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Article ; Online: The Ebola outbreak in West Africa

Peter Nsubuga

The Pan African Medical Journal, Vol 19, Iss

a story of related public health challenges and a pointer to solutions to mitigate the inevitable next outbreak

2014 Volume 48

Abstract: The current Ebola outbreak in West Africa has the world once again gripped by the threat of a zoonotic disease that has spread into several countries. While the underlying factors that have led to an increasing frequency of zoonotic disease outbreaks are ...

Abstract	The current Ebola outbreak in West Africa has the world once again gripped by the threat of a zoonotic disease that has spread into several countries. While the underlying factors that have led to an increasing frequency of zoonotic disease outbreaks are complex, including population pressure and rapid movement between locations in most of these epidemicsthere are least three related key driversa challenge of initial detection and appropriate investigation and response to a cluster of suspected cases, a challenge of management of an outbreak of a communicable disease, and a challenge of prediction or anticipation of what disease outbreak (both communicable and non-communicable) could come next (or is currently occurring but unseen). These three challenges reveal the urgent need of a public health workforce that is adequately trained and supported to operate multi-disease public health surveillance and response systems. Guinea, Sierra Leone, and Liberia do not yet have specific programs to develop this workforce and the system to support them while Nigeria does (and several other countries do), and this difference is critical in addressing the major public heath challenge posed by the current Ebola outbreak as well as a myriad of communicable and non-communicable diseases. We will take a look at each of the three challenges in turn.
Keywords	ebola ; public health ; systems ; workforce ; Medicine ; R
Subject code	306
Language	English
Publishing date	2014-09-01T00:00:00Z
Publisher	The Pan African Medical Journal
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The challenges of getting the research published when English is not the first language

Cynthia Semá Baltazar / Caroline Wheatley / Peter Nsubuga

The Pan African Medical Journal, Vol 33, Iss

the example of Mozambique Field Epidemiology Training Program

2019 Volume 208

Abstract: The Mozambican Field Epidemiology and Laboratory Training Program (Moz-FELTP) is a two-year, competency-based post-graduate training and service program designed to build sustainable public health capacity in applied epidemiology. Despite the efforts, ... ...

Abstract	The Mozambican Field Epidemiology and Laboratory Training Program (Moz-FELTP) is a two-year, competency-based post-graduate training and service program designed to build sustainable public health capacity in applied epidemiology. Despite the efforts, Moz-FELTP residents have historically difficulty to publishing their work for a variety of reasons that includes language barriers, lack of writing skills and motivation, limited budgetary support and lack of effective mentorship. This outline the need for different approaches to continuous improving the publication, such scientific writing mentorship for non-English FELTP residents.
Keywords	challenges ; published ; non-english ; mozambique ; Medicine ; R
Language	English
Publishing date	2019-07-01T00:00:00Z
Publisher	The Pan African Medical Journal
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The contribution of the polio eradication initiative on the operations and outcomes of non-polio public health programs

Peter Nsubuga / Ben Masiira / Luka Ibrahim / Nestor Ndakala / Norbert Dongmo

The Pan African Medical Journal, Vol 31, Iss

a survey of programs in the African region

2018 Volume 207

Abstract: INTRODUCTION: The effect of the Global polio eradication initiative (PEI) on public health programs beyond polio is widely debated. PEI contribution to other health programs has been assessed from the perspective of polio-funded personnel, which may ... ...

