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Osman AY, Mohamed H, Mumin FI, Mahrous H, Saidouni A, Elmi SA, Adawe AK, Mo'allim AA, Lubogo M, Malik SMMR, Mwatondo A, Raji T, Ahmed AD, Zumla A, Dar O, Kock R, Mor SM. Prioritization of zoonoses for multisectoral, One Health collaboration in Somalia, 2023. One Health 2023; 17:100634. [PMID: 38024279 PMCID: PMC10665150 DOI: 10.1016/j.onehlt.2023.100634] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/15/2023] [Accepted: 09/21/2023] [Indexed: 12/01/2023] Open
Abstract
Background The human population of Somalia is vulnerable to zoonoses due to a high reliance on animal husbandry. This disease risk is exacerbated by relatively low income (poverty) and weak state capacity for health service delivery in the country as well as climate extremes and geopolitical instability in the region. To address this threat to public health efficiently and effectively, it is essential that all sectors have a common understanding of the priority zoonotic diseases of greatest concern to the country. Methods Representatives from human, animal (domestic and wildlife), agriculture, and environmental health sectors undertook a multisectoral prioritization exercise using the One Health Zoonotic Disease Prioritization (OHZDP) tool developed by the United States CDC. The process involved: reviewing available literature and creating a longlist of zoonotic diseases for potential inclusion; developing and weighting criteria for establishing the importance of each zoonoses; formulating categorical questions (indicators) for each criteria; scoring each disease according to the criteria; and finally ranking the diseases based on the final score. Participants then brainstormed and suggested strategic action plans to prevent, and control prioritized zoonotic diseases. Results Thirty-three zoonoses were initially considered for prioritization. Final criteria for ranking included: 1) socioeconomic impact (including sensitivity) in Somalia; 2) burden of disease in humans in Somalia); 3) availability of intervention in Somalia; 4) environmental factors/determinants; and 5) burden of disease in animals in Somalia. Following scoring of each zoonotic disease against these criteria, and further discussion of the OHZDP tool outputs, seven priority zoonoses were identified for Somalia: Rift Valley fever, Middle East respiratory syndrome, anthrax, trypanosomiasis, brucellosis, zoonotic enteric parasites (including Giardia and Cryptosporidium), and zoonotic influenza viruses. Conclusions The final list of seven priority zoonotic diseases will serve as a foundation for strengthening One Health approaches for disease prevention and control in Somalia. It will be used to: shape improved multisectoral linkages for integrated surveillance systems and laboratory networks for improved human, animal, and environmental health; establish multisectoral public health emergency preparedness and response plans using One Health approaches; and enhance workforce capacity to prevent, control and respond to priority zoonotic diseases.
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Affiliation(s)
- Abdinasir Yusuf Osman
- Royal Veterinary College, University of London, London, UK
- National Institute of Health, Ministry of Health, Mogadishu, Somalia
| | - Halima Mohamed
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Farah I. Mumin
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
- International Livestock Research Institute, Addis Ababa, Ethiopia
- Red Sea University, Bosaso, Somalia
| | - Heba Mahrous
- World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Asma Saidouni
- World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Sharifo Ali Elmi
- Ministry of Livestock Forestry and Range, Mogadishu, Somalia
- Faculty of Veterinary Medicine, University Malaysia Kelantan, Kelantan, Malaysia
| | | | | | - Mutaawe Lubogo
- World Health Organization, Country Office, Mogadishu, Somalia
| | | | | | - Tajudeen Raji
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | | | - Alimuddin Zumla
- National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
- Department of Infection, Division of Infection and Immunity, University College London, London, UK
| | - Osman Dar
- Global Health Programme, Royal Institute of International Affairs, London, UK
- Global Operations, United Kingdom Health Security Agency, London, UK
| | - Richard Kock
- Royal Veterinary College, University of London, London, UK
| | - Siobhan M. Mor
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
- International Livestock Research Institute, Addis Ababa, Ethiopia
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Lubogo M, Evans B, Abdinasir A, Sherein E, Muhammad T, Mohamed A, Hussein A, Abdulrazeq F, Mamunur M. Responding to cholera outbreaks in Somalia in 2017-2019. East Mediterr Health J 2023; 29:734-741. [PMID: 37776135 DOI: 10.26719/emhj.23.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 01/04/2023] [Indexed: 10/01/2023]
Abstract
