Dr. Kizito Susan

MBChB (MUST), MScIH (Charite Universitatsmedizin Berlin)
Tel: +256 776222722/ +256 700 222722
Email: kirondesusan@gmail.com

Host Site: Neglected Tropical Diseases and Vector Control Division, Ministry of Health

Host Mentors: Dr. EdridahTukahebwa, Dr. Wamboga Charles

ABOUT THE FELLOW

Dr. Susan Kizito joined the Uganda Public Health Fellowship Program in January 2017 and was hosted at the Neglected Tropical Diseases (NTD) program, Vector Control Division (VCD), Ministry of Health for the two year apprenticeship. While at VCD, Susan was part of the National team that strives to control, eliminate and eradicate neglected tropical diseases.

In the two year apprenticeship, Susan has horned her skills in epidemiology including: investigation and mitigation of disease outbreak at the source, response to public health emergencies, establishment and evaluation of surveillance activities, design and implementation of operational research, program monitoring and evaluation, Scientific writing and communication among others.
Prior to joining the Fellowship Program, Susan worked as a medical officer at St. Francis hospital Nsambya HIV/AIDs Home Care Department for over five years.
Dr. Susan Kizito, is a DAAD scholarship awardee for Master of Science degree in International Health from the Institute of Tropical Medicine and International Health – Charite University in Berlin, Germany and has a Bachelor of Medicine and Bachelor of Surgery degree from Mbarara University of Science and Technology, Mbarara, Uganda.

  Achievements at the Host Site

• Led an investigation of increased schistosomiaisis morbidity and mortality in Oyam district
• Analyzed the distribution and incidences of Human African Trypanosomiasisas well as the incidence and distribution of scorpion and snake bite injuries in Uganda.
• Initiated efforts of having a Neglected Tropical Disease Epi-bulletin at the Vector Control Division
• Reviewed and updated the NTD Master Plan, 2017 – 2022
• Participated in NTD program data review and national planning meetings
• Active participant in the quarterly and annual VCD review meetings
• Central level supervisor of program activities in NTD endemic districts
• Reviewed checklists used for planning NTD activities
• Participated in NTD Technical Committee and High-level advocacy meetings
• Published a manuscript, “Trends and Spatial distribution of Human African Trypanosomiasis, Uganda, 2005 – 2015: A descriptive analysis of surveillance data” in the Journal of Interventional Epidemiology and Public Health, Issue 1, Volume 1, https://afenet-journal.net/?p=903

Fellowship program specific achievements

• Led and coordinated the investigation of Crimean Congo Hemorrhagic Fever and Schistosomiasis outbreaks
• Co-investigated disease outbreaks across the country including: An outbreak of cholera in Nebbi District, an outbreak of mumps in Wakiso, fatal poisoning following consumption of alcohol adulterated with methanol, and an outbreak of Influenza A (H1N1) virus in Kampala
• Part of the National Task Force responding to emergencies and presented and participated in the different National Task Force meetings
• Evaluated surveillance systems in Bidibidi Refugee Settlement
• Evaluated the tetanus surveillance data in Uganda.
• Part of the N-STOP team that conducted active surveillance of vaccine preventable disease like polio and measles in Kampala
• Designed an HIV Project, “Risk factors associated with HIV among young female-sex-workers in Kampala, Uganda”, using CRANE survey data
• Conducted a Quality Improvement project on, “Improving the screening of early cryptococcal disease among HIV positive patients at Nkozi Hospital, Mpigi district, Uganda, 2018”.
• Designed and implemented a TB/HIV Operational Research project
• Published 2 papers, “Notes from the Field: Crimean-Congo Hemorrhagic Fever Outbreak — Central Uganda, August–September 2017” in the Mortality and Morbidity Weekly Report, Volume 67, Number 22 http://dx.doi.org/10.15585/mmwr.mm6722a6
• Written abstracts accepted and presented at National and International Conferences. These include: “Crimean Congo Hemorrhagic Fever Outbreak in Central Uganda, July – August 2017”, “ Trends and Distribution of Human African Trypanosomiasis in Uganda, 2005 – 2015”, “Increased Schistosomiasis Morbidity in Oyam District, Uganda, April 2017”, and “Descriptive Epidemiology of Snake Bites in Uganda, 2016 – 2017”.
• Written a policy brief on the control of tick-borne diseases among humans using the One Health Approach: A case of recurrent Crimean-Congo Hemorrhagic Fever Outbreaks in Uganda” published in the UNIPH Epi bulletin volume 3, issue 3, September 2018
• Editor for the UNIPH Epi bulletin volume 4, issue 2
• Published a Newspaper article, “Scorpion bites terrorise Bidibidi camp refuges” in the New Vision, dated May 26, 2017
• Published three other articles in the UNIPH Epi-bulletin

Summary of Epidemiological Study: 

 Title: Outbreak in Central Uganda, August – September 2017

Background: On August 20, 2017, two cases of Crimean-Congo Hemorrhagic Fever (CCHF) were reported in Kyankwanzi and Nakaseke Districts, central Uganda. CCHF is the most widespread and highly fatal tick-borne viral hemorrhagic fever (VHF) which represents a global health security threat. Humans are infected through tick bites or contact with blood or body fluids of infected animals or persons. Symptoms include fevers, fatigue, and spontaneous bleeding. We investigated to determine the risk factors for the outbreak and to recommend control measures.

Methods:  onset of fever (>38°C) for ≥3 days between July 1 and September 30, 2017, plus any of the following: spontaneous bleeding or bruising, laboratory evidence of low leucocyte and platelet counts unexplained by other causes in a resident of the two affected districts. A confirmed case was a suspected case that tested positive for CCHF by both RT-PCR and IgM serology. Medical records review and active case-search was conducted in the affected community. A 1:4 case-control study was conducted to compare potential exposures of case-patients and controls (case-patients’ asymptomatic neighbors, matched by sex and age). Blood samples of cattle and goats from farms where confirmed case-patients worked were tested for CCHF infection using IgG ELISA.

Results: case-patients (both survived), five patients met the suspected case definition among 23 medical records reviewed (two of whom died). All case-patients were men. Tick exposure (i.e., being bitten by ticks or squashing ticks bare-handed) was reported by 4/7 (57%) suspected and confirmed case-patients and 3/28 (11%) controls (mOR=11, 95%CIFisher exact=1.1-112). Sero-positivity for CCHF was found in 60%(37/62) of cattle and 24% (5/21) of goats.

Conclusion;

Tick exposure was associated with developing symptoms consistent with CCHF. We recommended sensitization, health education, isolation of cases and tick-control reach-outs to farmers.

Key Lessons Learnt

• National level health programming
• Scientific writing and communication and editorial skills: abstract and manuscript writing in peer reviewed
• journals, conference presentation, peer training, policy briefs, bulletin and Newspaper articles
• Evaluation of surveillance systems in stable and emergency settings
• Grant writing skills
• Epidemiological data presentation on maps using QGIS and EPI info
• Data collection using ODK software in epidemiology
• Leadership skills through implementation of projects (QI and operational research)

Next Steps

With the epidemiological skills and competences acquired coupled with hard work, Susan hopes to have a sterling career in an epidemiology related field responding to her country and the world’s public health threats, writing and winning grants, conducting research in epidemiology and a public health leader. She also hopes to mentor the team she will work with using the skills she has acquired.