Abstract	INTRODUCTION: The effect of the Global polio eradication initiative (PEI) on public health programs beyond polio is widely debated. PEI contribution to other health programs has been assessed from the perspective of polio-funded personnel, which may introduce bias as PEI staff are probably more likely to show that they have benefited of other programs. We set out to identify and document how public health programs have benefitted from the public health capacity that was provided at the country level as part of the PEI program in a systematic and standardized manner. METHODS: Between July and November 2017, we conducted a mixed-methods cross-sectional study, which combined two methods: a multi-country quantitative survey and a qualitative study. We created a self-administered electronic multi-lingual questionnaire in English, French and Portuguese. The qualitative study, which followed an interim analysis of the quantitative survey, comprised interviews with national and subnational level staff in a few countries. RESULTS: A total of 127 public health workers from 43 of the 47 countries in the African WHO Region responded online. Most of the respondents 56/127 (42.7%) belonged to the immunization sector and 51/127 (38.9%) belonged to the emergencies and outbreaks sector. Respondents who identified themselves with the immunization (50/64 (78%)) and maternal health program (64/82 (78%)) reported the highest level of greatly benefiting from PEI resources. A total of 78/103 (76%) respondents rated PEI�s contribution data management system to their program very high and high. Of the 127 respondents, the majority 91 (71.6%) reported that the withdrawal of PEI resources would result in a weakening of surveillance for other diseases; 88 (62.9%) reported that there would be inadequate resources to carry out planned activities and 80 (62.9%) reported that there would be poor logistics and transport for implementation of activities. Cameroon, DRC, Nigeria and Uganda participated in the qualitative study. Each country had ...
Keywords	polio eradication ; public health programs ; african region ; Medicine ; R
Subject code	360 ; 027
Language	English
Publishing date	2018-11-01T00:00:00Z
Publisher	The Pan African Medical Journal
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Evaluation of the Ebola Virus Disease (EVD) preparedness and readiness program in Uganda

Peter Nsubuga / Ben Masiira / Christine Kihembo / Jayne Byakika-Tusiime / Caroline Ryan / Miriam Nanyunja / Raoul Kamadjeu / Ambrose Talisuna

The Pan African Medical Journal, Vol 38, Iss

2018 to 2019

2021 Volume 130

Abstract: INTRODUCTION: The Democratic Republic of Congo (DRC) declared its 10th outbreak of ebola virus disease (EVD) in 42 years on August 1st 2018. The rapid rise and spread of the EVD outbreak threatened health security in neighboring countries and global ... ...

Abstract	INTRODUCTION: The Democratic Republic of Congo (DRC) declared its 10th outbreak of ebola virus disease (EVD) in 42 years on August 1st 2018. The rapid rise and spread of the EVD outbreak threatened health security in neighboring countries and global health security. The United Nations developed an EVD preparedness and readiness (EVD-PR) plan to assist the nine neighboring countries to advance their critical preparedness measures. In Uganda, EVD-PR was implemented between 2018 and 2019. The World Health Organization commissioned an independent evaluation to assess the impact of the investment in EVD-PR in Uganda. Objectives: i) to document the program achievements; ii) to determine if the capacities developed represented good value for the funds and resources invested; iii) to assess if more cost-effective or sustainable alternative approaches were available; iv) to explore if the investments were aligned with country public health priorities; and v) to document the factors that contributed to the program success or failure. METHODS: during the EVD preparedness phase, Uganda´s government conducted a risk assessment and divided the districts into three categories, based on the potential risk of EVD. Category I included districts that shared a border with the DRC provinces where EVD was ongoing or any other district with a direct transport route to the DRC. Category II were districts that shared a border with the DRC but not bordering the DRC provinces affected by the EVD outbreak. Category III was the remaining districts in Uganda. EVD-PR was implemented at the national level and in 22 category I districts. We interviewed key informants involved in program design, planning and implementation or monitoring at the national level and in five purposively selected category I districts. RESULTS: ebola virus disease preparedness and readiness was a success and this was attributed mainly to donor support, the ministry of health´s technical capacity, good coordination, government support and community involvement. The ...
Keywords	ebola virus disease ; evaluation ; uganda ; Medicine ; R
Subject code	320
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	The Pan African Medical Journal
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Influenza preparedness and response

Nykiconia Preacely / Peter Nsubuga

The Pan African Medical Journal, Vol 10, Iss

Involvement of African Field Epidemiology and Laboratory Training Programs, 2009

2011 Volume 11

Abstract: st pandemic preparedness and response exercise, five (83%) of them were influenza specific. CONCLUSION: FELTPs played an important role in H1N1 surveillance and response in sub-Saharan Africa. Continued technical assistance and support to these programs ... ...

