My Fellowship Achievements Mafig igir iri i Richar ards dson, - - PowerPoint PPT Presentation

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My Fellowship Achievements Mafig igir iri i Richar ards dson, - - PowerPoint PPT Presentation

Jan 06, 2024 457 likes •770 views

Public Health Fellowship Program Field Epidemiology Tra ck My Fellowship Achievements Mafig igir iri i Richar ards dson, n, BSc Zoo/Che hem, , MSc IIDM Fellow, , cohort t 2015 Host site, Raka kai District ct Mission To

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Public Health Fellowship Program – Field Epidemiology Track

My Fellowship Achievements

Mafig igir iri i Richar ards dson, n, BSc Zoo/Che hem, , MSc IIDM Fellow, , cohort t 2015

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2

My Fellowship achievements

Host site, Raka kai District ct

  • Mission

– To serve community through a transparent & coordinated delivery of service which focus on national, local priority and contribute to improvement in quality of life of people in Rakai District

  • Mandate

– To provide health services through a decentralized system

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3

My Fellowship achievements

Response to Public Health Emergencies

  • Led outbreaks;

– Risk factors for measles death among children in Kyegegwa district – Measles outbreak in Kyegegwa district

  • Participated in;
  • Suspected food poisoning among primary school

pupils, Namutumba Dist.

  • A large typhoid outbreak in Kampala, 2015
  • Suspected bleeding disease, Hoima & Buliisa

districts

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4

My Fellowship achievements

Epidemiologica cal study

  • Under five mortality and househol
  • ld sanitary practice

ces in Kakuuto

  • County Raka

kai District ct, April 1st

st, 2014-March

ch 30th

th,

, 2016

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5

My Fellowship achievements

Public health surve veillance ce

  • Analysis of public health surveillance data on neonatal

and perinatal mortality in Rakai District

  • Typhoid verification in Lyantonde and Rakai districts
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6

My Fellowship achievements

Scientific Communication

  • HIV Prevalence among Youths & Services Uptake in

Kasensero, 1st NAHC & NFEC

  • Risk factors for measles death in children, Kyegegwa

District, AFENET & NFEC

  • Diarrheal diseases mortality in U5 & household sanitary

practices in Kakuuto County, Rakai District-NFEC

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7

My Fellowship achievements

Scientific Communication-Main Author

  • HIV Prevalence and Uptake of HIV Services among

Youth (15-24 Years) in Fishing and Neighboring Communities of Kasensero, Rakai District (BMC Public health)

  • Risk Factors for Measles Death in Children: Kyegegwa

District (BMC Infectious diseases)

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8

My Fellowship achievements

Scientific Communication, Co-Author

  • Suspected Bleeding Illness in Hoima and Surrounding

Districts, 2016 (Plos One)

  • Outbreak of Typhoid Fever in Kampala, 2015 (BMC

Public Health)

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9

My Fellowship achievements

Scientific Communication

  • News paper article on burden of TB in Uganda-new vision
  • Two articles in MoH quarterly epidemiology bulletin
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10

My Fellowship achievements

Leadership and management

  • Coordinated performance monitoring of HMIS reporting

from health facilities in district.

  • Coordinated quarterly surveillance reports for the

district

  • Trained records assistants on data management and

report writing

  • Coordinated designing IEC materials for health workers

and HIV clients to have viral load testing

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11

My Fellowship achievements

Leadership and management

  • Designed measurement performance plan tool for key

indicators for health surveillance system

  • Did HIV service availability and mapping activity in 5

districts

  • Mentored Frontline FETP health workers
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12

My Fellowship achievements

Other Achievement

  • Designed 1st draft of fellowship logo-currently being used
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Public Health Fellowship Program – Field Epidemiology Track

Risk Factors

  • rs for Measles Death

h in Childre dren: n: Kyegegwa wa Distri trict, t, Weste tern rn Uganda da, Feb - Sept t 2015

Mafigir

iri Richar ards dson, n, BSc Zoo/Chem, , MSc IIDM Fellow, , Cohort t 2015

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14

Risk factors for measles death

Measles affecte ted d Distr tricts ts

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15

Risk factors for measles death

Events ts leadi ding ng to investi tigati ation

  • n

18th Aug 2015 25th Aug 28th Aug 2015

Notificat ation

  • n of

suspected measles deat ath Start t of investi tigati ation

  • n

Lab confirm rmati ation

  • n of measles outb

tbre reak ak

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16

Risk factors for measles death

Objecti tives

  • Identi

ntify risk factor tors for meas asles death ath in Kyegegwa Distri trict t

  • Provide evidenc

nce-bas ased control trol meas asure ures to prevent nt futu ture re measles deat aths hs

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17

Risk factors for measles death

Case defini niti tion

  • ns
  • Probab

able case: Onset t of high fever r and genera ralized rash, h, plus us ≥1 of the following: conjunctivitis, coryza, or cough

  • Measles death:

th: Death th of probab able meas asles case

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18

Risk factors for measles death

Active case finding

  • Searche

hed for cases with th the help of VHTs

  • Reviewed medical

al record

  • rds
  • Analysed data

a in the DHIS S 2

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19

Risk factors for measles death

DHIS 2

  • An electroni

nic Mo MoH nat ational al heal alth h info format ation system

  • Used for;

– integrat ated data a manage nagement nt and anal alysis, – heal alth h program am moni nitoring ng and eval alua uation, n, – facility registry func nctions ns, etc.

