Plan to control rare Ebola outbreak in Uganda could be blueprint for others
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Key takeaways:
- There were 142 cases and 55 deaths during the first Sudan ebolavirus outbreak in Uganda in a decade.
- Uganda implemented an enhanced screening plan that could be a model for other outbreaks.
HOUSTON — Uganda rapidly scaled up screening during a rare outbreak of Ebola virus in 2022 using a plan that researchers said could be a blueprint for future responses.
The country’s rapid implementation of an infection prevention and control strategy successfully enhanced screening capacity in more than 1,000 health facilities during its first outbreak of Sudan ebolavirus in a decade, researchers reported during the Society for Healthcare Epidemiology of America Spring conference.
The outbreak was declared in September 2022 after six suspicious deaths were reported in the Mubende. According to WHO, there had been only seven previous outbreaks of Ebola caused by the Sudan ebolavirus species — including four in Uganda, the last occurring in 2012. Outbreaks caused by Zaire ebolavirus are much more common and are routinely brought under control now with the help of a vaccine.
“Uganda experiences different infectious disease outbreaks almost yearly, and given the locale of the country, patients start in lower level health care facilities before showing up in acute-care centers,” Shillah Nakato, MPH, faculty at the Infectious Diseases Institute at Makerere University, told Healio. “This was no different during the 2022 Sudan ebolavirus outbreak.”
By the time the outbreak was declared over in January 2023, 142 people had been infected — including 19 health care workers — and 55 died, including seven health care workers.
Responding to the outbreak, the Ministry of Health in Uganda instituted an infection prevention and control (IPC) strategy at health facilities that involved rapidly enhancing their capacity to screen for infections and control transmission.
“We set out to enhance capacity for screening and timely identifying suspect cases to minimize the chances of transmission among health workers and facilities — which we term ‘source control’ — by early identification of suspects, isolation and management,” Nakato said.
The strategy included training health workers identified as IPC mentors for 3 days, establishing screening areas, and providing screening supplies and communication materials at facilities in five high-risk districts between November 2022 and January 2023.
For the study, Nakato and colleagues then measured each facilities’ IPC capacity using five primary screen parameters: at least one meter distance between screener and the person screened, availability of a functional hand-washing facility and infrared thermometer, correct record of each person’s temperature, and appropriate referral process for those suspected of having Sudan ebolavirus to holding areas.
In total, the program trained 296 IPC mentors, with screening information cascaded to 3,899 health care workers and screening areas established in 1,135 facilities.
Based on results from the Ministry of Health IPC assessment tool, screening capacity improved from 44% at baseline to 67% at the study endpoint. More specifically, screening capacity improved from 33% at baseline to 60% at endpoint among level II care facilities and 54% to 76% in public health care facilities.
“For outbreak response in low-income countries, there is need to invest in preparedness efforts and infrastructure and to ensure availability of resources that offset response whenever there is an outbreak otherwise the health care system is strained at the face of public health threats,” Nakato concluded.
References:
- Nakato S, et al. Abstract 152. Presented at: Society for Healthcare Epidemiology of America Spring Conference; April 16-19; Houston.
- WHO. Ebola Uganda, 2022. https://www.who.int/emergencies/situations/ebola-uganda-2022. Accessed April 17, 2024.
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Nakato S, et al. Abstract 152. Presented at: Society for Healthcare Epidemiology of America Spring Conference; April 16-19; Houston.
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