Background Somalia reported repeated cholera outbreaks between 2017 and 2019. These outbreaks were attributed to multiple risk factors which made response challenging. Aims To describe lessons from the preparedness and response to the cholera outbreaks in Somalia between 2017 and 2019. Methods We reviewed outbreak response reports, surveillance records and preparedness plans for the cholera outbreaks in Somalia from January 2017 to December 2019 and other relevant literature. We present data on cholera-related response indicators including cholera cases and deaths and case fatality rates for the 3 years. Qualitative data were collected from 5 focus group discussions and 10 key informant interviews to identify the interventions, challenges and lessons learnt from the Somali experience. Results In 2017, a total of 78 701 cholera cases and 1163 related deaths were reported (case fatality rate 1.48%), in 2018, 6448 cholera cases and 45 deaths were reported (case fatality rate 0.70%), while in 2019, some 3089 cases and 4 deaths were reported in Somalia (case fatality rate 0.13%). The protracted conflict, limited access to primary health care, and limited access to safe water and proper sanitation among displaced populations were identified as the main drivers of the repeated cholera outbreaks. Conclusions Periodic assessment of response to and preparedness for potential epidemics is essential to identify and close gaps within the health systems. Somalia's experience offers important lessons on preventing and controlling cholera outbreaks for countries experiencing complex humanitarian emergencies.
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Affiliation(s)
- Mutaawe Lubogo
- World Health Organization, Somalia Country Office, Mogadishu, Somalia
| | - Buliva Evans
- Emergency Programme, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Abubakar Abdinasir
- Emergency Programme, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Elnossery Sherein
- Emergency Programme, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Tayyab Muhammad
- Emergency Programme, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | | | | | - Fayez Abdulrazeq
- Emergency Programme, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Malik Mamunur
- World Health Organization, Somalia Country Office, Mogadishu, Somalia
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Ssendagire S, Karanja MJ, Abdi A, Lubogo M, Azad Al A, Mzava K, Osman AY, Abdikarim AM, Abdi MA, Abdullahi AM, Mohamed A, Ahmed HS, Hassan NY, Hussein A, Ibrahim AD, Mohamed AY, Nur IM, Muhamed MB, Mohamed MA, Nur FA, Mohamed HSA, Derow MM, Diriye AA, Malik SMMR. Progress and experiences of implementing an integrated disease surveillance and response system in Somalia; 2016-2023. Front Public Health 2023; 11:1204165. [PMID: 37780418 PMCID: PMC10539911 DOI: 10.3389/fpubh.2023.1204165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction In 2021, a regional strategy for integrated disease surveillance was adopted by member states of the World Health Organization Eastern Mediterranean Region. But before then, member states including Somalia had made progress in integration of their disease surveillance systems. We report on the progress and experiences of implementing an integrated disease surveillance and response system in Somalia between 2016 and 2023. Methods We reviewed 20 operational documents and identified key integrated disease surveillance and response system (IDSRS) actions/processes implemented between 2016 and 2023. We verified these through an anonymized online survey. The survey respondents also assessed Somalia's IDSRS implementation progress using a standard IDS monitoring framework Finally, we interviewed 8 key informants to explore factors to which the current IDSRS implementation progress is attributed. Results Between 2016 and 2023, 7 key IDSRS actions/processes were implemented including: establishment of high-level commitment; development of a 3-year operational plan; development of a coordination mechanism; configuring the District Health Information Software to support implementation among others. IDSRS implementation progress ranged from 15% for financing to 78% for tools. Reasons for the progress were summarized under 6 thematic areas; understanding frustrations with the current surveillance system; the opportunity occasioned by COVID-19; mainstreaming IDSRS in strategic documents; establishment of an oversight mechanism; staggering implementation of key activities over a reasonable length of time and being flexible about pre-determined timelines. Discussion From 2016 to 2023, Somalia registered significant progress towards implementation of IDSRS. The 15 years of EWARN implementation in Somalia (since 2008) provided a strong foundation for IDSRS implementation. If implemented comprehensively, IDSRS will accelerate country progress toward establishment of IHR core capacities. Sustainable funding is the major challenge towards IDSRS implementation in Somalia. Government and its partners need to exploit feasible options for sustainable investment in integrated disease surveillance and response.
