NRU :: Browsing by Author "Nanyunja, Miriam"

Browsing by Author "Nanyunja, Miriam"

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Achieving measles control: lessons from the 2002–06 measles control strategy for Uganda
(Health policy and planning, 2002) Mbabazi, William B.; Nanyunja, Miriam; Makumbi, Issa; Braka, Fiona; Baliraine, Frederick N.; Kisakye, Annet; Bwogi, Josephine; Mugyenyi, Possy; Kabwongera, Eva; Lewis, Rosamund F.
The 2002–06 measles control strategy for Uganda was implemented to strengthen routine immunization, undertake large-scale catch-up and follow-up vaccination campaigns, and to initiate nationwide case-based, laboratory-backed measles surveillance. This study examines the impact of this strategy on the epidemiology of measles in Uganda, and the lessons learnt. Methods Number of measles cases and routine measles vaccination coverage reported by each district were obtained from the National Health Management Information System reports of 1997 to 2007. The immunization coverage by district in a given year was calculated by dividing the number of children immunized by the projected population in the same age category. Annual measles incidence for each year was derived by dividing the number of cases in a year by the mid-year projected population. Commercial measles IgM enzyme-linked immunoassay kits were used to confirm measles cases.
Achieving measles control: lessons from the 2002–06 measles control strategy for Uganda
(Health policy and planning, 2009) Mbabazi, William B.; Nanyunja, Miriam; Makumbi, Issa; Braka, Fiona; Baliraine, Frederick N.; Kisakye, Annet; Bwogi, Josephine; Mugyenyi, Possy; Kabwongera, Eva; Rosamund, F Lewis
Background The 2002–06 measles control strategy for Uganda was implemented to strengthen routine immunization, undertake large-scale catch-up and follow-up vaccination campaigns, and to initiate nationwide case-based, laboratory-backed measles surveillance. This study examines the impact of this strategy on the epidemiology of measles in Uganda, and the lessons learnt. Methods Number of measles cases and routine measles vaccination coverage reported by each district were obtained from the National Health Management Information System reports of 1997 to 2007. The immunization coverage by district in a given year was calculated by dividing the number of children immunized by the projected population in the same age category. Annual measles incidence for each year was derived by dividing the number of cases in a year by the mid-year projected population. Commercial measles IgM enzyme-linked immunoassay kits were used to confirm measles cases. Results Routine measles immunization coverage increased from 64% in 1997 to 90% in 2004, then stabilized around 87%. The 2003 national measles catch-up and 2006 follow-up campaigns reached 100% of children targeted with a measles supplemental dose. Over 80% coverage was also achieved with other child survival interventions. Case-based measles surveillance was rolled out nationwide to provide continuous epidemiological monitoring of measles occurrence. Following a 93% decline in measles incidence and no measles deaths, epidemic resurgence of measles occurred 3 years after a measles campaign targeting a wide age group, but no indigenous measles virus (D10) was isolated. Recurrence was delayed in regions where children were offered an early second opportunity for measles vaccination. Conclusion The integrated routine and campaign approach to providing a second opportunity for measles vaccination is effective in interrupting indigenous measles transmission and can be used to deliver other child survival interventions. Measles control can be sustained and the inter-epidemic interval lengthened by offering an early second opportunity for measles vaccination through other health delivery strategies.
Ebola disease outbreak caused by the Sudan virus in Uganda, 2022: a descriptive epidemiological study
(The Lancet Global Health, 2024-10-29) Kabami, Zainah; Ario, Alex R.; Ninsiima, Mackline; Ahirirwe, Sherry R.; Atwine, Diana; Ocero, Jane R Aceng; Nanyunja, Miriam; Ndyabakira, Alex; Zavuga, Robert; Kiggundu, Thomas
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.
Ebola Hemorrhagic Fever Associated with Novel Virus Strain, Uganda, 2007–2008
(Emerging infectious diseases, 2010) Wamala, Joseph F.; Lukwago, Luswa; Malimbo, Mugagga; Nguku, Patrick; Yoti, Zabulon; Musenero, Monica; Amone, Jackson; Mbabazi, William; Nanyunja, Miriam; Zaramba, Sam; Opio, Alex; Lutwama, Julius J.; Talisuna, Ambrose O.; Okware, Sam I.
