectious Diseases Institute, Kampala, Uganda
| | - Daniel Stowell
- Daniel Stowell, MPH, is a Global Health Security Specialist, US Centers for Disease Control and Prevention, Atlanta, GA
| |
Collapse
|
5
|
Merrill RD, Kilamile F, White M, Eurien D, Mehta K, Ojwang J, Laurent-Comlan M, Babigumira PA, Nakiire L, Boos A, Gatei W, Harris JR, Magazani A, Ocom F, Ssekubugu R, Kigozi G, Senyana F, Iyese FB, Elyanu PJ, Ward S, Makumbi I, Muruta A, McIntyre E, Massa K, Ario AR, Mayinja H, Remidius K, Ndungi DN. Using Population Mobility Patterns to Adapt COVID-19 Response Strategies in 3 East Africa Countries. Emerg Infect Dis 2022; 28:S105-S113. [PMID: 36502402 DOI: 10.3201/eid2813.220848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic spread between neighboring countries through land, water, and air travel. Since May 2020, ministries of health for the Democratic Republic of the Congo, Tanzania, and Uganda have sought to clarify population movement patterns to improve their disease surveillance and pandemic response efforts. Ministry of Health-led teams completed focus group discussions with participatory mapping using country-adapted Population Connectivity Across Borders toolkits. They analyzed the qualitative and spatial data to prioritize locations for enhanced COVID-19 surveillance, community outreach, and cross-border collaboration. Each country employed varying toolkit strategies, but all countries applied the results to adapt their national and binational communicable disease response strategies during the pandemic, although the Democratic Republic of the Congo used only the raw data rather than generating datasets and digitized products. This 3-country comparison highlights how governments create preparedness and response strategies adapted to their unique sociocultural and cross-border dynamics to strengthen global health security.
Collapse
|
6
|
Lamorde M, Ayebare R, Bulwadda D, Nanyondo J, Nakiire L, Walwema R, Otita M, Mukiibi P, Nabukenya I, Kakooza F, Kambugu A. Support for the response to COVID-19 in Uganda: contribution of the global health security program at Makerere University's Infectious Diseases Institute. Afr Health Sci 2022; 22:80-84. [PMID: 36321120 PMCID: PMC9590337 DOI: 10.4314/ahs.v22i2.13s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Outbreaks are occurring at increasing frequency and they require multisectoral and multi-stakeholder involvement for optimal response. The Global Health Security Agenda is a framework that governments and other stakeholders can use to strengthen countries' capacities to prevent, detect and respond to outbreaks but there are few examples of academic programs using this approach. Methods This is a narrative review of contributions of Makerere University through the Global Health Security Program at the Infectious Diseases Institute (IDI). Information was sourced from peer-reviewed publications and grey literature highlighting work done between 2017 – 2021. Results Aligned to GHSA, IDI made contributions to strengthen national and subnational capacities for biosafety and biosecurity, sample collection and transportation, electronic disease surveillance, infection prevention and control, case management prior to COVID-19 that were subsequently used to support response efforts for COVID-19 in Uganda. Conclusion The IDI Global Health Security program provides a model that can be used by institutions to deliberately develop capacities relevant to outbreak preparedness and response.
Collapse
|
7
|
Medley AM, Gasanani J, Nyolimati CA, McIntyre E, Ward S, Okuyo B, Kabiito D, Bender C, Jafari Z, LaMorde M, Babigumira PA, Nakiire L, Agwang C, Merrill R, Ndumu D, Doris K. Preventing the cross-border spread of zoonotic diseases: Multisectoral community engagement to characterize animal mobility-Uganda, 2020. Zoonoses Public Health 2021; 68:747-759. [PMID: 33749158 PMCID: PMC8518851 DOI: 10.1111/zph.12823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/22/2020] [Accepted: 02/02/2021] [Indexed: 11/28/2022]
Abstract
In Uganda, the borders are highly porous to animal movement, which may contribute to zoonotic disease spread. We piloted an animal adaptation of an existing human‐focused toolkit to collect data on animal movement patterns and interactions to inform One Health programs. During January 2020, we conducted focus group discussions and key informant interviews with participatory mapping of 2 national‐level One Health stakeholders and 2 local‐level abattoir representatives from Kampala. Zoonotic disease hotspots changed in 2020 compared with reports from 2017–2019. In contrast to local‐level participants, national‐level participants highlighted districts rather than specific locations. Everyone discussed livestock species; only national‐level participants mentioned wildlife. Participants described seasonality differently. Stakeholders used the results to identify locations for zoonotic disease interventions and sites for future data collection. This implementation of an animal‐adapted population mobility mapping exercise highlights the importance of multisectoral initiatives to promote One Health border health approaches.
