Key Fellowshi hip p Achievement nts Dr. Masii iira a Ben, - PowerPoint PPT Presentation

Public Health Fellowship Program – Field Epidemiology Tra ck Key Fellowshi hip p Achievement nts Dr. Masii iira a Ben, MBChB, , MSc Epide demio iolo logy Fellow, , Cohort t 2015

Host site – Epidemiology y and Surve veillance ce Divi vision  Goal: l: - To have a robust t and sustaina tainable ble syste tem for forecas asting ting, , early detectio tion n and response to epidemic ics, , emergenc ncie ies and other priority ity diseas ases so as to improve diseas ase preventio ntion and publi lic health h response nse at all levels. . 2

Response to public c health emergenci cies  Yellow fever outbr break ak in Masak aka a Distr tric ict  Measle les outbr break ak in Kiruhur hura Distric ict  Rapid id assessment nt of risks to public ic health th among ng refugees from Burundi ndi 3

Response to other public c health emergenci cies  Podoc ocon onios osis in Kamwenge District ct  Typhoi oid fever outbreak k in Kampala  Typhoi oid Intestinal Perfor oration on outbreak k in Kampala  Investigation on of typhoi oid in Nebbi and Moyo o districts  Outbreak k of food poison oning at Namutumba Primary Schoo ool  Outbreak k of red eyes in Gulu District ct 4

Public Health Surve veillance ce  Re Re-act ctivation on of the MoH weekl kly epidemiol olog ogica cal bulletin  Analysis of weekly kly epidemiol olog ogica cal surveillance ce data  IDSR evaluation on  IDSR and EPI supervision on  Evaluation on of Yellow ow fever outbreak k respon onse in Kalangala  Designing and Implementation on of Pre-Term Birth Surveillance ce in Uganda 5

Epidemiologica cal studies  Compiled and analyzed data on 8 epidemic c prone prior ority infect ctiou ous diseases in Uganda  Typhoi oid Intestinal Perfor oration ons during the typhoi oid outbreak k in Kampala 6

Scientific c communica cation  MoH weekl kly epidemiol olog ogica cal bulletin  Published 4 articl cles in the MoH quarterly epidemiol olog ogica cal bulletin  Conference ce presentation ons; 1 internation onal and 2 nation onal  Co Co-author or in a p publica cation on on the typhoi oid outbreak k in Kampala (2015) – BMC Public c Health Journal  Manuscr cript on animal bite injuries - Submitted to PLOS  Two articl cles published in the New Vision on 7

Leadership and management  Traini ning ng of distr tricts ts on IDSR  Traine ned the National nal Rapid id Respo pons nse Team on epidemic ic preparedne dness and respons nse  Development nt of guideli line nes for epidemic ic rapid d respons nse teams  Member of Nationa nal l Task Force and NRRT  Development nt of the natio ional nal multi i hazard d plan 8

Public Health Fellowship Program – Field Epidemiology Tra ck Trends ds and spatial ial distr trib ibut utio ion n of animal al bite injurie ies and rabies deaths hs in Uganda; da; 2001-2015 Dr. Masii iira a Ben, MBChB, , MSc Epide demio iolo logy Fellow, , Cohort t 2015

Rabies mortality y and morbidity  Neglecte ted d infectio tion n with one of the highest t CFR  Estim imate ated to kill l 50,0 ,000 to 60,000 people le annuall ually  Majority ity of deaths occur in developin ping countr trie ies in tropic pical al regions ns  Respons nsible ible for 1,460,0 ,000 DALYs  Many develope ped d countr trie ies have elimin inate ted d rabies 10

Rabies surve veillance ce in Uganda  Surveil illanc ance of human rabies infectio tion n is still ll weak  Challe leng nges in clinic ical al diagno nosis is  Lack of laborato atory diagno nostic tic facil ilitie ties  Under reporting ting of actual al rabies cases  Animal al bites are used as a proxy of rabies 11

Objecti ctive ves  Describe ibe secula lar trends of animal al bite injurie ies and suspe pecte ted d rabies deaths from 2001 to 2015  Describe ibe the geograph aphic ical al distr tributio bution n of animal l bite injurie ies in Uganda da from 2001 to 2015 12

Data collection  Weekly ly epidemio iolo logic ical al surveil illan lance data a from 2001 to 2015 was used  Collecte ted from 2521 health h facili litie ties in 112 distr tric icts ts of Uganda da 13

Data extracti ction  Extrac acte ted d data on number of animal al bite injurie ies by sex, age group p , period d (year), , region and distr trict  Extrac acte ted d number of rabies suspe pecte ted d deaths hs by year and region  Popul ulatio ation n data was extrac acte ted d from the Uganda da Natio ional al Census 2002 and 2014 14

Data analys ysis  Incide dence was calculate lated d per 100,0 ,000 popula ulatio tion  Line graphs hs used to describe ibe annual al trends  Annual al populatio ulations ns estimate ated d using a growth th rate of 3.03%  Regressio ion n used to test the signif ific icanc nce of trends ds  Geograph aphic ical al differenc nces illustr trate ated d using maps 15

Number of animal bites; 2001-2015 2015 Region Number Percent Central 57,252 27.4 Eastern 46,742 22.4 Northern 56,382 27.0 Western 48,344 23.2 Overall 208,720 100 16

Proportion of animal bites higher among males Period Gender Male (%) Female (%) 2013 8735 (65) 4716(35) 2014 10744 (60) 7328 (40) 2015 11210 (65) 5987 (35) Overall 30689 (63) 18031 (37) 17

Proportion of animal bites higher among ≥5 years Period Age (years) ≥5(%) 0-4 (%) 2013 1369 (10) 12082 (90) 2014 3822 (29) 14250 (71) 2015 3911 (23) 13286 (77) Overall 9102 (19) 39618 (81) 18

Significant increase in inci cidence ce of animal bites in all regions (p<0.001) 100.0 Northern Incidence (per 100,000) 80.0 Central 60.0 40.0 Western 20.0 Eastern 0.0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Year 19

Increase in rabies deaths in Central and Northern regions 25 Central (n=122) Eastern (n=132) Northern (n=125) Western (n=78) 20 15 10 5 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 20

Average annual inci cidence ce of animal bite injuries; 2001-2005 2005 21

Average annual inci cidence ce of animal bite injuries; 2006-2010 2010 22

Average annual inci cidence ce of animal bite injuries; 2011-2015 2015 23

Concl clusions  Evidenc nce of increas asin ing incide denc nce of animal al bite injurie ies in Uganda da  Increasin ing number of deaths hs due to suspe pecte ted d rabies in the Central al and Northe hern n regions ns  Geograph aphic ical al differenc nces in incide dence were observed 24

Reco commendations  Rabie ies should ld be given special ial attentio ntion n during ng planni ning ng of natio ional nal public ic health h prioriti ities  Streng ngthe then n rabies surveil illa lanc nce in order to colle lect t more reliabl able data that can guide interventio ntions ns  Streng ngthe then n animal al and human n control l strate tegie ies especia iall lly in the most affecte ted distr tric icts ts 25

Ackn knowl wledgement  MoH  Centers for Disease Control ol and Prevention on  Public c Health Fellow owship Prog ogram/FETP Secretariat  Makerere School ool of Public c Health  Dr. Issa Makumbi  Other mentor ors 26