Opio Denis Nixon

MSc. (Clinical Epi and Biostat) (Mak) BSc. (Qualitative Economics) (Mak)
National Health Information (NHI) MOH
Email: dnixon@musph.ac.ug
Phone No: +256-785291383

Host Site: Ms. Carol Kyozira, Mr. John Kissa

Host Mentors: Dr Shaban Mugerwa, Dr Joshua Musinguzi

ABOUT THE FELLOW

Denis Nixon Opio, has completed an advanced fellowship in Field Epidemiology with Uganda Public Health Fellowship Programme, Ministry of Health Uganda. As an FETP fellow, Denis completed the following deliverables which are very relevant to his career; Participated in Mentoring and giving technical support to other Advanced Fellows on Bio statistical/Epidemiological methods and Research design, supporting fellows in analysing and interpreting outbreak investigation data and other scientific studies. Led the following projects; Designed and implemented TB Operations Research Project titled Predictors of treatment outcome of TB patients age >=8 years enrolled on Directly Observed Treatment (DOT) at Lira Regional Referral Hospital, Conducted Descriptive analysis of the Trends, and spatial distribution of Multi Drug Resistant Tuberculosis (MDR-TB) in Uganda, 2010-2016, a Principal Investigator (PI) of Health Assessment in Kiryandongo Refugee Settlement, April 2017, a PI of an Evaluation of surveillance system in Kiryandongo Refugee Settlement, April 2017 as well as leading a training in Emergency Prevention and Response in Kiryandongo district and refugee settlement. He worked as a PI of an investigation of suspected Cholera outbreak in Kyaka II Refugee settlement, Kyegegwa district, March 2018, PI of an Investigation of Mumps outbreak in Children’s home X, Wakiso district, August 2017, a PI of an investigation of suspected Mercury Exposure among Artisanal Gold Miners, Amudat district, Jan 2018. He participated as Co-Investigator in 5 other outbreak investigations in Uganda. Denis also implemented an HIV Research project titled “Comparison of District Health Information System 2, Central Public Health Laboratory and Health Facility Datasets to Assess Early Infant Diagnosis Program Performance in Uganda, 2015-2018. He designed and implemented a Quality improvement project titled” Improving newborn health outcomes using Birth Weight Age at Death Boxes for Intervention and Evaluation System (BABIES) Matrix. From the above projects, he made 3 presentations at National Conferences, presented one International conference organized AFNET in Maputo Mozambique, and published 4 Epi bulletins, 1 Newspaper article and 1 Policy brief. I have also submitted 4 Manuscripts for publication; one to Pan African Medical Journal and 3 still under peer review.

  Achievements in Deliverables

• Mentoring and giving Technical support to other Advanced Fellows on Bio statistical methods, Research design
• Supporting fellows in designing data collection forms in EpiInfo and KOBO Collect open data kit
• Supporting fellows in analysing outbreak investigation data and other scientific studies
• A principal investigator (PI) of an HIV research project titled “Comparison of District Health Information System 2, Central Public Health Laboratory and Health Facility Datasets to Assess Early Infant Diagnosis Program Performance in Uganda, 2015-2018”. This study will cover 2 Health facilities per region giving a total of 20 facilities
• A PI of TB Operations Research project titled: Predictors of Treatment Outcome of Tuberculosis patients aged =>8 years accessing Treatment under Directly Observed Treatment (DOT) Strategy in Lira Regional Referral Hospital, Uganda.
• Conducted and submitted a manuscript titled “Descriptive analysis of the Trends, and spatial distribution of Multi Drug Resistant Tuberculosis (MDR-TB) in Uganda, 2010-2016, a descriptive analysis of HMIS data”
• Implemented a Quality Improvement project titled “Improving New born health outcomes using BABIES matrix in Pentecostal Assemblies of God Health Centre Four, Lira District, January 2017
• Conducted a rapid health assessment in Kiryandongo Refugee Settlement in Kiryandongo Refugee Settlement, 27th March to 1st April 2017
• Conducted a training on Integrated Disease Surveillance and Emergency Preparedness and Response in Kiryandongo district local government, 10th to 13th April, 2017
• He participated as Co-Investigator in 5 other outbreak investigations in Uganda (i.e., Cholera in Nebbi district, Mysterious deaths among children in Sironko district, Methanol Poisoning in Kawempe division Kampala, Marburg outbreak in Kapchorwa and Kween districts, October 2017 and Rift Valley Fever Outbreak in Buikwe district)
• Presented an abstract on surveillance system evaluation in Kiryandongo Refugee Settlement in Kiryandongo district, 27^th March to 1st April 2017 to Uganda National Field Epidemiology Conference and Joint Annual Scientific Health conference.
• Authored an NIPH bulletin article on Improvement in reporting and monitoring of Public Health Events following introduction of electronic
• based surveillance systems, January – March 2017, UNIPH Epidemiological Bulletin, volume 2, Issue 2, March 2017, page 4-7.
• Authored an NIPH bulletin article on an Evaluation of the Disease Surveillance System in Kiryandongo Refugee Settlement, Kiryandongo District, April 2017, UNIPH Epidemiological Bulletin, volume 3, Issue 2, June 2017, page 11-12
• Authored a policy brief in NIPH bulletin titled “Reducing Mercury Exposure among the Artisanal Gold Miners using a modern gold processing technology: A case of Amudat District in Uganda”
• Published a quarterly Epi Bulletin Titled “Mumps outbreak in Watoto Children’s Home, Nabuzinga Village, Wakiso District, August 2017”
• Submitted a newspaper article titled “Schools remain a hotspot for Mumps transmission in Uganda”
• Editor of MoH Weekly Epidemiological Bulletin Week12 of 2017 to Date
• Led an investigation of Mumps outbreak in Watoto Children’s Home, Nabuzinga Village, Wakiso District, August 2017 and produced a report
• Submitted a Manuscript Titled; surveillance system evaluation in Kiryandongo Refugee Settlement in Kiryandongo district, 27th March to 1st April 2017 to Pan African Medical Journal
• Made a presentation titled “Evaluation of Disease Surveillance System in Kiryandongo Refugee Settlement, April 2017” to JASH Conference
• Submitted a Manuscript for Review titled “Trends, and Treatment Outcome of Multi Drug Resistant Tuberculosis, Uganda, July 2015-June 2017, a descriptive analysis of Health Information
• In the October-December 2017 quarter, He led an Investigation of Suspected Mercury Exposure among the Artisanal Gold Miners in Karita Subcounty, Amudat District- 2017 and produced a report and draft abstract, yet to be published.
• The Fellow also co-investigated Mysterious Deaths in Nakilimbwa village, Sironko District- December 2017 and participated in investigating Marburg outbreak in Kapchorwa and Kween districts, October 2017.
• Participated as an Editor of MoH Weekly Epidemiological Bulletin Week12 to date, and as an Editor of Uganda National Institute of Public Health bulletin.
• The fellow participated in an Investigation of Suspected RVF outbreak in Buikwe district- Feb 2018
• Led an an investigation of Cholera outbreak in Kyaka II Refugee settlement, Kyegegwa District-Feb-March 2018.
• Finally, the fellow submitted 2 abstracts for AFNET Conference Mozambique, where one was accepted for presentation.

