My Fellowshi owship p Achievements nts Lilian Bulag age, BSTB, - PowerPoint PPT Presentation

Public Health Fellowship Program – Field Epidemiology Tra ck My Fellowshi owship p Achievements nts Lilian Bulag age, BSTB, MHSR Fellow ow, Cohor hort 2015 15

Host st Site: e: Central Public Health Laboratories es  Mandate ated – Provide stewa wardship for the National Health Laboratory Netwo work – Technical focal point for laboratory Services in Ministry of Health 2 My Fellowship Achievements

Public Health Emerge gency Invest estigat gations s Led  Cholera ra Outb tbre reak ak investi tigati ation, on, Bwihk hkong onge, , Bulam ambul uli, , 2016 2016  Measles outbre reak ak in a refugee popul ulat ation: on: Rwam amwanj anja Refugee Settl tlement, nt, 2015  Rapid Health th Assessment nt of Newly Arriving ng Refug ugees at Rwamwanj anja Settl tlement nt, 2015 15  Rapid Assessment nt of Suspecte ted Measles Outb tbre reak ak at Rwamwanj anja Primary ary Schoo hool, 2015 15 3 My Fellowship Achievements

Mentored ed by CDC Direc ector-Dr Thoma mas Fried eden en https://www.cdc.gov ov/glob oba lhealth/ h/he heal althp thprote otecti tion/ on/fe tp/stor tories/ug ugand anda-fetp tp- mentor oring ng-bul ulag age.htm html 4 My Fellowship Achievements

Public Health Emerge gency Invest estigat gations s Participated ed in  Measles outbre reak ak investigati tion, on, Kamwenge, 2015 15  Typhoi hoid Fever r outb tbre reak ak investi tigati ation on in Kampal ala, a, 2015 5 My Fellowship Achievements

Epidemi emiologi gical Studies: es: Lead Invest estiga gator  Risk factors ors assoc ociate ated with th typhoi hoid intesti tinal al perfora orati tions ons during a large outb tbre reak ak of typhoi hoid fever, r, Kampal ala a Ugand nda, 2015 2015 6 My Fellowship Achievements

Public Health Survei eillance  Typhoi hoid outb tbre reak ak verificati ation, on, Lyanto ntond nde and Rakai ai Distr tricts ts, 2015 2015  Evaluat uated the labora oratory ory respons nse to the 2015 5 typhoi hoid outbre reak ak in Kampal ala  Descripti tive analysis of viral load ad surv rveillan ance data a (Augus ust t 2014-Jul 2014 uly 2015 15)  Conduc ucte ted a follow ow up stud udy; – Factors Affecting Quality of Care for Virologically Non-suppressed HIV+ Patients, Jinja, , Buikwe we and Iganga Districts 7 My Fellowship Achievements

Scien entifi fic Comm mmunication-Confer feren ence e Presen sentations  Facto tors Assoc ociat ated with th Virol olog ogical al Non-sup uppre ression on among ng HIV+ + Patients nts on ART , Uganda, a, Aug 201 014-Jul 201 015 – National Field Epidemiological Conference (NF NFEC) C) 2015 – 6 th th AFENE NET T Scientific Conference, Abuja, Nigeria  Rapid Assessment nt of Health h Statu atus of Newly Arriving ng Refug ugees at Rwamwanj anja -JASH SH 2015 15 8 My Fellowship Achievements

Scien entifi fic Comm mmunication-Confer feren ence e Presen sentations  Facto tors Affecti ting Qual ality ty of Care re for Virol olog ogical ally Non- suppressed HIV+ V+ pati tients nts, Jinja, , Buikwe and Igang nga Distr tricts ts- 2 nd nd NFEC EC  Modifiab able Risk Fac actor tors for Typho hoid Inte testi tinal nal Perfor orati ations ns During ng a Large Outb tbre reak ak of Typho hoid Fever r -10t 0th h Inte ternat national nal Confere renc nce on Typhoi hoid and Othe her r Invas asive Salmone onellos oses 9 My Fellowship Achievements

Scien entifi fic Comm mmunication-Manusc scripts  First t author hor; – Factors Associated with Virological non- Suppression among HIV Patients on ART RT, Uganda, Aug 2014-Jul 2015-Submitted to BMC C Infectious Diseases – Modifiable Risk Factors for Ty Typhoid Intestinal Perforations During a Large Outbreak of Ty Typhoid Fever, Kampala Uganda, 2015- Submitted to BMC C Infectious Diseases 10 My Fellowship Achievements

Scientific c Communica cation-Manuscripts  2 nd nd author hor; – A large and persistent outbreak of typhoid fever caused by consuming contaminated water and street-vended beverages: Kampala, Uganda, Jan – Jun 2015-Published in BMC C Public Health – Factors contributing to Measles Tr Transmission during an Ou Outbreak in Kamwenge District, April to August 2015-Submitted to BMC C Public Health  Co Co-aut author hor for r the Measles outb tbre reak ak investi tigati ation n case stud udy, Kamweng nge distr trict 11 My Fellowship Achievements