During August 2007–February 2008, the novel Bundibugyo ebola virus species was identified during an outbreak of Ebola viral hemorrhagic fever in Bundibugyo district, western Uganda. To characterize the outbreak as a requisite for determining response, we instituted a caseseries investigation. We identified 192 suspected cases, of which 42 (22%) were laboratory positive for the novel species; 74 (38%) were probable, and 77 (40%) were negative. Laboratory confirmation lagged behind outbreak verification by 3 months. Bundibugyo ebola virus was less fatal (case fatality rate 34%) than Ebola viruses that had caused previous outbreaks in the region, and most transmission was associated with handling of dead persons without appropriate protection (adjusted odds ratio 3.83, 95% confidence interval 1.78–8.23). Our study highlights the need for maintaining a high index of suspicion for viral hemorrhagic fevers among healthcare workers, building local capacity for laboratory confirmation of viral hemorrhagic fevers, and institutionalizing standard precautions.
Ebola Viral Hemorrhagic Disease Outbreak in West Africa- Lessons from Uganda.
(African health sciences, 2014) Mbonye, Anthony K.; Wamala, Joseph F.; Nanyunja, Miriam; Opio, Alex; Makumbi, Issa; Aceng, Jane Ruth
There has been a rapid spread of Ebola Viral Hemorrhagic disease in Guinea, Liberia and Sierra Leone since March 2014. Since this is the first time of a major Ebola outbreak in West Africa; it is possible there is lack of understanding of the epidemic in the communities, lack of experience among the health workers to manage the cases and limited capacities for rapid response. The main objective of this article is to share Uganda’s experience in controlling similar Ebola outbreaks and to suggest some lessons that could inform the control of the Ebola outbreak in West Africa.The article is based on published papers, reports of previous Ebola outbreaks, response plans and experiences of individuals who have participated in the control of Ebola epidemics in Uganda. The success in the control of Ebola epidemics in Uganda has been due to high political support, effective coordination through national and district task forces. In addition there has been active surveillance, strong community mobilization using village health teams and other community resources persons, an efficient laboratory system that has capacity to provide timely results. These have coupled with effective case management and infection control and the involvement of development partners who commit resources with shared responsibility.Several factors have contributed to the successful quick containment of Ebola outbreaks in Uganda. West African countries experiencing Ebola outbreaks could draw some lessons from the Uganda experience and adapt them to contain the Ebola epidemic.
Ebola viral hemorrhagic disease outbreak in West Africa- lessons from Uganda.
(African health sciences, 2014-09) Mbonye, Anthony K.; Wamala, Joseph F.; Nanyunja, Miriam; Opio, Alex; Makumbi, Issa; Aceng, Jane Ruth
There has been a rapid spread of Ebola Viral Hemorrhagic disease in Guinea, Liberia and Sierra Leone since March 2014. Since this is the first time of a major Ebola outbreak in West Africa; it is possible there is lack of understanding of the epidemic in the communities, lack of experience among the health workers to manage the cases and limited capacities for rapid response. The main objective of this article is to share Uganda’s experience in controlling similar Ebola outbreaks and to suggest some lessons that could inform the control of the Ebola outbreak in West Africa. The article is based on published papers, reports of previous Ebola outbreaks, response plans and experiences of individuals who have participated in the control of Ebola epidemics in Uganda. Lessons learnt: The success in the control of Ebola epidemics in Uganda has been due to high political support, effective coordination through national and district task forces. In addition there has been active surveillance, strong community mobilization using village health teams and other community resources persons, an efficient laboratory system that has capacity to provide timely results. These have coupled with effective case management and infection control and the involvement of development partners who commit resources with shared responsibility. Several factors have contributed to the successful quick containment of Ebola outbreaks in Uganda. West African countries experiencing Ebola outbreaks could draw some lessons from the Uganda experience and adapt them to contain the Ebola epidemic.ca.
Evaluation of the ebola virus disease preparedness and readiness program in Uganda: 2018 to 2019
(Pan African Medical Journal, 2021) Nsubuga, Peter; Masiira, Ben; Kihembo, Christine; Byakika-Tusiime, Jayne; Ryan, Caroline; Nanyunja, Miriam; Kamadjeu, Raoul; Talisuna, Ambrose
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 resources invested in EVD-PR represented good value for the funds and the activities were well aligned to the public health priorities for Uganda. Conclusion: Ebola virus disease preparedness and readiness program in Uganda developed capacities that played an essential role in preventing cross border spread of EVD from the affected provinces in the DRC and enabled rapid containment of the two importation events. These capacities are now being used to detect and respond to the COVID-19 pandemic.
Hepatitis B infection is highly endemic in Uganda : findings from a national serosurvey
(African health sciences, 2009) Bwogi, Josephine; Braka, Fiona; Makumbi, Issa; Mishra, Vinod; Bakamutumaho, Barnabas; Nanyunja, Miriam; Opio, Alex; Downing, Robert; Biryahwaho, Benon; Lewis, Rosamund F.