Abstract	st pandemic preparedness and response exercise, five (83%) of them were influenza specific. CONCLUSION: FELTPs played an important role in H1N1 surveillance and response in sub-Saharan Africa. Continued technical assistance and support to these programs is vital to foster their capacity to monitor and control public health threats.
Keywords	Influenza ; FELTP ; surveillance ; preparedness ; response ; H1N1 ; pandemic ; field epidemiology ; Medicine ; R
Language	English
Publishing date	2011-09-01T00:00:00Z
Publisher	The Pan African Medical Journal
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A case-control study of factors associated with caesarean sections at health facilities in Kabarole District, Western Uganda, 2016

Jacinta Dusabe / Joseph Akuze / Angela Nakanwagi Kisakye / Benon Kwesiga / Peter Nsubuga / Elizabeth Ekirapa

The Pan African Medical Journal, Vol 29, Iss

2018 Volume 179

Abstract: INTRODUCTION: World Health Organization estimates that the appropriate caesarean section rates should range from 10% to 15% at the population level. There is limited access and utilisation of caesarean section services in Uganda. This case-control study ... ...

Abstract	INTRODUCTION: World Health Organization estimates that the appropriate caesarean section rates should range from 10% to 15% at the population level. There is limited access and utilisation of caesarean section services in Uganda. This case-control study explored factors associated with caesarean section delivery, focusing on service-related and individual level factors.
Keywords	caesarean section ; determinants ; case-control ; western uganda ; Medicine ; R
Language	English
Publishing date	2018-03-01T00:00:00Z
Publisher	The Pan African Medical Journal
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Level and factors associated with uptake of Human papillomavirus infection vaccine among female adolescents in Lira District, Uganda

Esther Kisaakye / Justine Namakula / Christine Kihembo / Angela Kisakye / Peter Nsubuga / Juliet Ndimwibo Babirye

The Pan African Medical Journal, Vol 31, Iss

2018 Volume 184

Abstract: INTRODUCTION: The principal burden of human papillomavirus (HPV) infections is cervical cancer. Cervical cancer ranks as the fourth most common malignancy in women affecting 500,000 women each year with an estimated 266,000 deaths. Uganda has one of the ... ...

Abstract	INTRODUCTION: The principal burden of human papillomavirus (HPV) infections is cervical cancer. Cervical cancer ranks as the fourth most common malignancy in women affecting 500,000 women each year with an estimated 266,000 deaths. Uganda has one of the highest cervical cancer incidence rates globally with an age-standardised incidence rate per 100,000 of 47.5. This study assessed the level and the factors associated with uptake of HPV vaccine by female adolescents in Lira district, Uganda. METHODS: A mixed methods approach was employed using a survey among 460 female adolescents. We collected data using an interviewer-administered questionnaire. We interviewed five key informants and conducted ten in-depth interviews. Uptake was defined as completing three doses of the vaccine as per the recommended schedule. Prevalence risk ratios were used as measures of association and were computed using modified poison regression. Content analysis was used for qualitative data. RESULTS: The mean age of the respondents was 13.97 (SD=1.24). Uptake was at 17.61% (81/460). The factors associated with uptake of HPV vaccine were: attaining ordinary level of education (aPR 1.48, 95%CI 1.11,1.97), positive attitude towards the vaccine (aPR 3.46, 95%CI 1.70,7.02), receiving vaccine doses from different vaccination sites (aPR 1.59, 95% CI 1.10,2.28) and encouragement from a health worker (aPR 1.55, 95%CI 1.15,2.11) or Village Health Team (aPR 3.47, 95%CI 1.50,8.02) to go for the vaccine. Other facors associated with uptake of HPV vaccine included; the existence of community outreaches (aPR 1.47, 95%CI 1.02,2.12), availability of vaccines at vaccination sites (aPR 4.84, 95%CI 2.90,8.08) and receiving full information about the vaccine at the vaccination site (aPR 1.90, 95%CI 1.26,2.85). CONCLUSION: HPV vaccine uptake was low in Lira district. Efforts to improve uptake of HPV vaccine should focus on ensuring a consistent supply of vaccines at the vaccination sites, health education aimed at creating a positive attitude towards the ...
Keywords	human papillomavirus vaccine ; uptake ; adolescents ; sub-saharan africa ; developing countries ; Medicine ; R
Language	English
Publishing date	2018-11-01T00:00:00Z
Publisher	The Pan African Medical Journal
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Factors associated with Schistosomiasis outbreak at Omindamba primary school, Omusati region, Namibia

