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Introduction:in the recent past, cities in sub-Saharan Africa have reported serious cholera outbreaks that last for several months. Uganda is one of the African countries where cities are prone to cholera outbreaks. Studies on cholera in Bangladesh show increased risk of cholera for the immediate household members (contacts) yet the control interventions mainly target cases with little or no focus on contacts. This study aimed to describe the rapid control of cholera outbreaks in Kampala and Mbale cities, Uganda, using, “Cases and Contacts Centered Strategy (3CS)” that consisted of identification and treatment of cases, promotion of safe water, sanitation, hygiene (WaSH) and selective chemoprophylaxis for the contacts. Methods:a cross-sectional study was conducted in 2015-2016 in the Kampala and Mbale cities during cholera outbreaks. Cholera cases were treated and 816 contacts from 188 households were listed and given cholera preventive packages. Data were collected, cleaned, analysed and stored in spreadsheet. Comparison of categories was done using Chi-Square test. Results:a total of 58 and 41 confirmed cholera cases out of 318 and 153 suspected cases were recorded in Kampala and Mbale cities respectively. The outbreaks lasted for 41 days in both cities. Case fatality rates were high; 12.1% (5/41) for Mbale city and 1.7% (1/58) for Kampala city. Fifty-five percent (210/379) of stool samples were tested by culture to confirmV. choleraeO1. No contacts listed and given cholera preventive package developed cholera. Both sexes and all age groups were affected. In Kampala city, the males were more affected than the females in the age groups less than 14 years, p-value of 0.0097. Conclusion:this study showed that by implementing 3CS, it was possible to rapidly control cholera outbreaks in Kampala and Mbale cities and no cholera cases were reported amongst the listed household contacts. The findings on 3CS and specifically, selective antibiotic chemoprophylaxis for cholera prevention, could be used in similar manner to oral cholera vaccines to complement the core cholera control interventions (disease surveillance, treatment of cases and WaSH). However, studies are needed to guide such rollout and to understand the age-sex differences in Kampala city.

Introduction : maternal-ill-health is common after delivery, and yet there is scanty information on postpartum morbidity. This problem is more prevalent in developing countries but, its importance has not been extensively recognized. Maternal morbidity increases the risk of death among affected women and also have the potential to cause long-term disabilities with consequences of poor quality of life of the mother and child. This study determined the magnitude and determinants of postpartum maternal morbidity among women in Mbale district. Methods : this was a cross-sectional study carried out between July and September 2015, data was collected from June to July among 474 randomly selected postpartum women of reproductive age who had delivered within 3 to 42 days before the survey. Structured questionnaires were used for data collection. The primary outcome of interest was presence of any of the four pre-selected postpartum morbidities (Postpartum hemorrhage, painful perineum, puerperal sepsis and fistula). For univariable analysis, frequencies and proportions were generated to describe key variables. Bivariable analysis was performed to identify factors associated with the outcome. Multivariable logistic regression was performed to adjust for potential confounding. Odds ratios and their corresponding 95% confidence interval were used to measure the strength of the associations. Results : about half (46.5%) of study participants had attained secondary education, majority (88.2%) were married and 66.4% were house wives. The prevalence of postpartum morbidity was 52.5%. The most common morbidity was hemorrhage (27.1%) and the least common was fistula (7.3%). The factors significantly associated with postpartum maternal morbidity delivering from home (AOR=2.7, CI 1.4-5.9), parity of 3 or more children (AOR=2.3, CI 1.3-4.0) and postnatal care attendance of 3 or more times (OR=1.7, CI-1.0-2.81). Conclusion : there is a high prevalence of postpartum morbidity in the district. The district health authorities should plan and prioritize postpartum maternal health and design interventions to prevent postpartum morbidity among women in the district.