Dorothy Aanyu

Dorothy Aanyu

BBLT, MPH (MUK) & Advanced Field Epidemiology Fellow (UNIPH)
Email: daanyu@uniph.go.ug
Telephone: +256 774009185, +256701838483

Host Site: Kampala Capital City Authority (KCCA)

Host Mentor:Dr. Daniel Okello Ayen, Dr. Alex Ndyabakira

ABOUT THE FELLOW

Dorothy Aanyu is an experienced epidemiologist  who holds a Bachelor of Biomedical Laboratory  Technology and Master of Public Health from  Makerere University Kampala. During 2023-2024,  she undertook and completed the Advanced Field Epidemiology Training Program (FETP) during  which time she was hosted at the Kampala Capital  City Authority (KCCA).

  Achievements at the Host Site

While at KCCA, she played a significant role in  the operational aspects of surveillance in the  urban settings, an opportunity that has been a  game-changer for her career. She gained skills in  leadership, outbreak investigation and response  including data analysis, interpretation, and use. She  led two outbreaks and participated in five others.

She was also involved in a number of projects and  activities including but not limited to:

• The rollout of the Measles-Rubella vaccination  in Kampala City, 23rd -27th June 2023.
• She  was a parish supervisor during this activity in  Makindye Division.

• Led the investigation on surge of reported  Typhoid disease cases in Kampala City, May June 2023.

• Led the active case search for Cholera cases in Katwe Parish, Makindye Division, July 2023 surveillance Training of trainers, August 2023
• Participated in the Pan respiratory disease
• Coordinated the training and roll out of the  3rd eIDSR guidelines in Kampala City, August September 2023
• Coordinated the rollout of Ebola Virus  vaccination for health workers in Kampala  City, September 2023
• Participated in a WHO EPR Flagship Initiatives  Scoping Mission, September 2023
• Participated in the review and update of the  Kampala City HIV strategic plan, September October 2023

Fellowship program specific achievements

1. Led two outbreak investigations whose  findings were disseminated through bulletin  articles, conference presentations and  manuscripts:

• Rotavirus outbreak at a Babies’ Home in Mpigi  District, August 2023
• Conjunctivitis outbreak at School X in Kampala  City, March 202

2. Participated in four other outbreak  investigations:  

• Anthrax outbreak in Ibanda District, March May 2023
• Mental illness among returnees from Middle east countries, March 2024
• Food poisoning in Jinja District
• Mpox investigation in Mukono and Wakiso  districts

3. Conducted two descriptive studies 

• Urban health: An assessment of Kampala City,  2018-2022
• Treatment outcomes among Tuberculosis  patients across six regions of Uganda

4. Led a National Survey to characterize  Tuberculosis cases and conduct contact  tracing across six regions in November December 2023
5. Conducted two epidemiological studies 

• Prevalence and Risk Factors of Occupational  Diseases among Sanitation Workers in  Kampala City, 2024
• Prevalence and associated factors of  tuberculosis among contacts of active  tuberculosis patients

6. Presented at three local conferences  ● Rotavirus outbreak at a Babies’ Home in Mpigi  District at the 9th National Field Epidemiology  Conference and the 3rd USHS conference ● Conjunctivitis outbreak at School X in Kampala  City at the 10th National Field Epidemiology  Conference
7. Wrote and published two newspaper  articles 

• Is the air you breathe at your home making you  sick? What 3 simple changes can you make to  be safer?
• Why Ugandans need to start recycling

8. Was an author for the October-December  2023 issue of the NIPH Epi-bulletin? 

9. Wrote and published two articles in the NIPH bulletin

• Rotavirus outbreak at a Babies’ Home in Mpigi  District, August 2023
• Conjunctivitis outbreak at School X in  Kampala City, March 2024

10. Implemented a QI study on improvement  of Mortality surveillance at Mbarara  Regional Referral Hospital and noted a >50%  improvement in death notification. She also  participated in the baseline assessment for  mortality surveillance quality improvement at  Lira Regional Referral Hospital.
11. Conducted a group HIV study on the Impact  of DQAs on PMTCT indicators in Mubende  sub-region
12. Writing a group policy brief on the control of

tickborne disease in Uganda.

