Conference abstract

Ebola virus disease preparedness and prevention strategies in Uganda following the 2017 outbreak in Congo

Pan African Medical Journal - Conference Proceedings. 2017:3(47).20 Oct 2017.
doi: 10.11604/pamj-cp.2017.3.47.206
Archived on: 20 Oct 2017
Contact the corresponding author
Keywords: Ebola Virus Disease (EVD), preparedness, border spread
Oral presentation

Ebola virus disease preparedness and prevention strategies in Uganda following the 2017 outbreak in Congo

Rebecca Nuwematsiko1,&, Victor Musiime1, Jonan Gasanani1, Amon Lucky Bwambale1, Phionah Apiyo1, Macklean Ayebare1, Comfort Mkina1, Musa Sekamatte1, Angella Musewa1

1Makerere University School of Public Health, Kampala, Uganda

&Corresponding author
Rebecca Nuwematsiko, Makerere University School of Public Health, Kampala, Uganda


Introduction: on May 11th, 2017, the World Health Organisation (WHO) confirmed an Ebola Virus Disease (EVD) outbreak in the North Eastern part of Congo after the death of three people suspected of EVD. Following the WHO announcement, Uganda Ministry of Health (MoH) activated preparedness and preventive measures at all entry points and at hospitals in high risky areas in a bid to prevent the spread of Ebola. We therefore set out to visit the three districts of Wakiso, Kasese and Bundibugyo which were at high risk. These three districts host entry points for Congolese through air, water and by land. We visited them on a fact finding mission to assess the level of preparedness of these districts and entry points to prevent the cross border spread of Ebola.

Methods: a qualitative multiple case study design was used to assess the level of preparedness of the three districts in regards to Ebola prevention. Key informant interviews and observations were used to obtain information on preparedness and prevention strategies in place. Twenty-five key informant interviews were conducted with district top administrators, health facility in-charges, doctors, nurses, laboratory workers, health facility cleaners, Immigration officers, police officers, local chairpersons and entry port administrators. The interviews were conducted by trained personnel who were also familiar with the local languages and had skills in qualitative research. Interviews were recorded by trained research assistants after obtaining consent from the participant and later manually analysed by two different individuals for themes. The WHO Ebola Virus Disease preparedness checklist was adopted and revised to suit the study areas for the observations. Ethical approval was obtained from Makerere University College of Veterinary Medicine and the participating districts.

Results: apart from the airport, all the other boarders we visited were porous with uncontrolled movements in out of the country. Most officers at the migration points had little knowledge about EVD and had not had any communication or support from the responsible personnel in regards to preparedness. Most borders did not have Ebola communication alerts, hand washing facilities, screening services and isolation units. Most district officials and health workers were aware of the outbreak, but had not done much about sensitising the public to take precautionary measures and had not held emergency preparedness meetings in response to the Ebola scare. Only one district had an emergency action plan and budget for EVD as a means of preparedness. Most health facilities did not have enough Personal Protective Equipment (PPEs) and had no essential supplies to handle EVD in case of an outbreak most especially gloves, gowns and laboratory equipment. Risk communication was very poor with few charts displayed and among those displayed; few were in the local languages. Few health facilities had isolation units and for those that had; they were in a bad state making them inhabitable and some were being used for other purposes.

Conclusion: there are few preparedness measures in place at entry points and tourism centres to protect and prevent the potential spread of EVD. None of the places met all the specific requirements. Almost none of the health facilities were ready to prevent, detect and treat EVD in case of an outbreak because of lack of PPEs, inadequate knowledge on EVD and no or dilapidated isolation units. The district administrations had not planned for and supported EVD preparedness activities because of perceptions that the disease was still far away from reach and limited funds.