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Affiliation(s)
| | | | | | - Mutaawe Lubogo
- World Health Organization Country Office, Mogadishu, Somalia
| | | | - Khadija Mzava
- Health Information Strengthening Project, Dar es Salaam, Tanzania
| | - Abdinasir Yusuf Osman
- Federal Ministry of Health, Mogadishu, Somalia
- The Royal Veterinary College, University of London, Hatfield, United Kingdom
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Lubogo M, Karanja MJ, Mdodo R, Elnossery S, Osman AA, Abdi A, Buliva E, Tayyab M, Omar OA, Ahmed MM, Abera SC, Abubakar A, Malik SMMR. Evaluation of the electronic Early Warning and Response Network (EWARN) system in Somalia, 2017–2020. Confl Health 2022; 16:18. [PMID: 35429985 PMCID: PMC9012990 DOI: 10.1186/s13031-022-00450-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 04/01/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
In 2008, Somalia introduced an electronic based Early Warning Alert and Response Network (EWARN) for real time detection and response to alerts of epidemic prone diseases in a country experiencing a complex humanitarian situation. EWARN was deactivated between 2008 to 2016 due to civil conflict and reactivated in 2017 during severe drought during a cholera outbreak. We present an assessment of the performance of the EWARN in Somalia from January 2017 to December 2020, reflections on the successes and failures, and provide future perspectives for enhancement of the EWARN to effectively support an Integrated Disease Surveillance and Response strategy.
Methods
We described geographical coverage of the EWARN, system attributes, which included; sensitivity, flexibility, timeliness, data quality (measured by completeness), and positive predictive value (PPV). We tested for trends of timeliness of submission of epidemiological reports across the years using the Cochran-Mantel–Haenszel stratified test of association.
Results
By December 2020, all 6 states and the Banadir Administrative Region were implementing EWARN. In 2017, only 24.6% of the records were submitted on time, but by 2020, 96.8% of the reports were timely (p < 0.001). Completeness averaged < 60% in all the 4 years, with the worst-performing year being 2017. Overall, PPV was 14.1%. Over time, PPV improved from 7.1% in 2017 to 15.4% in 2019 but declined to 9.7% in 2020. Alert verification improved from 2.0% in 2017 to 52.6% by 2020, (p < 0.001). In 2020, EWARN was enhanced to facilitate COVID-19 reporting demonstrating its flexibility to accommodate the integration of reportable diseases.
Conclusions
During the past 4 years of implementing EWARN in Somalia, the system has improved significantly in timeliness, disease alerts verification, and flexibility in responding to emerging disease outbreaks, and enhanced coverage. However, the system is not yet optimal due to incompleteness and lack of integration with other systems suggesting the need to build additional capacity for improved disease surveillance coverage, buttressed by system improvements to enhance data quality and integration.
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Lubogo M, Mohamed AM, Ali AH, Ali AH, Popal GR, Kiongo D, Bile KM, Malik M, Abubakar A. Oral cholera vaccination coverage in an acute emergency setting in Somalia, 2017. Vaccine 2020; 38 Suppl 1:A141-A147. [PMID: 31980193 DOI: 10.1016/j.vaccine.2020.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 11/09/2019] [Accepted: 01/07/2020] [Indexed: 10/25/2022]
Abstract
The first oral cholera vaccination (OCV) campaign in Somalia was implemented between March and October 2017. It was the first time the Ministry of Health had introduced and used OCV as part of the cholera prevention and control strategies. The Ministry of Health aimed to cover 1.1 million people ≥ 1 year with 2 doses of the OCV in 11 high-risk districts. Overall, 2-dose administrative OCV coverage in all targeted districts was 95.5%. Following the campaign, a random sample survey was conducted in 9 out of 11districts to evaluate coverage, awareness, reasons for non-vaccination, the water and sanitation status of households, and any resulting adverse events. The survey was conducted in 2 phases. Of the 3,715 eligible individuals in the first phase, 92.5% (95% CI 91.4-93.6%) received 2 doses of the OCV and 7.0% (95% CI 6.0-8.2%) 1 dose. In the second phase, of 1,926 individuals, 94.1% (95% CI 92.9-95.1%) received 2 doses and 2.6% (95% CI 2.0-3.4%) 1 dose. Despite challenges, this experience shows that OCV campaigns can be implemented in acute humanitarian settings through existing immunization structures.