Collapse
Affiliation(s)
- Alexandra Marie Medley
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Global Border Health Team, Atlanta, GA, USA.,Epidemic Intelligence Service, CDC, Atlanta, GA, USA
| | | | | | - Elvira McIntyre
- Perspecta Inc., Chantilly, VA, USA.,Geospatial Research, Analysis and Services Program (GRASP), Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah Ward
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Global Border Health Team, Atlanta, GA, USA
| | - Bosco Okuyo
- The Uganda Ministry of Agriculture, Animal Industries and Fisheries, Entebbe, Uganda
| | - Duncan Kabiito
- The Uganda Ministry of Health Emergency Operations Center, Kampala, Uganda
| | - Cristel Bender
- Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, TN, USA
| | - Zainab Jafari
- Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, TN, USA
| | | | | | | | | | - Rebecca Merrill
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Global Border Health Team, Atlanta, GA, USA
| | - Deo Ndumu
- The Uganda Ministry of Agriculture, Animal Industries and Fisheries, Entebbe, Uganda
| | - Kiconco Doris
- The Uganda Ministry of Agriculture, Animal Industries and Fisheries, Entebbe, Uganda
| |
Collapse
|
8
|
Nanziri C, Ario AR, Ntono V, Monje F, Aliddeki DM, Bainomugisha K, Kadobera D, Bulage L, Nsereko G, Kayiwa J, Nakiire L, Walwema R, Tusiime PK, Mabumba E, Makumbi I, Ocom F, Lamorde M, Kasule JN, Ward SE, Merrill RD. Ebola Virus Disease Preparedness Assessment and Risk Mapping in Uganda, August-September 2018. Health Secur 2020; 18:105-113. [PMID: 32324074 PMCID: PMC10838606 DOI: 10.1089/hs.2019.0118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Uganda's proximity to the tenth Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) presents a high risk of cross-border EVD transmission. Uganda conducted preparedness and risk-mapping activities to strengthen capacity to prevent EVD importation and spread from cross-border transmission. We adapted the World Health Organization (WHO) EVD Consolidated Preparedness Checklist to assess preparedness in 11 International Health Regulations domains at the district level, health facilities, and points of entry; the US Centers for Disease Control and Prevention (CDC) Border Health Capacity Discussion Guide to describe public health capacity; and the CDC Population Connectivity Across Borders tool kit to characterize movement and connectivity patterns. We identified 40 ground crossings (13 official, 27 unofficial), 80 health facilities, and more than 500 locations in 12 high-risk districts along the DRC border with increased connectivity to the EVD epicenter. The team also identified routes and congregation hubs, including origins and destinations for cross-border travelers to specified locations. Ten of the 12 districts scored less than 50% on the preparedness assessment. Using these results, Uganda developed a national EVD preparedness and response plan, including tailored interventions to enhance EVD surveillance, laboratory capacity, healthcare professional capacity, provision of supplies to priority locations, building treatment units in strategic locations, and enhancing EVD risk communication. We identified priority interventions to address risk of EVD importation and spread into Uganda. Lessons learned from this process will inform strategies to strengthen public health emergency systems in their response to public health events in similar settings.
Collapse
Affiliation(s)
- Carol Nanziri
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Alex Riolexus Ario
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Vivian Ntono
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Fred Monje
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Dativa Maria Aliddeki
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Kenneth Bainomugisha
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Daniel Kadobera
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Lilian Bulage
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Godfrey Nsereko
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Joshua Kayiwa
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Lydia Nakiire
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Richard Walwema
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Patrick K Tusiime
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Eldard Mabumba
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Issa Makumbi
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Felix Ocom
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Mohammed Lamorde
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Juliet Namugga Kasule
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Sarah E Ward
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Rebecca D Merrill
- Carol Nanziri, MPH; Vivian Ntono, MPH; Fred Monje, MVPM; Dativa Maria Aliddeki, MPH; Kenneth Bainomugisha, MPH; and Godfrey Nsereko, MPH, are Epidemiologists; Daniel Kadobera, MSc, is Field Supervisor; and Lilian Bulage, MSc, is a Scientific Writer; all in the Field Epidemiology Track, Uganda Public Health Fellowship Program, Kampala, Uganda. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. Joshua Kayiwa, MSc, is an Information Analyst, and Issa Makumbi, MSc, is Director; both in the Public Health Emergency Operations Centre, Ministry of Health, Kampala. Lydia Nakiire, MPH, is an Epidemiologist; Richard Walwema, MBA, is Project Manager; and Mohammed Lamorde, PhD, is Head of Department; all in Global Health Security, Infectious Diseases Institute, Makerere University, Kampala. Patrick K. Tusiime, MPH, is Commissioner, and Eldard Mabumba, MPH, is Principal Medical Officer; both in National Disease Prevention and Control, Ministry of Health, Kampala. Felix Ocom, MPH, is an Epidemiologist, Health Emergencies Program, World Health Organization Country Office, Kampala. Juliet Namugga Kasule, MSc, is a Public Health Specialist, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala. Sarah E. Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, GA
| |
Collapse
|
9
|
Nakiire L, Kabwama S, Majwala R, Bbale JK, Makumbi I, Kalyango J, Kihembo C, Masiira B, Bulage L, Kadobera D, Ario AR, Nsubuga P, Wanyenze R. Factors Associated with Utilisation of Couple HIV Counselling and Testing Among HIV-Positive Adults in Kyoga Fishing Community Uganda, May 2017: Cross Sectional Study. AIDS Behav 2020; 24:2935-2941. [PMID: 32300990 DOI: 10.1007/s10461-020-02844-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Couple HIV counseling and testing (CHCT) is key in preventing heterosexual HIV transmission and achievement of 90-90-90 UNAIDS treatment targets by 2020. We conducted secondary data analysis to assess utilization of CHCT and associated factors using logistic regression. 58/134 participants (49%) had ever utilized CHCT. Disclosure of individual HIV results to a partner [aOR = 16; 95% CI: (3.6-67)], residence for > 1 < 5 years [aOR = 0.04; 95% CI (0.005-0.33)], and none mobility [aOR = 3.6; 95% CI (1.1-12)] were significantly associated with CHCT. Age modified relationship between CHCT and disclosure (Likelihood-ratio test LR chi2 = 4.2 (p value = 0.041). Disclosure of individual HIV results with a partner and residence for more than 1 year improved utilization of CHCT; mobility reduced the odds of CHCT. Interventions should target prior discussion of individual HIV results among couples and mobile populations to increase CHCT.
