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Aliyu N, Bawa MK, Gidado S, Ohuabunwo C, Esapa L, Archer WR, Sule A, Bolatito HA, Mamman A, Olayinka A, Balogun MS, Getso KI, Dalhat MM, Haladu AS, Shehu UL, Nguku PM, Shehu A, Abdulganiyu S, Waziri NE. Revelation of an important weakness in polio elimination efforts in Nigeria: a descriptive cross-sectional study of nomadic dynamics in Sokoto and Taraba States, May 2013. Pan Afr Med J 2021; 40:12. [PMID: 36157561 PMCID: PMC9474948 DOI: 10.11604/pamj.supp.2021.40.1.32542] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/13/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Operational gaps in the Global Polio Eradication Initiative implementation had been partly responsible for inadequate population immunity and the continued transmission of wild poliovirus in Nigeria before the African Region was declared polio-free in 2020. Missed opportunities to provide services in nomadic populations due to frequent mobility, lack of inclusion in microplans and the remoteness of their settlements were the major challenges. During May 2013 we conducted immunization outreach to nomadic and other underserved communities in Rabah LGA, Sokoto state, and Ardo Kola LGA, Taraba state, in Nigeria to identify and vaccinate children missed during supplemental immunization activities while identifying missed acute flaccid paralysis cases. Methods An enumeration checklist and data collection instruments on Android cell phones were used to capture socio-demographic data and GPS coordinates on nomadic settlements, households, number of children aged <5 years, children previously missed for vaccination and their locations. Local guides led trained enumerators to underserved communities for the enumeration and vaccination. Data were analyzed using Microsoft Excel 2007. Results A total of 324 settlements were listed for the two states, and 111 (34.3%) of these were identified as missed when compared with micro-planning for the most recent SIA. In these settlements, 3,533 households and 9,385 children aged <5 years were listed. We administered oral poliovirus vaccine to all 1,946 missed children during the recent or any supplemental immunization activities. Of these, 527 (27.1%) had never been vaccinated. We found no missed acute flaccid paralysis cases. Conclusion Nomadic populations continue to be underserved, especially for vaccination services. This results in pockets of populations with low herd immunity and increased risk for poliovirus transmission. Community leaders and nomadic settlements should be included in the micro-planning of all supplemental immunization activities to ensure all children receive vaccination services.
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Affiliation(s)
- Nuruddeen Aliyu
- African Field Epidemiology Network, Abuja, Nigeria,,Corresponding author: Nuruddeen Aliyu, African Field Epidemiology Network, Abuja, Nigeria.
| | | | | | | | - Lisa Esapa
- US Centers for Disease Control and Prevention, Atlanta, Georgia, Unites States
| | | | - Adamu Sule
- African Field Epidemiology Network, Abuja, Nigeria
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Uba BV, Waziri NE, Akerele A, Biya O, Adegoke OJ, Gidado S, Ugbenyo G, Simple E, Usifoh N, Sule A, Kibret B, Franka R, Wiesen E, Elmousaad H, Ohuabunwo C, Esapa L, Mahoney F, Bolu O, Vertefeuille J, Nguku P. Strengthening facility-based immunization service delivery in local government areas at high risk for polio in Northern Nigeria, 2014-2015. Pan Afr Med J 2021; 40:6. [PMID: 36157565 PMCID: PMC9474952 DOI: 10.11604/pamj.supp.2021.40.1.25865] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/27/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The National Stop Transmission of Polio (NSTOP) program was created in 2012 to support the Polio Eradication Initiative (PEI) in Local Government Areas (LGAs) at high risk for polio in Northern Nigeria. We assessed immunization service delivery prior to the commencement of NSTOP support in 2014 and after one year of implementation in 2015 to measure changes in the implementation of key facility-based Routine Immunization (RI) components. METHODS The pre- and post-assessment was conducted in selected health facilities (HFs) in 61 LGAs supported by NSTOP in 5 states. A standardized questionnaire was administered to the LGA and HF immunization staff by trained interviewers on key RI service delivery components. RESULTS At the LGA level, an increase was observed in key components including availability of updated Reach Every Ward (REW) micro-plans with identification of hard to reach settlements (65.6% baseline, 96.8% follow-up, PR = 1.5 (95% CI 3.4 - 69.8), vaccine forecasting (77.1% baseline, 93.5% follow-up, PR =1.2 (95% CI 1.8 - 13.8), and timely delivery of monthly immunization reports (73.8% baseline, 90.2% follow-up; PR =1.2 (95% CI 1.2 - 9.0). At the HF level, there was an increase in percentage of HFs with written supervisory feedback (44.5% baseline, 82.5% follow-up, PR = 1.8 (95% CI 4.7 - 7.3), written stock records (66.5% baseline, 87.9% follow-up, PR = 1.3 (95% CI 2.9 - 4.7) and updated immunization monitoring charts (76.3% baseline, 95.6% follow-up, PR = 1.3 (95% CI 4.6 - 9.9). CONCLUSION We observed an improvement in key RI service delivery components following implementation of NSTOP program activities in supported LGAs.
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Affiliation(s)
- Belinda Vernyuy Uba
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria,,Corresponding author: Belinda Vernyuy Uba, National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria.
| | | | - Adekunle Akerele
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Oladayo Biya
- Global Immunization Division, United States Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Saheed Gidado
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Gideon Ugbenyo
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Edwin Simple
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Nnamdi Usifoh
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Adamu Sule
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Beza Kibret
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Richard Franka
- Global Immunization Division, United States Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric Wiesen
- Global Immunization Division, United States Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hashim Elmousaad
- Global Immunization Division, United States Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Chima Ohuabunwo
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Lisa Esapa
- Global Immunization Division, United States Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Frank Mahoney
- International Federation of Red Cross, Geneva, Switzerland
| | - Omotayo Bolu
- Global Immunization Division, United States Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John Vertefeuille
- Global Immunization Division, United States Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Patrick Nguku
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
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Okeke LA, Waziri N, Gidado S, Adegoke J, Edukugho A, Idris J, Abbot SL, Uba BV, Adewole A, Ajumobi O, Nguku P, Biya O, Esapa L, Bolu O, Wiesen E, Ohuabunwo C. Enhancing acute flaccid paralysis surveillance through the use of pictorial surveillance reminder cards during supplementary immunization activities, December 2014: a survey in Jigawa State, Nigeria. Pan Afr Med J 2021; 40:4. [PMID: 36157566 PMCID: PMC9474828 DOI: 10.11604/pamj.supp.2021.40.1.19647] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/17/2020] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Acute flaccid paralysis (AFP) pictorial surveillance reminder cards (AFP cards) could aid AFP case identification during supplementary immunization activities (SIAs). We assessed the availability and utilization of AFP cards among vaccination teams during the December 2014 polio SIAs in Jigawa State, Nigeria. METHODS We conducted a cross-sectional survey of a convenience sample of 95 vaccination team supervisors. We used a semi-structured interviewer-administered questionnaire to collect information on socio-demographics, knowledge of AFP cases, availability and utilization of the AFP cards for case identification and investigation and non-compliance resolution by vaccination teams. Univariate and bivariate analyses were performed using Epi Info version 3.5.1. RESULTS Of the 95 supervisors interviewed, 86 (91%) reported that vaccinators properly displayed the AFP cards, 90 (95%) reported use of cards for AFP case identification, 88 (93%) reported use of cards to resolve non-compliance with polio vaccination and 77 (81%) reported use of cards to ask caregivers six key questions to prevent missed children. Fifty-eight (61%) supervisors knew the AFP case definition. A total of 21 possible AFP cases were identified by vaccination team members with the aid of the cards, of which 17 (81%) were referred to the nearest health facility. CONCLUSION The survey demonstrated usefulness of reminder cards for identification and follow-up of AFP cases. Based on these findings, use of AFP cards was implemented in all Nigerian States and similar cards were developed and implemented for measles surveillance during SIAs.
