32 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. Environmental surveillance detects circulating vaccine-derived poliovirus type 2 that was undetected by acute flaccid paralysis surveillance in 2021 in Uganda
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Phionah Tushabe, Josephine Bwogi, James Peter Eliku, Francis Aine, Molly Birungi, Joseph Gaizi, Lucy Nakabazzi, Theopista Kabaliisa, Irene Turyahabwe, Prossy Namuwulya, Mary Bridget Nanteza, Henry Bukenya, Christopher Kanyesigye, Edson Katushabe, Immaculate Ampeire, Annet Kisakye, Barnabas Bakamutumaho, and Charles R. Byabamazima
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Virology ,General Medicine - Abstract
The success of the global polio eradication initiative is threatened by the genetic instability of the oral polio vaccine, which can result in the emergence of pathogenic vaccine-derived polioviruses following prolonged replication in the guts of individuals with primary immune deficiencies or in communities with low vaccination coverage. Through environmental surveillance, circulating vaccine-derived poliovirus type 2 was detected in Uganda in the absence of detection by acute flaccid paralysis (AFP) surveillance. This underscores the sensitivity of environmental surveillance and emphasizes its usefulness in supplementing AFP surveillance for poliovirus infections in the race towards global polio eradication.
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- 2023
13. Field investigation of high reported non-neonatal tetanus burden in Uganda, 2016–2017
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Rebecca Mary Casey, Joyce Nguna, Bernard Opar, Immaculate Ampaire, Joseph Lubwama, Patricia Tanifum, Bao-Ping Zhu, Annet Kisakye, Eva Kabwongera, Rania A Tohme, Benjamin A Dahl, Alison D Ridpath, and Heather M Scobie
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Epidemiology ,General Medicine - Abstract
Background Despite providing tetanus-toxoid-containing vaccine (TTCV) to infants and reproductive-age women, Uganda reports one of the highest incidences of non-neonatal tetanus (non-NT). Prompted by unusual epidemiologic trends among reported non-NT cases, we conducted a retrospective record review to see whether these data reflected true disease burden. Methods We analysed nationally reported non-NT cases during 2012–2017. We visited 26 facilities (14 hospitals, 12 health centres) reporting high numbers of non-NT cases (n = 20) or zero cases (n = 6). We identified non-NT cases in facility registers during 1 January 2016–30 June 2017; the identified case records were abstracted. Results During 2012–2017, a total of 24 518 non-NT cases were reported and 74% were ≥5 years old. The average annual incidence was 3.43 per 100 000 population based on inpatient admissions. Among 482 non-NT inpatient cases reported during 1 January 2016–30 June 2017 from hospitals visited, 342 (71%) were identified in facility registers, despite missing register data (21%). Males comprised 283 (83%) of identified cases and 60% were ≥15 years old. Of 145 cases with detailed records, 134 (92%) were clinically confirmed tetanus; among these, the case-fatality ratio (CFR) was 54%. Fourteen cases were identified at two hospitals reporting zero cases. Among >4000 outpatient cases reported from health centres visited, only 3 cases were identified; the remainder were data errors. Conclusions A substantial number of non-NT cases and deaths occur in Uganda. The high CFR and high non-NT burden among men and older children indicate the need for TTCV booster doses across the life course to all individuals as well as improved coverage with the TTCV primary series. The observed data errors indicate the need for data quality improvement activities.