Collapse
|
10
|
Aceng JR, Ario AR, Muruta AN, Makumbi I, Nanyunja M, Komakech I, Bakainaga AN, Talisuna AO, Mwesigye C, Mpairwe AM, Tusiime JB, Lali WZ, Katushabe E, Ocom F, Kaggwa M, Bongomin B, Kasule H, Mwoga JN, Sensasi B, Mwebembezi E, Katureebe C, Sentumbwe O, Nalwadda R, Mbaka P, Fatunmbi BS, Nakiire L, Lamorde M, Walwema R, Kambugu A, Nanyondo J, Okware S, Ahabwe PB, Nabukenya I, Kayiwa J, Wetaka MM, Kyazze S, Kwesiga B, Kadobera D, Bulage L, Nanziri C, Monje F, Aliddeki DM, Ntono V, Gonahasa D, Nabatanzi S, Nsereko G, Nakinsige A, Mabumba E, Lubwama B, Sekamatte M, Kibuule M, Muwanguzi D, Amone J, Upenytho GD, Driwale A, Seru M, Sebisubi F, Akello H, Kabanda R, Mutengeki DK, Bakyaita T, Serwanjja VN, Okwi R, Okiria J, Ainebyoona E, Opar BT, Mimbe D, Kyabaggu D, Ayebazibwe C, Sentumbwe J, Mwanja M, Ndumu DB, Bwogi J, Balinandi S, Nyakarahuka L, Tumusiime A, Kyondo J, Mulei S, Lutwama J, Kaleebu P, Kagirita A, Nabadda S, Oumo P, Lukwago R, Kasozi J, Masylukov O, Kyobe HB, Berdaga V, Lwanga M, Opio JC, Matseketse D, Eyul J, Oteba MO, Bukirwa H, Bulya N, Masiira B, Kihembo C, Ohuabunwo C, Antara SN, Owembabazi W, Okot PB, Okwera J, Amoros I, Kajja V, Mukunda BS, Sorela I, Adams G, Shoemaker T, Klena JD, Taboy CH, Ward SE, Merrill RD, Carter RJ, Harris JR, Banage F, Nsibambi T, Ojwang J, Kasule JN, Stowell DF, Brown VR, Zhu BP, Homsy J, Nelson LJ, Tusiime PK, Olaro C, Mwebesa HG, Woldemariam YT. Uganda's experience in Ebola virus disease outbreak preparedness, 2018-2019. Global Health 2020; 16:24. [PMID: 32192540 PMCID: PMC7081536 DOI: 10.1186/s12992-020-00548-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 02/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country. We describe Uganda's experience in EVD preparedness. RESULTS On 4 August 2018, the Uganda Ministry of Health (MoH) activated the Public Health Emergency Operations Centre (PHEOC) and the National Task Force (NTF) for public health emergencies to plan, guide, and coordinate EVD preparedness in the country. The NTF selected an Incident Management Team (IMT), constituting a National Rapid Response Team (NRRT) that supported activation of the District Task Forces (DTFs) and District Rapid Response Teams (DRRTs) that jointly assessed levels of preparedness in 30 designated high-risk districts representing category 1 (20 districts) and category 2 (10 districts). The MoH, with technical guidance from the World Health Organisation (WHO), led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at Points of Entry (PoEs) and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms. CONCLUSION As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significant and verifiable progress in EVD preparedness. There is a need to sustain these efforts, not only in EVD preparedness but also across the entire spectrum of a multi-hazard framework. These efforts strengthen country capacity and compel the country to avail resources for preparedness and management of incidents at the source while effectively cutting costs of using a "fire-fighting" approach during public health emergencies.
Collapse
Affiliation(s)
| | - Alex R Ario
- Ministry of Health, Kampala, Uganda.
