Performance of Epidemic Prevention, Preparedness and Response in West Nile Region, Uganda
[1]
Alfred Yayi, District Health Office, Yumbe District Local Government, Yumbe, Uganda.
[2]
Vivienne Laing, Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda.
[3]
Philip Govule, Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda.
[4]
Robert Anguyo DDM Onzima, Department of International Public Health, Liverpool School of Tropical Medicine, Kampala, Uganda.
[5]
Rogers Ayiko, East African Community Health Secretariat, Arusha, Tanzania.
Emerging and re-emerging communicable disease outbreaks are a global concern and Uganda is no exception. The West Nile region of Uganda has experienced annual epidemics of cholera, meningococcal meningitis, plaque, measles, hepatitis E among others – usually with high Case Fatality Rates (CFRs) despite interventions of epidemic prevention, preparedness and response (EPPR) entailed in cluster one of the Uganda National Minimum Health Care Package [1]. This paper documents performance of the West Nile districts in EPPR. Specifically, we looked at the levels of preparedness, response and implementation of prevention measures. This was a descriptive cross-sectional study aimed at exploring the possible reasons for continuous and frequent occurrence of epidemics in the region; and with high CFRs. We conducted interviews with members of EPPR committees at district and lower local governments. At the lower local governments, we compared prevention and preparedness levels between epidemic-prone and non-epidemic-prone sub-counties (S/Cs). The results indicate inadequate level of implementation of epidemic prevention measures and poor level of epidemic preparedness in virtually all the districts in the region. Non-functionality of existing structures and resources for EPPR majorly contributed to poor levels of prevention, preparedness and response. Despite the general poor implementation of epidemic prevention interventions within the region, non-epidemic-prone lower local governments (S/Cs) executed more epidemic prevention measures than their corresponding epidemic-prone counter parts. We concluded that the inadequate implementation of epidemic prevention and preparedness measures were possibly responsible for frequent occurrence of epidemics while inadequate preparedness and poor epidemic response account for the high case fatality in the West Nile region. Stakeholders must prioritize epidemic prevention and preparedness interventions in terms of planning, budgetary allocation, implementation, as well as dissemination of policy guidelines, surveillance tools; and training for their use.
Epidemic, Outbreak, Disaster, Epidemic Prevention, Epidemic Preparedness, Epidemic Response, Epidemic Committees
[1]
MoH, Uganda. Health sector strategic and Investment plan. Promoting people’s health to enhance socioeconomic development 2010/11-2014/15. Kampala: Ministry of Health, 2010.
[2]
WHO. A framework for global outbreak alert and response, 2002. [Internet]. Available from: http://www.who.int/csr/resources/publications/surveillance/whocdscsr2002.pdf. (Viewed on 24/3/2010).
[3]
WHO. Public health risk assessment and interventions. Conflict and humanitarian crisis in South Sudan. WHO/HQ/PEC/ERM/SCT/2014.1/PHRA, 2014. [Internet]. Available from: http://www.who.int/hac/crises/ssd/south_sudan_public_health_risk_assessment_15january2014_.pdf. (Viewed on 26/6/2015).
[4]
WHO. The International health regulations 2005: areas of work for implementation, 2007. [Internet]. Available from: http://www.afro.who.int/index.php?option=com_content&view=article&id=2056&Itemid=798. (Viewed on 23/3/2010).
[5]
WHO/AFRO. Epidemic and pandemic alert and response strategic plan 2009-2013, 2009b. [Internet]. Available from: http://www.afro.who.int/en/divisions-a-programmes/ddc/epidemic-a-pandemic-alert-and-response.html. (Viewed on 13/3/2010).
[6]
Ortu G, Mounier-Jack S, Coker R. Pandemic influenza preparedness in Africa is a profound challenge for an already distressed region: analysis of national preparedness plans. Health Policy and Planning, 2008; 23:161–169.
[7]
WHO and CDC. Technical guidelines for integrated disease surveillance and response in the African region. Harare, Zimbabwe and Atlanta, Georgia: World Health Organization Regional Office for Africa and the Center for Disease Control and Prevention, 2001. Available from: http://www.cdc.gov/idsr/focus/surv_sys_strengthening/tech_guidelines-integrated-diseaseENG.pdf. (Viewed on 25/2/2010).
[8]
MoH, Uganda. Annual health sector performance report: financial year 2008/2009. Kampala: Ministry of Health, 2009.
[9]
MoH, Uganda. Technical guidelines on integrated disease surveillance and response for Uganda. Kampala: Ministry of Health, 2002.
[10]
Office of the Prime Minister, Uganda. The National disaster preparedness and management policy (draft). Unpublished document, 2008.
[11]
MoH, Uganda. A field guide for epidemic response to meningococcal meningitis outbreak. Kampala: Ministry of Health, 2006.
[12]
MoH, Uganda. Annual health sector performance report: financial year 2007/2008. Kampala: Ministry of Health, 2008.
[13]
Heymann D [ed]. Control of communicable diseases manual. 19th ed. Washington DC: American Public Health Association, 2008.
[14]
Opio A et al. 2000. Assessment of infectious disease surveillance – Uganda, 2000. Morbidity and Mortality Weekly Report. Centers for Disease Control and Prevention. 2000; 49(30); 687-691. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4930a2.htm. (Viewed on 21/5/2010).
[15]
WHO. The World health report 2008: primary health care now more than ever. Geneva: World Health Organization, 2008.
[16]
U.S Department of Health and Humaitarian Services, CDC. The public health response to biological and chemical terrorism. Interima planning guidance for state public health officials, 2001. [Internet]. Available from: http://emergency.cdc.gov/documents/planning/planningguidance.pdf . (Viewed on 26/6/2015).
[17]
M’ikanatha NM, Lynfield R, Van Beneden CA and de Valk H (Ed). Infectious disease surveillance. 2nd Ed. Chichester, West Sussex: John Wiley & Sons, Ltd, 2013.
[18]
M’ikanatha NM and Iskander JK (Ed). Concepts and methods in infectious dosease surveillance. Chichester, West Sussex: John Wiley & Sons, Ltd, 2015.
[19]
Choi S, Lam P. Enhancing legal preparedness for the prevention and control of infectious diseases: Experience from severe acute respiratory syndrome in Hong Kong. Public Health, 2009; 123: 242–246.