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Affiliation(s)
- Mutaawe Lubogo
- World Health Organization, Somalia Country Office, Mogadishu, Somalia
| | | | | | - Aden H Ali
- Federal Ministry of Health, Mogadishu, Somalia
| | - Ghulam R Popal
- World Health Organization, Somalia Country Office, Mogadishu, Somalia
| | - David Kiongo
- Independent Monitoring and Evaluation Consultant, Nairobi, Kenya
| | | | - Mamunur Malik
- World Health Organization Eastern Mediterranean Region, Cairo, Egypt
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Lubogo M, Anguzu R, Wanzira H, Shour AR, Mukose AD, Nyabigambo A, Tumwesigye NM. Utilization of safe male circumcision among adult men in a fishing community in rural Uganda. Afr Health Sci 2019; 19:2645-2653. [PMID: 32127837 PMCID: PMC7040272 DOI: 10.4314/ahs.v19i3.40] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background In Uganda, most-at-riskpopulations(MARPs) such as fishing communities remain vulnerable to preventable HIV acquisition. Safe Male Circumcision (SMC) has been incorporated into Uganda's HIV prevention strategies. This study aimed at determining SMC utilization and associated factors among adult men in a rural fishing community in Uganda. Methods A cross-sectional study was conducted in a rural fishing village in central Uganda. Stratified random sampling of 369 fishermen aged 18–54 yearswas used according to their occupational category; fish monger, boat crew and general merchandise. The dependent variable wasutilization of SMC.A forward fitting multivariable logistic regression model was fitted with variables significant at p≤0.05 controlling for confounding and effect modification. Results Respondents'mean(SD) age was 30.0(9.3) years. Only8.4%hadSMC and among non-circumcised men, 84.9% had adequate knowledge of SMC benefits while 79.3% did not know were SMC services were offered. Peer support(AOR0.17;95%-CI0.05–0.60) and perceived procedural safety (AOR6.8;95%CI2.16–21.17) were independently associated with SMC utilization. Conclusion In this rural fishing community, SMC utilization was low. These findings underscore the need to inform HIV preventionstrategies inthecontextof peer support and perceptionsheld by rural dwelling men.
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Affiliation(s)
- Mutaawe Lubogo
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Uganda
| | - Ronald Anguzu
- Institute of Health and Equity, Medical College of Wisconsin, US
| | | | - Abdul R Shour
- Institute of Health and Equity, Medical College of Wisconsin, US
| | - Aggrey D Mukose
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Uganda
| | - Agnes Nyabigambo
- Department of Community Health and Behavioural Sciences, School of Public Health, Makerere University, Uganda
| | - Nazarius M Tumwesigye
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Uganda
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Lubogo M, Anguzu R, Wanzira H, Namugwanya I, Namuddu O, Ssali D, Nanyonga S, Ssentongo J, Seeley J. Willingness by people living with HIV/AIDS to utilize HIV services provided by Village Health team workers in Kalungu district, central Uganda. Afr Health Sci 2017; 17:216-224. [PMID: 29026396 DOI: 10.4314/ahs.v17i1.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/17/2022] Open
Abstract
BACKGROUND Less than one quarter of people in need have access to HIV services in Uganda. This study assessed willingness of people living with HIV/AIDS (PLWHAs) to utilize HIV services provided by Village Health Teams (VHTs) in Kalungu district, central Uganda. METHODS A cross-sectional study conducted in two health facilities providing anti-retroviral therapy enrolled 312 PLWHAs. Pre-tested semi-structured questionnaires were administered to participants at household level. A forward fitting logistic regression model computed the predictors of willingness of PLWHAs to utilize services provided by VHTs. RESULTS Overall, 49% were willing to utilize HIV services provided by VHTs increasing to 75.6% if the VHT member was HIV positive. PLWHAs who resided in urban areas were more likely to utilize HIV services provided by VHTs (AOR 0.24, 95%CI 0.06-0.87). Barriers to utilizing HIV services provided by VHTs were: income level > 40 USD (AOR 6.43 95%CI 1.19-34.68), being a business person (AOR 8.71 95%CI 1.23-61.72), peasant (AOR 7.95 95%CI 1.37-46.19), lack of encouragement from: peers (AOR 6.33 95%CI 1.43-28.09), spouses (AOR 4.93 95%CI 1.23-19.82) and community leader (AOR 9.67 95%CI 3.35-27.92). CONCLUSION Social support could improve willingness by PLWHAs to utilize HIV services provided by VHTs for increased access to HIV services by PLWHA.