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda.
| | | | - Issa Makumbi
- Ministry of Health, Kampala, Uganda
- Public Health Emergency Operations Centre, Ministry of Health, Kampala, Uganda
| | | | | | | | | | | | | | | | - William Z Lali
- World Health Organisation, Country Office, Kampala, Uganda
| | | | - Felix Ocom
- World Health Organisation, Country Office, Kampala, Uganda
| | - Mugagga Kaggwa
- World Health Organisation, Country Office, Kampala, Uganda
| | - Bodo Bongomin
- World Health Organisation, Country Office, Kampala, Uganda
| | - Hafisa Kasule
- World Health Organisation, Country Office, Kampala, Uganda
| | - Joseph N Mwoga
- World Health Organisation, Country Office, Kampala, Uganda
| | | | | | | | | | - Rita Nalwadda
- World Health Organisation, Country Office, Kampala, Uganda
| | - Paul Mbaka
- World Health Organisation, Country Office, Kampala, Uganda
| | | | | | | | | | | | | | - Solome Okware
- Ministry of Health, Kampala, Uganda
- Infectious Disease Institute, Kampala, Uganda
| | | | - Immaculate Nabukenya
- Ministry of Health, Kampala, Uganda
- Infectious Disease Institute, Kampala, Uganda
| | - Joshua Kayiwa
- Public Health Emergency Operations Centre, Ministry of Health, Kampala, Uganda
| | - Milton M Wetaka
- Public Health Emergency Operations Centre, Ministry of Health, Kampala, Uganda
| | - Simon Kyazze
- Public Health Emergency Operations Centre, Ministry of Health, Kampala, Uganda
| | - Benon Kwesiga
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Daniel Kadobera
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Lilian Bulage
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
- African Field Epidemiology Network, Kampala, Uganda
| | - Carol Nanziri
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Fred Monje
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Dativa M Aliddeki
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Vivian Ntono
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Doreen Gonahasa
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Sandra Nabatanzi
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Godfrey Nsereko
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | | | | | | | | | | | | | | | | | | | | | | | - Harriet Akello
- Ministry of Health, Kampala, Uganda
- Management Sciences for Health, Kampala, Uganda
| | | | | | | | | | | | | | | | | | - Derrick Mimbe
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Denis Kyabaggu
- East African Public Health Laboratory Network, Kampala, Uganda
| | | | - Juliet Sentumbwe
- Ministry of Agriculture, Animal Industry and Fisheries, Entebbe, Uganda
| | - Moses Mwanja
- Ministry of Agriculture, Animal Industry and Fisheries, Entebbe, Uganda
| | - Deo B Ndumu
- Ministry of Agriculture, Animal Industry and Fisheries, Entebbe, Uganda
| | | | | | | | | | | | - Sophia Mulei
- Uganda Virus Research Institute, Entebbe, Uganda
| | | | | | - Atek Kagirita
- Uganda National Health Laboratory Services, Ministry of Health, Kampala, Uganda
| | - Susan Nabadda
- Uganda National Health Laboratory Services, Ministry of Health, Kampala, Uganda
| | - Peter Oumo
- Ministry of Internal Affairs, Uganda Police Force, Kampala, Uganda
| | - Robinah Lukwago
- Department for International Development, UKAID, Kampala, Uganda
| | - Julius Kasozi
- United Nations High Commissioner for Refugees, Kampala, Uganda
| | | | | | | | | | - Joe C Opio
- United Nations Children's Fund, Kampala, Uganda
| | | | - James Eyul
- Civil Aviation Authority, Entebbe, Uganda
| | | | | | - Nulu Bulya
- African Field Epidemiology Network, Kampala, Uganda
| | - Ben Masiira
- African Field Epidemiology Network, Kampala, Uganda
| | | | | | | | | | | | | | | | - Victoria Kajja
- Intenational Organisation for Migration, Kampala, Uganda
| | | | - Isabel Sorela
- Intenational Organisation for Migration, Kampala, Uganda
| | - Gregory Adams
- United States Agency for International Development, Kampala, Uganda
| | - Trevor Shoemaker
- National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John D Klena
- National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Celine H Taboy
- National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah E Ward
- Division of Global Migration and Quarantine, Global Border Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rebecca D Merrill
- Division of Global Migration and Quarantine, Global Border Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rosalind J Carter
- Global Immunization Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julie R Harris
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | - Flora Banage
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | - Thomas Nsibambi
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | - Joseph Ojwang
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | - Juliet N Kasule
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | - Dan F Stowell
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | - Vance R Brown
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | - Bao-Ping Zhu
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | - Jaco Homsy
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | - Lisa J Nelson
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | | | | | | | | |
Collapse
|
11
|
Nakiire L, Mwanja H, Pillai SK, Gasanani J, Ntungire D, Nsabiyumva S, Mafigiri R, Muneza N, Ward SE, Daffe Z, Ahabwe PB, Kyazze S, Ojwang J, Homsy J, Mclntyre E, Lamorde M, Walwema R, Makumbi I, Muruta A, Merrill RD. Population Movement Patterns Among the Democratic Republic of the Congo, Rwanda, and Uganda During an Outbreak of Ebola Virus Disease: Results from Community Engagement in Two Districts - Uganda, March 2019. MMWR Morb Mortal Wkly Rep 2020; 69:10-13. [PMID: 31917781 PMCID: PMC6973344 DOI: 10.15585/mmwr.mm6901a3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
12
|
