Dr. Allan Komakech

Dr. Allan Komakech

MBCHB (Constantine), MPH (CIU), & Advanced Field Epidemiology Fellow (UPHFP)
Email: akomackech@musph.ac.ug
Telephone: +256789185617 /+256753931932

Host Site: Ministry of Health, Reproductive Health Department.

Host Mentor: Dr. Robert Mutumba, Dr. Irene Mwenyango, Dr. Robert Mugahi

ABOUT THE FELLOW

Dr. Allan Komakech is a medical doctor, a public health specialist and now a qualified field epidemiologist. Before joining the fellowship, he pursued a medical degree in medicine and surgery (MBChB) from the University of Constantine, Algeria and Masters degree in Public Health (MPH) from Clarke International University, Kampala, Uganda. He is also currently pursuing a post graduate diploma in program planning and management. Prior to joining the fellowship, he served as a practicing medical doctor in both private and public facilities, a program coordinator for the viral hepatitis program at Lugei foundation and also as a lecturer at the school of public health of Clarke International University.

During the fellowship, he was attached to the Reproductive Health Department (RHD), Ministry of Health (MoH). Consequently, his time at the host site has helped to improve my understanding of maternal and child health issues as well as adolescent and school health.

The fellowship has helped Allan gain skills in advanced outbreak detection and investigation (including during the recent Ebola outbreak), scientific writing, grant and proposal writing, grant management, and oral presentation. He also developed skills in data analysis using Epi info, STATA, R and QGIS. His leadership skills have greatly improved through the situations encountered during the two years that required me to be a leader.

In addition to his competencies, Allan is respectful, honest, and culturally-tolerant. The fellowship has reinforced these values and qualities of being a team player, flexible and hardworking, qualities that will help him excel as a public health specialist and field epidemiologist.

Dr. Allan Komakech won the best oral presentation award at the Uganda society for health scientists conference, 2022 on the abstract presented on “Adverse events following AstraZeneca COVID-19 vaccination in Uganda, March-April, 2021”.

  Achievements at the Host Site

• Participated in high level meetings for the proposed national roll-out of Sayana Press, a self-injectable contraceptive, in April 2021.
• Led the writing team of the MPDSR Costed Implementation Plan, 2021- 2025 in June, 2021
• Supported the writing and dissemination of the MPDSR reports for FY 2020/2021 and FY 2021/2022.
• Led several teams to district health facility MPDSR support supervisions to Butambala, Mpigi, Bukomansimbi and Lwengo Districts
• Supported the formulation of guidelines for improved antenatal care for pregnant mothers in Uganda, August 2021
• Led the evaluation of the availability of COVID-19 SOPs and surveillance in preparation for the re-opening of schools in Hoima District, October 2021.
• Supported the formulation and dissemination of the communication and action plan for safe motherhoods
• Participated in the National Training of Trainers and Finalization of a Guide on Medical Forensic Evidence Management and Filling of Medical Police Forms with the Objective of Improving Quality of Medico-Legal Support to the Victims/ Survivors- September, 2021.
• Part of the organizing committee of the first national safe motherhood conference, October 2021
• Participated in the formulation of reproductive health department integrated work plan, November 2021
• Conducted an assessment to understand experiences, perceptions & attitude towards antenatal care and integrated community case management (iCCM) services in Adjumani and Moyo, December 2021
• Co-edited the first edition of the Reproductive and Infant Health Quarterly bulletin, Jan-March 2022 edition
• Represented MoH reproductive health department at a round table discussion on “Increasing financing for family planning in Uganda”, January 2022
• Supported the development of a health facility based MPDSR and results-based financing mentorship tool with in collaboration with LifeNet International, February 2022
• Led teams for health facility malaria in pregnancy mentorship in Serere and Moroto Districts, Eastern Uganda, February-March, 2022
• Participated in the formulation of hospital Maternal and Child health Quality of Care Results Based Financing tool, March 2022
• Contributed in the formulation of the post-partum haemorrhage (PPH) intervention framework, March-June 2022
• Participated in the preeclampsia awareness campaign- May 2022 and the official launch of the maternal and newborn guidelines in Mbale, May 2022,
• Engaged with different stakeholders to establish the school health guidelines, Sept 2022

Fellowship program specific achievements

• Participated in 5 outbreaks and public health emergencies including: COVID-19 in Kampala, outbreak of malaria in Iganga, 2021, Multidrug resistant tuberculosis in Mbarara and Kabale regions, 2021 and most Outbreak of Ebola in Mubende, Kampala and Kassanda Districts, 2022.
• Conducted a descriptive analysis of surveillance data on “Trends and distribution of birth asphyxia in Uganda, 2017-2020.
• Led an HIV study on “Maintenance of HIV viral load suppression at six months post-antiretroviral therapy regimen optimization among treatment-experienced clients aged ≤19 years, Kampala, Uganda, 2020– 2021”.
• Led a study on “Assessment of the performance of laboratory services during the COVID-19 response in Uganda, September-October 2021”.
• Led a study on “Post COVID-19 condition (PCC) among individuals hospitalized during Wave 1 and Wave 2 at Mulago National Referral Hospital and Entebbe Regional Referral Hospital, Uganda, 2020- 2021”.
• Implemented a quality improvement on improving reporting of adverse events following COVID-19 vaccination at Mbale Regional Referral Hospital.
• Led a study on Ebola Super spreaders during the Ebola virus disease outbreak in Uganda, 2022

