Birungi Doreen

MSc (International Infectious Diseases Management) BBLT, Field Epidemiology Fellow (UPHFP).
Email: dbirungi@musph.ac.ug
Phone: 0777028277

Host Site: Uganda National Expanded Program on Immunization (UNEPI)

Host Mentors: Dr Opar Bernard Toliva, Dr. Immculate Ampaire, Dr. Henry Luzze

ABOUT THE FELLOW

Birungi Doreen holds a bachelor of Biomedical Laboratory Technology and Master of International Infectious Diseases Management from Makerere University
During her two year of the fellowship, she has gained skills in coordination, management and leadership, evaluation of public health surveillance systems, systematic outbreak investigation and response, use of QGIS, policy brief writing, technical reports and manuscript writing, good communication skills and conducting operational research activities.
Prior to joining the fellowship, Doreen worked extensively in disease investigations and response with Epidemiology and Surveillance Division, Ministry of Health.

• Conducted analysis on Trends of Rubella positivity from blood samples tested at Uganda Virus Research Institute, 2012 to 2016
• Led a quality improvement project on Reducing Routine Immunization drop-out rates using a defaulter tracking system in Kaliro District
• Led supervision activities of Rota Virus vaccine introduction in Kisoro district, June, 2018

Program Deliverables

Led an investigation on Fatal Methanol Poisoning Caused by Drinking Adulterated Locally-Distilled Alcohol: Wakiso District, Uganda, June 2017

• Led an investigation on Meningococcal Meningitis Outbreak in Bunyangabu District, Western Uganda: October, 2017
• Policy Brief on the Urgent need to introduce Measles Mumps Rubella (MMR) vaccine into Uganda’s Routine Immunization Schedule
• Conducted a TB operational research on factors associated with Treatment Outcomes among Pediatric Tuberculosis Patients at Jinja Regional Referral Hospital, Uganda, 2016-2017
• Conducted data analysis on Sero_prevalence and risk factors associated with HIV infection among women prisoners in Uganda Prisons 2013/2014
• Participated in the following outbreak investigations:
• Participated on Investigation of suspected Meningitis in Mukono District, February, 2018
• Participated in Fatal Rift Valley Outbreak in Western Uganda, 2018
• Participated in the investigation of Anthrax in Kiruhura
• Participated in Cost Analysis of a Measles Outbreak in Islands of Buvuma, March 2017
• Participated in the investigation of an outbreak of multidrug-resistant TB in Arua District associated with poor adherence to TB treatment and delayed initiation of TB treatment
• Participated in the investigation of Multidrug-resistant Tuberculosis in Arua District, 2013-2017
• Rift Valley Fever in Kiruhura District, Western Uganda, November, 2017
• Participated in Tetanus Evaluation in Uganda, 2017
• A cholera outbreak in Nebbi District associated with drinking unsafe water from the lake, 2017

 Conference Presentations

• Oral presentation on Fatal Methanol Poisoning Caused by Drinking Adulterated Locally-Distilled Alcohol: Wakiso District, Uganda, June 2017 at the National Field Epidemiology Conference, Kampala, 2017
• Oral poster presentation onFatal Methanol Poisoning Caused by Drinking Adulterated Locally-Distilled Alcohol: Wakiso District, Uganda, June 2017 at the 7th Africa Field Epidemiology Network Conference, Maputo, 2018
• Oral Presentation of Meningococcal Meningitis Outbreak in Bunyangabu District, Western Uganda: October, 2017
• Oral presentation on Fatal Methanol Poisoning Caused by Drinking Adulterated Locally-Distilled Alcohol: Wakiso District, Uganda, June 2017 at the Joint Annual Scientific and Health (JASH) Conference, Kampala, 2017

Publications and manuscripts written

Manuscript: Fatal Methanol Poisoning Caused by Drinking Adulterated Locally-Distilled Alcohol: Wakiso District, Uganda, June 2017:

