16 results on '"Annet Kisakye"'
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2. Exploring Important Attributes, the Potential Use Cases and Feasibility of Introduction of Measles and Rubella Microarray Patches (MR-MAPs): Insights from Nine Countries
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Mateusz Hasso-Agopsowicz, Dijana Spasenoska, Maarten Paul Maria Jansen, Balcha Girma Masresha, Desiree Pastor, Abay Hagos Gebrekidan, Olivi Silalahi, Janice Woolford, Annet Kisakye, Anna-Lea Kahn, and Birgitte Giersing
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microarray patches ,measles ,rubella ,vaccine ,Medicine - Abstract
Background: Microarray patches (MAPs) are innovative, needle-free vaccine delivery systems, suitable for administration by minimally trained health care workers or trained community health workers. Their introduction may transform immunization programmes, particularly for vaccines where high coverage is required for population immunity, such as measles, and where vaccine delivery is challenging, such as in low- and middle-income countries. Recognizing the need to understand how best to tailor these products to reflect country priorities, workshops on measles and rubella MAPs (MR-MAPs) were conducted in multiple regions to collect insights on needs and preferences from relevant stakeholders at country level. Methods: The CAPACITI Innovation Framework was used to structure stakeholder discussions in nine countries in the period from August 2022 to July 2023. The discussions, building on the findings from a situation analysis on the barriers related to measles and rubella vaccine delivery, followed the four-step process outlined in the framework. Results: Key barriers hindering delivery of measles and rubella vaccines across the countries were in the categories of human resource management, service delivery, and demand generation. MR-MAP attributes that stakeholders believed would reduce or eliminate these barriers included ease of preparation and administration, improved thermostability, fewer (ancillary) components, and single-dose presentation. Some attributes such as the site of administration, wear time, and storage volume could exacerbate certain barriers. Based on an understanding of key barriers, product attributes, and underserved populations, stakeholders identified several potential use cases for MR-MAPs: (i) delivery at a fixed health post, (ii) delivery through outreach sessions conducted by health workers, and (iii) administration by community health workers. To enable robust national decision making about the introduction of MR-MAPs and successful implementation, global and national evidence on feasibility and acceptability of MR-MAPs should be generated. To prepare for the potential introduction of MR-MAPs, immunization programmes should evaluate their immunization policies based on their preferred use cases and modify them if needed, for example, to enable community health workers to administer vaccines, along with making programmatic adjustments to waste management and training. Conclusions: MR-MAPs have the potential to reduce key barriers to MR delivery. Yet, their future impact depends on the ability of global stakeholders to steer the development of MR-MAPs to be responsive to country needs and preferences. The generation of evidence to enable robust decision making, timely modification of vaccine policies, and addressing programmatic considerations will be key to successful uptake.
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- 2024
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3. Rubella virus genotype 2B endemicity and related utility of serum-based molecular characterization in Uganda
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Phionah Tushabe, Barnabas Bakamutumaho, James Peter Eliku, Molly Birungi, Francis Aine, Prossy Namuwulya, Henry Bukenya, Immaculate Ampeire, Annet Kisakye, Charles R. Byabamazima, and Josephine Bwogi
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Rubella ,Congenital Rubella Syndrome ,Genotypes ,Endemic ,Sera ,Medicine ,Biology (General) ,QH301-705.5 ,Science (General) ,Q1-390 - Abstract
Abstract There are 13 globally recognized rubella virus genotypes of which only 2 (1E and 2B) have been detected recently. The largest percentage of all reported rubella virus sequences come from China and Japan with Africa reporting limited data. In a bid to address the lack of rubella genotype data in Uganda and the World Health Organization Africa region, we sought to characterize rubella viruses retrospectively using sera collected from suspected measles patients that turned out rubella IgM positive. Seven sequences belonging to genotype 2B sub-lineage 2B-L2c were obtained. These sequences clustered with other genotype 2B sequences previously reported from Uganda. None of the other genotypes (1E and 1G) reported from Uganda in the earlier years were detected. In addition, none of the sequences were obtained after the introduction of the measles-rubella containing vaccine. The above highlight the need for continuous rubella virological surveillance to confirm interruption of endemic rubella genotype circulation.