Scien entifi fic comm mmunication-New ewspaper er articles es  Antimicrob obial al resistanc ance: One of the greate test challeng nges to global al public health th  Uganda a makes more stri rides in the health th labora oratory ory sector tor 12 My Fellowship Achievements

Scien entifi fic comm mmunication-Articles es in MoH Quarter erly Epidemi emiologi gical Bullet etin  Overview of the labor orato atory respons onse to 201 015 5 typhoi oid outbre reak ak, Kampal ala, a, Ugand nda  Risk factor ors associat ated with h typho hoid intesti tinal nal perfor orati ations ns during a large outb tbre reak ak of typhoi hoid, Kampal ala, a, Ugand nda, a, 201 015  HIV Viral al Load Sample Delivery Times, Rejecti tion on Rate tes and Results ts Dispatc atch h Turna rnaround ound Time, Ugand nda, a, Aug 201 014-Jul ul 201 015 13 My Fellowship Achievements

Leader ersh ship and Manage gement ent  Member r of the team that t wrote ote draf aft t 0 of CPHL/UNHLS S 2015 2015-202 020 0 strat rategic plan an  Led the team that t wrot ote 2015 5 Microb robiol olog ogy Laborat ratory ory Annual al Report rt  Coord rdina nate ted the writing ng of monthl thly, quart arterl rly M and E report rts for r viral al load ad and early infant ant diagnos nosis units ts, 2015 15, 2016 2016 14 My Fellowship Achievements

Leader ersh ship and Manage gement ent  Member r of the team that t develop oped; – Bio-safety and bio-risk training curriculum and manual – Bio-safety and bio-risk health facility baseline assessment tools – Review w of the National Health Laboratory Test Menu – Operational plan for shifting of CPHL to Butabika 15 My Fellowship Achievements

Leader ersh ship and Manage gement ent  Mentor r and trai aine ner for r the Fron ontl tline FETP  Member r of the National onal Rap apid Respons onse Team am 16 My Fellowship Achievements

Sub-Editor-Uga ganda National Quarter erly Epidemi emiologi gical Bullet etin 17 My Fellowship Achievements

Public Health Fellowship Program – Field Epidemiology Tra ck Modif ifiabl iable Risk Factors for Typhoid id Inte testina tinal l Perforatio ations During ng a Large Outbr break ak of Typho hoid d Fever: : Kampala, ala, Uganda da, , 2015 Lilian Bulage, BSTB, MHSR Fellow ow, Cohor ort 2015

Increase in number of intestinal perforations (IPs) during the 2015 Typhoid Outbreak Ty Typhoid id cases 700 Increa ease e in IPs noted ed by surge geons 600 500 400 300 200 100 0 01-Jan-15 01-Feb-15 01-Mar-15 01-Apr-15 01-May-15 01-Jun-15 Date of onset 19 My Fellowship Achievements

Objecti ctive ves  Ascertain if there was an increase in intestinal perforations  Identify modifiable risk factors for Typhoid Intestinal Perforations (TI TIPs) during the outbreak  To inform prevention and control measures 20 My Fellowship Achievements

Definitions  Non-traumatic c IP: Onset of physici cian-diagnos osed perfor oration on in any part of the intestine of a patient who did not have a rece cent trauma or injury that could explain the perfor oration on  TIP case: O nset of non-traumatic c IP in the terminal ileum of a physici cian-diagnos osed typhoi oid patient Perfor orat ation on in termina nal ileum um 21 My Fellowship Achievements

Definitions  Other perforations: O nset of non-traumatic c IP that occurred in region ons other than the terminal ileum or otherwise did not meet the definition on of a T TIP  Control: A resident of Kampala City diagnosed with typhoid fever during the outbreak but without IP 22 My Fellowship Achievements

Extracte cted data from theatre registers and case files, 2013-2015 2015  Conduc ucte ted d at 5 major hospitals itals withi hin n Kampala ala: – Mulago o NRH, Naguru RRH, Nsambya, Mengo, o, and Rubaga Hospitals  Extrac acte ted d data from theatr tre registe ters and case files to identif tify IPs, , TIPs, , and other IPs, , 2013-2015  Variab ables considere red: – Socio-demographic factors; – Clinical information – Knowl wledge about typhoid fever and 2015 typhoid fever outbreak 23 My Fellowship Achievements

Indivi vidually match ched case-co control study y hed by age ( ± 5 years), sex and Division  Matche on (Count ounty) of residenc nce  Case-cont ontrol rol ratio: o: 1 : 3  Performe rmed face to face and phone one inte terv rviews  Conditi tional onal logistic regression on used to cater r for stud udy design 24 My Fellowship Achievements