To determine the baseline prevalence of hepatitis B virus (HBV) infection and explore risk factors. Methods: A hepatitis B prevalence study was nested in the 2005 national HIV/AIDS serobehavioural survey. Demographic characteristics and risk factors were explored by questionnaire. One third of blood specimens (n= 5875) from adults aged 15 to 59 years were tested for hepatitis B core antibodies (HBcAb); positive specimens were tested for hepatitis B surface antigen (HBsAg). Results: HBcAb was present in 52.3%(95% CI: 51.0-53.6) of adults, and HBsAg in 10.3%(9.5-11.1). By 15-19 years of age, 40.0% had been infected with HBV. Prevalence of both markers was significantly higher across northern Uganda, in rural areas, among the poor and least educated, and in uncircumcised men. Other independent predictors of infection were age, ethnic group, occupation, number of sex partners, and HIV and HSV-2 status. Conclusion: Hepatitis B virus infection is highly endemic in Uganda, with transmission occurring in childhood and adulthood. More than 1.4 million adults are chronically infected and some communities disproportionately affected. The hepatitis B infant immunization programme should be sustained and catch-up vaccination considered for older children
Hepatitis B infection is highly endemic in Uganda: findings from a national serosurvey
(African health sciences, 2009) Bwogi, Josephine; Braka, Fiona; Makumbi, Issa; Mishra, Vinod; Bakamutumaho, Barnabas; Nanyunja, Miriam; Opio, Alex; Downing, Robert; Biryahwaho, Benon; Lewis, Rosamund F.
Infant immunization against hepatitis B began in Uganda in 2002. Objective: To determine the baseline prevalence of hepatitis B virus (HBV) infection and explore risk factors. Methods: A hepatitis B prevalence study was nested in the 2005 national HIV/AIDS serobehavioural survey. Demographic characteristics and risk factors were explored by questionnaire. One third of blood specimens (n=5875) from adults aged 15 to 59 years were tested for hepatitis B core antibodies (HBcAb); positive specimens were tested for hepatitis B surface antigen (HBsAg). Results: HBcAb was present in 52.3% (95% CI: 51.0-53.6) of adults, and HBsAg in 10.3% (9.5-11.1). By 15-19 years of age, 40.0% had been infected with HBV. Prevalence of both markers was significantly higher across northern Uganda, in rural areas, among the poor and least educated, and in uncircumcised men. Other independent predictors of infection were age, ethnic group, occupation, number of sex partners, and HIV and HSV-2 status. Conclusion: Hepatitis B virus infection is highly endemic in Uganda, with transmission occurring in childhood and adulthood. More than 1.4 million adults are chronically infected and some communities disproportionately affected. The hepatitis B infant immunization programme should be sustained and catch-up vaccination considered for older children.
Measles vaccination effectiveness among children under 5 years of age in Kampala, Uganda
(Vaccine, 2006) Mupere, Ezekiel; Karamagi, Charles; Zirembuzi, George; Grabowsky, Mark; de Swart, Rik L.; Nanyunja, Miriam; Mayanja, Harriet
Measles control remains a great challenge in Uganda. We conducted a prospective study among household contacts aged 9–59 months to assess measles vaccination effectiveness. Index cases were measles patients seen in Kampala hospitals in 1999. Measles was diagnosed in 37/43 (86%) of unvaccinated and in 33/145 (23%) of vaccinated exposed contacts, respectively. Vaccination effectiveness was 74% (95% CI; 64–81), which was lower than expected. This may indicate the need for strengthening of the cold chain and/or introduction of a second opportunity for measles vaccination, either as part of the routine immunization program or in the form of supplementary immunization activities
Phylogenetic analysis of rubella viruses found in Morocco, Uganda, Cote d’Ivoire and South Africa from 2001 to 2007
(Journal of clinical virology, 2008) Caidi, Hayat; Abernathy, Emily S.; Benjouad, Aziz; Smit, Sheilagh; Bwogi, Josephine; Nanyunja, Miriam; Aouad, Rajae E.; Icenogle, Joseph
Rubella virus (RV) causes a mild disease, but maternal infection early in pregnancy often leads to birth defects known as congenital rubella syndrome (CRS). Rubella remains poorly controlled in Africa. Objectives: To identify RV genotypes found in Africa to help establish a genetic baseline for RV molecular epidemiology. Study design: Urine and nasopharyngeal specimens were collected between 2001 and 2004 during measles surveillance in Morocco, Uganda and South Africa, and from two persons in the United States who contracted rubella in Cote d’Ivoire and Uganda in 2004 and 2007, respectively. RVRNAwas obtained directly from specimens or from RV-infected cell cultures, amplified by reverse transcriptase polymerase chain reaction, and the resulting DNAs sequenced. Sequences were assigned to genotypes by phylogenetic analysis with RV reference sequences. Results: Nine RV sequences were assigned as follows: 1E in Morocco, 1G in Uganda and Cote d’Ivoire, and 2B in South Africa. Conclusions: Information about RV genotypes circulating in Africa is improved which should aid in control of rubella and CRS in Africa.