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Affiliation(s)
- Lilian Akudo Okeke
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria,,Corresponding author: Lilian Akudo Okeke, African Field Epidemiology Network, Abuja, Nigeria.
| | - Ndadilnasiya Waziri
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Saheed Gidado
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Joel Adegoke
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Aboyowa Edukugho
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Jibrin Idris
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Samuel Luka Abbot
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Belinda Vernyuy Uba
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Adefisoye Adewole
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Olufemi Ajumobi
- National Stop Transmission of Polio, African Field Epidemiology Network, Abuja, Nigeria
| | - Patrick Nguku
- Nigeria Field Epidemiology and Laboratory Training Programme, African Field Epidemiology Network, Abuja, Nigeria
| | - Oladayo Biya
- Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, United States
| | - Lisa Esapa
- Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, United States
| | - Omotayo Bolu
- Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, United States
| | - Eric Wiesen
- Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, United States
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Uba BV, Waziri NE, Adegoke OJ, Akerele A, Gidado S, Usifoh N, Adeoye OB, Akataobi CM, Ahmed SH, Obansa RU, Simple E, Kibret B, Ohuabunwo C, Biya O, Wiesen E, Nnadi C, Nguku P. Pilot implementation of a routine immunization module of the district health information system version 2 in Kano State, Nigeria, 2014 - 2015. Pan Afr Med J 2021; 40:5. [PMID: 36157556 PMCID: PMC9474934 DOI: 10.11604/pamj.supp.2021.40.1.24879] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/29/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction Timely and accurate data are necessary for informing sound decision-making and developing effective routine immunization (RI) programs. We launched a pilot project in Kano State to strengthen routine immunization (RI) data reporting through the immunization module of the District Health Information System version 2 (DHIS2). We examined the completeness and timeliness of reporting monthly RI data one year before and one year after DHIS2 module pilot in the State. Methods The first phase of the DHIS2 RI module pilot in Kano included training on RI data tools in November 2014 and in January 2015 for 36 state and zonal personnels, 276 local government area (LGA) personnel, and 2,423 health facility (HF) staff. A RI-focused dashboard to display core RI accountability framework indicators, such as completeness and timeliness of reporting, planned immunization sessions conducted, coverage and dropout was implemented. Report completeness was ratio of submitted reports to number of health facilities while report timeliness was ratio of reports on the DHIS2 by 14th of the month to number of expected. Results Completeness of data reporting increase from 70% in 2014 to 87% in 2015, while timeliness of reporting increase from 64% to 87% over the same period. Challenges encountered during the implementation process included limited access to internet, power outages, health workers strike, staff attrition and competing state activities. Conclusion The pilot implementation of the DHIS2 immunization module in Kano State led to modest improvement in the reporting of RI services. Several lessons learned were used to guide scale-up to other states in the country.
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Affiliation(s)
- Belinda Vernyuy Uba
- African Field Epidemiology Network, Abuja, Nigeria,,Corresponding author: Belinda Vernyuy Uba, African Field Epidemiology Network.
| | | | | | | | | | | | | | | | | | | | - Edwin Simple
- African Field Epidemiology Network, Abuja, Nigeria
| | - Beza Kibret
- African Field Epidemiology Network, Abuja, Nigeria
| | | | - Oladayo Biya
- United States Centre for Disease Control and Prevention, Atlanta, Georgia
| | - Eric Wiesen
- United States Centre for Disease Control and Prevention, Atlanta, Georgia
| | - Chime Nnadi
- African Field Epidemiology Network, Abuja, Nigeria
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5
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Masiira B, Antara SN, Kazoora HB, Namusisi O, Gombe NT, Magazani AN, Nguku PM, Kazambu D, Gitta SN, Kihembo C, Sawadogo B, Bogale TA, Ohuabunwo C, Nsubuga P, Tshimanga M. Building a new platform to support public health emergency response in Africa: the AFENET Corps of Disease Detectives, 2018-2019. BMJ Glob Health 2020; 5:bmjgh-2020-002874. [PMID: 33051282 PMCID: PMC7554452 DOI: 10.1136/bmjgh-2020-002874] [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: 05/09/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 11/04/2022] Open
Abstract
Public health emergency (PHE) response in sub-Saharan Africa is constrained by inadequate skilled public health workforce and underfunding. Since 2005, the African Field Epidemiology Network (AFENET) has been supporting field epidemiology capacity development and innovative strategies are required to use this workforce. In 2018, AFENET launched a continental rapid response team: the AFENET Corps of Disease Detectives (ACoDD). ACoDD comprises field epidemiology graduates and residents and was established to support PHE response. Since 2018, AFENET has deployed the ACoDD to support response to several PHEs. The main challenges faced during ACoDD deployments were financing of operations, ACoDD safety and security, resistance to interventions and distrust of the responders by some communities. Our experience during these deployments showed that it was feasible to mobilise and deploy ACoDD within 48 hours. However, the sustainability of deployments will depend on establishing strong linkages with the employers of ACoDD members. PHEs are effectively controlled when there is a fast deployment and strong linkages between the stakeholders. There are ongoing efforts to strengthen PHE preparedness and response in sub-Saharan Africa. ACoDD members are a competent workforce that can effectively augment PHE response. ACoDD teams mentored front-line health workers and community health workers who are critical in PHE response. Public health emergence response in sub-Saharan Africa is constrained by inadequacies in a skilled workforce and underfunding. ACoDD can be utilised to overcome the challenges of accessing a skilled public health workforce. To improve health security in sub-Saharan Africa, more financing of PHE response is needed.