• Manuscript: Factors associated with Treatment Outcomes among Pediatric Tuberculosis Patients at Jinja Regional Referral Hospital, Uganda, 2016-2017
• Manuscript: Seroprevalence and risk factors associated with HIV infection among women prisoners in Uganda Prisons 2013/2014
• Epibulletin article in the National Institute of Public Health quarterly bulletin: Rift Valley Fever Outbreak Caused by Handling a Dead calf: Kiruhura District, 2017-2018
• Epibulletin article in the National Institute of Public Health quarterly bulletin: Fatal Methanol Poisoning Caused by Drinking Adulterated Locally-Distilled Alcohol: Wakiso District, Uganda, June 2017

Summary of Epidemiological Study: 

 Title:  Estimation of Incidence and Trends of Road Traffic Injuries in Kampala District, Uganda (2012–2016)

Authors: Claire Biribawa1*, Phoebe Hildah Alitubeera1, Alex Riolexus Ario1, Benon Kwesiga1 Merissa Yellman2, Olive Kobusingye3
1Uganda Public Health Fellowship Program, Kampala, Uganda, 2Synergy America, Inc., Atlanta, Georgia, USA, 3Makerere University School of Public Health, Department of Environmental Science and Disease Control
Corresponding Author: Claire Biribawa, Uganda Public Health Fellowship Program, Kampala, Uganda,

Introduction:  Methanol, an industrial solvent, can cause severe illness and death if ingested. In June 2017, Wakiso District notified the Uganda Ministry of Health (MoH) of a cluster of seven deaths. Case-patients presented with sudden loss of eyesight, headache, vomiting, and other symptoms before death. All illness reportedly occurred after drinking alcohol. We conducted an epidemiological investigation to determine the cause of the outbreak, identify risk factors, and recommend evidence-based control and prevention measures.

Methods:  We defineda probable case as acute loss of eyesight and atleast one of the following: profuse sweating, vomiting, dizziness, or loss of consciousness in a resident of either Nabweru or Nangabo Sub-county from 1-30 June 2017. We reviewed medical records and conducted active community case-finding. In a case-control study, we compared exposures of case-patients and controls selected among asymptomatic neighbors who drank alcohol, matched by age, and sex. We conducted a trace-back investigation to identify the source of the implicated alcohol and conducted key informant interviews about alcohol distillation and distribution. We collected locally-distilled alcohol from implicated bars and Wholesaler X for testing.

Results: We identified 15 cases; 12 (80%) died. Among case-patients, 12 (80%) were men; the median age was 43 (range: 23-66) years. Thirteen (87%) of 15 case-patients and 15 (25%) of 60 controls last drank alcohol at one of three bars supplied by Wholesaler X (ORM-H=15; 95%CI: 2.3-106). Key informant interviews revealed that alcohol sellers sometimes added methanol to drinking alcohol to increase their profit margin. Among the 10 alcohol samples from Wholesaler X, the mean methanol content (1200mg/L, range: 77-2711mg/L) was 24 times higher than the safe level (<50 mg/L).

Conclusion: This outbreak was caused by drinking locally-distilled alcohol adulterated with methanol from Wholesaler X. Authorities closed the implicated bars and confiscated the implicated alcohol. Wholesaler X was arrested and prosecuted. We recommended enforcing existing laws governing alcohol manufacture and sale and use of methanol test strips by sellers to ensure product safety. We recommended timely administration of IV ethanol to victims of methanol poisoning and promotion of public health campaigns to create awareness of the dangers of methanol to human health.

Lessons Learned

Improved scientific writing competencies (proposal/protocol writing, manuscript writing)

• Management of Projects (gained experience in implementing projects)
• Collaborative approach of Implementing different programmes
• Ability to Multitask

 Scientific presentations i.e preparation of iposters

• Analytical skills (Deeper understanding of elements)
• Supervisory roles
• Consolidated data analysis skills and management, use of electronic data capture applications such as ODK, and use of QGIS
• Public speaking (with a lot of opportunity to present to different fora and researchers)