Brian KibwikaBEHS, MPH (Mak) & Advanced Feld Epidemiology (UNIPH) Host Site: Baylor Foundation Uganda– Global Health Security DirectorateHost Mentor: Dr. Peter James Elyanu |
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ABOUT THE FELLOWNow a field epidemiologist, I hold a master’s degree in Public Health with a background in Environmental Health Science and a particular interest in the implementation of event-based surveillance systems in Public Health. During the fellowship, I was attached to the Global Health Security program at Baylor Foundation Uganda, whose mandate is to improve prevention, early detection, and effective response to public health threats. Through the in-service training, I have attained great skills in leadership, outbreak investigation, and response including data analysis, interpretation, and use. I have led one outbreak investigation and participated in four others. I have also been involved in several activities including policy brief writing, integrating COVID-19 vaccination into the national schedule, coordinating mass Yellow Fever vaccination, mortality surveillance, documenting proceedings from the Joint External Evaluation (JEE) for assessment and testing of IHR core capacities and responding to the Ebola outbreak in Mubende and Kassanda Districts. Achievements at the Host SiteAt Baylor Foundation Uganda, I participated in, and led several projects and activities including but not limited to: – Conducting regional co-creation to integrate COVID-19 vaccination into the national routine structure. – Supervising Yellow Fever vaccination campaign in Bunyoro Region – Led a continuous quality improvement project on the initiation of intensive Adherence Counselling at the Centre of Excellence clinic. – Deployment as the regional epidemiologist for Bunyoro Region Public Health Emergency Operations Centre. – Coordinating event-based surveillance activities in 9 districts of the Bunyoro Region Fellowship program specific achievementsLed one outbreak investigation: – Anthrax outbreak associated with handling and/or consuming meat from animals that died suddenly – Ibanda District, Uganda, May 2023. Participated in four other outbreak investigations: – Food poisoning caused by Aeromonas bacteria at a funeral in Buyengo Town Council in Jinja District, February 2024 – Lessons from an imported Cholera Outbreak, Elegu border point, Uganda, January 2024: A 7-1-7 approach – Rotavirus outbreak linked to poor hygiene practices at a babies home in Mpigi District, 2023 – Rift Valley Fever Outbreak in Nakaseke District, Central Uganda, July 2023 Participated in other studies: – Excess mortality survey in Uganda and led the Fort Portal City and Kabarole District team, March 2023 – Using EMR Data to Profile Persons Newly Diagnosed with HIV in Uganda, January 2022-December 2023.- Analyzed mortality surveillance data from the Iganga Mayuge Health and Demographic Surveillance Site, 2005-2021 Presented at three local conferences – Anthrax outbreak associated with handling and/or consuming meat from animals that died suddenly – Ibanda District, Uganda, May 2023 at the 9th National Field Epidemiology Conference and the 18th Joint Annual Scientific Conference, 16th-18th October 2024 – A descriptive analysis of deaths occurring within a population-based cohort, Eastern Uganda, 2005–2021, at the 10th National Field Epidemiology Conference, 21st November 2024. Published one newspaper article – Reporting deaths; does it even matter? August, 2023 Editor for the Issue 3 Volume 8 PHB July September, 2023, Epi-bulletin Published two articles in the PHB – Anthrax outbreak associated with handling and/or consuming meat from animals that died suddenly – Ibanda District, Uganda, May 2023 – A descriptive analysis of deaths occurring within a population-based cohort, Eastern Uganda, 2005–2021 Designed and implemented a Quality Improvement Project to improve the initiation of Intensive Adherence Counselling at the Centre of Excellence clinic, Baylor Foundation Uganda, May December 2024 Participated in the group HIV study: -Using EMR Data to Profile Persons Newly Diagnosed with HIV in Uganda January 2022-December 2023. Submitted a manuscript for publication to a peer-reviewed journal titled ‘Anthrax outbreak associated with handling and/or consuming meat from animals that died suddenly – Ibanda District, Uganda, May 2023’. Summary of Epidemiological Study:Title: A descriptive analysis of deaths occurring within a population-based cohort, Eastern Uganda, 2005–2021 Background: Globally, nearly half of all deaths are not recorded which tends to underestimate the burden of disease in the general population or particular sections of it. Using routinely updated data from the Iganga-Mayuge Health and Demographic Surveillance Site (IMHDSS), we explored the place of death and described the characteristics of the deaths to guide interventions for health programming. Methods: The cohort is from 65 villages in Iganga and Mayuge Districts located in Eastern Uganda. Data on all deaths that occurred between 2005 and 2021 within the IMHDSS were abstracted from the electronic database for inclusion in the study. Data on the place of death (community or hospital); the deceased’s demographic characteristics (age at death and sex) and assigned cause of death were abstracted. Descriptive statistics including counts and percentages were calculated, with bar graphs and pie charts. Mortality rates were calculated using the annual mid-year population sizes of the cohort for the study period. Annual mortality trends were presented as line graphs and tested for significance using Mann-Kendall analysis. Results: A total of 8,036 deaths were recorded in the 16 years, of which, most deaths, 4424 (53%), occurred among males and 4867 (60%) occurred in the community. The overall mortality rate was 6.1/1,000, with an increasing trend by age group. Males had a higher mortality rate, 6.6/1,000 (t = 0.5147, p = 0.0055), than females, 5.6/1,000 (t = 0.3225, p = 0.0035). The age group ≥80 had the highest mortality rate of 100.2/1,000 population. Most deaths from communicable diseases were due to Malaria (42%), while for non-communicable diseases, most were cardiovascular (42%). As age at death increased, the proportion of community deaths increased from 55% in the <1 year old to 90% in the ≥101 years old. Conclusion: The highest mortality rates were among males, and adults aged 80 years and over, occurred in the community and due to communicable diseases. Malaria, HIV/AIDS, cardiovascular disorders, and cancer were the leading causes of death. We recommend Ministry of Health programmes targeted at improving health-seeking behavior to reduce community deaths, mainly due to preventable communicable diseases. Key lessons learnt during the fellowship
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