Uzenia Ndatelela Mupakeleni / Kofi Mensah Nyarko / Francina Ananias / Peter Nsubuga / Emmy-Else Ndevaetela

The Pan African Medical Journal, Vol 28, Iss

a case-control study, March 2016

2017 Volume 212

Abstract: INTRODUCTION: On March 2, 2016, the principal of Omindamba primary school in Outapi district notified the Outapi hospital of a cluster of students complaining of dysuria and passing bloody urine. We conducted an investigation to identify the agent, ... ...

Abstract	INTRODUCTION: On March 2, 2016, the principal of Omindamba primary school in Outapi district notified the Outapi hospital of a cluster of students complaining of dysuria and passing bloody urine. We conducted an investigation to identify the agent, source of infection, and to determine factors associated with the outbreak. METHODS: An unmatched 1:1 case-control study was conducted. A case was defined as any student of Omindamba primary school, who passed bloody urine with or without dysuria or lower abdominal pains from 2nd- 4th March 2016, during the time of the investigation. A control was a classmate of a case. We collected demographic, clinical and environmental data. RESULTS: 125 cases and 125 controls were enrolled into the study. The mean age for cases was 11.3 years and controls was 11.0 years, with standard deviation of 3.2 years in both cases and controls. The most affected age group was 11-15 years with 63 (50.4%) cases, followed by 6-10 years with 51(40.8%) cases. Schistosoma hematobium was isolated in the urine specimens examined. Swimming in the canal (adjusted OR=3.58; 95% CI=1.14-11.2; p-value=0.03), and using Etaka pond as a source of water (adjusted OR=1.95; 95% CI=1.09-3.50, p-value=0.02) were independent factors associated with contracting schistosomiasis. CONCLUSION: The Schistosomiasis outbreak among the school children was caused by Schistosoma hematobium. Swimming in the canal and using Etaka pond as a source of drinking water were the predictive factors for the infection. A community-based health education on the prevention of Schistosomiasis was implemented.
Keywords	schistosomiasis outbreak ; schistosoma hematobium ; omusati region ; namibia ; case-control study ; Medicine ; R
Subject code	370
Language	English
Publishing date	2017-11-01T00:00:00Z
Publisher	The Pan African Medical Journal
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effects and factors associated with indoor residual spraying with Actellic 300 CS on malaria morbidity in Lira District, Northern Uganda

Abdulaziz Tugume / Fiston Muneza / Frederick Oporia / Arthur Kiconco / Christine Kihembo / Angela Nakanwagi Kisakye / Peter Nsubuga / Sekimpi Deogratias / Adoke Yeka

Malaria Journal, Vol 18, Iss 1, Pp 1-

2019 Volume 10

Abstract: Abstract Background Indoor residual spraying (IRS) with Actellic 300 CS was conducted in Lira District between July and August 2016. No formal assessment has been conducted to estimate the effect of spraying with Actellic 300 CS on malaria morbidity in ... ...

