Patricia Eyu

BBLT (Mak), MPH (Mak), Field Epidemiology Fellow (PHFP)
Tel: +256783199694, +256701591402
Email: patricia.eyu@musph.ac.ug /eyupatricia@gmail.com

Host Site: Neglected Tropical & Vector Borne Diseases Control Program, Ministry of Health

Host Mentors: Dr. EdridahTukahebwa, Dr. Wamboga Charles

ABOUT THE FELLOW

Patricia Eyu holds a master’s degree in Public Health and a Bachelor of Biomedical Laboratory Technology all from Makerere University Kampala, Uganda. Patricia has worked in a number of clinical laboratories, the most recent being the African Air Rescue laboratories as a laboratory technologist. Patricia is currently hosted at Neglected Tropical & Vector Borne Diseases Control Program of the Ministry of Health. The major focus of the Program is to scale up the Neglected Tropical disease control efforts with the eventual aim of achieving prevention, control, elimination and/or eradication of Neglected Tropical diseases in line with the World Health Organization roadmap for elimination of Neglected Tropical diseases from Africa.Patricia has developed skills in Applied Epidemiology, effective communication and emergency public response and has interest in using epidemiologic methods in solving global health challenges.

  Achievements at the Host Site

• Bilharzia advocacy, training of trainers and micro planning for Buyende, Gulu, Tororo, Kaberamaido, Serere, Kasese, Ntoroko, Kagadi, Mubende, Mityana and Kabarole districts.\
• Support supervision for Bilharzia mass drug administration in Budaka district and registration of communities in Arua district.
• Participant in NTD Control Programme Data Review and National Planning Meeting; NTD Regional review meeting in Gulu; Bilharzia and Worm Control Program data review meeting for schistosomiasis low and high endemic districts in Uganda; High level advocacy for NTDs in Kitgum district; NTD secretariat meeting; Reviewing the Pest and vector control guidelines of Uganda among others.

Fellowship-Program-specific Achievements

Descriptive analysis

• Analysis of Surveillance Data to Determine Distribution of Human Brucellosis: Uganda, July 2015 – June 2017

Field investigations

• (Led)- Cholera Outbreak associated with Drinking Unsafe River Water in Panyimur and Parombo Sub-counties, Nebbi District, Uganda-2017
• (Led)- Epidemiology Investigation of a Fatal Outbreak due to Eating Fried Rice Balls Intentionally Tainted with Quinalphos, Uganda, a case report
• (Led)- Investigation of Grasshopper-related Illness in persons Handling Edible Grasshoppers in Kampala and other districts
• (Participated)-An investigation of increasing Schistosomiasis cases in Oyam district, Northern Uganda, 2017
• (Participated)-Fatal Methanol Poisoning Outbreak Caused by Drinking Adulterated Alcohol, Uganda-2017
• (Participated)-Mumps outbreak in Children’s Home X, Wakiso district-2017
• (Participated)-Cassava food poisoning in Kasese, Uganda-2017
• (Participated)-Marburg Outbreak in Kween district, Uganda-2017
• (Participated)-Cassava floor poisoning outbreak in kasese district, Uganda-2018
• (Participated)-Anthrax outbreak investigation in Arua district, Uganda-2018
• (Participated)-Cholera and Shigellosis outbreak in Kyaka II settlement camp, Kyegegwa district, Uganda-2017

Bulletin articles

• (Lead author)- Analysis of Surveillance Data to determine Distribution of Human Brucellosis in Uganda, July 2015 to June 2017
• (Lead author)- Cholera Outbreak associated with Drinking Unsafe River Water in Panyimur and Parombo Sub-counties, Nebbi District, Uganda-2017
• (Lead author)- Epidemiology Investigation of a Fatal Outbreak due to Eating Fried Rice Balls Intentionally Tainted with Quinalphos, Uganda, a case report..

Quality improvement project

• Improving diagnosis, management and reporting of Schistosomiasis using a Quality Improvement approach at health facilities around Lake Albert basin in Buliisa District, Uganda-2018

Abstracts presented

• Analysis of Surveillance Data to Determine Distribution of Human Brucellosis in Uganda, July 2015 to June 2017 (National Field Epidemiology Conference 2017)
• Cholera Outbreak associated with Drinking Unsafe River Water in Panyimur and Parombo Sub-counties, Nebbi District, Uganda-2017(National Field Epidemiology Conference 2017)
• Epidemiology Investigation of a Fatal Outbreak due to Eating Fried Rice Balls Intentionally Tainted with Quinalphos, Uganda, a case report (National Field Epidemiology Conference 2018)
• An investigation of increasing Schistosomiasis cases in Oyam district, Northern Uganda, 2017 (African Field Epidemiology Network Conference 2018)

Policy brief

• Increasing Bilharzia Morbidity in Oyam District- Northern Uganda, 2017

HIV project

• Seroprevalence and Factors Associated with Hepatitis B Virus Infection among Prisoners and Prisons Staff in Uganda Prisons, 2013/2014

TB operational research

• Deaths among Tuberculosis Patients compared with TB/HIV co-infected Patients ≥15 years in Lira Regional Referral Hospital, Uganda January 2012 to December 2017.

