20 research outputs found
The looming threat of dengue fever: the Africa context
No full textIn Africa, compared to 2019, dengue infections have surged ninefold by December 2023, with over 270 000 cases and 753 deaths reported across 18 African Union (AU) Member States. This commentary synthesises the context of dengue outbreaks in Africa and provides recommendations for sustainable control. In 2023, 18 African Union Member States reported outbreaks of dengue, among which seven had ongoing armed conflicts. These countries were amongst the top 15 African countries contributing to the most displaced persons on the continent and accounted for 98% of all dengue cases reported in the continent in 2023. Climate change remains an important driver, both through the displacement of people and global warming. The continent continues to face several challenges in detection, reporting and management, such as the lack of local laboratory capacity, misclassification of dengue cases and lack of medical countermeasures. Solutions targeting the strengthening of cross-border surveillance and early warning systems using a multisectoral one-health approach, local research and development for therapeutics and diagnostics and community engagement empowering communities to protect themselves and understand the gravity of the threat could help curb the spread of the disease in Africa
Cholera case trends in Eastern Africa using surveillance data, 2007-2024
No full textIntroduction: Cholera is a public health threat in Africa, with an estimated 68,480 cases and 895 deaths reported across seven of 14 Member States in the Eastern region in 2023. Within the region, cholera outbreak has been protracted in the horn of Africa, with countries responding to the outbreak amid prolonged harsh drought, floods and complex humanitarian emergencies. In recent months, an upsurge in cases and deaths has been observed in the region, with five countries reporting active outbreaks this year. We describe the trend of cholera cases in Comoros, Ethiopia, Kenya, Somalia and Tanzania for 2007-2024. Methods: Descriptive trend analysis of cholera case data for Comoros, Ethiopia, Kenya, Somalia and Tanzania, from 2007-2024, was performed. Data were obtained from the Event Management System of the Africa Centres for Disease Control and Prevention (2023-2024) and the Global Infectious Disease and Epidemiology Network (GIDEON) online resource for data (2007-2022). Water, Sanitation and Hygiene (WASH) data was sourced from WHO/UNICEF Joint Monitoring Program for WASH. The term 'cholera case' includes both confirmed and suspected. Results: From 2007 to 5 April 2024, a total of 578,449 cholera cases and 8,514 deaths [case fatality rate (CFR): 1.5%] were reported from Comoros, Ethiopia, Kenya, Somalia and Tanzania. Somalia accounted for 55.2% (315,972) of the cases and 54.6% (4,700) of the corresponding deaths. The average CFR per year was 1.4%, ranging from 0.3% in 2014 to 2.4% in 2016. During the review period, notable geographical patterns that were triggered by climate change were observed. Somalia experienced annual cholera outbreaks beginning November and December and receding in May, with largest occurrences in 2011 (77,636 cases) and 2017 (75,414 cases). Widespread outbreaks occurred in Ethiopia from 2007-2010, with a high peak in 2009 (31,509 cases) and recently in 2023 (29,869 cases). For this year, cases in Kenya appear to be on the decline while Tanzania shows an increasing pattern. Comoros reported its first cholera outbreak since 2007 in February 2024 through a cross-border event with Tanzania. Ethiopia is among countries in Africa with the largest population practicing open defecation in 2022. Discussion: The trend analysis underscores the persistent nature of cholera outbreak in the Eastern region. Climate change impacts the dynamics of the outbreak by limiting access to safe water and sanitation, and triggering increased cross-border movements. The average CFR per year surpassed the recommended <1% threshold. Conclusion: The cholera response requires a regional multi-sectoral and coordination mechanism approach, given the same protracted nature and cross-border transmissions. Significant resources are needed to implement long-term WASH strategies. With the predicted above-normal rainfall for the horn of Africa between March and May 2024, climate change in relation to health outcomes should be considered an emerging area of focus
Health Secur
No full textUganda is highly vulnerable to public health emergencies (PHEs) due to its geographic location next to the Congo Basin epidemic hot spot, placement within multiple epidemic belts, high population growth rates, and refugee influx. In view of this, Uganda's Ministry of Health established the Public Health Emergency Operations Center (PHEOC) in September 2013, as a central coordination unit for all PHEs in the country. Uganda followed the World Health Organization's framework to establish the PHEOC, including establishing a steering committee, acquiring legal authority, developing emergency response plans, and developing a concept of operations. The same framework governs the PHEOC's daily activities. Between January 2014 and December 2021, Uganda's PHEOC coordinated response to 271 PHEs, hosted 207 emergency coordination meetings, trained all core staff in public health emergency management principles, participated