Outbreak response by the Uganda Public Health Fellowship Program, October–December, 2024

The Public Health Fellowship Program has responded to several outbreaks during this quarter as part of the national rapid response team and suggested recommendations per outbreak investigation as follows;

Multi-Drug Resistant Tuberculosis (MDR-TB) outbreak investigation in Buikwe and Kayunga districts: 21^st–28^th October 2024

There was a rise in number of MDR-TB cases in Buikwe and Kayunga districts. There were six cases reported in Buikwe District and two cases reported in Kayunga District as of November 1, 2024. The rise in cases was likely driven by transmission in the local drinking points. Recommendations included; intensifying TB case finding through contact tracing and screening, reconsider switch treatment model for MDR/RR-TB cases to hospitalization, enhance community sensitization for TB prevention, timely evacuation of MDR-TB cases to treatment unit.

Mpox outbreak investigation in Masindi District and Hoima City: 14^th–26^th October 2024

Mpox cases were reported in Masindi and Nakasongola prisons. A traceback investigations identified communities in Kijunjubwa Sub-county as the possible source of the outbreak in the prisons. The first Mpox death was reported during this investigation in Masindi and had been living in Hoima City. As of November 24, 2024, there were four confirmed cases in the two prisons and one confirmed case in the communities. Several cases had been managed in the community and there was evidence of ongoing transmission in the communities of both areas. We recommended strengthening surveillance to improve case identification, prompt isolation, and management. We activated the district task force of Masindi District and trained health workers on Mpox.

Mpox outbreak in Paradise island, Mukono District: 15^th–22^nd November, 2024

Following a report of a confirmed Mpox case on the island, a team of fellows was sent to investigate the outbreak at the island. Most cases had healed in the community and although there were some active cases. The index case had travelled from school with symptoms to the island. There were clusters of cases with evidence of ongoing transmission at the island. There were three confirmed cases and about 27 suspected cases as of November 22, 2024. The team conducted health education using the community radio, strengthened surveillance at the island by building capacity of the village health team Members (VHT).

Mpox outbreak response in Nakasongola District, Uganda August–November, 2024

Fellows have been responding to an outbreak of Mpox in Nakasongola District since September, 2024. As of November 30, 2024, there were 66 confirmed cases investigated with males more affected than females. Lwampanga Town Council had the highest number of cases, of whom; majority were fisherfolks and commercial sex workers. There was a total of 66 confirmed cases as of November 30, 2024. The district task force was activated with meetings to respond and control the outbreak. Surveillance and alert management were heightened to identify cases and monitor the occurrence of new cases. Identified cases were isolated and treated at Lwampanga Health Centre (HC) III and Nakasongola HC IV. Community sensitization has been ongoing and has prevented spread to other areas.

Mpox outbreak in Kampala Metropolitan Area (KMA) September–to date

An Mpox outbreak was first reported in KMA in September, 2024. Since then, fellows have been deployed in turns to respond to this outbreak that has been growing in magnitude. The cases are isolated and managed at Entebbe isolation and treatment unit in Entebbe Municipality, Wakiso District. There are total of 508 cases in total as of December 5, 2024. Kampala City is the most affected with most cases being reported from Kawempe Division. Majority of the cases had contact with sex workers and they are the likely drivers of the outbreak. The teams conducted case investigations, active case search in the communities, health education on community radios, supported the divisions and districts in building capacity of village health teams (VHT) members and heightened surveillance for Mpox cases.

Mpox outbreak in Mbarara, October–to date 

Mbarara reported her first Mpox case on 14^th October, 2024 and a team of fellows was deployed to support the response on 20^th October, 2024 since then. So far, a total of 10 cases have been reported with most of the cases in Mbarara City. The team conducted case investigations, activated the surveillance system, an isolation and treatment unit was set up at Mbarara Regional Referral Hospital, and behavioral change communication was conducted in the area.

Yellow fever outbreak in Kibuku District, November, 2024–to date

In December, 2024, Kibuku District reported an outbreak of Yellow Fever with three confirmed cases. A team of fellows was deployed to the district to support the investigation. As of December 1, 2024, they were three confirmed yellow fever cases in the district.