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Affiliation(s)
- Ben Masiira
- Programs, African Field Epidemiology Network, Kampala, Uganda
| | - Simon N Antara
- Office of the Director of AFENET, African Field Epidemiology Network, Kampala, Uganda
| | | | - Olivia Namusisi
- Programs, African Field Epidemiology Network, Kampala, Uganda
| | - Notion T Gombe
- Programs, African Field Epidemiology Network, Harare, Zimbabwe
| | - Alain N Magazani
- Programs, African Field Epidemiology Network, Kinshasa, Congo (the Democratic Republic of the)
| | | | - Ditu Kazambu
- African Field Epidemiology Network, Kinshasa, Congo (the Democratic Republic of the)
| | - Sheba N Gitta
- Programs, African Field Epidemiology Network, Kampala, Uganda
| | | | | | - Tatek A Bogale
- Programs, African Field Epidemiology Network, Addis Ababa, Ethiopia
| | | | - Peter Nsubuga
- Global Public Health Solutions, Atlanta, Georgia, USA
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6
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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.
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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
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7
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Osunkwo D, Mohammed A, Zoakah A, Nguku P, Huldah N, Ohuabunwo C, Chikwe I, Ibrahim M. PO216 Prevalence and Predictors of Metabolic Syndrome In Adults In Benue State, Nigeria. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.183] [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: 10/28/2022] Open
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Nnadi C, Etsano A, Uba B, Ohuabunwo C, Melton M, Wa Nganda G, Esapa L, Bolu O, Mahoney F, Vertefeuille J, Wiesen E, Durry E. Approaches to Vaccination Among Populations in Areas of Conflict. J Infect Dis 2017; 216:S368-S372. [PMID: 28838202 PMCID: PMC5754212 DOI: 10.1093/infdis/jix175] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Vaccination is an important and cost-effective disease prevention and control strategy. Despite progress in vaccine development and immunization delivery systems worldwide, populations in areas of conflict (hereafter, “conflict settings”) often have limited or no access to lifesaving vaccines, leaving them at increased risk for morbidity and mortality related to vaccine-preventable disease. Without developing and refining approaches to reach and vaccinate children and other vulnerable populations in conflict settings, outbreaks of vaccine-preventable disease in these settings may persist and spread across subnational and international borders. Understanding and refining current approaches to vaccinating populations in conflict and humanitarian emergency settings may save lives. Despite major setbacks, the Global Polio Eradication Initiative has made substantial progress in vaccinating millions of children worldwide, including those living in communities affected by conflicts and other humanitarian emergencies. In this article, we examine key strategic and operational tactics that have led to increased polio vaccination coverage among populations living in diverse conflict settings, including Nigeria, Somalia, and Pakistan, and how these could be applied to reach and vaccinate populations in other settings across the world.
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Affiliation(s)
- Chimeremma Nnadi
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Andrew Etsano
- Nigeria Polio Emergency Operations Center, National Primary Health Care Development Agency
| | - Belinda Uba
- National Stop Transmission of Polio Program, Africa Field Epidemiology and Training Network Nigeria Country Office, Abuja, Nigeria
| | - Chima Ohuabunwo
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Musa Melton
- National Stop Transmission of Polio Program, Africa Field Epidemiology and Training Network Nigeria Country Office, Abuja, Nigeria
| | - Gatei Wa Nganda
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Lisa Esapa
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Omotayo Bolu
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Frank Mahoney
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - John Vertefeuille
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Eric Wiesen
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Elias Durry
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
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9
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Wassilak SGF, Williams CL, Murrill CS, Dahl BA, Ohuabunwo C, Tangermann RH. Using Acute Flaccid Paralysis Surveillance as a Platform for Vaccine-Preventable Disease Surveillance. J Infect Dis 2017; 216:S293-S298. [PMID: 28838175 PMCID: PMC5853448 DOI: 10.1093/infdis/jiw593] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Surveillance for acute flaccid paralysis (AFP) is a fundamental cornerstone of the global polio eradication initiative (GPEI). Active surveillance (with visits to health facilities) is a critical strategy of AFP surveillance systems for highly sensitive and timely detection of cases. Because of the extensive resources devoted to AFP surveillance, multiple opportunities exist for additional diseases to be added using GPEI assets, particularly because there is generally 1 district officer responsible for all disease surveillance. For this reason, integrated surveillance has become a standard practice in many countries, ranging from adding surveillance for measles and rubella to integrated disease surveillance for outbreak-prone diseases (integrated disease surveillance and response). This report outlines the current level of disease surveillance integration in 3 countries (Nepal, India, and Nigeria) and proposes that resources continue for long-term maintenance in resource-poor countries of AFP surveillance as a platform for surveillance of vaccine-preventable diseases and other outbreak-prone diseases.
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Affiliation(s)
- Steven G F Wassilak
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cheryl L Williams
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher S Murrill
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Benjamin A Dahl
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Chima Ohuabunwo
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rudolf H Tangermann
- Polio Eradication Department, World Health Organization, Geneva, Switzerland
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10
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Amemor EA, Sackey SO, Yebuah N, Folitse RD, Emikpe BO, Afari E, Wurapa F, Ohuabunwo C, Addo K, Mensah D, Gaglo E, Mark-Hansen, Johnson S, Tasiame W, Amedzovor D, Nkunafa D, Bonsu F. THE PREVALENCE OF TUBERCULOSIS IN CATTLE AND THEIR HANDLERS IN NORTH TONGU, VOLTA REGION, GHANA. Afr J Infect Dis 2017; 11:12-17. [PMID: 28480452 PMCID: PMC5411979 DOI: 10.21010/ajid.v11i1.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The need to understand the contribution of bovine tuberculosis (BTB) to the general tuberculosis burden in a poor resource setting is paramount. The aim of this study is to determine the burden of BTB among herdsmen and cattle in the North Tongu district of Volta Region in Ghana. MATERIALS AND METHODS A cross- sectional study was conducted in the North Tongu District of the Volta Region between the period of October 2011- March 2012. A well-structured questionnaire was used to collect socio-demographic information and possible risk factor information on cattle from participants. Sputum samples from 68 herdsmen and blood samples from 200 cattle belonging to these herdsmen were also collected. Sputum samples were analyzed using Ziehl- Neelsen staining while Anigen Rapid BTB Test was used for Cattle blood samples. RESULTS Ninety percent (61/68) of respondents were also found to consume fresh milk while 84% (57/68) do not use protective clothing. Of a total of 1580 cattle owned by the herdsmen, 200 cattle consisting of 14 bulls and 186 cows were screened where the prevalence of bovine TB was 19% (38/200) and those affected were all females. All (100%) human sample tested negative for Acid-Fast Bacilli (AFB). However, the seropositivity of cattle and kraal density were statistically associated (p= 0.001). CONCLUSION Bovine TB is prevalent in cattle in North Tongu district. Although herdsmen indulge in risky lifestyles that expose them to BTB, a zero prevalence of BTB was observed, further study is envisaged using a larger sample size.