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- 2023
14. Prevention of cholera and COVID-19 pandemics in Uganda: understanding vaccine coverage survey Plus
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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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Background Between March, 2020 and December, 2021, Uganda experienced high prevalence of cholera and Coronavirus Disease 2019 (COVID-19) leading to 1,534 cholera cases with 14 deaths and 136,065 COVID-19 cases with 3,285 deaths reported respectively. This study investigated mass vaccination campaigns for the prevention of the two pandemics namely Oral Cholera Vaccine (OCV) and COVID-19 vaccine coverages; Adverse Events Following Immunization (AEFI); barriers and enablers for the vaccine uptake and the feasibility of incorporating Water, Sanitation and Hygiene (WASH) assessments into vaccine coverage surveys. Methods A household survey was conducted between January and February, 2022 in the six districts of Uganda which had recently conducted OCV mass vaccination campaigns or 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 and analysed using STATA statistical package. Frequencies, percentages, Odds ratios, confidence intervals and maps were generated and interpreted. Results The OCV coverage for dose one and two were 85% (CI: 84.2–86.4) and 67% (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% (CI: 67.8–71.8) and 18.8% (CI: 17.1–20.5) respectively. Approximately, 23% (478/2,085) of COVID-19 vaccine recipient reported AEFI; 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) coverages were low at 7.4% − 37.4%. Conclusion There were high OCV coverages but low COVID-19 vaccine and sanitation coverages with high number of moderate cases of AEFI recorded due to COVID-19 vaccines. The low COVID-19 coverage could indicate vaccine hesitancy for COVID-19 vaccines. Furthermore, incorporation of WASH 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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- 2022
15. Simulation Exercises To Strengthen Polio Outbreak Preparedness in The Horn of Africa: Experiences and Lessons Learnt
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Joseph Okeibunor, Farkhard Imambakiev, Samuel Okiror, Chidiadi Nwogu, Rustam Hydarov, John Ogange, Djiboui Karim, Obianuju Igweonu, Annet Kisakye, and Hemant Shukla
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Polio outbreak simulation exercise (POSE) ,Economic growth ,Outbreak ,Preparedness exercise ,medicine.disease ,complex mixtures ,Article ,Test (assessment) ,Poliomyelitis ,Poliovirus ,HoA ,Political science ,Poliomyelitis eradication ,Preparedness ,medicine ,Polio eradication - Abstract
Background: Poliovirus importations and related outbreaks occurred in the Horn of Africa (HoA) following an initial outbreak, which started in Somalia, spread into Kenya within ten days and later into Ethiopia and gradually to other countries in the region. National preparedness plans for responding to poliovirus introduction were insufficient in many countries of the Region. We describe a series of polio outbreak simulation exercises that were implemented to formally test polio outbreak preparedness plans in the HoA countries, as a step to interrupting further transmission. Methods: The Polio Outbreak Simulation Exercises (POSEs) were designed and implemented. The results were evaluated and recommendations made. The roles of outbreak simulation exercises in maintaining regional polio-free status were assessed. In addition, we performed a comprehensive review of the national plans of all for seven countries in the HoA Region. Results: Seven simulation exercises, delivered between 2016 and 2017 revealed that participating countries were generally prepared for poliovirus introduction, but the level of preparedness needed improvement. The areas in particular need of strengthening were national preparedness plans, initial response, plans for securing vaccine supply, and communications. Conclusions: Polio outbreak simulation exercises can be valuable tools to help maintain polio-free status and should be extended to other high-risk countries and subnational areas in the HoA Region and elsewhere. There is also need to standardize the process and methods for conducting POSE for comparability.
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- 2021
16. 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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17. Financial cost analysis of a strategy to improve the quality of administrative vaccination data in Uganda
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Sarah Wood Pallas, Kirsten Ward, David Matseketse, Anita E. Heywood, Henry Luzze, Carol Kyozira, Anthony T. Newall, Annet Kisakye, Peter B. Bloland, Adam MacNeil, and Kevin Mugenyi
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Opportunity cost ,Total cost ,030231 tropical medicine ,03 medical and health sciences ,0302 clinical medicine ,Health facility ,Humans ,Uganda ,030212 general & internal medicine ,Finance ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Immunization Programs ,Vaccination ,Public Health, Environmental and Occupational Health ,Capacity building ,Workforce development ,Data Accuracy ,Infectious Diseases ,Cost driver ,Data quality ,Workforce ,Costs and Cost Analysis ,Molecular Medicine ,Health Facilities ,business - Abstract
Background High-quality vaccination data are critical to planning, implementation and evaluation of immunization programs. However, sub-optimal administrative vaccination data quality in low- and middle-income countries persist for heterogeneous reasons, though most relate to organizational factors and human behavior. The nationwide Data Improvement Team (DIT) strategy in Uganda aimed to strengthen human resource capacity to generate quality administrative vaccination data at the health facility. Methods A financial cost analysis of the Uganda DIT strategy (2014–2016) was conducted from the program funder perspective. Activity-based micro-costing from funder financial and program monitoring records was used to estimate total and unit costs by program area (in 2016 US dollars). Hypothetical scenarios were developed to illustrate potential approaches to reducing costs. Results Over 25 months the DIT strategy was implemented in all 116 operational districts and 3443 (89%) health facilities in Uganda at a total financial cost of US $575 275. Training and deployment of DITs accounted for the highest proportion of expenditure across program areas (69%). Transport, per diems, lodging, and honoraria for DIT members and national supervisors were the main cost drivers of the strategy. Deployment of 557 DIT members cost US $839 per DIT member, US $4 030 per district, and US $136 per health facility. The estimated opportunity cost of government staff time wasn’t a major cost driver (2.5%) of total cost. Conclusion The results provide the first estimates of the magnitude and drivers of cost to implement a national workforce capacity building strategy to improve administrative vaccination data quality in a low- or middle-income country. Financial costs are a critical input to combine with future outcome data to describe the cost of strategies relative to performance outcomes. The operational costs of the strategy were modest (0.5–1.6%) relative to the estimated operational costs of Uganda’s national immunization program.
