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ACENG JANERUTH, BOSA HENRYKYOBE, KAMARA NEEMA, ATWINE DIANA, MWEBESA HENRY, NYIKA HOWARD, MAUREEN KATUSIIME, OLARO CHARLES, KAGIRITA ATEK, LARMODE MOHAMMED, RIEK LULPOUT, TEMFACK ELVIS, SALYER STEPHANIE, ALIDDEKI DATIVA, MACHINGAIDZE SHINGAI, MAZUGUNI FESTO, KIRENGA BRUCE, MUTTAMBA WINTERS, WAYENGERA MISAKI, BBUYE MUDASHIR, KASAMBULA ARTHUR, EURIEN DANIEL, GRACE AKELLO, AMPAIRE INGRID, HERBERT ISABIRYE, TUT MATHEW, BANGURE DONEWELL, MANKOULA WESSAM, SONKO IBRAHIMA, KOKOU ALINONNOUWAME, MAGODI SIMON, MHIRAF ADDIS, BULWADDA DANIEL, KYABAYINZE DANIEL, KABAMI ZAINAH, MURUTA ALLAN, BAHATUNGIRE RONY, GEORGE UPENTHO, NABADDA SUSAN, BIRUNGI GLORIA, RICHARD KABANDA, ARAGAW MERAWI, OUMA AHMEDOGWELL. Continental concerted efforts to control the seventh outbreak of Ebola Virus disease in Uganda: The first 90 days of the response. J Public Health Afr 2023; 14:2735. [PMID: 37881727 PMCID: PMC10594597 DOI: 10.4081/jphia.2023.2735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023] Open
Abstract
On 20th September 2022, Uganda declared the 7th outbreak of Ebola virus disease (EVD) caused by the Sudan Ebola strain following the confirmation of a case admitted at Mubende Regional Referral Hospital. Upon confirmation, the Government of Uganda immediately activated the national incident management system to initiate response activities. Additionally, a multi-country emergency stakeholder meeting was held in Kampala; convening Ministers of Health from neighbouring Member States to undertake cross-border preparedness and response actions. The outbreak spanned 69 days and recorded 164 cases (142 confirmed, 22 probable), 87 recoveries and 77 deaths (case fatality ratio of 47%). Nine out of 136 districts were affected with transmission taking place in 5 districts but spilling over in 4 districts without secondary transmission. As part of the response, the Government galvanised robust community mobilisation and initiated assessment of medical counter measures including therapeutics, new diagnostics and vaccines. This paper highlights the response actions that contributed to the containment of this outbreak in addition to the challenges faced with a special focus on key recommendations for better control of future outbreaks.
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Affiliation(s)
| | | | - NEEMA KAMARA
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | | | | | - HOWARD NYIKA
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | | | | | | | - MOHAMMED LARMODE
- Makerere University Institute of Infectious Diseases, Kampala, Uganda
| | - LUL POUT RIEK
- Africa Centres for Disease Control and Prevention, Nairobi, Kenya
| | - ELVIS TEMFACK
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - STEPHANIE SALYER
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - DATIVA ALIDDEKI
- Africa Centres for Disease Control and Prevention, Nairobi, Kenya
| | | | - FESTO MAZUGUNI
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | | | | | | | | | | | | | | | | | | | - MATHEW TUT
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - DONEWELL BANGURE
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - WESSAM MANKOULA
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - IBRAHIMA SONKO
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | | | - SIMON MAGODI
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - ADDIS MHIRAF
- Africa Centres for Disease Control and Prevention, Nairobi, Kenya
| | - DANIEL BULWADDA
- Makerere University Institute of Infectious Diseases, Kampala, Uganda
| | | | | | | | | | | | | | | | | | - MERAWI ARAGAW
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - AHMED OGWELL OUMA
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
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Ario AR, Aliddeki DM, Kadobera D, Bulage L, Kayiwa J, Wetaka MM, Kyazze S, Ocom F, Makumbi I, Mbaka P, Behumbiize P, Ayebazibwe I, Balinandi SK, Lutwama JJ, Crawley A, Divi N, Lule JR, Ojwang JC, Harris JR, Boore AL, Nelson LJ, Borchert J, Jarvis D. Uganda's experience in establishing an electronic compendium for public health emergencies. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001402. [PMID: 36962840 PMCID: PMC10021891 DOI: 10.1371/journal.pgph.0001402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/28/2022] [Indexed: 02/12/2023]
Abstract