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Affiliation(s)
| | - Ronald Anguzu
- Makerere University School of Public Health (MakSPH)
- El-Channun Community Health Initiatives, Uganda (ELCOHIN)
| | | | | | | | - Denis Ssali
- District Health Team, Kalungu District Local Government
| | | | - Josephine Ssentongo
- Medical Research Council / Uganda Virus Research Institute (MRC/UVRI), Uganda
| | - Janet Seeley
- Medical Research Council / Uganda Virus Research Institute (MRC/UVRI), Uganda
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Weppelmann TA, Donewell B, Haque U, Hu W, Magalhaes RJS, Lubogo M, Godbless L, Shabani S, Maeda J, Temba H, Malibiche TC, Berhanu N, Zhang W, Bawo L. Determinants of patient survival during the 2014 Ebola Virus Disease outbreak in Bong County, Liberia. Glob Health Res Policy 2016; 1:5. [PMID: 29202055 PMCID: PMC5675064 DOI: 10.1186/s41256-016-0005-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 06/16/2016] [Indexed: 11/22/2022] Open
Abstract
Background The unprecedented size of the 2014 Ebola Virus Disease (EVD) outbreak in West Africa has allowed for a more extensive characterization of the clinical presentation and management of this disease. In this study, we report the trends in morbidity, mortality, and determinants of patient survival as EVD spread into Bong County, Liberia. Methods An analysis of suspected, probable, or confirmed cases of EVD (n = 607) reported to the Liberian Ministry of Health and Social Welfare (MOHSW) between March 23rd and December 31st 2014 was conducted. The likelihood of infection given exposure factors was determined using logistic regression in individuals with a definitive diagnosis by RT-PCR (n = 321). The risk of short-term mortality (30 days) given demographic factors, clinical symptoms, and highest level of treatment received was assessed with Cox regression and survival analyses (n = 391). Results The overall mortality rate was 53.5 % (95 % CI: 49 %, 58 %) and decreased as access to medical treatment increased. Those who reported contact with another EVD case were more likely to be infected (OR: 5.7), as were those who attended a funeral (OR: 3.9). Mortality increased with age (P < 0.001) and was higher in males compared to females (P =0.006). Fever (HR: 6.63), vomiting (HR: 1.93), diarrhea (HR: 1.99), and unexplained bleeding (HR: 2.17) were associated with increased mortality. After adjusting for age, hospitalized patients had a 74 % reduction in the risk of short term mortality (P < 0.001 AHR: 0.26; 95 % CI AHR: 0.18, 0.37), compared to those not given medical intervention. Conclusion Even treatment with only basic supportive care such as intravenous rehydration therapy was able to significantly improve patient survival in suspected, probable, or confirmed EVD cases.