13. Submitted a manuscript for publication to  peer peer-reviewed journal titled ‘Rotavirus  outbreak at a Babies’ Home in Mpigi District”  and have four others under internal review  titled

• Trends and Distribution of Urban Health  Indicators in Kampala City, 2018-2022
• Investigation of an Outbreak of Conjunctivitis  at School X in Kampala City, March 2024
•  Prevalence Contact Tracing Yield and  Associated Factors for Tuberculosis Diagnosis  among Contacts of Active Tuberculosis Cases  in Uganda, 2023

14. Trained and mentored four vibrant FETPs  in Cohort 24 of the frontline epidemiology  training program
15. Coordinated the immunization coverage  survey in Kampala City, September 2024 16. Supervised the data collection for the excess  mortality survey in Kampala City

Summary of Epidemiological Study: 

 Title: Investigation of an Outbreak of Conjunctivitis  at School X in Kampala City, March 2024

Background: On March 11, 2024, Kampala  Capital City Authority received an alert of an  increase in the number of conjunctivitis cases at  School X in Rubaga Division, Kampala City. We  investigated the outbreak to determine the scope  of the outbreak, identify factors associated with  its spread, and recommend control measures.

Methods: We defined a case as redness of one  or both eyes and any of the following: tearing,  swelling, itching, or discharge in a pupil or staff of  school X from March 5-31, 2024. The school had  148 staff and 1,800 learners, 700 of whom were  in the boarding section. We identified cases  by reviewing health records at the school. We  calculated attack rates by age, sex, class, and  dormitory using staff and pupils of the infant school  as the source population.We also conducted staff  interviews and an environmental assessment. We  matched case-patients to controls by residence  and identified factors associated with the spread  of conjunctivitis in the school using logistic  regression.

Results: We found 175 cases of conjunctivitis, 167  of whom were pupils and 8 were staff. The mean  age for case-patients was 11.4 years (range 5–45  years). Attack rates(%) (AR) were similar in females  and males (10 vs 8.4). Pupils in the boarding section  were more affected than day scholars (AR:23) with  residents of Alpha dormitory more affected than  other dormitories (AR:50). Pupils in P4-P7 were the  most affected compared to lower class groups  (AR:17). We found that being a boarding scholar  (aOR=10, 95%CI: 2.1-51) increased the odds of  conjunctivitis. Persons who washed their hands  at arrival back at the dormitory/ home (aOR= 0.38,  95%CI: 0.16-0.91) and pupils in classes P4-P7 (aOR=  0.34 95%CI: 0.14-0.77) were protected against  conjunctivitis. We observed that most dormitories  were congested with pupils sleeping in triple  decker beds, the average living space per pupil  was 3m2 compared to the 5m2 recommended by  Ministry of Health. Hand washing facilities were  also not well distributed.

Conclusion: The outbreak was likely facilitated  by dormitory congestion and poor hand hygiene  practices. Boarding scholars were most affected;  regular hand washing and attending upper classes  were protective. Education and awareness of  good hand hygiene measures could mitigate the  risk of similar outbreaks in the future.

Keywords: Conjunctivitis, outbreak, congestion,  hand hygiene

• Led the writing and dissemination of the  weekly malaria bulletin.

Key lessons learnt during the fellowship

During the fellowship, I learnt and developed the  following skill sets:

• Outbreak investigation and response including  institution of interventions
• Evaluation of surveillance systems
• Designing and implementing Quality  Improvement Projects
• Data management, analysis, and interpretation  using such software as STATA, EpiInfo, and  QGIS
• Policy brief formulation
• Economic analysis for projects
• Scientific writing (for Abstracts, Manuscripts,  Policy Briefs and short articles)
• Presentation skills and dissemination of  findings

Pictorial