Uganda has implemented several interventions that have contributed to prevention, early detection, and effective response to Public Health Emergencies (PHEs). However, there are gaps in collecting and documenting data on the overall response to these PHEs. We set out to establish a comprehensive electronic database of PHEs that occurred in Uganda since 2000. We constituted a core development team, developed a data dictionary, and worked with Health Information Systems Program (HISP)-Uganda to develop and customize a compendium of PHEs using the electronic Integrated Disease Surveillance and Response (eIDSR) module on the District Health Information Software version 2 (DHIS2) platform. We reviewed literature for retrospective data on PHEs for the compendium. Working with the Uganda Public Health Emergency Operations Center (PHEOC), we prospectively updated the compendium with real-time data on reported PHEs. We developed a user's guide to support future data entry teams. An operational compendium was developed within the eIDSR module of the DHIS2 platform. The variables for PHEs data collection include those that identify the type, location, nature and time to response of each PHE. The compendium has been updated with retrospective PHE data and real-time prospective data collection is ongoing. Data within this compendium is being used to generate information that can guide future outbreak response and management. The compendium development highlights the importance of documenting outbreak detection and response data in a central location for future reference. This data provides an opportunity to evaluate and inform improvements in PHEs response.
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Affiliation(s)
- Alex Riolexus Ario
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | | | - Daniel Kadobera
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | - Lilian Bulage
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | - Joshua Kayiwa
- Uganda National Institute of Public Health, Kampala, Uganda
- Uganda Public Health Emergency Operations Center, Kampala, Uganda
| | - Milton M. Wetaka
- Uganda National Institute of Public Health, Kampala, Uganda
- Uganda Public Health Emergency Operations Center, Kampala, Uganda
| | - Simon Kyazze
- Uganda National Institute of Public Health, Kampala, Uganda
- Uganda Public Health Emergency Operations Center, Kampala, Uganda
| | - Felix Ocom
- Uganda National Institute of Public Health, Kampala, Uganda
- Uganda Public Health Emergency Operations Center, Kampala, Uganda
| | - Issa Makumbi
- Uganda National Institute of Public Health, Kampala, Uganda
- Uganda Public Health Emergency Operations Center, Kampala, Uganda
| | - Paul Mbaka
- Uganda National Institute of Public Health, Kampala, Uganda
- Division of Health Information, Ministry of Health, Kampala, Uganda
| | | | | | | | | | - Adam Crawley
- Ending Pandemics, San Francisco, California, United States of America
| | - Nomita Divi
- Ending Pandemics, San Francisco, California, United States of America
| | - John R. Lule
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | | | - Julie R. Harris
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | - Amy L. Boore
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | - Lisa J. Nelson
- US Centers for Disease Control and Prevention, Kampala, Uganda
| | - Jeff Borchert
- Division of Vector-Borne Diseases, National Center for Emerging, Zoonotic, Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America
| | - Dennis Jarvis
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Kayiwa J, Homsy J, Nelson LJ, Ocom F, Kasule JN, Wetaka MM, Kyazze S, Mwanje W, Kisakye A, Nabunya D, Nyirabakunzi M, Aliddeki DM, Ojwang J, Boore A, Kasozi S, Borchert J, Shoemaker T, Nabatanzi S, Dahlke M, Brown V, Downing R, Makumbi I. Establishing a Public Health Emergency Operations Center in an Outbreak-Prone Country: Lessons Learned in Uganda, January 2014 to December 2021. Health Secur 2022; 20:394-407. [PMID: 35984936 PMCID: PMC10985018 DOI: 10.1089/hs.2022.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Uganda is highly vulnerable to public health emergencies (PHEs) due to its geographic location next to the Congo Basin epidemic hot spot, placement within multiple epidemic belts, high population growth rates, and refugee influx. In view of this, Uganda's Ministry of Health established the Public Health Emergency Operations Center (PHEOC) in September 2013, as a central coordination unit for all PHEs in the country. Uganda followed the World Health Organization's framework to establish the PHEOC, including establishing a steering committee, acquiring legal authority, developing emergency response plans, and developing a concept of operations. The same framework governs the PHEOC's daily activities. Between January 2014 and December 2021, Uganda's PHEOC coordinated response to 271 PHEs, hosted 207 emergency coordination meetings, trained all core staff in public health emergency management principles, participated in 21 simulation exercises, coordinated Uganda's Global Health Security Agenda activities, established 6 subnational PHEOCs, and strengthened the capacity of 7 countries in public health emergency management. In this article, we discuss the following lessons learned: PHEOCs are key in PHE coordination and thus mitigate the associated adverse impacts; although the functions of a PHEOC may be legalized by the existence of a National Institute of Public Health, their establishment may precede formally securing the legal framework; staff may learn public health emergency management principles on the job; involvement of leaders and health partners is crucial to the success of a public health emergency management program; subnational PHEOCs are resourceful in mounting regional responses to PHEs; and service on the PHE Strategic Committee may be voluntary.