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- 2023
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4. Cholera and COVID-19 pandemic prevention in multiple hotspot districts of Uganda: vaccine coverage, adverse events following immunization and WASH conditions survey
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Godfrey Bwire, Annet Kisakye, Esther Amulen, John Baptist Bwanika, Joan Badebye, Christine Aanyu, Brenda Doreen Nakirya, Alfred Okello, Stephen Acellam Okello, Justine N. Bukenya, and Christopher Garimoi Orach
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COVID ,Vaccine hesitancy ,Cholera ,Africa ,Pandemic ,Uganda ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Between March, 2020 and December, 2021 due to cholera and coronavirus disease 2019 (COVID-19) pandemics, there were 1,534 cholera cases with 14 deaths and 136,065 COVID-19 cases with 3,285 deaths reported respectively in Uganda. This study investigated mass vaccination campaigns for the prevention of the two pandemics namely: oral cholera vaccine (OCV) and COVID-19 vaccine coverage; adverse events following immunization (AEFI); barriers and enablers for the vaccine uptake and assessed water, sanitation and hygiene (WASH) conditions in the six cholera and COVID-19 hotspot districts of Uganda. Methods A household survey was conducted between January and February, 2022 in the six cholera hotspot districts of Uganda which had recently conducted OCV mass vaccination campaigns and had ongoing COVID-19 mass vaccination campaigns. The survey randomly enrolled 900 households with 4,315 persons of whom 2,085 were above 18 years. Data were collected using a data entry application designed in KoBoToolbox and analysed using STATA version 14. Frequencies, percentages, odds ratios, means, confidence intervals and maps were generated and interpreted. Results The OCV coverage for dose one and two were 85% (95% CI: 84.2—86.4) and 67% (95% CI: 65.6—68.4) respectively. Among the 4,315 OCV recipients, 2% reported mild AEFI, 0.16% reported moderate AEFI and none reported severe AEFI. The COVID-19 vaccination coverage for dose one and two were 69.8% (95% CI: 67.8–71.8) and 18.8% (95% CI: 17.1–20.5) respectively. Approximately, 23% (478/2,085) of COVID-19 vaccine recipient reported AEFI; most 94% were mild, 0.6% were moderate and 2 cases were severe. The commonest reason for missing COVID-19 vaccine was fear of the side effects. For most districts (5/6), sanitation (latrine/toilet) coverage were low at 7.4%—37.4%. Conclusion There is high OCV coverage but low COVID-19 vaccine and sanitation coverage with high number of moderate cases of AEFI recorded due to COVID-19 vaccines. The low COVID-19 vaccine coverage could indicate vaccine hesitancy for COVID-19 vaccines. Furthermore, incorporation of WASH conditions assessment in the OCV coverage surveys is recommended for similar settings to generate data for better planning. However, more studies are required on COVID-19 vaccine hesitancy.
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- 2023
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5. Trends of key surveillance performance indicators of acute flaccid paralysis: a descriptive analysis, Uganda, 2015–2020
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Bob Omoda Amodan, Annet Kisakye, Patricia Thiwe Okumu, Sherry Rita Ahirirwe, Daniel Kadobera, Alfred Driwale, and Alex Riolexus Ario
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AFP ,Eradication ,Polio ,Surveillance ,Uganda ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Polio is disease caused by poliovirus which can in turn cause irreversible paralytic disease, presenting as Acute Flaccid Paralysis (AFP). A sensitive AFP surveillance system, in which all reported AFP cases are evaluated, first to determine if they are true AFP cases or not, is key for tracking polio eradication. True AFP cases are then later categorized as polio AFP or non-polio AFP (NPAFP) cases. Sensitivity is defined by meeting an annual NPAFP rate/100,000 population
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- 2022
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6. Ebola virus disease surveillance in the absence of a confirmed case; the case of the Rwenzori region of Uganda
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Emmanuel Angmorteh Mensah, Annet Kisakye, and Samuel Ofori Gyasi
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ebola virus disease ,kasese district ,surveillance activities ,preparedness ,rwenzori region ,points of entry ,Medicine - Abstract
INTRODUCTION: the August 2018 ebola outbreak in Democratic Republic of Congo turns out to be second largest outbreak of ebola in public health history. The response to the outbreak which would have halted wider spread to neighboring countries failed. Hence, high risk districts in Uganda initiated preparedness activities in the wake of a possible inflow of cases. This study was therefore designed to identify, describe and asses surveillance activities and preparedness in the Kasese, Ntoroko and Bundibugyo districts of Uganda. METHODS: the study employed the mixed method approach. The qualitative arm involved the use of participant observation to describe surveillance activities that were carried out as part of the ebola preparedness surveillance in the high-risk districts. The quantitative arm included assessment of 102 health facilities on ebola Virus Disease preparedness with a WHO standard checklist hosted on the Open Data Kit software. Descriptive statistics were performed using STATA (version 14). RESULTS: the study showed that high risk districts employed numerous interlocking public health emergency activities which included readiness assessment, risk mapping and temperature-based screening for ebola at points of entry. Most health workers (91.18%) could correctly state the case definition of ebola although only 56.86% of them were trained on ebola surveillance. CONCLUSION: health worker knowledge on ebola virus disease case definition was high but training and logistics were inadequate. Continuous efforts are required to sustain health workers knowledge on ebola surveillance through trainings and supportive supervision whiles addressing gaps in the operation of ebola screening posts.
