Mercy Wendy Wanyana

Mercy Wendy Wanyana

BHUN (MaK); MPH (MaK)
Email:mwanyana@uniph.go.ug
Telephone: +256779207928

Host Site: Department of Integrated Epidemiology, Surveillance and Public Health Emergencies (IES and PHE), Ministry of Health.

Host Mentor:

ABOUT THE FELLOW

Mercy Wanyana is now a field epidemiologist. She holds a Masters degree in Public Health, Postgraduate Diploma in Monitoring and Evaluation and a Bachelors in Environmental Health. Mercy has an interest in disease surveillance and response. During the fellowship, she was attached to the Division of Surveillance, Information and Knowledge Management (SIKM) in the Department of Integrated Epidemiology, Surveillance and Public Health Emergencies (IES and PHE), Ministry of Health.

During the in-service training, she has developed skills and competencies in the design, implementation and evaluation of surveillance systems, outbreak investigation, applying epidemiological concepts in complex emergencies, advanced statistical skills and public health communication.

During the fellowship, she led one outbreak investigation and participated in four others including the 2022 Ebola outbreak. She conceptualised and designed projects utilising routinely collected surveillance data and primary data collected. These experiences built her competencies in conducting operational research. She evaluated the yellow fever surveillance system and the performance of contact tracing cascade during the Ebola Disease outbreak, gaining experience in health surveillance systems evaluation.

Additionally, she worked on various border health projects that built her competencies in global health diplomacy. Working on these various projects with multiple stakeholders and multidisciplinary teams in the Ministry of Health has developed her skills in teamwork, collaboration and public health leadership.

  Achievements at the Host Site

• Participated in the drafting of the National Framework for Multi-hazard Preparedness and Response.
• Participated in drafting of the Weekly Epidemiological Bulletin.
• Technical supervisor for the quarterly support supervision in disease detection and response at Points of Entry.
• Trained and mentored port health staff in West Nile and Northern Regions in electronic-based reporting of surveillance data.
• Led the orientation of port health staff on developing and reviewing public health emergency response plans.
• Led the organising of cross-border meetings to strengthen cross-border surveillance between the Republic of Uganda and the United Republic of Tanzania in June 2023.
• Participated in organizing the Annual National Point of Entry Stakeholder’s meeting.
• Participated in the Annual Point of Entry capacity assessment at designated Points of Entry in Uganda.
• Led the Marburg preparedness at Points of Entry training along the Uganda-Tanzania border during the Marburg Outbreak in Tanzania, 2023.
• Routinely analysed Point of Entry data to inform the Point of Entry surveillance sub-pillar.

Fellowship program specific achievements

• Led one outbreak investigation; ‘Yellow fever outbreak in Masaka, Wakiso and Bundibugyo.’
• Participated in four other outbreak/public health events investigations:

• • Severe malaria in Namutumba District
  • Ebola disease outbreak in Mubende, Kassanda and Jinja Districts
  • Syndromic surveillance during the Namugongo Matyrs day pilgrimage
  • Typhoid in Kampala Metropolitan area

• Analysed surveillance data from District Health Information System on:

• • Pneumonia cases and deaths among children <5 years in Uganda between 2013 to 2021.
  • Visceral Leishmaniasis in the Karamoja Region between 2015 to 2022.
  • The capacity in detection, reporting and responding to Public Health events of International Concern at Points of Entry, Uganda, July–October 2022.
  •  Evaluated the Yellow Fever sentinel surveillance system in Uganda,2017-2022. Presented at two local conferences and one international
  • 8th and 9th National Field Epidemiology Conference
  • 8th AFNET Conference in Mombasa, Kenya

• Wrote and published two newspaper articles like ‘Why the COVID-19 vaccine is still relevant.’
• Editor of the Uganda Public Health Bulletin; Volume 7 issue 2.

