Joselyn Annet Atuhairwe
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ABOUT THE FELLOWJoselyn Annet Atuhairwe is a medical and veterinary entomologist/parasitologist with excellent skills and experience in epidemiology. She holds a Master of Science degree in Biology and Control of Parasites and Disease Vectors from University of Liverpool, United Kingdom and a Bachelor of Science degree in Zoology and Botany from Makerere University, Uganda. She is a fellow alumnus of: International Atomic Energy Agency (IAEA) in the field of Insect Pest Control and International Livestock Resources Research Institute (ILRI), Kenya where she evaluated the use of Insecticide Treated Netting (ITN) for control of flies in Butcheries in Nairobi, Kenya. Prior to joining the Uganda Public Health Fellowship program, Joselyn worked as an entomologist with Ministry of Agriculture, Animal Industry and Fisheries (MAAIF) on the African Union funded tsetse and trypanosomiasis eradication project: “Creation of Sustainable Tsetse and Trypanosomiasis Free Areas in East and West Africa” (STATFA), Uganda component. She spearheaded the Sterile Insect Technique (SIT) component of the project providing leadership to eight insectary, field and support staff. Together with eight other entomologists, she established a colony of Glossina fuscipes fuscipes using wild material from Buvuma Islands. She was part of the team that designed and implemented: entomological monitoring; operational research studies to inform and support tsetse control interventions and studies to evaluate the effectiveness of new vector control tools. Joselyn was also part of the team that designed the Uganda Tsetse and Trypanosomiasis Eradication Program (UTTEP) a document which doubles for resource mobilisation and guiding tsetse control and eradication efforts in the country. Joselyn is keen on using surveillance data for early warning and detection of epidemics to allow for prompt response to contain epidemics. Achievements at the host siteJoselyn was based at the National Malaria Control program of Ministry of Health Uganda. Here she was a member of the national Insecticide Resistance Management (IRM) taskforce and two Technical Working Groups (TWGs) namely: Malaria Surveillance, Monitoring and EvaluationOperations Research (SME-OR) TWG and the Integrated Vector Management (IVM) TWG. During the first quarter of her stay at NMCP, Joselyn was assigned a task to coordinate Indoor Residual Spraying activities in 11 districts in Northern Uganda on-behalf of the Program Manager. This was part of the intermediate response to the Northern Uganda malaria epidemic which started in 2015. She ably took on the responsibility and worked with a multidisciplinary, multistakeholder team to develop the IRS implementation strategy and refined the budgets. Joselyn later worked with her team through the Ministry of Health financial management system to effectively coordinate implementation of the activity in the epidemic districts. She coordinated the regional training meetings in IRS, drafted management letters to the implementing district administration, organised multi-stakeholder engagement meetings to review progress of implementation of the malaria epidemic response plan which was followed by bottleneck analysis to identify barriers to implementation. She closely followed up jointly agreed resolutions from these meetings and ensured their implementation. Joselyn also undertook other assignments at NMCP ranging from analysis of surveillance data, coauthoring policy documents and implementation guidelines, establishment of surveillance systems and support supervision summarised below:
Program-specific achievements (key deliverables)Joselyn was involved in outbreak investigations and other epidemiological studies.
Summary of an Epidemiological study: TITLE: Changes in malaria morbidity following Indoor Residual Spraying: a comparative analysis of IRS and non-IRS districts in Eastern and Northern Uganda, 2013-2016 Introduction: Uganda contributes the fourth-highest number of cases to the global malaria burden, accounting for 8,480,000 cases in 2015. Indoor Residual Spraying (IRS) of insecticides is a proven effective intervention against malaria. Since December 2014, districts in Northern and Eastern Uganda have implemented IRS. We analysed malaria surveillance data for 2013-2016 to compare malaria morbidity before and after application of IRS in Eastern and Northern Uganda. Methods: We analysed routine malaria surveillance data reported to the Uganda Health Management Information System during 2013-2016. We fit a negative binomial regression model to total confirmed malaria cases reported in five IRS districts and five non-IRS districts, using the natural log (Ln) of the population as the offset. We included rainfall level, Monthly Blood Examination Rate (MBER), district reporting rates, and 2013 (as baseline) total confirmed malaria cases as covariates. The IRS and non-IRS districts included in the study were from the same region with comparable malaria incidence at baseline. Results: Malaria incidence in IRS districts decreased from 19/1000 population in 2013 to 14/1000 population in 2016 (p<0.0001), while non-IRS districts registered an increase from 13/1000 population in 2013 to 25/1000 population in 2016 (p<0.0001). The modelling results showed that, in reference to 2013 levels, IRS districts had 47% fewer confirmed malaria cases than nonIRS districts by 2016 (Incidence Rate Ratio [IRR]=0.53; 95% CI=0.43-0.66) after offsetting for Ln population and accounting for district reporting rates, rainfall, MBER and baseline malaria cases. Conclusion and recommendations: IRS application was associated with a significant reduction in malaria morbidity. We recommend that IRS be used as one of the key strategies for malaria control in all remaining endemic regions of the country. |
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