in 21 simulation exercises, coordinated Uganda's Global Health Security Agenda activities, established 6 subnational PHEOCs, and strengthened the capacity of 7 countries in public health emergency management. In this article, we discuss the following lessons learned: PHEOCs are key in PHE coordination and thus mitigate the associated adverse impacts; although the functions of a PHEOC may be legalized by the existence of a National Institute of Public Health, their establishment may precede formally securing the legal framework; staff may learn public health emergency management principles on the job; involvement of leaders and health partners is crucial to the success of a public health emergency management program; subnational PHEOCs are resourceful in mounting regional responses to PHEs; and service on the PHE Strategic Committee may be voluntary.CC999999/ImCDC/Intramural CDC HHSUnited States
Health Secur
No full textUganda's proximity to the tenth Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) presents a high risk of cross-border EVD transmission. Uganda conducted preparedness and risk-mapping activities to strengthen capacity to prevent EVD importation and spread from cross-border transmission. We adapted the World Health Organization (WHO) EVD Consolidated Preparedness Checklist to assess preparedness in 11 International Health Regulations domains at the district level, health facilities, and points of entry; the US Centers for Disease Control and Prevention (CDC) Border Health Capacity Discussion Guide to describe public health capacity; and the CDC Population Connectivity Across Borders tool kit to characterize movement and connectivity patterns. We identified 40 ground crossings (13 official, 27 unofficial), 80 health facilities, and more than 500 locations in 12 high-risk districts along the DRC border with increased connectivity to the EVD epicenter. The team also identified routes and congregation hubs, including origins and destinations for cross-border travelers to specified locations. Ten of the 12 districts scored less than 50% on the preparedness assessment. Using these results, Uganda developed a national EVD preparedness and response plan, including tailored interventions to enhance EVD surveillance, laboratory capacity, healthcare professional capacity, provision of supplies to priority locations, building treatment units in strategic locations, and enhancing EVD risk communication. We identified priority interventions to address risk of EVD importation and spread into Uganda. Lessons learned from this process will inform strategies to strengthen public health emergency systems in their response to public health events in similar settings.001/WHO_/World Health OrganizationInternational/CC999999/ImCDC/Intramural CDC HHSUnited States
Characteristics of tuberculosis patients registered for treatment in Kyangwali Refugee Settlement, 2016–2017.
No full textCharacteristics of tuberculosis patients registered for treatment in Kyangwali Refugee Settlement, 2016–2017.</p
Characteristics of patients (N = 254) by treatment outcome.
No full textCharacteristics of patients (N = 254) by treatment outcome.</p
Treatment outcomes among TB patients in Kyangwali Refugee Settlement, 2017–2017.
No full textTreatment outcomes among TB patients in Kyangwali Refugee Settlement, 2017–2017.</p
Flow chart of selection of patient records for the study.
No full textFlow chart of selection of patient records for the study.</p
Uganda's experience in establishing an electronic compendium for public health emergencies.
No full textUganda has implemented several interventions that have contributed to prevention, early detection, and effective response to Public Health Emergencies (PHEs). However, there are gaps in collecting and documenting data on the overall response to these PHEs. We set out to establish a comprehensive electronic database of PHEs that occurred in Uganda since 2000. We constituted a core development team, developed a data dictionary, and worked with Health Information Systems Program (HISP)-Uganda to develop and customize a compendium of PHEs using the electronic Integrated Disease Surveillance and Response (eIDSR) module on the District Health Information Software version 2 (DHIS2) platform. We reviewed literature for retrospective data on PHEs for the compendium. Working with the Uganda Public Health Emergency Operations Center (PHEOC), we prospectively updated the compendium with real-time data on reported PHEs. We developed a user's guide to support future data entry teams. An operational compendium was developed within the eIDSR module of the DHIS2 platform. The variables for PHEs data collection include those that identify the type, location, nature and time to response of each PHE. The compendium has been updated with retrospective PHE data and real-time prospective data collection is ongoing. Data within this compendium is being used to generate information that can guide future outbreak response and management. The compendium development highlights the importance of documenting outbreak detection and response data in a central location for future reference. This data provides an opportunity to evaluate and inform improvements in PHEs response
Process of prospective data collection and entry into the compendium.
No full textProcess of prospective data collection and entry into the compendium.</p