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- 2020
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7. The detection of 3 ambiguous type 2 vaccine-derived polioviruses (VDPV2s) in Uganda
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Mary Bridget Nanteza, Barnabas Bakamutumaho, Annet Kisakye, Prossy Namuwulya, Henry Bukenya, Edson Katushabe, Josephine Bwogi, Charles Rutebarika Byabamazima, Raffaella Williams, and Nicksy Gumede
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Vaccine-derived poliovirus ,Uganda ,Poliovirus ,Immunization ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background The Oral Polio Vaccine (OPV or Sabin) is genetically unstable and may mutate to form vaccine-derived polioviruses (VDPVs). Methods In 2014, two VDPVs type 2 were identified during routine surveillance of acute flaccid paralysis (AFP) cases. Consequently, a retrospective VDPV survey was conducted to ensure that there was no circulating VDPV in the country. All Sabin poliovirus isolates identified in Uganda 6 months before and 6 months after were re-screened; Sabin 1 and 3 polioviruses were re-screened for Sabin 2 and Sabin 2 polioviruses were re-screened for VDPVs type 2. The Poliovirus rRT-PCR ITD/VDPV 4.0 assay and sequencing were used respectively. Results The first two VDPVs type2 were identified in Eastern Uganda and the third was identified during the survey from South-western Uganda. These regions had low OPV coverage and poor AFP surveillance indicators. Conclusion The retrospective VDPV survey was a useful strategy to screen for VDPVs more exhaustively. Supplementary surveillance methods need to be encouraged.
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- 2018
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8. Enhancing Workforce Capacity to Improve Vaccination Data Quality, Uganda
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Kirsten Ward, Kevin Mugenyi, Amalia Benke, Henry Luzze, Carol Kyozira, Ampeire Immaculate, Patricia Tanifum, Annet Kisakye, Peter Bloland, and Adam MacNeil
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vaccination ,immunization ,data quality ,information systems ,workforce development ,program evaluation ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
In Uganda, vaccine dose administration data are often not available or are of insufficient quality to optimally plan, monitor, and evaluate program performance. A collaboration of partners aimed to address these key issues by deploying data improvement teams (DITs) to improve data collection, management, analysis, and use in district health offices and health facilities. During November 2014–September 2016, DITs visited all districts and 89% of health facilities in Uganda. DITs identified gaps in awareness and processes, assessed accuracy of data, and provided on-the-job training to strengthen systems and improve healthcare workers’ knowledge and skills in data quality. Inaccurate data were observed primarily at the health facility level. Improvements in data management and collection practices were observed, although routine follow-up and accountability will be needed to sustain change. The DIT strategy offers a useful approach to enhancing the quality of health data.
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- 2017
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9. Positive predictive value and effectiveness of measles case-based surveillance in Uganda, 2012-2015.