Nyakarahuka L, Shoemaker TR, Balinandi S, Chemos G, Kwesiga B, Mulei S, Kyondo J, Tumusiime A, Kofman A, Masiira B, Whitmer S, Brown S, Cannon D, Chiang CF, Graziano J, Morales-Betoulle M, Patel K, Zufan S, Komakech I, Natseri N, Chepkwurui PM, Lubwama B, Okiria J, Kayiwa J, Nkonwa IH, Eyu P, Nakiire L, Okarikod EC, Cheptoyek L, Wangila BE, Wanje M, Tusiime P, Bulage L, Mwebesa HG, Ario AR, Makumbi I, Nakinsige A, Muruta A, Nanyunja M, Homsy J, Zhu BP, Nelson L, Kaleebu P, Rollin PE, Nichol ST, Klena JD, Lutwama JJ. Marburg virus disease outbreak in Kween District Uganda, 2017: Epidemiological and laboratory findings. PLoS Negl Trop Dis 2019; 13:e0007257. [PMID: 30883555 PMCID: PMC6438581 DOI: 10.1371/journal.pntd.0007257] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 03/28/2019] [Accepted: 02/22/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION In October 2017, a blood sample from a resident of Kween District, Eastern Uganda, tested positive for Marburg virus. Within 24 hour of confirmation, a rapid outbreak response was initiated. Here, we present results of epidemiological and laboratory investigations. METHODS A district task force was activated consisting of specialised teams to conduct case finding, case management and isolation, contact listing and follow up, sample collection and testing, and community engagement. An ecological investigation was also carried out to identify the potential source of infection. Virus isolation and Next Generation sequencing were performed to identify the strain of Marburg virus. RESULTS Seventy individuals (34 MVD suspected cases and 36 close contacts of confirmed cases) were epidemiologically investigated, with blood samples tested for MVD. Only four cases met the MVD case definition; one was categorized as a probable case while the other three were confirmed cases. A total of 299 contacts were identified; during follow- up, two were confirmed as MVD. Of the four confirmed and probable MVD cases, three died, yielding a case fatality rate of 75%. All four cases belonged to a single family and 50% (2/4) of the MVD cases were female. All confirmed cases had clinical symptoms of fever, vomiting, abdominal pain and bleeding from body orifices. Viral sequences indicated that the Marburg virus strain responsible for this outbreak was closely related to virus strains previously shown to be circulating in Uganda. CONCLUSION This outbreak of MVD occurred as a family cluster with no additional transmission outside of the four related cases. Rapid case detection, prompt laboratory testing at the Uganda National VHF Reference Laboratory and presence of pre-trained, well-prepared national and district rapid response teams facilitated the containment and control of this outbreak within one month, preventing nationwide and global transmission of the disease.
Collapse
Affiliation(s)
- Luke Nyakarahuka
- Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda
- Department of Biosecurity, Ecosystems, and Veterinary Public Health, Collage of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala Uganda
| | - Trevor R. Shoemaker
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - Stephen Balinandi
- Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda
| | - Godfrey Chemos
- Kween District Health Team, Kween District Local Government, Kween, Uganda
| | - Benon Kwesiga
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Sophia Mulei
- Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda
| | - Jackson Kyondo
- Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda
| | - Alex Tumusiime
- Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda
| | - Aaron Kofman
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - Ben Masiira
- African Field Epidemiology Network, Kampala, Uganda
| | - Shannon Whitmer
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - Shelley Brown
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - Debi Cannon
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - Cheng-Feng Chiang
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - James Graziano
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - Maria Morales-Betoulle
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - Ketan Patel
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - Sara Zufan
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | | | - Nasan Natseri
- World Health Organization – Country Office, Kampala, Uganda
| | | | | | | | - Joshua Kayiwa
- Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Innocent H. Nkonwa
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Patricia Eyu
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Lydia Nakiire
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | | | - Leonard Cheptoyek
- Kween District Health Team, Kween District Local Government, Kween, Uganda
| | | | - Michael Wanje
- Kween District Health Team, Kween District Local Government, Kween, Uganda
| | | | - Lilian Bulage
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | | | - Alex R. Ario
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Issa Makumbi
- Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | | | | | | | - Jaco Homsy
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - Bao-Ping Zhu
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Lisa Nelson
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - Pontiano Kaleebu
- Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda
| | - Pierre E. Rollin
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - Stuart T. Nichol
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - John D. Klena
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America
| | - Julius J. Lutwama
- Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda
| |
Collapse
|
13
|
Nakiire L, Masiira B, Kihembo C, Katushabe E, Natseri N, Nabukenya I, Komakech I, Makumbi I, Charles O, Adatu F, Nanyunja M, Nsubuga P, Woldetsadik SF, Tusiime P, Yahaya AA, Fall IS, Wondimagegnehu A. Healthcare workers' experiences regarding scaling up of training on integrated disease surveillance and response (IDSR) in Uganda, 2016: cross sectional qualitative study. BMC Health Serv Res 2019; 19:117. [PMID: 30760259 PMCID: PMC6374884 DOI: 10.1186/s12913-019-3923-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 01/22/2019] [Indexed: 11/24/2022] Open