Newspaper articles

• Bilharzia, the neglected killer in Oyam District-Northern Uganda
• Careful inspection of imported cassava at border points can prevent cassava food poisoning

Manuscripts

• Seroprevalence and Factors Associated with Hepatitis B Virus Infection among Prisoners and Prisons Staff in Uganda Prisons, 2013/2014(under review by co-authors)
• Deaths among Tuberculosis Patients compared with TB/HIV co-infected Patients ≥15 years in Lira Regional Referral Hospital, Uganda January 2012 to December 2017(under review by co-authors).
• Epidemiology Investigation of a Fatal Outbreak due to Eating Fried Rice Balls Intentionally Tainted with Quinalphos, Uganda, a case report(submitted to peer review journal)

Summary of Epidemiological Study: 

 Title: Deaths among Tuberculosis Patients compared with TB/HIV co-infected Patients ≥15 years in Lira Regional Referral Hospital, Uganda January 2012 to December 2017

Authors: Denis Okethwangu1, Godfrey Nsereko1, Daniel Eurien1, Claire Biribawa1, Carol Nanziri1, Daniel Kadobera1, Jimmy Opigo2, Alex R. Ario1,3, 1Uganda Public Health Fellowship Program, 2National Malaria Control Program, Uganda Ministry of Health, 3Uganda National Institute of Public Health

Introduction:  Tuberculosis (TB) is the ninth leading cause of death worldwide. In Uganda between 2014 and 2016, TB prevalence and incidence was at 253/100,000 and 234/100,000 persons. We aimed to compare the difference in proportion of, and median time to death comparing HIV positive and HIV negative patients, and determine the trend, mortality rate and predictors of death among TB patients receiving care at Lira Regional Referral Hospital (LRRH) between 2012 and 2017.

Methods:  We used a retrospective cohort study design to review data of 3547 TB patients, from the Health Management Information System (HMIS) form 096a, which is the TB register at LRRH between 2012 and 2017. We analysed data using STATA. Univariate descriptive analysis was conducted using a non-parametric procedure, Kaplan Meier method, and Cox proportional Hazard model was used for multivariable analysis to determine possible predictors and to obtain adjusted hazard ratios.

Results: The proportion of deaths is similar comparing HIV positive and HIV negative patients [HIV positive (338/2297, 14.7%), HIV negative (180/1251, 14.4%)]. The median time to death was similar comparing HIV positive to HIV negative patients [HIV positive (median=145, IQR=57-247), HIV negative (median=246, IQR=52-246)]. The mortality rate was 68 deaths/ 10,000 person days. The deaths rate declined over the years (p-0.018). The Kaplan Meier curves differed significantly for type of patient, treatment model, and disease class [(log rank statistic, p-value), (0.0063), (<0.01), (<0.01)]. Multivariable Cox regression showed patients undergoing facility DOTs had a hazard of 0.69 compared to those on community DOTs (Adj HR: 0.69, 95% CI: 0.6705-0.835). Patients clinically diagnosed and those with extra pulmonary TB had a hazard of 1.44 and 2.13 compared to those with Pulmonary bacteriologically confirmed TB [(Adj HR: 1.44, 95% CI: 1.19-1.73), (Adj HR: 2.13, 95% CI: 1.51-3.015)].

Conclusion and Recommendations: The proportion of deaths in TB patients compared with TB/HIV co-infected patients was similar. Median time to death comparing TB patients to TB/HIV co-infected patients was the same. The death rate was declining over the years. Deaths lower in patients attending facility DOTs compared to community DOTs, and higher in clinically diagnosed and extra pulmonary TB patients compared to pulmonary bacteriologically confirmed patients. We recommended strengthening community DOTS, and increasing efforts on bacteriological diagnosis of TB.

Key Skills and Competences acquired

• Practical skills in disease outbreak investigation, response and control.
• Scientific writing and presentation skills to various audiences.
• Analysis, interpretation and evaluation of surveillance data to improve health.
• Leadership and management skills attained from the different assignments at the host site and the Quality Improvement project conducted in Buliisa district.

Next Steps

• With the knowledge and skills I have acquired in field epidemiology, I desire to build a career in infectious disease epidemiology and mainly the neglected tropical diseases.
• I also intend to transfer the knowledge and skills I have gained to persons with interest in field epidemiology.