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Fred Nsubuga, Immaculate Ampaire, Simon Kasasa, Henry Luzze, and Annet Kisakye
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Medicine ,Science - Abstract
Disease surveillance is a critical component in the control and elimination of vaccine preventable diseases. The Uganda National Expanded Program on Immunization strives to have a sensitive surveillance system within the Integrated Disease Surveillance and Response (IDSR) framework. We analyzed measles surveillance data to determine the effectiveness of the measles case-based surveillance system and estimate its positive predictive value in order to inform policy and practice.An IDSR alert was defined as ≥1 suspected measles case reported by a district in a week, through the electronic Health Management Information System. We defined an alert in the measles case-based surveillance system (CBS) as ≥1 suspected measles case with a blood sample collected for confirmation during the corresponding week in a particular district. Effectiveness of CBS was defined as having ≥80% of IDSR alerts with a blood sample collected for laboratory confirmation. Positive predictive value was defined as the proportion of measles case-patients who also had a positive measles serological result (IgM +). We reviewed case-based surveillance data with laboratory confirmation and measles surveillance data from the electronic Health Management Information System from 2012-2015.A total of 6,974 suspected measles case-persons were investigated by the measles case-based surveillance between 2012 and 2015. Of these, 943 (14%) were measles specific IgM positive. The median age of measles case-persons between 2013 and 2015 was 4.0 years. Between 2013 and 2015, 72% of the IDSR alerts reported in the electronic Health Management Information System, had blood samples collected for laboratory confirmation. This was however less than the WHO recommended standard of ≥80%. The PPV of CBS between 2013 and 2015 was 8.6%.In conclusion, the effectiveness of measles case-based surveillance was sub-optimal, while the PPV showed that true measles cases have significantly reduced in Uganda. We recommended strengthening of case-based surveillance to ensure that all suspected measles cases have blood samples collected for laboratory confirmation to improve detection and ensure elimination by 2020.
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- 2017
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10. Possible Interruption of Measles Virus Transmission, Uganda, 2006–2009
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Frederick N. Baliraine, Josephine Bwogi, Henry Bukenya, Ronald Seguya, Theopista Kabaliisa, Annet Kisakye, William B. Mbabazi, and Sheilagh B. Smit
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viruses ,measles ,interruption ,genotype B3.1 ,Uganda ,dispatch ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
To determine what measles virus genotype(s) circulated in Uganda after strategic interventions aimed at controlling/eliminating measles, we examined samples obtained during 2006–2009 and found only genotype B3.1, which had not been previously detected. Kenya was the likely source, but other countries cannot be excluded.
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- 2011
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11. Action for child survival: elimination of Haemophilus influenzae type b meningitis in Uganda
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Rosamund F Lewis, Annet Kisakye, Bradford D Gessner, Chaplain Duku, John Bosco Odipio, Robert Iriso, Denis Nansera, Fiona Braka, Issa Makumbi, and Addy Kekitiinwa
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Public aspects of medicine ,RA1-1270 - Abstract
OBJECTIVE: To guide immunization policy, we determined the public health benefit of introducing Haemophilus influenzae type b (Hib) vaccine in Uganda and estimated the vaccine effectiveness. METHODS: Surveillance data for acute bacterial meningitis among children aged 0-59 months were reviewed from three hospital sentinel sites, for July 2001 to June 2007, to determine the incidence of Hib meningitis, the effectiveness of Hib vaccine with a case-control design, and the number of vaccine-preventable cases and deaths of Hib disease in Uganda. FINDINGS: Of the 13 978 children from 17 districts with suspected bacterial meningitis, 269 had confirmed Hib meningitis, declining from 69 patients in the prevaccine year (2001-2002) to three in 2006-2007. Hib meningitis incidence dropped from 88 cases per 100 000 children aged < 5 years in the year before vaccine introduction to 13 within 4 years, and to near zero in the fifth year. Vaccine effectiveness for 2 or more doses was 93% (95% confidence interval, CI: 69-99) against confirmed Hib meningitis and 53% (95% CI: 11-68) against purulent meningitis of unknown cause. In Uganda, Hib vaccine prevents an estimated 28 000 cases of pneumonia and meningitis, 5000 deaths and 1000 severe meningitis sequelae each year. CONCLUSION: Infant immunization with Hib vaccine has virtually eliminated Hib meningitis in Uganda within 5 years. Ensuring long-term benefits of Hib vaccine urgently requires sustainable vaccine financing, high-quality ongoing surveillance, and a health sector able to deliver a robust immunization programme.
