Key Fellowshi hip p Achievement nts Dr. Masii iira a Ben, - - PowerPoint PPT Presentation

Public Health Fellowship Program – Field Epidemiology Track

Key Fellowshi hip p Achievement nts

• Dr. Masii

iira a Ben, MBChB, , MSc Epide demio iolo logy Fellow, , Cohort t 2015

2

Host site – Epidemiology y and Surve veillance ce Divi vision

• Goal:

l:

• To have a robust

t and sustaina tainable ble syste tem for forecas asting ting, , early detectio tion n and response to epidemic ics, , emergenc ncie ies and other priority ity diseas ases so as to improve diseas ase preventio ntion and publi lic health h response nse at all levels. .

3

Response to public c health emergenci cies

• Yellow fever outbr

break ak in Masak aka a Distr tric ict

• Measle

les outbr break ak in Kiruhur hura Distric ict

• Rapid

id assessment nt of risks to public ic health th among ng refugees from Burundi ndi

4

Response to other public c health emergenci cies

• Podoc
• con
• nios
• sis in Kamwenge District

ct

• Typhoi
• id fever outbreak

k in Kampala

• Typhoi
• id Intestinal Perfor
• ration
• n outbreak

k in Kampala

• Investigation
• n of typhoi
• id in Nebbi and Moyo
• districts
• Outbreak

k of food poison

• ning at Namutumba Primary Schoo
• ol
• Outbreak

k of red eyes in Gulu District ct

5

Public Health Surve veillance ce

• Re

Re-act ctivation

• n of the MoH weekl

kly epidemiol

• log
• gica

cal bulletin

• Analysis of weekly

kly epidemiol

• log
• gica

cal surveillance ce data

• IDSR evaluation
• n
• IDSR and EPI supervision
• n
• Evaluation
• n of Yellow
• w fever outbreak

k respon

• nse in Kalangala
• Designing and Implementation
• n of Pre-Term Birth

Surveillance ce in Uganda

6

Epidemiologica cal studies

• Compiled and analyzed data on 8 epidemic

c prone prior

• rity

infect ctiou

• us diseases in Uganda
• Typhoi
• id Intestinal Perfor
• ration
• ns during the typhoi
• id outbreak

k in Kampala

7

Scientific c communica cation

• MoH weekl

kly epidemiol

• log
• gica

cal bulletin

• Published 4 articl

cles in the MoH quarterly epidemiol

• log
• gica

cal bulletin

• Conference

ce presentation

• ns; 1 internation
• nal and 2 nation
• nal
• Co

Co-author

• r in a p

publica cation

• n on the typhoi
• id outbreak

k in Kampala (2015) – BMC Public c Health Journal

• Manuscr

cript on animal bite injuries - Submitted to PLOS

• Two articl

cles published in the New Vision

• n

8

Leadership and management

• Traini

ning ng of distr tricts ts on IDSR

• Traine

ned the National nal Rapid id Respo pons nse Team on epidemic ic preparedne dness and respons nse

• Development

nt of guideli line nes for epidemic ic rapid d respons nse teams

• Member of Nationa

nal l Task Force and NRRT

• Development

nt of the natio ional nal multi i hazard d plan

Public Health Fellowship Program – Field Epidemiology Track

Trends ds and spatial ial distr trib ibut utio ion n of animal al bite injurie ies and rabies deaths hs in Uganda; da; 2001-2015

• Dr. Masii

iira a Ben, MBChB, , MSc Epide demio iolo logy Fellow, , Cohort t 2015

10

Rabies mortality y and morbidity

• Neglecte

ted d infectio tion n with one of the highest t CFR

• Estim

imate ated to kill l 50,0 ,000 to 60,000 people le annuall ually

• Majority

ity of deaths occur in developin ping countr trie ies in tropic pical al regions ns