The road to a polio-free Uganda; contribution of the Expanded Program on Immunization Laboratory (EPI-LAB) at Uganda Virus Research Institute
(African Health Sciences, 2023) Nanteza, Mary B.; Tushabe, Phionah; Bukenya, Henry; Namuwulya, Prossy; Kabaliisa, Theopista; Birungi, Molly; Tibanagwa, Mayi; Ampeire, Immaculate; Kakooza, Proscovia; Katushabe, Edson; Bwogi, Josephine; Bakamutumaho, Barnabas; Nanyunja, Miriam; Byabamazima, Charles R.
Background: The control of poliomyelitis in Uganda dates back as far as 1950 and acute flaccid paralysis (AFP) surveillance has since been used as a criterion for identifying wild polioviruses. Poliovirus isolation was initially pursued through collaborative research however, in 1993, the Expanded Program on Immunization Laboratory (EPI-LAB) was established as a member of the Global Poliovirus Laboratory Network (GPLN) and spearheaded this activity at Uganda Virus Research Institute. Objectives: The aim of this report is to document the progress and impact of the EPI-LAB on poliovirus eradication in Uganda. Methods: Poliovirus detection and identification were achieved fundamentally through tissue culture and intra-typic differentiation of the poliovirus based on the real-time reverse transcriptase polymerase chain reaction (rRT PCR). The data obtained was entered into the national AFP database and analysed using EpiInfoTM statistical software. Results: Quantitative and qualitative detection of wild and Sabin polioviruses corresponded with the polio campaigns. The WHO target indicators for AFP surveillance were achieved essentially throughout the study period. Conclusion: Virological tracking coupled with attaining standard AFP surveillance indicators has been pivotal in achieving and maintaining the national wild polio-free status. Laboratory surveillance remains key in informing the certification process of polio eradication.
Tuberculosis Control in Resource Limited settings: Health Systems considerations
(WHO, 2013) Orem, Juliet N.; Nabukalu, Joy B.; Nkolo, Abel; Nanyunja, Miriam
Tuberculosis (TB) remains a significant public health problem globally, with higher incidence and prevalence in resource limited settings in sub-Saharan Africa and South East Asia (World Health Organization, 2012). This is compounded by the high Human Immunodeficiency Virus (HIV) prevalence in some of the resource limited countries, especially in sub-Saharan Africa where HIV is associated with increasing TB incidence of 5– 10% annually (De Cock & Chaisson, 1999). Globally about 8.7 million new cases of TB …
Uganda’s Experience in Ebola Virus Disease Outbreak Preparedness, 2018–2019
(Globalization and health, 2020) Aceng, Jane Ruth; Ario, Alex R.; Muruta, Allan N.; Nanyunja, Miriam; N. Bakainaga, Andrew; Talisuna, Ambrose O.
Since the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country. We describe Uganda’s experience in EVD preparedness.On 4 August 2018, the Uganda Ministry of Health (MoH) activated the Public Health Emergency Operations Centre (PHEOC) and the National Task Force (NTF) for public health emergencies to plan, guide, and coordinate EVD preparedness in the country. The NTF selected an Incident Management Team (IMT), constituting a National Rapid Response Team (NRRT) that supported activation of the District Task Forces (DTFs) and District Rapid Response Teams (DRRTs) that jointly assessed levels of preparedness in 30 designated high-risk districts representing category 1 (20 districts) and category 2 (10 districts). The MoH, with technical guidance from the World Health Organisation (WHO), led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at Points of Entry (PoEs) and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significantand verifiable progress in EVD preparedness. There is a need to sustain these efforts, not only in EVD preparedness but also across the entire spectrum of a multi-hazard framework. These efforts strengthen country capacity and compel the country to avail resources for preparedness and management of incidents at the source while effectively cutting costs of using a “fire-fighting” approach during public health emergencies.

Browsing by Author "Nanyunja, Miriam"

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