Abstract	Abstract Background Indoor residual spraying (IRS) with Actellic 300 CS was conducted in Lira District between July and August 2016. No formal assessment has been conducted to estimate the effect of spraying with Actellic 300 CS on malaria morbidity in the Ugandan settings. This study assessed malaria morbidity trends before and after IRS with Actellic 300 CS in Lira District in Northern Uganda. Methods The study employed a mixed methods design. Malaria morbidity records from four health facilities were reviewed, focusing on 6 months before and after the IRS intervention. The outcome of interest was malaria morbidity defined as; proportion of outpatient attendance due to total malaria, proportion of outpatient attendance due to confirmed malaria and proportion of malaria case numbers confirmed by microscopy or rapid diagnostic test. Since malaria morbidity was based on count data, an ordinary Poisson regression model was used to obtain percentage point change (pp) in monthly malaria cases before and after IRS. A household survey was also conducted in 159 households to determine IRS coverage and factors associated with spraying. A modified Poisson regression model was fitted to determine factors associated with household spray status. Results The proportion of outpatient attendance due to malaria dropped from 18.7% before spraying to 15.1% after IRS. The proportion of outpatient attendance due to confirmed malaria also dropped from 5.1% before spraying to 4.0% after the IRS intervention. There was a decreasing trend in malaria test positivity rate (TPR) for every unit increase in month after spraying. The decreasing trend in TPR was more prominent 5–6 months after the IRS intervention (Adj. pp = − 0.60, P-value = 0.015; Adj. pp = − 1.19, P-value < 0.001). The IRS coverage was estimated at 89.3%. Households of respondents who were formally employed or owned any form of business were more likely to be unsprayed; (APR = 5.81, CI 2.72–12.68); (APR = 3.84, CI 1.20–12.31), respectively. Conclusion Coverage of IRS with Actellic 300 CS was high and was associated with a significant decline in malaria related morbidity 6 months after spraying.
Keywords	Malaria ; Indoor residual spraying (IRS) ; Morbidity trends ; Percentage point (pp) ; Test positivity rate (TPR) ; Arctic medicine. Tropical medicine ; RC955-962 ; Infectious and parasitic diseases ; RC109-216
Subject code	616
Language	English
Publishing date	2019-02-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A cholera outbreak in a rural north central Nigerian community

Chioma Cindy Dan-Nwafor / Uzoma Ogbonna / Pamela Onyiah / Saheed Gidado / Bashorun Adebobola / Patrick Nguku / Peter Nsubuga

BMC Public Health, Vol 19, Iss 1, Pp 1-

an unmatched case-control study

2019 Volume 7

Abstract: Abstract Background Cholera remains a disease of public health importance in Nigeria associated with high morbidity and mortality. In November 2014, the Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP) was notified of an increase in ... ...

Abstract	Abstract Background Cholera remains a disease of public health importance in Nigeria associated with high morbidity and mortality. In November 2014, the Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP) was notified of an increase in suspected cholera cases in Gomani, Kwali Local Government Area. NFELTP residents were deployed to investigate the outbreak with the objectives of verifying the diagnosis, identifying risk factors and instituting appropriate control measures to control the outbreak. Methods We conducted an unmatched case-control study. We defined a cholera case as any person aged ≥5 years with acute watery diarrhea in Gomani community. We identified community controls. A total of 43 cases and 68 controls were recruited. Structured questionnaires were administered to both cases and controls. Four stool samples from case-patients and two water samples from the community water source were collected for laboratory investigation. We performed univariate and bivariate analysis using Epi-Info version 7.1.3.10. Results The mean age of cases and controls was 20.3 years and 25.4 respectively (p value 0.09). Females constituted 58.1% (cases) and 51.5%(controls). The attack rate was 4.3% with a case fatality rate of 13%. Four stool (100%) specimen tested positive for Vibrio cholerae. The water source and environment were polluted by indiscriminate defecation. Compared to controls, cases were more likely to have drank from Zamani river (OR 14.2, 95% CI: 5.5–36.8) and living in households(HH) with more than 5 persons/HH (OR 5.9, 95% CI: 1.3–27.2). Good hand hygiene was found to be protective (OR 0.3, 95% CI: 0.1–0.7). Conclusion Vibrio cholerae was the cause of the outbreak in Gomani. Drinking water from Zamani river, living in overcrowded HH and poor hand hygiene were significantly associated with the outbreak. We initiated hand hygiene and water treatment to control the outbreak.
Keywords	Unmatched case control study ; Cholera outbreak ; Hand hygiene ; Nigeria ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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