• Respons

nsible ible for 1,460,0 ,000 DALYs

• Many develope

ped d countr trie ies have elimin inate ted d rabies

11

Rabies surve veillance ce in Uganda

• Surveil

illanc ance of human rabies infectio tion n is still ll weak

• Challe

leng nges in clinic ical al diagno nosis is

• Lack of laborato

atory diagno nostic tic facil ilitie ties

• Under reporting

ting of actual al rabies cases

• Animal

al bites are used as a proxy of rabies

12

Objecti ctive ves

• Describe

ibe secula lar trends of animal al bite injurie ies and suspe pecte ted d rabies deaths from 2001 to 2015

• Describe

ibe the geograph aphic ical al distr tributio bution n of animal l bite injurie ies in Uganda da from 2001 to 2015

13

Data collection

• Weekly

ly epidemio iolo logic ical al surveil illan lance data a from 2001 to 2015 was used

• Collecte

ted from 2521 health h facili litie ties in 112 distr tric icts ts of Uganda da

14

Data extracti ction

• Extrac

acte ted d data on number of animal al bite injurie ies by sex, age group p , period d (year), , region and distr trict

• Extrac

acte ted d number of rabies suspe pecte ted d deaths hs by year and region

• Popul

ulatio ation n data was extrac acte ted d from the Uganda da Natio ional al Census 2002 and 2014

15

Data analys ysis

• Incide

dence was calculate lated d per 100,0 ,000 popula ulatio tion

• Line graphs

hs used to describe ibe annual al trends

• Annual

al populatio ulations ns estimate ated d using a growth th rate

• f 3.03%
• Regressio

ion n used to test the signif ific icanc nce of trends ds

• Geograph

aphic ical al differenc nces illustr trate ated d using maps

16

Number of animal bites; 2001-2015 2015

Region Number Percent Central 57,252 27.4 Eastern 46,742 22.4 Northern 56,382 27.0 Western 48,344 23.2 Overall 208,720 100

17

Proportion of animal bites higher among males

Period Gender Male (%) Female (%) 2013 8735 (65) 4716(35) 2014 10744 (60) 7328 (40) 2015 11210 (65) 5987 (35) Overall 30689 (63) 18031 (37)

18

Proportion of animal bites higher among ≥5 years

Period Age (years) 0-4 (%) ≥5(%) 2013 1369 (10) 12082 (90) 2014 3822 (29) 14250 (71) 2015 3911 (23) 13286 (77) Overall 9102 (19) 39618 (81)

19

Significant increase in inci cidence ce of animal bites in all regions (p<0.001)

0.0 20.0 40.0 60.0 80.0 100.0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Incidence (per 100,000) Year

Northern Central Eastern Western

20

Increase in rabies deaths in Central and Northern regions

5 10 15 20 25 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Central (n=122) Eastern (n=132) Northern (n=125) Western (n=78)

21

Average annual inci cidence ce of animal bite injuries; 2001-2005 2005

22

Average annual inci cidence ce of animal bite injuries; 2006-2010 2010

23

Average annual inci cidence ce of animal bite injuries; 2011-2015 2015

24

Concl clusions

• Evidenc

nce of increas asin ing incide denc nce of animal al bite injurie ies in Uganda da

• Increasin

ing number of deaths hs due to suspe pecte ted d rabies in the Central al and Northe hern n regions ns

• Geograph

aphic ical al differenc nces in incide dence were

• bserved

25

Reco commendations

• Rabie

ies should ld be given special ial attentio ntion n during ng planni ning ng of natio ional nal public ic health h prioriti ities

• Streng

ngthe then n rabies surveil illa lanc nce in order to colle lect t more reliabl able data that can guide interventio ntions ns

• Streng

ngthe then n animal al and human n control l strate tegie ies especia iall lly in the most affecte ted distr tric icts ts

26

Ackn knowl wledgement

• MoH
• Centers for Disease Control
• l and

Prevention

• n
• Public

c Health Fellow

• wship

Prog

• gram/FETP Secretariat
• Makerere School
• ol of Public

c Health

• Dr. Issa Makumbi
• Other mentor
• rs