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Affiliation(s)
- Esther A Amemor
- School of Veterinary Medicine, Kwame Nkrumah University of Science and Technology, Kumasi.Ghana Field Epidemiology and Laboratory Training Programme, School of public Health, Ghana, Legon
| | - S O Sackey
- Tuberculosis Control Programme, Ghana Health Service
| | - Nathaniel Yebuah
- Tuberculosis Control Programme, Ghana Health Service.,Veterinary Services Department Directorate Noguchi Memorial Institute
| | - Raphael Deladem Folitse
- School of Veterinary Medicine, Kwame Nkrumah University of Science and Technology, Kumasi.Ghana Field Epidemiology and Laboratory Training Programme, School of public Health, Ghana, Legon
| | - Benjamin O Emikpe
- School of Veterinary Medicine, Kwame Nkrumah University of Science and Technology, Kumasi.Ghana Field Epidemiology and Laboratory Training Programme, School of public Health, Ghana, Legon
| | - E Afari
- School of Veterinary Medicine, Kwame Nkrumah University of Science and Technology, Kumasi.Ghana Field Epidemiology and Laboratory Training Programme, School of public Health, Ghana, Legon
| | - F Wurapa
- Tuberculosis Control Programme, Ghana Health Service
| | - C Ohuabunwo
- Tuberculosis Control Programme, Ghana Health Service
| | - K Addo
- Veterinary Services Department Directorate Noguchi Memorial Institute
| | - David Mensah
- Veterinary Services Department Directorate Noguchi Memorial Institute
| | - E Gaglo
- Veterinary Services Department Directorate Noguchi Memorial Institute
| | - Mark-Hansen
- Veterinary Services Department Directorate Noguchi Memorial Institute
| | - S Johnson
- Tuberculosis Control Programme, Ghana Health Service
| | - William Tasiame
- School of Veterinary Medicine, Kwame Nkrumah University of Science and Technology, Kumasi.Ghana Field Epidemiology and Laboratory Training Programme, School of public Health, Ghana, Legon
| | - D Amedzovor
- Veterinary Services Department Directorate Noguchi Memorial Institute
| | - D Nkunafa
- Veterinary Services Department Directorate Noguchi Memorial Institute
| | - Frank Bonsu
- Veterinary Services Department Directorate Noguchi Memorial Institute
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11
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Mensah EK, Karikari K, Aikins M, Vanotoo L, Sackey S, Ohuabunwo C, Wurapa F, Sifah TK, Afari E. Secondary analysis of snake bite data in the Western Region of Ghana: 2006-2010. Ghana Med J 2017; 50:103-6. [PMID: 27635098 DOI: 10.4314/gmj.v50i2.8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND A snake bite is an injury caused by a bite from a snake, often resulting in puncture wounds, amputations and sometimes envenomation. Envenoming resulting from snake bite is a particularly important public health problem in rural areas of tropical and sub-tropical countries in Africa. This paper reports the incidence of snake bites and its associated mortality in the Western Region of Ghana. METHOD The study was a descriptive cross-sectional review of 2006 - 2010 snake bite secondary data generated by the Western Regional Health Information Office in Ghana. Data was extracted from the District Health Information Management System (DHIMS) database. Data was managed and analyzed using SPSS Version 16.0. Univariate analyses were expressed as percentages and graphs. RESULTS The year 2009 recorded the highest incidence of Snake bites in the Western Region with Juabeso district recording the highest incidence of snake bites over the study period. Over the period about 55% of the incidence was between 50 - 100 per 100,000 population. The total number of snake bites recorded in the region for the period was 7,275, of which 52% (3,776) were males. About 60% of the patients were of the age group 15-49 years. A total of 12 reported snake bite deaths were recorded, of which 67% were men. This study recommends to the Districts Health Directorates in the Western Region to regularly organize community education on snake bite and the use of protective clothing by the farmers. FUNDING None declared.
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Affiliation(s)
| | - Kwaku Karikari
- Western Regional Health Directorate, Ghana Health Service, Sekondi, Ghana
| | - Moses Aikins
- School of Public Health, University of Ghana, Legon, Ghana
| | - Linda Vanotoo
- Public Health Laboratory, P.O. Box 229 Sekondi, Ghana
| | - Samuel Sackey
- School of Public Health, University of Ghana, Legon, Ghana
| | | | - Fred Wurapa
- School of Public Health, University of Ghana, Legon, Ghana
| | - Tweneboah K Sifah
- Western Regional Health Directorate, Ghana Health Service, Sekondi, Ghana
| | - Edwin Afari
- School of Public Health, University of Ghana, Legon, Ghana
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12
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Nnadi C, Damisa E, Esapa L, Braka F, Waziri N, Siddique A, Jorba J, Nganda GW, Ohuabunwo C, Bolu O, Wiesen E, Adamu U. Continued Endemic Wild Poliovirus Transmission in Security-Compromised Areas - Nigeria, 2016. MMWR Morb Mortal Wkly Rep 2017; 66:190-193. [PMID: 28233765 PMCID: PMC5657850 DOI: 10.15585/mmwr.mm6607a2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
On August 10, 2016, 2 years after the most recent wild poliovirus (WPV) case was reported in Nigeria (in July 2014) (1), two WPV cases were reported in the northeastern state of Borno, which has been severely affected by insurgency-related insecurity since 2013. On September 9 and 26, 2016, two additional WPV cases were reported in Borno in children whose families migrated from security-compromised, inaccessible areas of the state. All four cases were WPV serotype 1 (WPV1), with genetic differences indicating prolonged undetected transmission. A large-scale emergency response plan was developed and implemented. The plan initially called for vaccination of 815,791 children during August 15-18 in five local government areas (LGAs) in the immediate vicinity of the first two WPV cases. Subsequently, the plan was expanded to regionally synchronized supplementary immunization activities (SIAs), conducted during August 27-December 6 in five Lake Chad basin countries at increased risk for national and regional WPV1 transmission (Cameroon, Central African Republic, Chad, Niger, and Nigeria). In addition, retrospective searches for missed cases of acute flaccid paralysis (AFP), enhanced environmental surveillance for polioviruses, and polio surveillance system reviews were conducted. Prolonged undetected WPV1 transmission in Borno State is a consequence of low population immunity and severe surveillance limitations associated with insurgency-related insecurity and highlights the risk for local and international WPV spread (2). Increasing polio vaccination coverage and implementing high-quality polio surveillance, especially among populations in newly secured and difficult-to-access areas in Borno and other Lake Chad basin areas are urgently needed.