Abstract
Background The Integrated Disease Surveillance and Response (IDSR) strategy was adopted as the framework for implementation of International Health Regulation (2005) in the African region of World Health Organisation (WHO AFRO). While earlier studies documented gains in performance of core IDSR functions, Uganda still faces challenges due to infectious diseases. IDSR revitalisation programme aimed to improve prevention, early detection, and prompt response to disease outbreaks. However, little is known about health worker’s perception of the revitalised IDSR training. Methods We conducted focus group discussions of health workers who were trained between 2015 and 2016. Discussions on benefits, challenges and possible solutions for improvement of IDSR training were recorded, transcribed, translated and coded using grounded theory. Results In total, 22/26 FGDs were conducted. Participants cited improved completeness and timeliness of reporting, case detection and data analysis and better response to disease outbreaks as key achievements after the training. Programme challenges included an inadequate number of trained staff, funding, irregular supervision, high turnover of trained health workers, and lack of key logistics. Suggestions to improve IDSR included pre-service and community training, mentorship, regular supervision and improving funding at the district level. Conclusion Health workers perceived that scaling up revitalized IDSR training in Uganda improved public health surveillance. However, they acknowledge encountering challenges that hinder their performance after the training. Ministry of Health should have a mentorship plan, integrate IDSR training in pre-service curricula and advocate for funding IDSR activities to address some of the gaps highlighted in this study.
Collapse
Affiliation(s)
- Lydia Nakiire
- Public Health Emergency Operation Centre, Ministry of Health, P.O BOX 7072, Kampala, Uganda.
| | - Ben Masiira
- Epidemiology and Surveillance Division, Ministry of Health Kampala, Kampala, Uganda
| | - Christine Kihembo
- Epidemiology and Surveillance Division, Ministry of Health Kampala, Kampala, Uganda
| | | | - Nasan Natseri
- World Health Organization, Country Office, Kampala, Uganda
| | - Immaculate Nabukenya
- Epidemiology and Surveillance Division, Ministry of Health Kampala, Kampala, Uganda
| | | | - Issa Makumbi
- Public Health Emergency Operation Centre, Ministry of Health, P.O BOX 7072, Kampala, Uganda
| | - Okot Charles
- World Health Organization, Country Office, Kampala, Uganda
| | | | | | - Peter Nsubuga
- Global Public Health Solutions Inc, Atlanta, Georgia, USA
| | | | - Patrick Tusiime
- National Disease Control, Ministry of Health, Kampala, Uganda
| | - Ali Ahmed Yahaya
- World Health Organization Africa Regional Office, Brazzaville, Congo
| | | | | |
Collapse
|
14
|
Masiira B, Nakiire L, Kihembo C, Katushabe E, Natseri N, Nabukenya I, Komakech I, Makumbi I, Charles O, Adatu F, Nanyunja M, Woldetsadik SF, Fall IS, Tusiime P, Wondimagegnehu A, Nsubuga P. Evaluation of integrated disease surveillance and response (IDSR) core and support functions after the revitalisation of IDSR in Uganda from 2012 to 2016. BMC Public Health 2019; 19:46. [PMID: 30626358 PMCID: PMC6327465 DOI: 10.1186/s12889-018-6336-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 12/17/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Uganda is a low income country that continues to experience disease outbreaks caused by emerging and re-emerging diseases such as cholera, meningococcal meningitis, typhoid and viral haemorrhagic fevers. The Integrated Disease Surveillance and Response (IDSR) strategy was adopted by WHO-AFRO in 1998 as a comprehensive strategy to improve disease surveillance and response in WHO Member States in Africa and was adopted in Uganda in 2000. To address persistent inconsistencies and inadequacies in the core and support functions of IDSR, Uganda initiated an IDSR revitalisation programme in 2012. The objective of this evaluation was to assess IDSR core and support functions after implementation of the revitalised IDSR programme. METHODS The evaluation was a cross-sectional survey that employed mixed quantitative and qualitative methods. We assessed IDSR performance indicators, knowledge acquisition, knowledge retention and level of confidence in performing IDSR tasks among health workers who underwent IDSR training. Qualitative data was collected to guide the interpretation of quantitative findings and to establish a range of views related to IDSR implementation. RESULTS Between 2012 and 2016, there was an improvement in completeness of monthly reporting (69 to 100%) and weekly reporting (56 to 78%) and an improvement in timeliness of monthly reporting (59 to 93%) and weekly reporting (40 to 68%) at the national level. The annualised non-polio AFP rate increased from 2.8 in 2012 to 3.7 cases per 100,000 population < 15 years in 2016. The case fatality rate for cholera decreased from 3.2% in 2012 to 2.1% in 2016. All districts received IDSR feedback from the national level. Key IDSR programme challenges included inadequate numbers of trained staff, inadequate funding, irregular supervision and high turnover of trained staff. Recommendations to improve IDSR performance included: improving funding, incorporating IDSR training into pre-service curricula for health workers and strengthening support supervision. CONCLUSION The revitalised IDSR programme in Uganda was associated with improvements in performance. However in 2016, the programme still faced significant challenges and some performance indicators were still below the target. It is important that the documented gains are consolidated and challenges are continuously identified and addressed as they emerge.