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Affiliation(s)
- Thomas A Weppelmann
- Department of Environmental and Global Health, University of Florida, Gainesville, FL USA.,Emerging Pathogens Institute, University of Florida, 2055 Mowry Rd, Gainesville, FL USA
| | - Bangure Donewell
- African Union Support to Ebola Outbreak in West Africa (ASEOWA), Monrovia, Liberia
| | - Ubydul Haque
- Emerging Pathogens Institute, University of Florida, 2055 Mowry Rd, Gainesville, FL USA.,Department of Geography, University of Florida, Gainesville, FL USA
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Ricardo J Soares Magalhaes
- School of Veterinary Science, The University of Queensland, Brisbane, Australia.,Children's Health Research Centre, The University of Queensland, St Lucia, Australia
| | - Mutaawe Lubogo
- African Union Support to Ebola Outbreak in West Africa (ASEOWA), Monrovia, Liberia
| | - Lucas Godbless
- African Union Support to Ebola Outbreak in West Africa (ASEOWA), Monrovia, Liberia
| | - Sasita Shabani
- African Union Support to Ebola Outbreak in West Africa (ASEOWA), Monrovia, Liberia
| | - Justin Maeda
- African Union Support to Ebola Outbreak in West Africa (ASEOWA), Monrovia, Liberia
| | - Herilinda Temba
- African Union Support to Ebola Outbreak in West Africa (ASEOWA), Monrovia, Liberia
| | - Theophil C Malibiche
- African Union Support to Ebola Outbreak in West Africa (ASEOWA), Monrovia, Liberia
| | - Naod Berhanu
- African Union Support to Ebola Outbreak in West Africa (ASEOWA), Monrovia, Liberia
| | - Wenyi Zhang
- Institute of Disease Control and Prevention, Academy of Military Medical Science, Beijing, People's Republic of China
| | - Luke Bawo
- Liberian Ministry of Health and Social Work (MOHSW), Monrovia, Liberia
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Lubogo M, Donewell B, Godbless L, Shabani S, Maeda J, Temba H, Malibiche TC, Berhanu N. Ebola virus disease outbreak; the role of field epidemiology training programme in the fight against the epidemic, Liberia, 2014. Pan Afr Med J 2015. [DOI: 10.11604/pamj.supp.2015.22.1.6053] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Lubogo M, Donewell B, Godbless L, Shabani S, Maeda J, Temba H, Malibiche TC, Berhanu N. Ebola virus disease outbreak; the role of field epidemiology training programme in the fight against the epidemic, Liberia, 2014. Pan Afr Med J 2015; 22 Suppl 1:5. [PMID: 26779298 PMCID: PMC4709128 DOI: 10.11694/pamj.supp.2015.22.1.6053] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 07/23/2015] [Indexed: 11/22/2022] Open
Abstract
The African Field Epidemiology Network (AFENET) is a public health network established in 2005 as a non-profit networking alliance of Field Epidemiology and Laboratory Training Programs (FELTPs) and Field Epidemiology Training Programs (FETPs) in Africa. AFENET is dedicated to supporting Ministries of Health in Africa build strong, effective and sustainable programs and capacity to improve public health systems by partnering with global public health experts. The Network's goal is to strengthen field epidemiology and public health laboratory capacity to contribute effectively to addressing epidemics and other major public health problems in Africa. The goal for the establishment of FETP and FELTP was and still is to produce highly competent multi-disciplinary public health professionals who would assume influential posts in the public health structures and tackle emerging and re-emerging communicable and non-communicable diseases. AFENET currently networks 12 FELTPs and FETPs in sub-Saharan Africa with operations in 20 countries. During the Ebola Virus Disease (EVD) outbreak in West Africa, African Union Support for the Ebola Outbreak in West Africa (ASEOWA) supported FETP graduates from Uganda, Zimbabwe, Ethiopia and Tanzania for the investigation and control of the EVD outbreak in Liberia. The graduates were posted in different counties in Liberia where they lead teams of other experts conduct EVD outbreak investigations, Infection Control and Prevention trainings among health workers and communities, Strengthening integrated disease surveillance, developing Standard Operating Procedures for infection control and case notification in the Liberian setting as well as building capacity of local surveillance officers’ conduct outbreak investigation and contact tracing. The team was also responsible for EVD data management at the different Counties in Liberia. The FETP graduates have been instrumental in the earlier successes registered in various counties in Liberia in the control of the Ebola virus disease. Such efforts should be sustained by supporting local authorities develop strong health systems that are able to respond to epidemic of such magnitude in the near future.