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13
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Ohuabunwo C, Ameh C, Oduyebo O, Ahumibe A, Mutiu B, Olayinka A, Gbadamosi W, Garcia E, Nanclares C, Famiyesin W, Mohammed A, Nguku P, Koko RI, Obasanya J, Adebayo D, Gbadegesin Y, Idigbe O, Oguntimehin O, Nyanti S, Nzuki C, Abdus-Salam I, Adeyemi J, Onyekwere N, Musa E, Brett-Major D, Shuaib F, Nasidi A. MERS. Int J Infect Dis 2016. [PMID: 27575939 PMCID: PMC7129421 DOI: 10.1016/j.ijid.2016.11.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Chima Ohuabunwo
- African Field Epidemiology Network, Kampala, Uganda; Department of Medicine, Morehouse School of Medicine, 720 West View Drive SW, Atlanta, GA 30310, USA.
| | - Celestine Ameh
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Oyin Oduyebo
- College of Medicine, University of Lagos, Lagos, Nigeria
| | - Anthony Ahumibe
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Bamidele Mutiu
- Lagos State University Teaching Hospital, Ikeja, Nigeria
| | - Adebola Olayinka
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria; College of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | | | | | | | - Wale Famiyesin
- World Health Organization Country Office, Abuja, Nigeria
| | - Abdulaziz Mohammed
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Patrick Nguku
- African Field Epidemiology Network, Kampala, Uganda; Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Richard I Koko
- World Health Organization Country Office, Abuja, Nigeria
| | | | | | | | - Oni Idigbe
- Nigeria Institute of Medical Research, Yaba, Lagos, Nigeria
| | | | | | | | | | - Joseph Adeyemi
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | | | - Emmanuel Musa
- World Health Organization Country Office, Abuja, Nigeria
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14
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Etsano A, Damisa E, Shuaib F, Nganda GW, Enemaku O, Usman S, Adeniji A, Jorba J, Iber J, Ohuabunwo C, Nnadi C, Wiesen E. Environmental Isolation of Circulating Vaccine-Derived Poliovirus After Interruption of Wild Poliovirus Transmission — Nigeria, 2016. MMWR Morb Mortal Wkly Rep 2016; 65:770-3. [DOI: 10.15585/mmwr.mm6530a4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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15
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Musa EO, Adedire E, Adeoye O, Adewuyi P, Waziri N, Nguku P, Nanjuya M, Adebayo B, Fatiregun A, Enya B, Ohuabunwo C, Sabitu K, Shuaib F, Okoh A, Oguntimehin O, Onyekwere N, Nasidi A, Olayinka A. Epidemiological profile of the Ebola virus disease outbreak in Nigeria, July-September 2014. Pan Afr Med J 2015; 21:331. [PMID: 26587177 PMCID: PMC4633745 DOI: 10.11604/pamj.2015.21.331.5834] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 04/14/2015] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION In July 2014, Nigeria experienced an outbreak of Ebola virus disease following the introduction of the disease by an ill Liberian Traveler. The Government of Nigeria with the support of Technical and Development Partners responded quickly and effectively to contain the outbreak. The epidemiological profile of the outbreak that majorly affected two States in the country in terms of person, place and time characteristics of the cases identified is hereby described. METHODS Using field investigation technique, all confirmed and probable cases were identified, line-listed and analysed using Microsoft Excel 2007 by persons, time and place. RESULTS A total of 20 confirmed and probable cases; 16 in Lagos (including the index case from Liberia) and 4 in Port Harcourt were identified. The mean age was 39.5 ± 12.4 years with over 40% within the age group 30-39 years. The most frequent exposure type was direct physical contact in 70% of all cases and 73% among health care workers. The total case-fatality was 40%; higher among healthcare workers (46%) compared with non-healthcare workers (22%). The epidemic curve initially shows a typical common source outbreak, followed by a propagated pattern. CONCLUSION Investigation revealed the size and spread of the outbreak and provided information on the characteristics of persons, time and place. Enhanced surveillance measures, including contact tracing and follow- up proved very useful in early case detection and containment of the outbreak.
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Affiliation(s)
| | | | - Olawunmi Adeoye
- Nigeria Field Epidemiology and Laboratory Training programme, Abuja
| | - Peter Adewuyi
- Nigeria Field Epidemiology and Laboratory Training programme, Abuja
| | | | - Patrick Nguku
- Nigeria Field Epidemiology and Laboratory Training programme, Abuja
| | - Miriam Nanjuya
- World Health Organization, Department of Communicable Diseases, Kampala District, Uganda
| | - Bisola Adebayo
- Department of Community Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Akinola Fatiregun
- World Health Organisation, Field Office, State Ministry of Health, Akure, Ondo State, Nigeria
| | - Bassey Enya
- World Health Organization, Country Office, Abuja, Nigeria
| | - Chima Ohuabunwo
- Nigeria Field Epidemiology and Laboratory Training programme, Abuja
| | - Kabiru Sabitu
- Nigeria Field Epidemiology and Laboratory Training programme, Abuja ; Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | | | - Alex Okoh
- Federal Ministry of Health, Abuja, Nigeria
| | | | | | | | - Adebola Olayinka
- Nigeria Field Epidemiology and Laboratory Training programme, Abuja
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16
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Mohammed A, Sheikh TL, Gidado S, Poggensee G, Nguku P, Olayinka A, Ohuabunwo C, Waziri N, Shuaib F, Adeyemi J, Uzoma O, Ahmed A, Doherty F, Nyanti SB, Nzuki CK, Nasidi A, Oyemakinde A, Oguntimehin O, Abdus-Salam IA, Obiako RO. An evaluation of psychological distress and social support of survivors and contacts of Ebola virus disease infection and their relatives in Lagos, Nigeria: a cross sectional study--2014. BMC Public Health 2015; 15:824. [PMID: 26307047 PMCID: PMC4550041 DOI: 10.1186/s12889-015-2167-6] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 08/18/2015] [Indexed: 11/30/2022] Open
Abstract
Background By September 2014, an outbreak of Ebola Viral Disease (EVD) in West African countries of Guinea, Liberia, Sierra Leone, Senegal and Nigeria, had recorded over 4500 and 2200 probable or confirmed cases and deaths respectively. EVD, an emerging infectious disease, can create fear and panic among patients, contacts and relatives, which could be a risk factor for psychological distress. Psychological distress among this subgroup could have public health implication for control of EVD, because of potential effects on patient management and contact tracing. We determined the Prevalence, pattern and factors associated with psychological distress among survivors and contacts of EVD and their relatives. Methods In a descriptive cross sectional study, we used General Health Questionnaire to assess psychological distress and Oslo Social Support Scale to assess social support among 117 participants who survived EVD, listed as EVD contacts or their relatives at Ebola Emergency Operation Center in Lagos, Nigeria. Factors associated with psychological distress were determined using chi square/odds ratio and adjusted odds ratio. Results The mean age and standard deviation of participants was 34 +/ - 9.6 years. Of 117 participants, 78 (66.7 %) were females, 77 (65.8 %) had a tertiary education and 45 (38.5 %) were health workers. Most frequently occurring psychological distress were inability to concentrate (37.6 %) and loss of sleep over worry (33.3 %). Losing a relation to EVD outbreak (OR = 6.0, 95 % CI, 1.2–32.9) was significantly associated with feeling unhappy or depressed while being a health worker was protective (OR = 0.4, 95 % CI, 0.2–0.9). Adjusted Odds Ratio (AOR) showed losing a relation (AOR = 5.7, 95 % CI, 1.2–28.0) was a predictor of “feeling unhappy or depressed”, loss of a relation (AOR = 10.1, 95 % CI, 1.7–60.7) was a predictor of inability to concentrate. Conclusions Survivors and contacts of EVD and their relations develop psychological distress. Development of psychological distress could be predicted by loss of family member. It is recommended that psychiatrists and other mental health specialists be part of case management teams. The clinical teams managing EVD patients should be trained on recognition of common psychological distress among patients. A mental health specialist should review contacts being monitored for EVD for psychological distress or disorders.