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Affiliation(s)
- Joshua Kayiwa
- Joshua Kayiwa, MSc, is a Plans Chief and Information Analyst, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Jaco Homsy
- Jaco Homsy, MD, MPH, is an Associate Clinical Professor, Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California San Francisco School of Medicine, San Francisco, CA
| | - Lisa J Nelson
- Lisa J. Nelson, MD, MPH, MSc, is a Medical Officer and Uganda Country Director, US Centers for Disease Control and Prevention (CDC) Country Office, Kampala, Uganda
| | - Felix Ocom
- Felix Ocom, MD, is Deputy Director, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Juliet N Kasule
- Juliet N. Kasule, MSc, is an Early Warning Specialist, US Centers for Disease Control and Prevention (CDC) Country Office, Kampala, Uganda
| | - Milton M Wetaka
- Milton M. Wetaka is a Logistics Chief and Laboratory Specialist, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Simon Kyazze
- Simon Kyazze, MSc, is an Operations Chief, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Wilbrod Mwanje
- Wilbrod Mwanje, MPH, is an Epidemiologist, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Anita Kisakye
- Anita Kisakye, MSc, is a Monitoring and Evaluation Specialist, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Dorothy Nabunya
- Dorothy Nabunya is an Administrative Specialist, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Margaret Nyirabakunzi
- Margaret Nyirabakunzi is an Administrative Assistant, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Dativa Maria Aliddeki
- Dativa Maria Aliddeki, MSc, is an Epidemiologist, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
| | - Joseph Ojwang
- Joseph Ojwang, MPH, is an Epidemiologist, US Centers for Disease Control and Prevention (CDC) Country Office, Kampala, Uganda
| | - Amy Boore
- Amy Boore, PhD, is Director, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC) Country Office, Kampala, Uganda
| | - Sam Kasozi
- Sam Kasozi is a Systems Developer, Health Information Systems Program Uganda, Kampala, Uganda
| | - Jeff Borchert
- Jeff Borchert, MSc, is a Public Health Advisor, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), US CDC, Fort Collins, CO
| | - Trevor Shoemaker
- Trevor Shoemaker, PhD, is an Epidemiologist, Division of High-Consequence Pathogens and Pathology, NCEZIDUS CDC, Atlanta, GA
| | - Sandra Nabatanzi
- Sandra Nabatanzi, MSc, is an Epidemiologist, Monitoring and Evaluation Technical Support Program, Makerere University School of Public Health, Kampala, Uganda
| | - Melissa Dahlke
- Melissa Dahlke, MSc, is an Epidemiologist, Global Immunization Division, Center for Global Health, US CDC, Atlanta, GA
| | - Vance Brown
- Vance Brown, MA, is a Public Health Advisor, Division of Global Health Protection, NCEZID, US CDC, Atlanta, GA
| | - Robert Downing
- Robert Downing, PhD, is a Laboratory Specialist, Uganda Virus Research Institute, Ministry of Health, Entebbe, Uganda
| | - Issa Makumbi
- Issa Makumbi, MSc, is Director, Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda
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