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Affiliation(s)
- Mutaawe Lubogo
- Field Epidemiology & Laboratory Training Program, Uganda
| | | | - Lucas Godbless
- Field Epidemiology & Laboratory Training Program, Tanzania
| | - Sasita Shabani
- Field Epidemiology & Laboratory Training Program, Tanzania
| | - Justin Maeda
- Field Epidemiology & Laboratory Training Program, Tanzania
| | | | | | - Naod Berhanu
- Field Epidemiology & Laboratory Training Program Ethiopia
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Kateh F, Nagbe T, Kieta A, Barskey A, Gasasira AN, Driscoll A, Tucker A, Christie A, Karmo B, Scott C, Bowah C, Barradas D, Blackley D, Dweh E, Warren F, Mahoney F, Kassay G, Calvert GM, Castro G, Logan G, Appiah G, Kirking H, Koon H, Papowitz H, Walke H, Cole IB, Montgomery J, Neatherlin J, Tappero JW, Hagan JE, Forrester J, Woodring J, Mott J, Attfield K, DeCock K, Lindblade KA, Powell K, Yeoman K, Adams L, Broyles LN, Slutsker L, Larway L, Belcher L, Cooper L, Santos M, Westercamp M, Weinberg MP, Massoudi M, Dea M, Patel M, Hennessey M, Fomba M, Lubogo M, Maxwell N, Moonan P, Arzoaquoi S, Gee S, Zayzay S, Pillai S, Williams S, Zarecki SM, Yett S, James S, Grube S, Gupta S, Nelson T, Malibiche T, Frank W, Smith W, Nyenswah T. Rapid response to Ebola outbreaks in remote areas - Liberia, July-November 2014. MMWR Morb Mortal Wkly Rep 2015; 64:188-92. [PMID: 25719682 PMCID: PMC5779593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
West Africa is experiencing its first epidemic of Ebola virus disease (Ebola). As of February 9, Liberia has reported 8,864 Ebola cases, of which 3,147 were laboratory-confirmed. Beginning in August 2014, the Liberia Ministry of Health and Social Welfare (MOHSW), supported by CDC, the World Health Organization (WHO), and others, began systematically investigating and responding to Ebola outbreaks in remote areas. Because many of these areas lacked mobile telephone service, easy road access, and basic infrastructure, flexible and targeted interventions often were required. Development of a national strategy for the Rapid Isolation and Treatment of Ebola (RITE) began in early October. The strategy focuses on enhancing capacity of county health teams (CHT) to investigate outbreaks in remote areas and lead tailored responses through effective and efficient coordination of technical and operational assistance from the MOHSW central level and international partners. To measure improvements in response indicators and outcomes over time, data from investigations of 12 of 15 outbreaks in remote areas with illness onset dates of index cases during July 16-November 20, 2014, were analyzed. The times to initial outbreak alerts and durations of the outbreaks declined over that period while the proportions of patients who were isolated and treated increased. At the same time, the case-fatality rate in each outbreak declined. Implementation of strategies, such as RITE, to rapidly respond to rural outbreaks of Ebola through coordinated and tailored responses can successfully reduce transmission and improve outcomes.
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Affiliation(s)
- Francis Kateh
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | - Thomas Nagbe
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | - Abraham Kieta
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | | | | | | | | | - Ben Karmo
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | - Collin Bowah
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | | | - Emmanuel Dweh
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | | | - Gabriel Kassay
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | | | - Gorbee Logan
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | | | - Hawa Koon
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | | | - Isaac B. Cole
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lawrence Larway
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | - Lorraine Cooper
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | | | | | | | | | | | | | - Moses Fomba
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | | | | | | | - Samuel Gee
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | - Samuel Zayzay
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | | | | | - Sheldon Yett
- United Nations Children’s Fund, New York City, New York
| | - Stephen James
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | | | - Thelma Nelson
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | | | - Wilmont Frank
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | - Wilmot Smith
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
| | - Tolbert Nyenswah
- Liberia Ministry of Health and Social Welfare, Monrovia, Liberia
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