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Affiliation(s)
- Abdulaziz Mohammed
- Department of Clinical Services, Federal Neuropsychiatric Hospital Kaduna, Barnawa, Kaduna, Kaduna State, Nigeria.
| | - Taiwo Lateef Sheikh
- Department of Clinical Services, Federal Neuropsychiatric Hospital Kaduna, Barnawa, Kaduna, Kaduna State, Nigeria.,Department of Psychiatry, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Saheed Gidado
- Nigerian Field Epidemiology and Laboratory Training Program (NFELTP), Abuja, Nigeria
| | - Gabriele Poggensee
- Nigerian Field Epidemiology and Laboratory Training Program (NFELTP), Abuja, Nigeria
| | - Patrick Nguku
- Nigerian Field Epidemiology and Laboratory Training Program (NFELTP), Abuja, Nigeria
| | - Adebola Olayinka
- Nigerian Field Epidemiology and Laboratory Training Program (NFELTP), Abuja, Nigeria.,Department of Microbiology, Ahmadu Bello University, Zaria, Kaduna, Nigeria
| | | | - Ndadilnasiya Waziri
- Nigerian Field Epidemiology and Laboratory Training Program (NFELTP), Abuja, Nigeria
| | | | - Joseph Adeyemi
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Ogbonna Uzoma
- Nigerian Field Epidemiology and Laboratory Training Program (NFELTP), Abuja, Nigeria
| | - Abubakar Ahmed
- Nigerian Field Epidemiology and Laboratory Training Program (NFELTP), Abuja, Nigeria
| | - Funmi Doherty
- Department of Medical Social Services, Lagos University Teaching Hospital, Lagos, Nigeria
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17
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Mohammed A, Sheikh TL, Gidado S, Abdus-Salam IA, Adeyemi J, Olayinka A, Ohuabunwo C, Victor OO, Nguku P, Rasheed EA, Doherty F, Waziri N, Shuaib F, Joseph BO, Bomai IM, Oyemakinde A. Psychiatric treatment of a health care worker after infection with Ebola virus in Lagos, Nigeria. Am J Psychiatry 2015; 172:222-4. [PMID: 25727534 DOI: 10.1176/appi.ajp.2014.14121576] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Abdulaziz Mohammed
- From the Ebola Emergency Operation Center, Lagos, Nigeria; the Department of Clinical Services, Federal Neuropsychiatric Hospital Kaduna, Kaduna State, Nigeria; the Department of Psychiatry, Ahmadu Bello University Zaria, Kaduna; the Nigerian Field Epidemiology and Laboratory Training Program, Abuja, Nigeria; the Lagos State Ministry of Health, Lagos; the Department of Psychiatry, University of Lagos, Lagos; the Department of Microbiology, Ahmadu Bello University Zaria, Kaduna; the African Field Epidemiology Network, Abuja; Morehouse School of Medicine, Atlanta; the Department of Social Welfare Services, Federal Neuropsychiatric Hospital Yaba, Lagos; the Department of Medical Social Services, Lagos University Teaching Hospital, Lagos; and the Federal Ministry of Health, Abuja
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18
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Michael CA, Ashenafi S, Ogbuanu IU, Ohuabunwo C, Sule A, Corkum M, Mackay S, Storms AD, Achari P, Biya O, Nguku P, Newberry D, Bwaka A, Mahoney F. An evaluation of community perspectives and contributing factors to missed children during an oral polio vaccination campaign--Katsina State, Nigeria. J Infect Dis 2014; 210 Suppl 1:S131-5. [PMID: 25316827 DOI: 10.1093/infdis/jiu288] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Unvaccinated children contribute to accumulation of susceptible persons and the continued transmission of wild poliovirus in Nigeria. In September 2012, the Expert Review Committee (ERC) on Polio Eradication and Routine Immunization in Nigeria recommended that social research be conducted to better understand why children are missed during supplementary immunization activities (SIAs), also known as "immunization plus days (IPDs)" in Nigeria. METHODS Immediately following the SIA in October 2012, polio eradication partners and the government of Nigeria conducted a study to assess why children are missed. We used semistructured questionnaires and focus group discussions in 1 rural and 1 urban local government area (LGA) of Katsina State. RESULTS Participants reported that 61% of the children were not vaccinated because of poor vaccination team performance: either the teams did not visit the homes (25%) or the children were reported absent and not revisited (36%). This lack of access to vaccine was more frequently reported by respondents from scattered/nomadic communities (85%). In 1 out of 4 respondents (25%), refusal was the main reason their child was not vaccinated. The majority of respondents reported they would have consented to their children being vaccinated if the vaccine had been offered. CONCLUSIONS Poor vaccination team performance is a major contributor to missed children during IPD campaigns. Addressing such operational deficiencies will help close the polio immunity gap and eradicate polio from Nigeria.
