Sporadic outbreaks of crimean-congo haemorrhagic fever in Uganda, July 2018- January 2019

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dc.contributor.authorMirembe, Bernadette Basuta
dc.contributor.authorMusewa, Angella
dc.contributor.authorKadobera, Daniel
dc.contributor.authorKisaakye, Esther
dc.contributor.authorBirungi, Doreen
dc.contributor.authorEurien, Daniel
dc.contributor.authorNyakarahuka, Luke
dc.contributor.authorBalinandi, Stephen
dc.contributor.authorTumusiime, Alex
dc.contributor.authorKyondo, Jackson
dc.contributor.authorMbula Mulei, Sophia
dc.contributor.authorBaluku, Jimmy
dc.contributor.authorKwesiga, Benon
dc.contributor.authorNdugwa Kabwama, Steven
dc.contributor.authorZhu, Bao-Ping
dc.contributor.authorHarris, Julie R.
dc.contributor.authorLutwama, Julius Julian
dc.contributor.authorAlex, Riolexus Ario
dc.date.accessioned2021-12-15T12:56:02Z
dc.date.available2021-12-15T12:56:02Z
dc.date.issued2019
dc.description.abstractCrimean-Congo haemorrhagic fever (CCHF) is a tick-borne, zoonotic viral disease that causes haemorrhagic symptoms. Despite having eight confirmed outbreaks between 2013 and 2017, all within Uganda’s ‘cattle corridor’, no targeted tick control programs exist in Uganda to prevent disease. During a seven-month-period from July 2018-January 2019, the Ministry of Health confirmed multiple independent CCHF outbreaks. We investigated to identify risk factors and recommend interventions to prevent future outbreaks. We defined a confirmed case as sudden onset of fever (�37.5 ̊C) with �4 of the following signs and symptoms: anorexia, vomiting, diarrhea, headache, abdominal pain, joint pain, or sudden unexplained bleeding in a resident of the affected districts who tested positive for Crimean-Congo haemorrhagic fever virus (CCHFv) by RT-PCR from 1 July 2018–30 January 2019. We reviewed medical records and performed active case-finding. We conducted a case-control study and compared exposures of case-patients with age-, sex-, and sub-county-matched control-persons (1:4). We identified 14 confirmed cases (64% males) with five deaths (case-fatality rate: 36%) from 11 districts in the western and central region. Of these, eight (73%) case patients resided in Uganda’s ‘cattle corridor’. One outbreak involved two case-patients and the remainder involved one. All case-patients had fever and 93% had unexplained bleeding. Case-patients were aged 6–36 years, with persons aged 20–44 years more affected (AR: 7.2/1,000,000) than persons �19 years (2.0/1,000,000), p = 0.015. Most (93%) case-patients had contact with livestock �2 weeks before symptom onset. Twelve (86%) lived <1 km from grazing fields compared with 27 (48%) controls (OR M-H = 18, 95% CI = 3.2-1) and 10 (71%) of 14 case-patients found ticks attached to their bodies �2 weeks before symptom onset, compared to 15 (27%) of 56 control-persons (OR M-H = 9.3, 95%CI = 1.9–46). CCHF outbreaks occurred sporadically during 2018–2019, both within and outside the ‘cattle corridor’ districts of Uganda. Most cases were associated with tick exposure. The Ministry of Health should partner with the Ministry of Agriculture, Animal Industry, and Fisheries to develop joint nationwide tick control programs and strategies with shared responsibilities through a One Health approach.en_US
dc.identifier.citationMirembe, B. B., Musewa, A., Kadobera, D., Kisaakye, E., Birungi, D., Eurien, D., ... & Ario, A. R. (2021). Sporadic outbreaks of crimean-congo haemorrhagic fever in Uganda, July 2018-January 2019. PLoS neglected tropical diseases, 15(3), e0009213. DOI: https://doi.org/10.1371/journal.pntd.0009213en_US
dc.identifier.urihttps://doi.org/10.1371/journal.pntd.0009213
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/617
dc.language.isoenen_US
dc.publisherPLoS neglected tropical diseasesen_US
dc.relation.ispartofseriesPLoS neglected tropical diseases;
dc.titleSporadic outbreaks of crimean-congo haemorrhagic fever in Uganda, July 2018- January 2019en_US
dc.typeArticleen_US
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