Veronicah MasanjaDCM (SOCO-Mbale), Bsc PH (CIU), MEPI (UA), Advanced-FETP (UPHFP) Host Site: National Tuberculosis and Leprosy Program, Ministry of HealthHost Mentor: Dr. Stavia Turyahabwe, Dr. Majwala Robert |
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ABOUT THE FELLOWVeronicah Masanja, a Field Epidemiologist with a clinical and public heath background. she holds a Master of Science degree in Epidemiology from Universteit Antwerpen, Belgium. She has overtime gained special interest in antimicrobial resistance and Tuberculosis surveillance. During the fellowship, she was attached to the National TB and Leprosy program (NTLP), Ministry of Health. At the NTLP, she provided technical support at both national and sub-national levels as a facilitator in TB and Leprosy surveillance and Electronic case-based surveillance system. She has participated in planning, implementation and monitoring of community awareness, screening, testing and treatment to end tb and leprosy (cast tb) campaign strategies. She conceptualized, designed and implemented projects like the “Patterns of tuberculosis case notification and treatment outcomes in the context of COVID-19 pandemic: analysis of national surveillance data, January 2019 – June 2021”. Veronica has led and coordinated different projects both at the fellowship and host site ranging from outbreak investigations to epidemiological studies. She participated in the COVID-19 and Ebola responses in various capacities: contact tracing, case investigation, alert management. She led the Ebola surveillance pillar in Kassanda District. This improved her leadership, coordination, training, disease surveillance and response skills. She is skilled in data analysis, and interpretation using statistical and spatial packages like Epi Info, STATA, and QGIS. Achievements at the Host Site
Fellowship program specific achievementsOutbreak and other projects
Written Communication
Conference presentations
Summary of Epidemiological Study:Title: SPatterns of tuberculosis case notification and treatment outcomes in the context of COVID-19 pandemic: analysis of national surveillance data, January 2019 – June 2021 Background: Tuberculosis case notification and outcomes monitoring are critical for TB control but can both be disturbed by interruptions to normal health system functioning. The first major wave of COVID-19 in Uganda occurred during August-December 2020. The government-imposed lockdown measures during March- June 2020 in which residents were required to stay at home. Kampala was particularly affected by the lockdown. We investigated trends and distribution of TB case notification rates (CNR) and treatment success rates (TSR) during January 2019-June 2021 to determine the effect of COVID-19 epidemic and associated lockdown. Methods: We analysed TB case notification and treatment success data for January 2019-June 2021 from the Uganda District Health Information Software version2 (DHIS2) and disaggregated them by region. We also collected data on the COVID-19 cases and compared COVID-19 cases with the TSR, and CNR trends over the period. We computed the CNR per 100,000 population, defined as number of notified TB cases/100,000 population. TSR was defined as the proportion of patients initiated on TB treatment that successfully completed treatment or cured. We described the quarterly trends and distribution of CNR and TSR pre (January 2019-March 2020) and during COVID-19 (April 2020-June 2021). We used interrupted time series analysis to determine the significance of the trends before and during COVID-19. We defined time periods by year (2019, 2020, or 2021) and quarter (Q). Results: The overall TB CNR between January 2019 and June 2021, was 165/100,000; TSR was 79.4%. CNR ranged from 166.2/100,000 pre COVID-19 to 164/100,000 during COVID-19. CNR declined significantly by 22% (p=0.042, CI= [-41.4, -1.1]) from January 2020 to April 2020, concurrent with the lockdown and rising COVID-19 cases and was primarily driven by the sharp decline from 426/100,000 to 265/100,000 in Kampala City. This was followed by a significant quarterly increase in the national CNR of 16/100,000 (p<0.001, CI= [10.0,21.6]), and 39/100,000 (p=0.01, CI= [15.66,62.32]) in Kampala. TSR increased significantly by 1.6% (p<0.0001,95%CI 1.3-1.9%) quarterly. Conclusion: CNR appeared to be affected by the initial lockdown but recovered quickly. However, this decline was heavily driven by declines in CNR in Kampala District. Kampala CNR trends are not reflective of the rest of the country during 2019-2021 and should be examined separately. TSR increased over time but was still below the 90% target. There is need to focus on continuity of TB care interventions in future in areas heavily affected by lockdowns. Key lessons learnt during the fellowship
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