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Hepatitis E in Karamoja, Uganda, 2009–2012: epidemiology and challenges to control in a setting of semi-nomadic pastoralism
- Source :
- Transactions of The Royal Society of Tropical Medicine and Hygiene. 108:648-655
- Publication Year :
- 2014
- Publisher :
- Oxford University Press (OUP), 2014.
-
Abstract
- BACKGROUND A prolonged hepatitis E outbreak occurred between 2009 and 2012 among a semi-nomadic pastoralist population in the Karamoja region of Uganda. As data on the public health problems of nomadic pastoralists in sub-Saharan Africa is limited, we sought to characterize the epidemiology and challenges to control of hepatitis E in such a setting. METHODS A retrospective case-series investigation was undertaken. Surveillance line-lists of suspected hepatitis E cases maintained during the outbreak were analyzed. Standardized interviews and focus group discussions were conducted with key informants involved in outbreak control activities. RESULTS Between August 2009 and September 2012, 987 hepatitis E cases with individual case-based data were identified. Of 22 total deaths, almost half occurred during the first 4 months of the outbreak. Infection attack rates were higher among males and young adults. The average time between onset of jaundice and presentation was approximately 1 week. Challenges to control were related to persistent consumption of untreated water, poor sanitation infrastructure, remote geography, nomadic movement and civil insecurity. CONCLUSIONS The hepatitis E outbreak in Karamoja highlights the emergence of sanitation and hygiene-related disease among semi-nomadic pastoralist populations. Improving sanitation and safe water access and extending health education programs to remote pastoralist communities is crucial to prevent such diseases from becoming endemic.
- Subjects :
- Adult
Male
medicine.medical_specialty
Veterinary medicine
Sanitation
Pastoralism
Population
Nomadic pastoralism
Disease Outbreaks
Young Adult
Age Distribution
Environmental health
Epidemiology
medicine
Humans
Uganda
Sex Distribution
Child
education
Aged
Retrospective Studies
Transients and Migrants
education.field_of_study
business.industry
Incidence
Public health
Public Health, Environmental and Occupational Health
Disease Management
Infant
Outbreak
Hygiene
General Medicine
Focus Groups
Middle Aged
Hepatitis E
medicine.disease
Infectious Diseases
Child, Preschool
Population Surveillance
Female
Parasitology
business
Subjects
Details
- ISSN :
- 18783503 and 00359203
- Volume :
- 108
- Database :
- OpenAIRE
- Journal :
- Transactions of The Royal Society of Tropical Medicine and Hygiene
- Accession number :
- edsair.doi.dedup.....9ca37cd0361ccfbe319669f8911ff9b4