Early cases of SARS-CoV-2 infection in Uganda: epidemiology and lessons learned from risk-based testing approaches – March-April 2020
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Globalization and Health
Abstract
On March 13, 2020, Uganda instituted COVID-19 symptom screening at its international airport,
isolation and SARS-CoV-2 testing for symptomatic persons, and mandatory 14-day quarantine and testing of
persons traveling through or from high-risk countries. On March 21, 2020, Uganda reported its first SARS-CoV-2
infection in a symptomatic traveler from Dubai. By April 12, 2020, 54 cases and 1257 contacts were identified. We
describe the epidemiological, clinical, and transmission characteristics of these cases.
Methods: A confirmed case was laboratory-confirmed SARS-CoV-2 infection during March 21–April 12, 2020 in a
resident of or traveler to Uganda. We reviewed case-person files and interviewed case-persons at isolation centers.
We identified infected contacts from contact tracing records.
Results: Mean case-person age was 35 (±16) years; 34 (63%) were male. Forty-five (83%) had recently traveled
internationally (‘imported cases’), five (9.3%) were known contacts of travelers, and four (7.4%) were community
cases. Of the 45 imported cases, only one (2.2%) was symptomatic at entry. Among all case-persons, 29 (54%) were
symptomatic at testing and five (9.3%) were pre-symptomatic. Among the 34 (63%) case-persons who were ever
symptomatic, all had mild disease: 16 (47%) had fever, 13 (38%) reported headache, and 10 (29%) reported cough.
Fifteen (28%) case-persons had underlying conditions, including three persons with HIV. An average of 31 contacts
(range, 4–130) were identified per case-person. Five (10%) case-persons, all symptomatic, infected one contact each.
Conclusion: The first 54 case-persons with SARS-CoV-2 infection in Uganda primarily comprised incoming air
travelers with asymptomatic or mild disease. Disease would likely not have been detected in these persons without
the targeted testing interventions implemented in Uganda. Transmission was low among symptomatic persons and
nonexistent from asymptomatic persons. Routine, systematic screening of travelers and at-risk persons, and
thorough contact tracing will be needed for Uganda to maintain epidemic control
Description
Keywords
COVID-19, SARS-Cov-2, Epidemiology, Surveillance, Uganda
Citation
Migisha, R., Kwesiga, B., Mirembe, B. B., Amanya, G., Kabwama, S. N., Kadobera, D., ... & Ario, A. R. (2020). Early cases of SARS-CoV-2 infection in Uganda: epidemiology and lessons learned from risk-based testing approaches–March-April 2020. Globalization and Health, 16(1), 1-9.