Petranilla Nakamya is a happy fully fledged field epidemiologist. She holds a master’s degree in public health with a background in pharmacy. She has particular interest in maternal and child health.
During the fellowship Petranilla I was attached to the Public Health Emergency operation Centre (PHEOC), the information and coordination centre for public health events in Uganda.
The training has empowered her with knowledge and skills in outbreak investigation and response, scientific writing and better knowledge on the public health system on Uganda. She served her country using the platforms granted.
At the PHEOC, Petranilla was part of the team that enhanced capacities to manage and respond to the public health emergencies through strengthening the surveillance systems. She was involved in development of documents and systems that support surveillance.
This training also exposed her broadening her outlook towards life and her network.
Achievements at the Host Site
Participated in organizing for consensus meeting on 2021 internal multi-sectoral self-assessment on the JEE score card and operational planning.
Coodinated Mbale Regional team during the COVID-19 response
Reviewed the sustainability plan for withdraw of indoor residual spraying in Alebtong and Otuke.
Participated in the 2021 NAPHS annual review monitoring and evaluation training
Took part in the assessment of antibiotic use and consumption in 6 regional referral hospitals in Uganda
Participated in organizing for the AMR awareness week in November 2021
Participated in week’s training on Evidence Based by Africa CDC where I chaired the sessions on one of the days
Participated in organising the Uganda biosecurity and biosafety stakeholders’ meetings.
Supervised research assistants and IDSR focal person in the study on follow-up on adverse events following immunisation for NOPV2
Updated the 717-monitoring tool for outbreak response and wrote a policy brief on the piloting of the 717 matrix
Joined the IMT for managing the yellow-fever outbreak in 2022
Participated in the Events Management System building workshopan d facilitated the trainings.
Chaired the COVID-19 Inter- Action Review (IAR) for Kampala response
Reviewed signals on the EIDSR system and forwarded them to the respective districts for verification.
Coordinated Deep dive implementation and conducted key informant interviews
Participated in the review of standard operating procedures for the EOC
Facilitated Ebola virus disease preparedness in Health facilities in the Kampala Metropolitan area
Participated in planning for an EVD simulation exercise
Supported the National Malaria Control Program in assessing of the exit plan for Indoor Residual Spraying (IRS) project for districts Alebtong and Otuke.
Fellowship program specific achievements
Led an epidemiological investigation which compared hospitalized and non-hospitalized patients among the three waves of COVID-19 in Uganda.
Participated in other outbreak investigations:
Malaria outbreak investigation in Iganga District
EVD outbreak in Kampala Metropolitan Area
COVID-19 pandemic
Participated in other investigations of public health importance:
An evaluation of laboratory services in the COVID-19 response in Uganda
end line survey on evaluation of mosquito nets utilization in Uganda
Evaluation of the Implementation of Xpert MTB/RIF Ultra assay Testing in Uganda, 2019-2021
Investigation of hospitalised COVID-19 cases at Mulago NRRH
Analyzed surveillance data from DHIS on stillbirths in Uganda between 2014 to 2020
Designed and implemented a QI study to improve reporting mortality in Jinja Regional Referral Hospital, Uganda
Conducted an HIV evaluating retention and risks of adolescent girls and young women receiving a package of services from the DREAMS program, 2016 to 2021 in Uganda
Written communication
Manuscript: ‘Trends and geospatial distribution of stillbirths in Uganda, 2014-2020’.
Newspaper article in the New Vision: ‘advice on the use of herbal medicines during the COVID-19 pandemic’
Edited the Issue 1 Volume 7 of the Uganda National Institute of Public Health epidemiological bulletin and published 3 articles in the same:
Still births in Uganda
COVID-19 inter-Action Review, June 2022
6th Graduation ceremony of the Uganda public fellowship program
Published in the one health bulletin on Uganda Multi-Sectoral Self-Assessment, 2021
Conference presentations
Presented at three national and one international conferences
National Field Epidemiology Conference (NFEC) 2021 and 2022
Uganda Society for Health Scientists conference (USHS) 2022
Africa Mortality Symposium
Summary of Epidemiological Study:
Background: Uganda has experienced three major waves of COVID-19 since March 2020, driven by the Alpha variant (wave 1; W1), Delta variant (wave 2; W2), and Omicron variant (wave 3; W3). We compared the epidemiology of cases across the three waves to inform decision-making in pandemic control
Methods: We compared W3 cases to previously published results for W1 and W2 cases in Uganda. We collected medical records for 200 PCR-confirmed hospitalized patients (HP) from Entebbe and Mulago Referral Hospitals during W3 from December 2021 to February 2022. We interviewed by phone 200 randomly selected, PCR-confirmed non-hospitalized patients (NHPs) identified from lab records. Data on demographics, clinical characteristics, and vaccination status were collected from patients or next-of-kin (for fatal cases).
Results: There was no difference in median age between patients in any wave. Among HP, the proportions female in W1, W2, and W3 were 27%, 46%, and 36%, respectively; all comparisons were significantly different (p<0.05). Among NHP, the proportions female in W1, W2, and W3 were 42%, 48%, and 43%, respectively, none significantly different. Among HP and NHP, the commonest comorbidity in all 3 waves was hypertension. W1, W2, and W3 had 18%, 28%, and 17% of HP with hypertension (significantly different between W3 and W2 (p=0.009) but not W3 and W1 (p=0.79)). There were no differences in the proportion of NHP with hypertension between any of the waves. No patients were vaccinated in W1. Among HP, more were fully vaccinated in W3 than W2 (46% vs 1%, p<0.001). Among HP, 6%, 26%, and 11% died in W1, W2, and W3, respectively, with W3 having significantly lower proportions of HP dying than W2 (p<0.001), but not W1 (p=0.073).
Conclusion: The characteristics of HP and NHP with COVID-19 were modestly different in three COVID-19 waves in Uganda. Overall, W3 cases were somewhat more similar to those in W1 than W2. However, disease appeared to be less severe in W3 and W1 than W2. As the SARS-CoV-2 pandemic continues to evolve, monitoring waves and new variants should remain a priority to inform response.
Key lessons learnt during the fellowship
During the fellowship, I learnt and developed the following skill sets:
Outbreak Investigation and response including institution of interventions
Evaluation of surveillnace systems
Designing and implementing Quality Improvement Projects
Data management, analysis and interpretation using such sofware as STATA, EpiInfo and QGIS
Scientific writing (for Abstracts, Manuscripts, Policy Briefs and short articles)
Presentation skills and dissemination of findings
Networking and lobbying skills
Next Steps
I have been equipped with knowledge and skills to enable me serve with various agencies/implementing partners or Ministry of health to combat public health emergencies and threats, improve the public health system of Uganda, as well as Globally.
Pictorial
Petranilla with a colleague during a malaria outbreak investigation in Iganga district, 2021
Petranilla (red band) mentoring cohort 16 trainees of the FETP-Frontline
I was awarded best abstract at the USHS conference