Browsing by Author "Gidudu, Samuel"

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    Ebola disease outbreak caused by the Sudan virus in Uganda, 2022: a descriptive epidemiological study
    (Elsevier Ltd, 2024-10) Ario, Alex R; Ahirirwe, Sherry R; Ocero, Jane R Aceng; Atwine, Diana; Muruta, Allan N; Kagirita, Atek; Tegegn, Yonas; Kadobera, Daniel; Kwesiga, Benon; Gidudu, Samuel; Migisha, Richard; Makumbi, Issa; Elyanu, Peter J; Ndyabakira, Alex; Et.al
    Uganda has had seven Ebola disease outbreaks, between 2000 and 2022. On Sept 20, 2022, the Ministry of Health declared a Sudan virus disease outbreak in Mubende District, Central Uganda. We describe the epidemiological characteristics and transmission dynamics.BACKGROUNDUganda has had seven Ebola disease outbreaks, between 2000 and 2022. On Sept 20, 2022, the Ministry of Health declared a Sudan virus disease outbreak in Mubende District, Central Uganda. We describe the epidemiological characteristics and transmission dynamics.For this descriptive study, cases were classified as suspected, probable, or confirmed using Ministry of Health case definitions. We investigated all reported cases to obtain data on case-patient demographics, exposures, and signs and symptoms, and identified transmission chains. We conducted a descriptive epidemiological study and also calculated basic reproduction number (Ro) estimates.METHODSFor this descriptive study, cases were classified as suspected, probable, or confirmed using Ministry of Health case definitions. We investigated all reported cases to obtain data on case-patient demographics, exposures, and signs and symptoms, and identified transmission chains. We conducted a descriptive epidemiological study and also calculated basic reproduction number (Ro) estimates.Between Aug 8 and Nov 27, 2022, 164 cases (142 confirmed, 22 probable) were identified from nine (6%) of 146 districts. The median age was 29 years (IQR 20-38), 95 (58%) of 164 patients were male, and 77 (47%) patients died. Symptom onsets ranged from Aug 8 to Nov 27, 2022. The case fatality rate was highest in children younger than 10 years (17 [74%] of 23 patients). Fever (135 [84%] of 160 patients), vomiting (93 [58%] patients), weakness (89 [56%] patients), and diarrhoea (81 [51%] patients) were the most common symptoms; bleeding was uncommon (21 [13%] patients). Before outbreak identification, most case-patients (26 [60%] of 43 patients) sought care at private health facilities. The median incubation was 6 days (IQR 5-8), and median time from onset to death was 10 days (7-23). Most early cases represented health-care-associated transmission (43 [26%] of 164 patients); most later cases represented household transmission (109 [66%]). Overall Ro was 1·25.FINDINGSBetween Aug 8 and Nov 27, 2022, 164 cases (142 confirmed, 22 probable) were identified from nine (6%) of 146 districts. The median age was 29 years (IQR 20-38), 95 (58%) of 164 patients were male, and 77 (47%) patients died. Symptom onsets ranged from Aug 8 to Nov 27, 2022. The case fatality rate was highest in children younger than 10 years (17 [74%] of 23 patients). Fever (135 [84%] of 160 patients), vomiting (93 [58%] patients), weakness (89 [56%] patients), and diarrhoea (81 [51%] patients) were the most common symptoms; bleeding was uncommon (21 [13%] patients). Before outbreak identification, most case-patients (26 [60%] of 43 patients) sought care at private health facilities. The median incubation was 6 days (IQR 5-8), and median time from onset to death was 10 days (7-23). Most early cases represented health-care-associated transmission (43 [26%] of 164 patients); most later cases represented household transmission (109 [66%]). Overall Ro was 1·25.Despite delayed detection, the 2022 Sudan virus disease outbreak was rapidly controlled, possibly thanks to a low Ro. Children (aged <10 years) were at the highest risk of death, highlighting the need for targeted interventions to improve their outcomes during Ebola disease outbreaks. Initial care-seeking occurred at facilities outside the government system, showing a need to ensure that private and public facilities receive training to identify possible Ebola disease cases during an outbreak. Health-care-associated transmission in private health facilities drove the early outbreak, suggesting gaps in infection prevention and control.INTERPRETATIONDespite delayed detection, the 2022 Sudan virus disease outbreak was rapidly controlled, possibly thanks to a low Ro. Children (aged <10 years) were at the highest risk of death, highlighting the need for targeted interventions to improve their outcomes during Ebola disease outbreaks. Initial care-seeking occurred at facilities outside the government system, showing a need to ensure that private and public facilities receive training to identify possible Ebola disease cases during an outbreak. Health-care-associated transmission in private health facilities drove the early outbreak, suggesting gaps in infection prevention and control.None.FUNDINGNone. MEDLINE - Academic
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    Trends and distribution of Vibrio cholerae isolates at the National Microbiology Reference Laboratory, Ministry of Health, Uganda, 2014 –2023
    (Uganda Public Health, 2018) Baliruno, Leah Naluwagga; Namusoosa, Rita; Gidudu, Samuel; Okello, Paul Edward; Nakigozi, Harriet; Okiria, Chris; Ssewanyana, Isaac; Nabadda, Suzan; Najjuka, Grace; Ario, Alex Riolexus
    Background: As per the World Health Organization, countries including Uganda are to end cholera by 2030 through prevention and treatment. This achievement can be hindered due to rapid changes in antimicrobial response patterns and serotype among other factors. We described confirmed cholera cases by person, place, time, serotype, antimicrobial resistance, and multi-antimicrobial-resistant phenotype patterns, Uganda, 2014–2023. Methods: We conducted a descriptive study using the 2014 – 2023 data on confirmed cholera cases abstracted from the National Microbiology Reference Laboratory (NMRL) register. We described the cases by age group, sex, district, serotype, reporting period, antimicrobial resistance (resistant and intermediate)(rates), and multi-antimicrobialresistant phenotype patterns. We described the confirmed cases and the antimicrobial resistance patterns over time. Mann-Kendall tests for trends were used to test the significance of AMR trends. Results: We identified 489 confirmed cholera cases between January 2014 to December 2023 whose V. cholerae isolates were referred by 35 districts in Uganda. The majority of the identified confirmed cholera cases were male (239, 49%), aged 21- 40 years (170, 38%), had V. cholerae 01 Ogawa (256, 52%) and were from Kampala District (138, 28%). We observed a gradual decline in confirmed cholera cases over time with peaks in 2015, 2018 and 2023. Vibro cholerae 01 ogawa was observed to dominate throughout the period. We observed consistent resistance by V. cholerae to 6 antimicrobials from 2014 to 2023. 194 (39.7%) isolates showed multiple antimicrobialresistant with 90 (18.6%) resistant to more than one class of antimicrobials. Conclusion: We observed males, persons aged 21-40 years, and Kampala District as being most affected with cholera in Uganda with peaks in 2015, 2018, and 2023 and Vibro cholerae 01 Ogawa as the predominate serotype. Consistent antimicrobial resistance was exhibited over time between 2014 and 2023. Intensifying cholera disease prevention by the Ministry of Health targeting males, persons aged 21-40 years, and Kampala District is critical. Routine antimicrobial surveillance to guide informed antimicrobial use and prevent the spread of AMR, especially during cholera outbreaks is important.