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- 2019
18. Descriptive epidemiology of rubella disease and associated virus strains in Uganda
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Charles Byabamazima, Suganthi Suppiah, Prossy Namuwulya, Theopista Kabaliisa, Mayi Tibanagwa, Barnabas Bakamutumaho, Proscovia Kakooza, Andrew Bakainaga, Josephine Bwogi, Ronald Seguya, Phionah Tushabe, James P. Eliku, Emily Abernathy, Immaculate Ampaire, Henry Bukenya, Molly Birungi, Annet Kisakye, and Joseph P. Icenogle
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Male ,Adolescent ,Genotype ,medicine.disease_cause ,Antibodies, Viral ,Measles ,Rubella ,Disease Outbreaks ,03 medical and health sciences ,0302 clinical medicine ,Cost of Illness ,Pregnancy ,Virology ,medicine ,Seroprevalence ,Humans ,Rubella Vaccine ,Uganda ,030212 general & internal medicine ,Child ,Phylogeny ,Research Articles ,Congenital rubella syndrome ,business.industry ,Incidence (epidemiology) ,Incidence ,congenital rubella syndrome ,Outbreak ,Rubella virus ,medicine.disease ,vaccination ,Vaccination ,Infectious Diseases ,Immunoglobulin M ,Child, Preschool ,030211 gastroenterology & hepatology ,Female ,business ,Research Article - Abstract
Rubella virus causes a mild disease; however, infection during the first trimester of pregnancy may lead to congenital rubella syndrome (CRS) in over 80% of affected pregnancies. Vaccination is recommended and has been shown to effectively reduce CRS incidence. Uganda plans to introduce routine rubella vaccination in 2019. The World Health Organization recommends assessing the disease burden and obtaining the baseline molecular virological data before vaccine introduction. Sera collected during case‐based measles surveillance from January 2005 to July 2018 were tested for rubella immunoglobulin M (IgM) antibodies. Sera from confirmed rubella outbreaks from January 2012 to August 2017 were screened using real‐time reverse‐transcription polymerase chain reaction (RT‐PCR); for positive samples, a region within the E1 glycoprotein coding region was amplified and sequenced. Of the 23 196 suspected measles cases serologically tested in parallel for measles and rubella, 5334 (23%) were rubella IgM‐positive of which 2710 (50.8%) cases were females with 2609 (96.3%) below 15 years of age. Rubella IgM‐positive cases were distributed throughout the country and the highest number was detected in April, August, and November. Eighteen (18%) of the 100 sera screened were real‐time RT‐PCR‐positive of which eight (44.4%) were successfully sequenced and genotypes 1G and 2B were identified. This study reports on the seroprevalence and molecular epidemiology of rubella. Increased knowledge of former and current rubella viruses circulating in Uganda will enhance efforts to monitor the impact of vaccination as Uganda moves toward control and elimination of rubella and CRS.