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- 2008
12. Bacterial meningitis among children under the age of 2 years in a high human immunodeficiency virus prevalence area after Haemophilus influenzae type b vaccine introduction
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Nansera, Denis, Max, Irama, Annet, Kisakye, and Gessner, Bradford D
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- 2012
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13. Behind the data: establishing the Network for Surveillance of Pneumococcal Disease in the East African Region
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Douglas Makewa, Ben Amos, Dennis Nansera, Sandra Mudhune, Thomas Ngwiri, Mike English, Hadija Mwamtemi, Maranga Wamae, and Annet Kisakye
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Microbiology (medical) ,High rate ,Pediatrics ,medicine.medical_specialty ,Economic growth ,Pneumococcal disease ,business.industry ,Data management ,Infant ,Africa, Eastern ,Community Networks ,Pneumococcal Infections ,Article ,Public health care ,Infectious Diseases ,Child, Preschool ,Population Surveillance ,Clinical diagnosis ,Health care ,East africa ,Humans ,Medicine ,business - Abstract
In a region with high rates of mortality among children aged
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- 2016
14. Barriers to effective uptake and provision of immunization in a rural district in Uganda.
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Malande, Oliver Ombeva, Munube, Deogratias, Afaayo, Rachel Nakatugga, Annet, Kisakye, Bodo, Bongomin, Bakainaga, Andrew, Ayebare, Elizabeth, Njunwamukama, Sam, Mworozi, Edison Arwanire, and Musyoki, Andrew Munyalo
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IMMUNIZATION ,IMMUNOTHERAPY ,HEALTH programs ,THERAPEUTICS ,HEALTH policy - Abstract
Introduction: Hoima, one of the largest districts in mid- western Uganda, has persistently performed poorly with low immunization coverage, high immunization drop outs rates and repeated outbreaks of vaccine preventable diseases especially measles. The objectives of this study were to evaluate the state of immunization services and to identify the gaps in immunization health systems that contribute to low uptake and completion of immunization schedules in Hoima District. Methods: This was a cross sectional mixed methods study, utilizing both qualitative and quantitative approaches. A situation analysis of the immunization services was carried out using in-depth interviews with vaccinators, focus group discussions and key informant interviews with ethno-videography. Secondary data was sourced from records at headquarters and vaccination centres within Hoima District. The quantitative component utilized cluster random sampling with sample size estimated using the World Health Organization’s 30 cluster sampling technique. Results: A total of 311 caretaker/child pairs were included in the study. Immunization completion among children of age at least 12 months was 95% for BCG, 96% for OPV0, 93% for DPT1, 84.5% for DPT2, 81% for DPT3 and 65.5% for measles vaccines. Access to immunization centres is difficult due to poor road terrain, which affects effectiveness of outreach program, support supervision, mentorship and timely delivery of immunization program support supplies especially refrigerator gas and vaccines. Some facilities are under-equipped to effectively support the program. Adverse Events Following Immunization (AEFI) identification, reporting and management is poorly understood. Conclusion: Immunization services in Hoima District require urgent improvement in the following areas: vaccine supply, expanding service delivery points, more health workers, transport and tailored mechanisms to ensure adequate communication between health workers and caretakers. [ABSTRACT FROM AUTHOR]
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- 2019
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15. Assessment of core capacities for the International Health Regulations (IHR[2005]) – Uganda, 2009
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Joseph F. Wamala, Annet Kisakye, Rajesh Sreedharan, Thomas Aisu, Barnabas Bakamutumaho, Stella Chungong, Peter Gaturuku, Miriam Nanyunja, Nasan Natseri, Julius J. Lutwama, Jun Xing, Charles Okot, Issa Makumbi, and Fernando Da Silveira
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medicine.medical_specialty ,Capacity Building ,International Cooperation ,Context (language use) ,Review ,International Health Regulations ,Disease Outbreaks ,Environmental health ,Zoonoses ,Health care ,medicine ,Animals ,Humans ,Operations management ,Uganda ,Health policy ,Disease surveillance ,business.industry ,Public health ,lcsh:Public aspects of medicine ,Public Health, Environmental and Occupational Health ,International health ,lcsh:RA1-1270 ,Social Control, Formal ,Systems Integration ,Cross-Sectional Studies ,Preparedness ,Population Surveillance ,Communicable Disease Control ,Guideline Adherence ,Public Health ,business ,Sentinel Surveillance - Abstract