  • Data

a from heal alth h units is captur ured using ng HMIS S tools

  • Anal

alysis of data a done ne periodical ally at nationa nal level for reporting ng and determinat ation n of diseas ase trend nds and alerts

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20

Risk factors for measles death

Case count nt from active case findi ding ng

  • 94 persons
  • ns with

h prob

  • bab

able meas asles diag agnos

  • sis

64 <5 years rs 30 ≥5 years rs

  • 16 deaths

hs, all were re <5 years rs

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21

Risk factors for measles death

Acti tive communi nity case findi ding ng yielde ded d more deaths hs than DHIS2

Data a sour urce Measles cases Deaths hs CFR DHIS2 S2 85 85 1 1. 1.2 Active Communi unity ty surveillanc ance 94 94 16 16 17 17

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22

Risk factors for measles death

Locati tion n of cases

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23

Risk factors for measles death

Case-con

  • ntr

trol

  • l study

dy

  • Cases: 16 childre

ren (<5) 5) who

  • had measles and died
  • Contr

trol

  • ls: 48 childre

ren n (<5) who

  • had measles and surv

rvived

  • Matche

hed by age and villag age

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24

Risk factors for measles death

Potent ntial al risk factor

  • rs
  • Vaccina

nati tion

  • n stat

atus us

  • Vitamin

n A supplement nt

  • Inappro

ropri riate te treat atment nt

  • Nutri

riti tion

  • n sta

tatus tus

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25

Risk factors for measles death

Facto tors rs assoc

  • ciat

ated d with th measl asles death

Va Variab ables %of Cases (n=16) %of Contr trol

  • ls

(n=48) 8) OR (95% CI) Tr Treatme tment t at home 63 63 6 33(6.8-159 59) No vaccinat nation 94 94 54 54 12(1. 1.6-104 04) No Vit A supp. 56 56 35 35 2.3(0. 0.74-7.4) Malnut utri riti tion

  • n

38 38 25 25 2.5(0. 0.67 67-9. 9.1)

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26

Risk factors for measles death

Conclusi usion

  • ns
  • Non-vaccinati

nation n was assoc

  • ciate

ated with th measles death th

  • Management

nt of measles pati tients nts at home was associat ated with th death

  • More measles deaths

ths occurr urred in communi unity ty than n repor

  • rte

ted in the National nal surv rveillanc ance syste tem

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27

Risk factors for measles death

Recom

  • mmenda

ndati tion

  • ns
  • Enhanc

ncement nt of measles vaccinati nation

  • n amon
  • ng childre

ren n <5 years rs

  • Measles patients

ts shou

  • uld be manag

aged at health th facilities for better r treatm atment nt outcom

  • me
  • Streng

ngthe thening ng communi nity ty compone

  • nent

nt of HMIS for more re complete te reporti rting ng

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28

Risk factors for measles death

Ackno nowl wledg dgement nt

  • Ministr

try of Health th

  • US Centers

rs for Diseas ase Contr ntrol

  • l and Preventi

ntion

  • n
  • Makere

rere re School

  • ol of Public Health

th

  • Kyegegwa Distr

trict t Health th Team

  • Public Health

th Fellow

  • wshi

hip Progra ram

  • Rakai

ai Health h Scienc nces Program ram

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29

Risk factors for measles death

Facto tors rs prote tecti tive against nst measles death th

Va Variab ables % of Cases (n=16) % of Contr trol

  • ls

(n=48) 8) ORM-H (95% CI) Va Vaccinati ation

  • n for

measles 6.3 46 46 0.0 (0.0-0. 0.33 33) Vit A supplement nt during illne ness 37 37 67 67 0.14 14 (0.03 037-0. 0.77 77) Approp

  • pri

riate te treatm tment nt 25 25 98 98 0.0 (0.0-0. 0.12 12) Malnut utri riti tion

  • n

38 38 25 25 2.5 (0.67 67-9. 9.1) 1)

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Risk factors for measles death

Assessment nt for malnutrition

  • Used prox
  • xy pictur

tures to parents nts of deceas ased childre ren – Severely malnour

  • urishe

hed – Moderat rately malnour

  • urishe

hed – Normal child