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Affiliation(s)
| | - Samra Ashenafi
- US Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Adamu Sule
- African Field Epidemiology Network (AFENET)
| | - Melissa Corkum
- United Nations Children Fund (UNICEF), Nigeria Country Office
| | - Susan Mackay
- United Nations Children Fund (UNICEF), Nigeria Country Office
| | - Aaron D Storms
- US Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - David Newberry
- US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ado Bwaka
- African Field Epidemiology Network (AFENET) US Centers for Disease Control and Prevention, Atlanta, Georgia United Nations Children Fund (UNICEF), Nigeria Country Office World Health Organization (WHO), Katsina State Office, Nigeria
| | - Frank Mahoney
- US Centers for Disease Control and Prevention, Atlanta, Georgia
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Gidado SO, Ohuabunwo C, Nguku PM, Ogbuanu IU, Waziri NE, Biya O, Wiesen ES, Mba-Jonas A, Vertefeuille J, Oyemakinde A, Nwanyanwu O, Lawal N, Mahmud M, Nasidi A, Mahoney FJ. Outreach to underserved communities in northern Nigeria, 2012-2013. J Infect Dis 2014; 210 Suppl 1:S118-24. [PMID: 25316825 PMCID: PMC10546473 DOI: 10.1093/infdis/jiu197] [Citation(s) in RCA: 15] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Persistent wild poliovirus transmission in Nigeria constitutes a major obstacle to global polio eradication. In August 2012, the Nigerian national polio program implemented a strategy to conduct outreach to underserved communities within the context of the country's polio emergency action plans. METHODS A standard operating procedure (SOP) for outreach to underserved communities was developed and included in the national guidelines for management of supplemental immunization activities (SIAs). The SOP included the following key elements: (1) community engagement meetings, (2) training of field teams, (3) field work, and (4) acute flaccid paralysis surveillance. RESULTS Of the 46,437 settlements visited and enumerated during the outreach activities, 8607 (19%) reported that vaccination teams did not visit their settlements during prior SIAs, and 5112 (11.0%) reported never having been visited by polio vaccination teams. Fifty-two percent of enumerated settlements (23,944) were not found in the existing microplan used for the immediate past SIAs. CONCLUSIONS During a year of outreach to >45,000 scattered, nomadic, and border settlements, approximately 1 in 5 identified were missed in the immediately preceding SIAs. These missed settlements housed a large number of previously unvaccinated children and potentially served as reservoirs for persistent wild poliovirus transmission in Nigeria.
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Affiliation(s)
- Saheed O. Gidado
- Nigeria Field Epidemiology and Laboratory Training Programme, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Chima Ohuabunwo
- Nigeria Field Epidemiology and Laboratory Training Programme, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Patrick M. Nguku
- Nigeria Field Epidemiology and Laboratory Training Programme, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Ikechukwu U. Ogbuanu
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Ndadilnasiya E. Waziri
- Nigeria Field Epidemiology and Laboratory Training Programme, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Oladayo Biya
- Nigeria Field Epidemiology and Laboratory Training Programme, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Eric S. Wiesen
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Adamma Mba-Jonas
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - John Vertefeuille
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | | | | | - Namadi Lawal
- Nigeria National Primary Health Care Development Agency, Abuja, Nigeria
| | - Mustapha Mahmud
- Nigeria National Primary Health Care Development Agency, Abuja, Nigeria
| | | | - Frank J. Mahoney
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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Ado JM, Etsano A, Shuaib F, Damisa E, Mkanda P, Gasasira A, Banda R, Korir C, Johnson T, Dieng B, Corkum M, Enemaku O, Mataruse N, Ohuabunwo C, Baig S, Galway M, Seaman V, Wiesen E, Vertefeuille J, Ogbuanu IU, Armstrong G, Mahoney FJ. Progress Toward Poliomyelitis Eradication in Nigeria. J Infect Dis 2014; 210 Suppl 1:S40-9. [DOI: 10.1093/infdis/jiu318] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Becker KM, Ohuabunwo C, Ndjakani Y, Nguku P, Nsubuga P, Mukanga D, Wurapa F. Field Epidemiology and Laboratory Training Programs in West Africa as a model for sustainable partnerships in animal and human health. J Am Vet Med Assoc 2012; 241:572-9. [PMID: 22916854 DOI: 10.2460/javma.241.5.572] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The concept of animal and human health experts working together toward a healthier world has been endorsed, but challenges remain in identifying concrete actions to move this one health concept from vision to action. In 2008, as a result of avian influenza outbreaks in West Africa, international donor support led to a unique opportunity to invest in Field Epidemiology and Laboratory Training Programs (FELTPs) in the region that engaged the animal and human health sectors to strengthen the capacity for prevention and control of zoonotic diseases. The FELTPs mixed 25% to 35% classroom and 65% to 75% field-based training and service for cohorts of physicians, veterinarians, and laboratory scientists. They typically consisted of a 2-year course leading to a master's degree in field epidemiology and public health laboratory management for midlevel public health leaders and competency-based short courses for frontline public health surveillance workers. Trainees and graduates work in multidisciplinary teams to conduct surveillance, outbreak investigations, and epidemiological studies for disease control locally and across borders. Critical outcomes of these programs include development of a cadre of public health leaders with core skills in integrated disease surveillance, outbreak investigation, vaccination campaigns, laboratory diagnostic testing, and epidemiological studies that address priority public health problems. A key challenge exists in identifying ways to successfully scale up and transform this innovative donor-driven program into a sustainable multisectoral one health workforce capacity development model.
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Affiliation(s)
- Karen M Becker
- Tauri Group, 675 N Washington St, Alexandria, VA 22314, USA.
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Opare J, Ohuabunwo C, Afari E, Wurapa F, Sackey S, Der J, Afakye K, Odei E. Outbreak of cholera in the East Akim Municipality of Ghana following unhygienic practices by small-scale gold miners, November 2010. Ghana Med J 2012; 46:116-123. [PMID: 23661823 PMCID: PMC3645159] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND In October 2010 an outbreak of cholera began among a group of small-scale gold miners in the East-Akim Municipality (EAM), Eastern Region. We investigated to verify the diagnosis, identify risk factors and recommend control measures. METHODS We conducted a descriptive investigation, active case-search and an unmatched case-control study. A cholera case-patient was a person with acute watery diarrhoea, with or without vomiting in EAM from 1st October to 20(th) November, 2010. Stool from case-patients and water samples were taken for laboratory diagnosis. We performed univariate and bivariate analysis using epi-info version 3.3. RESULTS Of 136 case-patients, 77 (56.6%) were males, of which 40% were miners or from miners households. Index case, a 20 yr-old male miner from Apapam village reported on October 13(th), and case-patients peaked (18.4%) 20 days later. Attack rate was 2/1000 population with no fatality. Ages ranged from 1-84 years; mean of 34±18 yrs. Age-group 20-29 yrs was mostly affected (30.1%) with Apapam village having most case-patients (19.9%). Vibrio cholera serotype ogawa was isolated from stool samples. The main water source, Birim river was polluted by small-scale miners through defecation, post-defecation baths and sand-washings. Compared to controls, case-patients were more likely to have drunk from Birim-River [OR= 6.99, 95% CI: 2.75-18]. CONCLUSION Vibrio cholera serotype ogawa caused the EAM cholera-outbreak affecting many young adult-males. Drinking water from contaminated community-wide -River was the major risk factors. Boiling or chlorination of water was initiated based on our recommendations and this controlled the outbreak.
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Affiliation(s)
- Jkl Opare
- Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, P. O. Box LG13, Legon, Ghana.