Collapse
Affiliation(s)
- Ben Masiira
- Epidemiology and Surveillance Division, Ministry of Health, P.O Box 7072, Kampala, Uganda
| | - Lydia Nakiire
- Public Health Emergency Operation Centre, Ministry of Health, Kampala, Uganda
| | - Christine Kihembo
- Epidemiology and Surveillance Division, Ministry of Health, P.O Box 7072, Kampala, Uganda
| | - Edson Katushabe
- World Health Organization, Uganda Country Office, Kampala, Uganda
| | - Nasan Natseri
- World Health Organization, Uganda Country Office, Kampala, Uganda
| | - Immaculate Nabukenya
- Epidemiology and Surveillance Division, Ministry of Health, P.O Box 7072, Kampala, Uganda
| | | | - Issa Makumbi
- Public Health Emergency Operation Centre, Ministry of Health, Kampala, Uganda
| | - Okot Charles
- World Health Organization, Uganda Country Office, Kampala, Uganda
| | - Francis Adatu
- Epidemiology and Surveillance Division, Ministry of Health, P.O Box 7072, Kampala, Uganda
| | - Miriam Nanyunja
- World Health Organization, Uganda Country Office, Kampala, Uganda
| | | | | | - Patrick Tusiime
- National Disease Control, Ministry of Health, Kampala, Uganda
| | | | | |
Collapse
|
15
|
Majwala RK, Nakiire L, Kadobera D, Ario AR, Kusiima J, Atuhairwe JA, Matovu JKB, Zhu BP. Measles outbreak propagated by children congregating at water collection points in Mayuge District, eastern Uganda, July - October, 2016. BMC Infect Dis 2018; 18:412. [PMID: 30126362 PMCID: PMC6102928 DOI: 10.1186/s12879-018-3304-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 08/01/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND On 12 October, 2016 a measles outbreak was reported in Mayuge District, eastern Uganda. We investigated the outbreak to determine its scope, identify risk factors for transmission, evaluate vaccination coverage and vaccine effectiveness, and recommend evidence-based control measures. METHODS We defined a probable case as onset of fever (≥3 days) and generalized rash, plus ≥1 of the following: conjunctivitis, cough, and/or runny nose in a Mayuge District resident. A confirmed case was a probable case with measles-specific IgM (+) not explained by vaccination. We reviewed medical records and conducted active community case-finding. In a case-control investigation involving probable case-persons and controls matched by age and village, we evaluated risk factors for transmission for both cases and controls during the case-person's likely exposure period (i.e., 7-21 days prior to rash onset). We estimated vaccine effectiveness (VE) using the formula: VE ≈ (1-ORprotective) × 100. We calculated vaccination coverage using the percentage of controls vaccinated. RESULTS We identified 62 probable case-persons (attack rate [AR] = 4.0/10,000), including 3 confirmed. Of all age groups, children < 5 years were the most affected (AR = 14/10,000). The epidemic curve showed a propagated outbreak. Thirty-two percent (13/41) of case-persons and 13% (21/161) of control-persons visited water-collection sites (by themselves or with parents) during the case-persons' likely exposure period (ORM-H = 5.0; 95% CI = 1.5-17). Among children aged 9-59 months, the effectiveness of the single-dose measles vaccine was 75% (95% CI = 25-92); vaccination coverage was 68% (95% CI = 61-76). CONCLUSIONS Low vaccine effectiveness, inadequate vaccination coverage and congregation at water collection points facilitated measles transmission in this outbreak. We recommended increasing measles vaccination coverage and restriction of children with signs and symptoms of measles from accessing public gatherings.