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- 2019
19. Barriers to effective uptake and provision of immunization in a rural district in Uganda
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Malande, Oliver Ombeva, primary, Munube, Deogratias, additional, Afaayo, Rachel Nakatugga, additional, Annet, Kisakye, additional, Bodo, Bongomin, additional, Bakainaga, Andrew, additional, Ayebare, Elizabeth, additional, Njunwamukama, Sam, additional, Mworozi, Edison Arwanire, additional, and Musyoki, Andrew Munyalo, additional
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- 2019
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20. Enhancing Workforce Capacity to Improve Vaccination Data Quality, Uganda
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Amalia Benke, Adam MacNeil, Peter B. Bloland, Annet Kisakye, Henry Luzze, Ampeire Immaculate, Kirsten Ward, Kevin Mugenyi, Patricia Tanifum, and Carol Kyozira
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workforce development ,Microbiology (medical) ,Program evaluation ,Epidemiology ,Data management ,lcsh:Medicine ,immunization ,information systems ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,0302 clinical medicine ,Health facility ,Nursing ,Health care ,data quality ,Uganda ,lcsh:RC109-216 ,Operations management ,030212 general & internal medicine ,global health security ,Data collection ,business.industry ,Research ,030503 health policy & services ,lcsh:R ,program evaluation ,Enhancing Workforce Capacity to Improve Vaccination Data Quality, Uganda ,vaccines ,vaccination ,Workforce development ,Infectious Diseases ,Data quality ,Workforce ,Business ,0305 other medical science - 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
21. Vaccine associated paralytic poliomyelitis cases from children presenting with acute flaccid paralysis in Uganda
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Mary Bridget Nanteza, Josephine Bwogi, Martin O. C. Ota, Nicksy Gumede, and Annet Kisakye
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Acute flaccid paralysis ,business.industry ,Retrospective cohort study ,medicine.disease ,complex mixtures ,Virology ,Poliomyelitis ,Infectious Diseases ,Immunization ,Paralysis ,Medicine ,medicine.symptom ,business ,Poliovirus type ,Vaccine-Associated Paralytic Poliomyelitis ,Birth cohort - Abstract
A retrospective study to identify VAPP cases from the entire Uganda was conducted between January 2003 and December 2011. Eleven of the 106 AFP cases were VAPPs. The VAPP rate ranged from 0 to 3.39 cases per 1,000,000 birth cohorts and the peak was in 2009 when there was scaling up of OPV immunization activities following an importation of wild poliovirus in the country. All the subsequent polio suspect cases since then have been vaccine-associated polio cases. Our data support the strategy to withdraw OPV and introduce IPV progressively in order to mitigate against the paralysis arising from Sabin polioviruses.
- Published
- 2015
22. Rotavirus Prevalence and Genotypes Among Children Younger Than 5 Years With Acute Diarrhea at Mulago National Referral Hospital, Kampala, Uganda
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M. Jeffrey Mphahlele, Annet Kisakye, Luyanda M. Seheri, Esther Nalumansi, Amos Odiit, Jason M. Mwenda, and Augustine Mulindwa
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Male ,Rotavirus ,Microbiology (medical) ,Pediatrics ,medicine.medical_specialty ,Reoviridae ,medicine.disease_cause ,Rotavirus Infections ,Public health surveillance ,Epidemiology ,Prevalence ,Humans ,Medicine ,Uganda ,Genotyping ,biology ,business.industry ,Infant, Newborn ,Infant ,biology.organism_classification ,Rotavirus vaccine ,Hospitalization ,Diarrhea ,Infectious Diseases ,El Niño ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,medicine.symptom ,business ,Sentinel Surveillance - Abstract
Background: Rotavirus is the most common cause of severe diarrhea among children
- Published
- 2014
23. 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
- Published
- 2016
24. Possible Interruption of Measles Virus Transmission, Uganda, 2006–2009
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Annet Kisakye, Frederick N. Baliraine, Henry Bukenya, Josephine Bwogi, Ronald Seguya, Theopista Kabaliisa, Sheilagh B. Smit, and William B. Mbabazi
