Dr. Namubiru Saudah KizitoMBChB (MUK), MMed (MUK), Hospital and HealthCare Management (UMI) & Advanced Field Epidemiology Fellow Host Site: National Health Laboratory & Diagnostic Services Department (NHLDS), MOH.
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ABOUT THE FELLOWDr. Namubiru Saudah Kizito is a public health microbiologist seasoned epidemiologist, and an anti-microbial resistance (AMR) control advocate and steward. She holds a Bachelor of Medicine and Surgery (MBChB) Degree and a Master of Medicine (MMed Microbiology). She is an experienced health manager with a post-graduate diploma in Hospital and Healthcare Management. During the fellowship Saudah was hosted at the National Health Laboratory and Diagnostic Services Department (NHLDS) of the Ministry of Health, Uganda. She has evolved into a competent professional, making significant contributions to both epidemiology and public health microbiologist. While at the National Health Laboratory and Diagnostic Services Department (NHLDS) she played a significant role in AMR surveillance at both National and sub-national levels. She is a member of the National Coordination Centre for AMR Control and is very instrumental, in championing diagnostic stewardship of microbiology testing to improve AMR surveillance data quality and quantity. Efforts in analyzing trends of resistance in antibiotic resistance, sensitizing health workers and the public about AMR, capacity-building sessions, and evaluating the drivers of AMR at the community level have advanced her career aspirations as a public health microbiologist and AMR advocate. Dr. Saudah has served as a subject matter expert on several platforms both locally and on National and regional AMR communicable disease engagements. Bestowed with the unique skills and competencies of a clinician, infectious disease physician (clinical microbiologist) health system manager and now epidemiologist, she has utilized her potential always. My diverse experiences and skills showcase a well-rounded professional dedicated to advancing public health and addressing emerging challenges Disease Surveillance and Response, rapid risk assessments of public health events, the Joint External Evaluation, After-Action Reviews, scientific writing.Similarly, I demonstrated commendable capacity in emergency response, notably during the suspected cholera outbreak in Luwero Island, Buvuma district, I coordinated both the epidemiology and laboratory teams and we managed to verify the alert despite the geographical barriers and beliefs of the locals that No woman has and will ever not visit the affected island. Due to this outstanding, and prompt response, I was nominated to represent Uganda to the Global Task Force on Cholera Meeting, in Maputo, Mozambique. While there, I made a presentation on molecular diagnostic journey in Uganda. Achievements at the Host Site
Fellowship program specific achievements
Summary of Epidemiological Study:Title: Increasing trends of antibiotic resistance in Uganda: an analysis of the National antimicrobial resistance surveillance data, 2018−2021 Background: Continuous monitoring of antimicrobial resistance (AMR) among isolates from clinical samples can inform effective drug selection for patients. In Uganda, human AMR surveillance occurs at national and regional referral hospitals and in selected public universities. Bacterial isolates from patients are subjected to drug susceptibility testing; the results are used in real-time for patient care. Isolates are then sent to the National Microbiology Reference Laboratory (NMRL) for reanalysis to generate national AMR surveillance data and for global reporting. Although isolated analysis results from NMRL are considered official AMR surveillance data, there is limited utilization of these data to inform public health planning. We valuated the trends and spatial distribution of AMR to common antibiotics used in Uganda. Methods: We analyzed data from pathogenic bacterial isolates from blood, cerebrospinal, peritoneal, and pleural fluid from AMR surveillance data for from 2018– 2021. We calculated the proportions of isolates that were resistant to common antimicrobial classes. We use the chi-square test for trends to evaluate changes in AMR resistance over the study period. Results: Out of 537 isolates with 15 pathogenic bacteria, 478 (89%) were from blood, 34 (6.3%) were from pleural fluid, 21 (4%) were from cerebrospinal fluid, and 4 (0.7%) were from peritoneal fluid. The most common pathogen was Staphylococcus aureus (20.1%), followed by Salmonella species (18.8%). The overall change in resistance over the four years was 63–84% for sulfonamides, fluoroquinolones macrolides (46–76%), phenicols (48–71%), penicillins (42–97%), ß-lactamase inhibitors (20–92%), aminoglycosides (17–53%), cephalosporins (8.3–90%), carbapenems (5.3–-26%), and glycopeptides (0–20%). Annual resistance rates to ciprofloxacin increased from 2018-2021 for gram-positive organisms (26–-45% p=0.02). Among gram-negative organisms, there were increases in resistance to tetracycline (29-78% p<0.001), ciprofloxacin (17-43%, p=0.004), ceftriaxone (8–-72%, p=0.003), imipenem (6-26%, p=0.004), and meropenem (7-18, p=0.03). Conclusion: There was a significant increase in the trends of drug resistance to antibiotics such as ciprofloxacin, ceftriaxone, meropenem, imipenem, and tetracycline (among gram-negative organisms) in Uganda. Continuous monitoring of AMR trends at the national level to improve efforts to reduce the AMR problem in Uganda through public health policy and planning is crucial. Key lessons learnt during the fellowship
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