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Wurapa F, Afari E, Ohuabunwo C, Sackey S, Clerk C, Kwadje S, Yebuah N, Amankwa J, Amofah G, Appiah-Denkyira E. One Health concept for strengthening public health surveillance and response through Field Epidemiology and Laboratory Training in Ghana. Pan Afr Med J 2011; 10 Supp 1:6. [PMID: 22359694 PMCID: PMC3266674] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 12/14/2011] [Indexed: 11/07/2022] Open
Abstract
The lack of highly trained field epidemiologists in the public health system in Ghana has been known since the 1970s when the Planning Unit was established in the Ghana Ministry of Health. When the Public Health School was started in 1994, the decision was taken to develop a 1 academic-year general MPH course. The persisting need for well-trained epidemiologists to support the public health surveillance, outbreak investigation and response system made the development of the Field Epidemiology and Laboratory Training Programme (FELTP) a national priority. The School of Public health and the Ministry of Health therefore requested the technical and financial assistance of the United States Centers for Disease Control and Prevention (CDC) in organizing the Programme. The collaboration started by organizing short courses in disease outbreak investigations and response for serving Ghana Health Service staff. The success of the short courses led to development of the FELTP. By October 2007, the new FELTP curriculum for the award of a Masters of Philosophy in Applied Epidemiology and Disease Control was approved by the Academic Board of the University of Ghana and the programme started that academic year. Since then five cohorts of 37 residents have been enrolled in the two tracks of the programme. They consist of 12 physicians, 12 veterinarians and 13 laboratory scientists. The first two cohorts of 13 residents have graduated. The third cohort of seven has submitted dissertations and is awaiting the results. The fourth cohort has started the second year of field placement while the fifth cohort has just started the first semester. The field activities of the graduates have included disease outbreak investigations and response, evaluation of disease surveillance systems at the national level and analysis of datasets on diseases at the regional level. The residents have made a total of 25 oral presentations and 39 poster presentations at various regional and global scientific conferences. The Ghana FELTP (GFELTP) has promoted the introduction of the One Health concept into FELTP. It hosted the first USAID-supported workshop in West Africa to further integrate and strengthen collaboration of the animal and human health sectors in the FETP model. GFELTP has also taken the lead in hosting the first AFENET Center for Training in Public Health Leadership and Management, through which the short course on Management for Improving Public Health Interventions was developed for AFENET member countries. The GFELTP pre-tested the Integrated Avian Influenza Outbreak and Pandemic Influenza course in preparation for introducing the materials into the curriculum of other FELTP in the network. The leadership positions to which the graduates of the program have been appointed in the human and animal Public Health Services, improvement in disease surveillance, outbreak investigation and response along with the testimony of the health authorities about their appreciation of the outputs of the graduates at various fora, is a strong indication that the GFELTP is meeting its objectives.
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Affiliation(s)
- Frederick Wurapa
- School of Public Health, University of Ghana, Ghana,Corresponding author: Frederick Wurapa, Program Director, Ghana Field Epidemiology and Laboratory Training Program (GFELTP), School of Public Health. University of Ghana, P.O Box LG13 Legon, Accra, Ghana
| | | | - Chima Ohuabunwo
- School of Public Health, University of Ghana, Ghana,Morehouse School of Medicine, Atlanta GA, USA
| | | | | | - Simon Kwadje
- Ministry of Health, Ghana Health Services, Accra, Ghana
| | - Nathaniel Yebuah
- Veterinary Services Department, Ministry of Food and Agriculture, Ghana
| | | | - George Amofah
- Ministry of Health, Ghana Health Services, Accra, Ghana
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Nsubuga P, Johnson K, Tetteh C, Oundo J, Weathers A, Vaughan J, Elbon S, Tshimanga M, Ndugulile F, Ohuabunwo C, Evering-Watley M, Mosha F, Oleribe O, Nguku P, Davis L, Preacely N, Luce R, Antara S, Imara H, Ndjakani Y, Doyle T, Espinosa Y, Kazambu D, Delissaint D, Ngulefac J, Njenga K. Field Epidemiology and Laboratory Training Programs in sub-Saharan Africa from 2004 to 2010: need, the process, and prospects. Pan Afr Med J 2011; 10:24. [PMID: 22187606 PMCID: PMC3224071 DOI: 10.4314/pamj.v10i0.72235] [Citation(s) in RCA: 31] [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: 10/05/2011] [Accepted: 10/14/2011] [Indexed: 11/17/2022] Open
Abstract
As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competency-based training for field epidemiologists and public health laboratory scientists providing a master's degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a strategy to develop a locally trained public health workforce that can operate multi-disease surveillance and response systems.
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Affiliation(s)
- Peter Nsubuga
- Division of Public Health Systems and Workforce Development, Center for Global Health, US Centers for Disease Control and Prevention, USA
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Opare J, Ohuabunwo C, Afari E, Bonsu G, Sackey S, Wurapa F. P2-535 Progress towards eradication of poliomyelitis in Ghana: a review of eastern region- Ghana, 1997-2009. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976m.62] [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: 11/03/2022]
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Opare J, Der J, Afakye K, Bonsu G, Ohuabunwo C, Afari E, Wurapa F, Sackey S. SP5-12 Outbreak of cholera, East-Akim Municipality, Ghana, November 2010. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976p.48] [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: 11/04/2022]
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Ivonye C, Ohuabunwo C, Henriques-Forsythe M, Uma J, Kamuguisha LK, Olejeme K, Onwuanyi A. Evaluation of Telemetry Utilization, Policy, and Outcomes in an Inner-City Academic Medical Center. J Natl Med Assoc 2010; 102:598-604. [DOI: 10.1016/s0027-9684(15)30637-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ohuabunwo C, Perevoscikovs J, Griskevica A, Gargiullo P, Brilla A, Viksna L, Glismann S, Wharton M, Vitek C. Respiratory diphtheria among highly vaccinated military trainees in Latvia: improved protection from DT compared with Td booster vaccination. ACTA ACUST UNITED AC 2006; 37:813-20. [PMID: 16308214 DOI: 10.1080/00365540500262658] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
An outbreak of respiratory diphtheria occurred among highly-vaccinated trainees at a Latvian military academy in August-September 2000. We reviewed immunization, clinical and laboratory records and administered a questionnaire to obtain data on exposure factors. Among 207 trainees, 45 (22%) diphtheria cases and 79 (38%) carriers of toxigenic Corynebacterium diphtheriae were identified. All patients survived; 1 had severe myocarditis. Sharing cups was a risk factor for infection. Over 85% of trainees had received > or =5 doses of diphtheria toxoid. Neither infection nor disease was associated with the number of doses or interval since last dose. However, the risk of disease was lower and diphtheria antitoxin levels were higher among trainees who received their last booster dose with higher-antigen diphtheria toxoid (DT) instead of lower-antigen Td. Outbreaks of mild diphtheria can occur among highly-vaccinated persons living in crowded conditions with intense exposure; high-antigen diphtheria booster-vaccination might provide better protection under these conditions.
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