Background Uganda is currently implementing the International Health Regulations (IHR[2005]) within the context of Integrated Disease Surveillance and Response (IDSR). The IHR(2005) require countries to assess the ability of their national structures, capacities, and resources to meet the minimum requirements for surveillance and response. This report describes the results of the assessment undertaken in Uganda. Methods We conducted a descriptive cross-sectional assessment using the protocol developed by the World Health Organisation (WHO). The data collection tools were adapted locally and administered to a convenience sample of HR(2005) stakeholders, and frequency analyses were performed. Results Ugandan national laws relevant to the IHR(2005) existed, but they did not adequately support the full implementation of the IHR(2005). Correspondingly, there was a designated IHR National Focal Point (NFP), but surveillance activities and operational communications were limited to the health sector. All the districts (13/13) had designated disease surveillance offices, most had IDSR technical guidelines (92%, or 12/13), and all (13/13) had case definitions for infectious and zoonotic diseases surveillance. Surveillance guidelines were available at 57% (35/61) of the health facilities, while case definitions were available at 66% (40/61) of the health facilities. The priority diseases list, surveillance guidelines, case definitions and reporting tools were based on the IDSR strategy and hence lacked information on the IHR(2005). The rapid response teams at national and district levels lacked food safety, chemical and radio-nuclear experts. Similarly, there were no guidelines on the outbreak response to food, chemical and radio-nuclear hazards. Comprehensive preparedness plans incorporating IHR(2005) were lacking at national and district levels. A national laboratory policy existed and the strategic plan was being drafted. However, there were critical gaps hampering the efficient functioning of the national laboratory network. Finally, the points of entry for IHR(2005) implementation had not been designated. Conclusions The assessment highlighted critical gaps to guide the IHR(2005) planning process. The IHR(2005) action plan should therefore be developed to foster national and international public health security.
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16. Achieving measles control: lessons from the 2002-06 measles control strategy for Uganda.
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William B Mbabazi, Miriam Nanyunja, Issa Makumbi, Fiona Braka, Frederick N Baliraine, Annet Kisakye, Josephine Bwogi, Possy Mugyenyi, Eva Kabwongera, and Rosamund F Lewis
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MEASLES vaccines ,VACCINATION ,IMMUNIZATION ,EPIDEMIOLOGY ,HEALTH programs ,FOLLOW-up studies (Medicine) ,IMMUNOASSAY ,DISEASE incidence - Abstract
Background The 2002â06 measles control strategy for Uganda was implemented to strengthen routine immunization, undertake large-scale catch-up and follow-up vaccination campaigns, and to initiate nationwide case-based, laboratory-backed measles surveillance. This study examines the impact of this strategy on the epidemiology of measles in Uganda, and the lessons learnt. Methods Number of measles cases and routine measles vaccination coverage reported by each district were obtained from the National Health Management Information System reports of 1997 to 2007. The immunization coverage by district in a given year was calculated by dividing the number of children immunized by the projected population in the same age category. Annual measles incidence for each year was derived by dividing the number of cases in a year by the mid-year projected population. Commercial measles IgM enzyme-linked immunoassay kits were used to confirm measles cases. Results Routine measles immunization coverage increased from 64% in 1997 to 90% in 2004, then stabilized around 87%. The 2003 national measles catch-up and 2006 follow-up campaigns reached 100% of children targeted with a measles supplemental dose. Over 80% coverage was also achieved with other child survival interventions. Case-based measles surveillance was rolled out nationwide to provide continuous epidemiological monitoring of measles occurrence. Following a 93% decline in measles incidence and no measles deaths, epidemic resurgence of measles occurred 3 years after a measles campaign targeting a wide age group, but no indigenous measles virus (D10) was isolated. Recurrence was delayed in regions where children were offered an early second opportunity for measles vaccination. Conclusion The integrated routine and campaign approach to providing a second opportunity for measles vaccination is effective in interrupting indigenous measles transmission and can be used to deliver other child survival interventions. Measles control can be sustained and the inter-epidemic interval lengthened by offering an early second opportunity for measles vaccination through other health delivery strategies. [ABSTRACT FROM AUTHOR]
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- 2009
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