Conference abstract

An evaluation of the district level preparedness and response to the 2016 yellow fever outbreak in Kalangala District, Uganda

Pan African Medical Journal - Conference Proceedings. 2017:3(18).16 Dec 2017.
doi: 10.11604/pamj-cp.2017.3.18.135

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Keywords: Yellow fever, preparedness and response, outbreak, qualitative study
Oral presentation

An evaluation of the district level preparedness and response to the 2016 yellow fever outbreak in Kalangala District, Uganda

George Kiwanuka1,&, Doreen Tuhebwe1, Michael Ediau1, Hillary Bitakalamire1

1Makerere University School of Public Health, Kampala, Uganda

&Corresponding author
George Kiwanuka, Makerere University School of Public Health, Kampala, Uganda

Abstract

Introduction: yellow fever is endemic in 33 sub-Saharan Africa countries, including Uganda. Kalangala district, an island district in Uganda experienced a yellow fever outbreak from April-September 2016. This study aimed to evaluate the districtís preparedness and response to this outbreak in order to inform efforts for combating future outbreaks.

Methods: a qualitative cross-sectional study was conducted in November 2016. We conducted in-depth interviews and focus group discussions with survivors and affected persons. Key informant interviews were also conducted. The interviews focused on assessment of the effectiveness of the four technical sub-committees established during the outbreak response, i.e., outbreak coordination, surveillance and laboratory, social mobilization, and case management. Audio recorded interviews were transcribed and analyzed using thematic analysis.

Results: a total of 40 interviews was conducted with 6 district health team members, 5 political leaders, 9 health workers and 20 community members. The most affected island was Bugala, the most urban, and a destination point for travelers. Adults were affected most with, 7/8 of suspected patients. Community members noted that they had never experienced yellow fever before, this affected care seeking. All key informants noted lack of preparedness prior to the outbreak. The rapid response team lacked sample collection and transportation means, and infection control equipment. Coordination was ranked highly due to stakeholder engagements. Continuing medical education, trainings, treatment center, and referral systems were established by the case management team. Key informants re-iterated lack of resources for surveillance. Socio-mobilization was limited to the main island and the posters used were not in the local language.

Conclusion: the preparedness for managing the outbreak was ranked very low. The response was partly functional with adequate coordination and appropriate case management but with gaps in surveillance, laboratory and social mobilization Multi-sectoral collaboration is recommended to ensure adequate preparedness and response to future outbreaks.