Cholera Outbreak Dynamics and Hotspot Mapping In Uganda - Project
Background
Uganda has repeatedly been affected by cholera outbreaks since its first appearance in 1971 despite advances in science and technology for prevention, detection, and treatment. According to WHO, cholera prevention and control should be priority in areas at risk and vaccines should be included among other cholera prevention and control strategies.
The Government of Uganda instituted preventive and control measures that included promotion of access to safe water; sanitation and hygiene; health education and community mobilization; disease surveillance and case management in an effort to end cholera outbreaks in the country. However cholera continues to occur regularly in selected areas of the country and remains as a major public health problem.
Project Aim: The aim of this exercise is to provide an overview of the cholera outbreak dynamics and contextual risk factors for the cholera hotspots to facilitate Uganda’s ongoing efforts towards cholera control and elimination.
Project Activities
- Collect and compile all data on historical cholera burden in Uganda for the last 10 Data to be collected include:
- Number of cases, deaths and case-fatality rate by the district level or lower;
- Outbreak frequency, magnitude and severity by the district level or lower; and
- Areas thought to be affected by the ‘origin’ cholera outbreaks in the past.
For each identified hotspot, we shall evaluate the following contextual factors:
- Population mobility: Located on trade routes, transportation hubs (e.g. crossroads, railways junctions, bus terminals, and ports of entry ), markets, other major industries (e.g. mining or other major industrial activities).
- Population density: An assessment of the potential risk for the disease to rapidly spread (e.g. urban rural; local population vs. refugees etc.), mapped on the available resources and risk areas.
- Special populations: groups of individuals who are at higher risk for cholera transmission (e.g. migrant workers, fishermen, internally displaced persons, refugees, slum areas, gender and age
- Weather patterns: heavy rainy seasons, flooding, droughts, periods of abnormally high temperature that are known locally to be a risk factor for outbreaks.
- Accessibility: Evaluate whether any of the cholera hotspots have accessibility issues (e.g., security, poor linkages to roads, etc).
- The vulnerability of the population, i.e., behavioural, social, and environmental factors likely to impact infection risk and if the population engages in risk mitigation, such as health-seeking behaviours. Vulnerable populations may include detainees, children, homeless, and elderly.
- If available, provide information on the susceptibility of the population, e., the level of protection by earlier exposure to cholera from previous vaccination, economic, psychological status, and trust of a response.
- Access to water, sanitation and hygiene (WASH) services and current WASH practices:
- An assessment of current levels of WASH coverage per SDG 6 (JMP – WHO / UNICEF Joint Monitoring Programme for Water, Sanitation, and Hygiene data may be used) and access to WASH services in hotspots.
- An assessment of current WASH practices and risk behaviours that might cause disease transmission (e.g. does the population drink unsafe water, what is the knowledge of key hand washing times and actual behaviours, what is the prevalence of open defecation, levels of knowledge of prevention measures, food safety practices)
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- Assessment and if available of information pertaining to identified hotspots on water quality (e.g. proportion of households with access to improved water supply), including chlorination of piped supplies (proportion of households with access to basic sanitation), reliability of supplies, household water treatment and safe storage practices, and availability of household water treatment products, the proportion of people using unimproved sanitation, or additional details on sanitation services in high-risk areas such as internally displaced person/refugee camps/slums, itinerant/mobile populations and border.