Written communication

• Manuscripts

Lead author

• Assessment of adverse events following AstraZeneca COVID-19 vaccination in Greater Kampala, Uganda, March-April 2021
• Trends and distribution of birth asphyxia in Uganda, 2017-2020.
• Ebola super spreaders during the Ebola virus disease outbreak, September- December, 2022

Co-author

• Outbreak of malaria in Iganga district, April 2021
• Ownership and utilization of long-lasting insecticide-treated nets 3 months following a mass distribution, May 2021
• Trends and distribution of neonatal sepsis in Uganda, 2016-202
• Trends and distribution of stillbirths in Uganda, 2012- 2020
• District leader community dialogues improved willingness to receive COVID-19 vaccines in Western Uganda, May 2021
• Readiness of health facilities to manage COVID-19, Uganda, June 2021
• Risk factors associated with deaths among hospitalized pregnant women with COVID-19 in Uganda, June 2020 to August 2021

• Rotavirus vaccine introduction into the routine immunization schedule reduced incidence of watery diarrhea among children under five years, Uganda, 2016-2021
• Trends and spatial distribution of all cause pneumonia among children under five years in Uganda, 2016-2021: analysis of surveillance data
• Notes from the Field: Outbreak of Ebola Virus Disease Caused by Sudan ebola virus, Uganda, August– October 2022

Conference presentations

• Presented my work at several conferences including:

• • Oral presentation on “Adverse events following AstraZeneca COVID-19 vaccination in Greater Kampala, Uganda, March-April 2021”-
  • 8th East African Health and Scientific Conference 2021, 21st Uganda society of health scientists (USHS) conference, 2022
  • Poster presentation on “Trends and distribution of birth asphyxia in Uganda, 2017-2020: an analysis of surveillance data”-JASH 2022

Summary of Epidemiological Study: 

 Title: Assessment of adverse events following COVID-19 AstraZeneca vaccination in Greater Kampala,Uganda, March-April 2021

Background: Tracking adverse events helps to assess vaccine safety. Uganda rolled out AstraZeneca vaccination in March 2021 primarily targeting teachers, health workers, security personnel, and older persons. However, information about adverse events following the nationwide rollout of the AstraZeneca vaccination in Uganda is limited. We, therefore, assessed adverse events following AstraZeneca vaccination among adults in the Greater.

Methods: We used routinely collected data about AstraZeneca vaccination to identify persons who received ≥1 dose of the vaccine. Data were collected between March 10 and April 30, 2021 through telephone interviews on a random sample of vaccinated individuals. We defined adverse events as any untoward medical occurrence after vaccination and serious adverse events as any event leading to hospitalization, persistent disability ˃28 days, death, or congenital anomaly. We summarized data descriptively, performed bivariate analysis, and determined factors independently associated with adverse events using a multivariable logistic regression.

Results: We studied 374 participants aged 20-85 years and found 235 (62.8%) had received only the first dose of Astra-Zeneca vaccine while 139 (37.2%) received two doses of the vaccine. The prevalence of adverse events was 76.5% and the common adverse events included injection site redness, pain, or itching, and headache but no serious adverse event was reported. Participants aged 20–29 years (AOR 4.58; 95% CI: 1.92– 10.95), 30-39 years (AOR 3.69; 95% CI: 1.81–7.51) and 40-49 years (AOR 2.78; 95% CI 1.26–4.90) were more likely to develop adverse events compared to those aged ≥50 years.

Conclusion: Adverse events is prevalent among persons vaccinated with Astra- Zeneca vaccine, largely among those below 50 years old. However, serious adverse events are rare. Persons <50 years old should be targeted for surveillance of adverse events and receive appropriate health education and counseling.

Key lessons learnt during the fellowship

During the fellowship, I learnt and developed the following competencies:

• Logically conducting outbreak investigations
• Best practice approaches to public health emergencies
• Scientific writing skills: Abstracts, manuscripts, policy briefs, editing of bulletins
• Data analysis using Epi info, STATA, R, SPSS, QGIS, NVivo
• Oral presentation skills: scientific conferences (national and international), colloquiums, synopses
• Designing and implementing quality improvement projects
• Media usage: News briefs, newspaper articles, radio and TV talk shows
• Social networking and community engagement
• Capacity building in field epidemiology

Next Steps

I hope to further my career in field epidemiology through roles in national and international organizations in disease surveillance, global health security and health program designing and implementation and building capacity. I will also ensure that all the work done during the fellowship will be published in reputable peer-reviewed journals. I will continue supporting FETP frontline and intermediate trainees as part of my capacity building roles

Pictorial