Host Site Achievements

• I have participated as a team lead in conducting Missed Opportunity for Vaccination survey organized by WHO and MoH
• Regularly attended monthly eHealth meetings with the host institution (Division of Health Management Information)
• Contributed to the finalization of Maternal and Perinatal Death Audit Guidelines
• Participated in Joint External Evaluation Meeting
• Led the training of Health workers in Hoima District on DHIS2, 23rd to 25th May 2017
• Participated in a one-week training workshop on Monitoring and Evaluation of Programmes, organised by Uganda Civil Service College, Jinja, June 2017
• Led Data Quality Assessment in 16 Health Facilitates located in 4 districts of Masaka, Rakai, Kalungu, and Lwengo
• Participated in Monthly Data Management Technical Working group (TWG) and eHealth TWG
• Conducted a Data Quality Assessment in 12 Health Facilitates in Nwoya district, December 2017.
• Prepared an analysis of weekly epidemiological reports up week 38, 2018 and other surveillance activities
• Led data Cleaning Exercise for July-Sept 2018 quarter for Acholi Sub region
• Led monthly data Cleaning Exercise for Oct-Dec 2018 quarter for South Western Uganda
• Attended Monthly meetings for DHI
• Completed 2018 Vaccination coverage survey indicators: analysis and interpretation (WHO Survey Scholar Module A3 Workshop) (Completed Community Assignment1, Survey Manager Assignment1, Analyst Qualifying Assignment, and Survey Managers Qualifying Assignment, a Creator Project and attended a graduation on 3rd Oct 2018.

Summary of Epidemiological Study: 

 Title: Mumps outbreak in Watoto Children’s Home, Nabuzinga Village, Wakiso District, August 2017

Introduction:  On the 28th July 2017, Public Health Emergency Operations Centre in Uganda received an alert of 12 suspected cases of mumps among children in Watoto Children’s Home (WCH), an orphanage with a school in Wakiso district. We investigated to determine the scope, identify exposures, and recommend control interventions for future outbreaks.

Methods:  We defined a suspected case as acute onset of swollen/painful salivary glands in a person living in Wakiso district from 1st June-September 15, 2017. Cases were identified through medical record review at 27 the school clinic; controls were asymptomatic children at the school. We administered a questionnaire to the children, teachers, and parents about children’s exposures and hygienic behaviors.

Results:  had parotitis (100%) and reported poor appetite (67%), jaw pain and fever (56% each), general body weakness (44%), and headache (44%). Overall, the attack-rate (AR) for mumps among children <10 years at WCH was 21%. The AR was highest in nursery class (64%) and Primary1 (46%) and lowest in Preparatory (6.3%) and Primary2 class (4.6%). Both Nursery and Primary1 classes had 5-6 children per table, while Preparatory and Primary2 classes had 2-3 children per table. Being in Primary1 [(OR=9.6(95% CI; 2.7-34.2)] and talking or playing with a sick child [OR=15.5 (95% CI; 3.4-70.1)] were associated with case status.

Conclusion and Recommendations: A mumps outbreak affected children in lower primary classes at WCH. The findings of our investigation suggest that crowding in the classroom and poor recognition of mumps clinical characteristics may have contributed to the outbreak. We recommended vaccination of all asymptomatic children <10 years in WCH, isolation of symptomatic children for 5 days after symptom onset, and reducing the number of pupils per table in classes where possible. The Uganda Ministry of Health should consider including MMR vaccine in routine vaccination schedules.

Lessons Learned

• Completed assignments in time
• Gained good presentation, writing and communication skills
• Created a network of professionals and friends
• Authored bulletins and publications for the first time
• Now planning to work in a senior position in the MoH and its partners or as a consultant in a reputable organization.