Collapse
Affiliation(s)
- Robert Kaos Majwala
- Uganda Public Health Fellowship Program - Field Epidemiology Track, Ministry of Health of Uganda and Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
- National Tuberculosis and Leprosy Program, Ministry of Health Uganda, Kampala, Uganda
| | - Lydia Nakiire
- Uganda Public Health Fellowship Program - Field Epidemiology Track, Ministry of Health of Uganda and Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - Daniel Kadobera
- Uganda Public Health Fellowship Program - Field Epidemiology Track, Ministry of Health of Uganda and Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - Alex Riolexus Ario
- Uganda Public Health Fellowship Program - Field Epidemiology Track, Ministry of Health of Uganda and Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - Joy Kusiima
- Uganda Public Health Fellowship Program - Field Epidemiology Track, Ministry of Health of Uganda and Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - Joselyn Annet Atuhairwe
- Uganda Public Health Fellowship Program - Field Epidemiology Track, Ministry of Health of Uganda and Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - Joseph K. B. Matovu
- Uganda Public Health Fellowship Program - Field Epidemiology Track, Ministry of Health of Uganda and Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
- Makerere University School of Public Health, Kampala, Uganda
| | - Bao-Ping Zhu
- Centers for Disease Control and Prevention, Atlanta, GA USA
| |
Collapse
|
16
|
Kihembo C, Masiira B, Nakiire L, Katushabe E, Natseri N, Nabukenya I, Komakech I, Okot CL, Adatu F, Makumbi I, Nanyunja M, Woldetsadik SF, Tusiime P, Nsubuga P, Fall IS, Wondimagegnehu A. The design and implementation of the re-vitalised integrated disease surveillance and response (IDSR) in Uganda, 2013-2016. BMC Public Health 2018; 18:879. [PMID: 30005613 PMCID: PMC6045850 DOI: 10.1186/s12889-018-5755-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 06/26/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Uganda adopted and has been implementing the Integrated Disease Surveillance (IDSR) strategy since 2000. The goal was to build the country's capacity to detect, report promptly, and effectively respond to public health emergencies and priorities. The considerable investment into the program startup realised significant IDSR core performance. However, due to un-sustained funding from the mid-2000s onwards, these achievements were undermined. Following the adoption of the revised World Health Organization guidelines on IDSR, the Uganda Ministry of Health (MoH) in collaboration with key partners decided to revitalise IDSR and operationalise the updated IDSR guidelines in 2012. METHODS Through the review of both published and unpublished national guidelines, reports and other IDSR program records in addition to an interview of key informants, we describe the design and process of IDSR revitalisation in Uganda, 2013-2016. The program aimed to enhance the districts' capacity to promptly detect, assess and effectively respond to public health emergencies. RESULTS Through a cascaded, targeted skill-development training model, 7785 participants were trained in IDSR between 2015 and 2016. Of these, 5489(71%) were facility-based multi-disciplinary health workers, 1107 (14%) comprised the district rapid response teams and 1188 (15%) constituted the district task forces. This training was complemented by other courses for regional teams in addition to the provision of logistics to support IDSR activities. Centrally, IDSR implementation was coordinated and monitored by the MoH's national task force (NTF) on epidemics and emergencies. The NTF and in close collaboration with the WHO Country Office, mobilised resources from various partners and development initiatives. At regional and district levels, the technical and political leadership were mobilised and engaged in monitoring and overseeing program implementation. CONCLUSION The IDSR re-vitalization in Uganda highlights unique features that can be considered by other countries that would wish to strengthen their IDSR programs. Through a coordinated partner response, the program harnessed resources which primarily were not earmarked for IDSR to strengthen the program nation-wide. Engagement of the local district leadership helped promote ownership, foster accountability and sustainability of the program.
Collapse
Affiliation(s)
- Christine Kihembo
- Epidemiology and Surveillance Division, Ministry of Health, P.O BOX 7072 Kampala, Uganda
| | - Ben Masiira
- Epidemiology and Surveillance Division, Ministry of Health, P.O BOX 7072 Kampala, Uganda
| | - Lydia Nakiire
- Public Health Emergency Operations Centre, Ministry of Health, P.O BOX 7072 Kampala, Uganda
| | - Edson Katushabe
- World Health Organization, Uganda Country Office, P.O BOX 24578 Kampala, Uganda
| | - Nasan Natseri
- World Health Organization, Uganda Country Office, P.O BOX 24578 Kampala, Uganda
| | - Immaculate Nabukenya
- Epidemiology and Surveillance Division, Ministry of Health, P.O BOX 7072 Kampala, Uganda
| | - Innocent Komakech
- World Health Organization, Uganda Country Office, P.O BOX 24578 Kampala, Uganda
| | - Charles Lukoya Okot
- World Health Organization, Uganda Country Office, P.O BOX 24578 Kampala, Uganda
| | - Francis Adatu
- Epidemiology and Surveillance Division, Ministry of Health, P.O BOX 7072 Kampala, Uganda
| | - Issa Makumbi
- Public Health Emergency Operations Centre, Ministry of Health, P.O BOX 7072 Kampala, Uganda
| | - Miriam Nanyunja
- World Health Organization, Uganda Country Office, P.O BOX 24578 Kampala, Uganda
| | | | - Patrick Tusiime
- National Disease Control, Ministry of Health, P.O BOX 7072 Kampala, Uganda
| | - Peter Nsubuga
- Global Public Health Solutions LLC, Atlanta, GA 30326 USA
| | - Ibrahima Soce Fall
- World Health Organization, Africa Regional Office, Brazzaville, Republic of Congo
| | | |
Collapse
|
17
|
Bosa HK, Majwala R, Nakiire L, Ario A, Kiwanuka N, Kibuuka H, Downing R, Lutwama J. Missed opportunities for Yellow Fever Surveillance in Uganda, July 2015 - May 2016. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.11.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|