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Microbiology (medical) ,interruption ,Adolescent ,Genotype ,Epidemiology ,Measles virus genotype ,Measles Vaccine ,lcsh:Medicine ,Urine ,Measles ,lcsh:Infectious and parasitic diseases ,Measles virus ,parasitic diseases ,Humans ,measles ,Medicine ,viruses ,Uganda ,lcsh:RC109-216 ,Child ,biology ,business.industry ,Transmission (medicine) ,Vaccination ,lcsh:R ,Infant ,dispatch ,medicine.disease ,biology.organism_classification ,Virology ,Infectious Diseases ,Child, Preschool ,Population Surveillance ,Pharynx ,Measles vaccine ,genotype B3.1 ,business - 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
25. Burden and Epidemiology of Rotavirus Diarrhea in Selected African Countries: Preliminary Results from the African Rotavirus Surveillance Network
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Kinkela Mina Ntoto, Nicola Page, Nicholas M. Kiulia, Annet Kisakye, Evans M. Mpabalwani, Marc-Alain Widdowson, Isoro Pazvakavambwa, L.M. Seheri, Almaz Abebe, George E. Armah, Jason M. Mwenda, Christabel Enweronu-Laryea, Ismail Amina, Jackson Mchomvu, and A. Duncan Steele
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Diarrhea ,medicine.medical_specialty ,Pediatrics ,Time Factors ,Reoviridae ,Rotavirus Infections ,medicine.disease_cause ,Rotavirus disease ,fluids and secretions ,Rotavirus ,Epidemiology ,medicine ,Humans ,Immunology and Allergy ,Severe diarrhea ,Africa South of the Sahara ,biology ,business.industry ,Public health ,Infant ,biology.organism_classification ,Virology ,Infectious Diseases ,Child, Preschool ,Population Surveillance ,Diarrhea, Infantile ,Seasons ,medicine.symptom ,business - Abstract
Severe rotavirus diarrhea in children
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- 2010
26. Achieving measles control: lessons from the 2002-06 measles control strategy for Uganda
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William B. Mbabazi, Miriam Nanyunja, Eva Kabwongera, Annet Kisakye, Frederick N. Baliraine, Josephine Bwogi, Possy Mugyenyi, Rosamund F. Lewis, Fiona Braka, and Issa Makumbi
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Adolescent ,Population ,Health Promotion ,Measles ,Measles virus ,Environmental health ,medicine ,Humans ,Uganda ,Child ,education ,education.field_of_study ,biology ,Immunization Programs ,Transmission (medicine) ,business.industry ,Health Policy ,Incidence (epidemiology) ,Infant ,biology.organism_classification ,medicine.disease ,Vaccination ,Databases as Topic ,Immunization ,Child, Preschool ,Population Surveillance ,Organizational Case Studies ,Immunology ,Measles vaccine ,business - Abstract
BACKGROUND The 2002-06 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 (D(10)) 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.
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- 2009
27. Surveillance forStreptococcus pneumoniaeMeningitis in Children Aged <5 Years: Implications for Immunization in Uganda
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Bradford D. Gessner, Issa Makumbi, Denis Nansera, Duku Chaplain, Fiona Braka, Annet Kisakye, Esther Nalumansi, Rosamund F. Lewis, William B. Mbabazi, and Eric Wobudeya
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Microbiology (medical) ,Pediatrics ,medicine.medical_specialty ,Population ,Microbial Sensitivity Tests ,medicine.disease_cause ,Pneumococcal conjugate vaccine ,Pneumococcal Vaccines ,Case fatality rate ,Streptococcus pneumoniae ,medicine ,Humans ,Uganda ,Serotyping ,education ,education.field_of_study ,Meningitis, Pneumococcal ,business.industry ,Incidence ,Incidence (epidemiology) ,Infant, Newborn ,Infant ,medicine.disease ,Virology ,Anti-Bacterial Agents ,Bacterial Typing Techniques ,Vaccination ,Infectious Diseases ,Pneumococcal vaccine ,Child, Preschool ,business ,Meningitis ,medicine.drug - Abstract
Affordable pneumococcal conjugate vaccines will soon become available to developing countries through the Global Alliance for Vaccines and Immunization. Data on Streptococcus pneumoniae meningitis epidemiology in Uganda will assist decision makers in determining the best national vaccine policy. We reviewed acute bacterial meningitis surveillance data for children aged
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- 2009
