Dr. Brian Agaba

Dr. Brian Agaba

MBChB, MMed (Obs & Gyn), MPH, Fellowship in Field Epidemiology
Email: agababrian@uniph.go.ug / agababrian18@gmail.com
Telephone: +256774125554

Host Site: Reproductive and Infant Health Division, Ministry of Health

Host Mentor: Dr. Robert Mutumba

ABOUT THE FELLOW

Brian is a medical doctor with specialisation in Obstetrics and Gynecology, a public health specialist and an epidemiologist. He holds a Bachelor’s degree in Medicine and Surgery (MBChB), a Masters of Medicine in Obstetrics and Gynecology, a Masters of Public Health and a fellowship in Field Epidemiology.

Prior to joining the fellowship, Brian worked as a clinician for a decade and rose through the ranks to serve as the head of department of Obstetrics and Gynecology at a large not-for-profit hospital in Kampala. Desiring to have a greater impact on health outcomes of both individuals and populations, he decided to transition his career into the public health domain.

During the fellowship, Brian was attached to the Reproductive and Infant Health Division (RHD) of the Ministry of Health (MoH). His time at the host site helped improve his understanding of maternal, child health and adolescent health programming and policy environment.

Brian possesses competences in several areas of public health/ epidemiology such as: disease outbreak investigation and control, evaluation of surveillance systems, research, scientific writing and communication, grant and proposal writing, grant management, data analysis, program design and management, quality improvement and assurance. In addition, Brian has excellent communication and leadership skills.

The fellowship has broadened his view of health services beyond the clinical/ hospital based. It has taught him to combine and develop synergies between both his clinical and public health backgrounds. Brian is adequately prepared to contribute to the advancement of health in a holistic way.

  Achievements at the Host Site

• Led an investigation of a bacterial meningitis outbreak in a Palorinya Refugee Settlement, Obongi District, Uganda, March, 2023.
• Co-investigated several outbreaks and public health emergencies including: Malaria deaths in Namutumba District, March 2022, Anthrax outbreak in Bududa District, May 2022, Scabies outbreak in Hoima District, June 2022, Food poisoning in Packwach District, September 2022, Ebola Disease outbreak in Uganda, September–November 2022.
• Conducted a descriptive analysis of surveillance data on trends and spatial distribution of perinatal deaths in Uganda, 2017–2021.
• Conducted a study on impact of male involvement in antenatal care on maternal and infant outcomes among participants in the prevention of mother to child transmission of HIV impact evaluation study, Uganda, 2017– 2019.
• Conducted an epidemiological study on prevalence of and factors associated with anxiety, depression and post-traumatic stress disorder among Sudan ebolavirus disease survivors and family members, Uganda, January 2023.
• Conducted an epidemiological study on prevalence of and factors associated with depression among pregnant women attending antenatal care at Kawempe National Referral Hospital, Uganda.
• Implemented a quality improvement project on improving reporting of perinatal and maternal deaths at Kawempe National Referral Hospital, June – November 2023.
• Authored 3 manuscripts which are under peer-review in journals.
• Presented at several national and international conferences including: the national field epidemiology conference, the joint annual scientific conference and the AFENET conference.
• Published two articles in the Uganda National Institute of Public Health (UNIPH) quarterly public health bulletin.
• Co-editor of the July-September 2022 edition of the UNIPH quarterly public health bulletin.
• Published a newspaper article in the local newspaper, New vision titled mental health disorders in pregnancy: women are suffering silently.
• Mentor and trainer of the Field Epidemiology Training Program (FETP) intermediate tier.

Summary of Epidemiological Study: 

 Title: Prevalence of and factors associated with anxiety, depression and post-traumatic stress disorder among Sudan  ebola virus disease survivors and family members, Uganda, January 2023: a cross-sectional study

Background: Communities affected by Ebola disease (EBOD) may face resulting increases in mental health disorders. We evaluated the prevalence of and factors associated with mental health disorders among persons affected by the 2022 Sudan virus disease (SVD) outbreak in Uganda.

Methods: We conducted a cross-sectional study among SVD survivors and family members of survivors and fatal cases from 15– 31 January 2023 (six weeks after the last case was discharged). We included only laboratory-confirmed, consenting SVD survivors and family members who lived with or cared for confirmed SVD patients during their illness and who were home at the time of our visits. The Hospital Anxiety and Depression Scale was used to evaluate anxiety and depression. The post-traumatic stress disorder (PTSD) checklist for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition was used to evaluate PTSD. We used modified Poisson regression (adjusted for clustering by household) to determine factors associated with each mental health disorder.

Results: We enrolled 54 survivors and 82 family members from 96 households; median participant age was 30 years (range, 15-73), and 54% were female. The prevalence of anxiety (55%) and depression (50%) was higher than PTSD (17%); 64% had ≥1 mental health disorder. The prevalence of anxiety among persons from households with 2-4 members (aPR=0.54, 95%CI:0.31- 0.92) was lower than among persons who lived alone. The prevalence of PTSD was lower in persons from households with 2-4 members (aPR=0.24, 95%CI:0.08-0.66) and >4 members (aPR=0.32, 95%CI:0.13- 0.78) compared to persons who lived alone. Persons from households with ≥1 SVD death had a higher prevalence of depression (aPR=1.8, 95%CI:1.1-3.3) and anxiety (aPR=1.9, 95%CI:1.1-3.5) compared to households with no EBOD deaths. The prevalence of all mental health disorders was similar between survivors and family members.

Conclusion: Approximately two-thirds of SVD survivors and family members of patients in the 2022 outbreak in Uganda had ≥1 mental health disorder shortly after the outbreak ended. Strengthening mental health services during and after Ebola virus outbreaks for survivors and family members of patients may enhance the quality of outbreak response.

Next Steps

Brian hopes to develop a career in field epidemiology through roles in national and international organisations. He is particularly interested in roles with components of disease surveillance and response, global health security and maternal and newborn health system strengthening. Brian will always be an advocate for women’s and children’s health.

Pictorial