• • Published four articles in the NIHP bulletin:
  • Trends and spatial distribution of pneumonia admissions and deaths among children <5 years
  • Rapid assessment of knowledge and perceptions regarding Ebola Disease and infection prevention and control among health workers in Uganda, November– December 2022
  • Yellow fever surveillance system in Uganda,2012–2022:strengths and weaknesses
  • Factors associated with severe pneumonia among children <5 years, Kasese District, Uganda, 2023

• Designed and implemented a quality improvement project on improving disease surveillance at Busia One Stop Border point using Integrated Disease Surveillance and Response (IDSR) approaches.
• Designed an epidemiological study on factors associated with severe pneumonia among children <5 years in Kasese, 2023.
• Evaluated the role of Audio Computer-Assisted Self-Interview, a digital health intervention in facility-based identification and uptake of HIV prevention services among key populations in Uganda, 2020-2022
• Submitted four manuscripts to peer-reviewed journals

• • Evaluation of the sentinel yellow fever surveillance system in Uganda, 2017–2022: strengths and weaknesses
  • Factors associated with severe pneumonia among children <5 years, Kasese District, Uganda, 2023
  • Assessment of capacity and performance in detection, reporting and responding to Public Health Events of International Concern at Points of Entry, Uganda, July–October 2022
  • Performance and impact of contact tracing in the Sudan Virus Outbreak in Uganda, September 2022–January 2023

Summary of Epidemiological Study: 

 Title: Assessment of capacity in ditection, reporting and responding to Public Health Events of international concern at points of entry Uganda,
5th October 2022

Background: Expanded human mobility has increasingly led to the spread of disease outside of the areas in which it first occurs. Consequently, there is an enhanced focus on building capacity to detect disease at points of entry (PoEs). We assessed capacity and performance in detection, reporting, and responding to public health events of international concern (PHEIC) and public health emergencies at PoEs in Uganda.

Methods:  We conducted a cross-sectional assessment from June 27 to September 12, 2022, at official PoEs in Uganda. We adopted a standardised assessment tool for the World Health Organisation’s (WHO) PoE capacity requirements. Capacity areas included coordination and communication, routine prevention and control measures expected at all times, and response to PHEIC. We abstracted and analysed surveillance data on performance of PoEs including completeness of PoE reporting, proportion of travellers screened and proportion of suspected ill travellers isolated, investigated and referred for further care if necessary.

Results: We assessed all 53 gazetted PoEs (4 airports, 16 inland ports, and 33 ground crossings). Most (94%) reported communication capacities with national and sub-health authorities with 88% completeness of reporting. Forty-two per cent provided access to appropriate medical services for assessment and care of ill travellers, 42% had access to sanitary facilities, 21% had access to safe water, and 23% had appropriate waste management and vector control. Regarding capacity to respond to PHEIC and public health emergencies, all designated PoEs had a public health emergency contingency plan,74% provided screening of all travellers but screened 56% of the travellers, 38% had the capacity to quarantine and isolate suspected human cases, and 15% had the capacity to transport suspected cases to referral health facilities. Twenty three percent of the suspected ill travellers were isolated, investigated and referred for further care if necessary. Only 8% assessed animals being transported through PoEs for priority animal transboundary diseases.

Conclusion:Existing capacity and performance gaps in detection and response to PHEICs and public health emergencies may limit the ability to effectively respond to potential public health emergencies. There is a need to establish infrastructure, equipment and personnel for and assessment, isolation and quarantine of humans and animals.

Key lessons learnt during the fellowship

During the fellowship, I have developed the following skills and competencies

• Outbreak investigation
• Design and evaluation of disease surveillance systems
• Collection, analysis and interpretation of epidemiological data
• Application of epidemiological concepts on complex emergency
• Conceptualising and implementing quality improvement projects
• Applied operational research
• Public health communication: oral presentations, newspaper articles and policy briefs
• Scientific communication: manuscript writing
• Teamwork and collaboration
• Teaching, training and mentorship

Next Steps

After successfully completing the fellowship, I plan to continue my career in field epidemiology in the government or private sector contributing to disease surveillance, outbreak response and health promotion. I plan on publishing all the work done during the fellowship period in peer review journals. In addition, I plan to engage in research activities, working on studies advancing understanding diseases, risk factors and interventions.

Pictorial