28. Positive predictive value and effectiveness of measles case-based surveillance in Uganda, 2012-2015
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Immaculate Ampaire, Annet Kisakye, Fred Nsubuga, Simon Kasasa, and Henry Luzze
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RNA viruses ,Male ,Viral Diseases ,Pediatrics ,Research Facilities ,Epidemiology ,lcsh:Medicine ,Pathology and Laboratory Medicine ,Antibodies, Viral ,Disease Outbreaks ,Geographical Locations ,0302 clinical medicine ,Medicine and Health Sciences ,Uganda ,030212 general & internal medicine ,lcsh:Science ,Disease surveillance ,Multidisciplinary ,biology ,Predictive value ,Infectious Diseases ,Serology ,Medical Microbiology ,Viral Pathogens ,Population Surveillance ,Viruses ,Female ,Vaccine-preventable diseases ,Pathogens ,Research Laboratories ,0305 other medical science ,Research Article ,medicine.medical_specialty ,Surveillance data ,Infectious Disease Control ,Measles Virus ,Disease Surveillance ,Research and Analysis Methods ,Microbiology ,History, 21st Century ,Sensitivity and Specificity ,Measles ,Measles virus ,03 medical and health sciences ,medicine ,Humans ,Microbial Pathogens ,030505 public health ,Biology and life sciences ,business.industry ,lcsh:R ,Health Services Administration and Management ,Organisms ,biology.organism_classification ,medicine.disease ,Virology ,Health Care ,Specific igm ,Immunoglobulin M ,Immunization ,Infectious Disease Surveillance ,People and Places ,Africa ,Paramyxoviruses ,lcsh:Q ,business ,Government Laboratories - Abstract
Introduction 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. Methods 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. Results 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%. Conclusion 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
29. Projected health benefits and costs of pneumococcal and rotavirus vaccination in Uganda
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Fiona Braka, Amos Odiit, Jacqueline E. Tate, Prosper Mugyenyi, Diana Kizza, and Annet Kisakye
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medicine.medical_specialty ,Cost effectiveness ,Cost-Benefit Analysis ,medicine.disease_cause ,Pneumococcal Infections ,Rotavirus Infections ,Pneumococcal Vaccines ,Rotavirus ,Environmental health ,Medicine ,Humans ,Uganda ,health care economics and organizations ,Disease burden ,Models, Statistical ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Public health ,Vaccination ,Public Health, Environmental and Occupational Health ,Rotavirus Vaccines ,Infant ,medicine.disease ,Virology ,Rotavirus vaccine ,Pneumococcal infections ,Infectious Diseases ,Pneumococcal vaccine ,Child, Preschool ,Molecular Medicine ,business - Abstract
We determined impact and cost-effectiveness of pneumococcal and rotavirus vaccination programs among children
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- 2010
30. Action for child survival: elimination of Haemophilus influenzae type b meningitis in Uganda
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Annet Kisakye, Issa Makumbi, Rosamund F. Lewis, John Bosco Odipio, Denis Nansera, Fiona Braka, Addy Kekitiinwa, Chaplain Duku, Bradford D. Gessner, and Robert Iriso
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Pediatrics ,medicine.medical_specialty ,Population ,complex mixtures ,medicine ,Pneumonia, Bacterial ,Humans ,Uganda ,education ,Bacterial Capsules ,Meningitis, Haemophilus ,Haemophilus Vaccines ,education.field_of_study ,business.industry ,Immunization Programs ,Incidence (epidemiology) ,Public health ,Research ,Public Health, Environmental and Occupational Health ,Haemophilus influenzae type b ,Infant, Newborn ,Infant ,medicine.disease ,Pneumonia ,Immunization ,Hib vaccine ,Child, Preschool ,Population Surveillance ,Tropical medicine ,bacteria ,business ,Meningitis - 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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- 2007
31. 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, primary, Max, Irama, additional, Annet, Kisakye, additional, and Gessner, Bradford D, additional
- Published
- 2011
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32. 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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