Nampeera Rose

MBChB (MUK), MCEB (MUK)
Email: rnampeera@musph.ac.ug
Telephone: +(256) 704 902 283

Host Site: Uganda Cancer Institute (UCI)

Host Mentor:Dr. Nixon Niyonzima,, Dr. Noleb Mugisha,

ABOUT THE FELLOW

Nampeera Rose holds a Master of Clinical Epidemiology and Biostatistics and a Bachelor’s degree in Medicine and Bachelor’s degree in surgery from Makerere University. Before joining the Fellowship program Rose worked for the Ministry of Health as an epidemiologist in COVID-19 pandemic response.

During her time as a Field epidemiology fellow, she was attached to the Uganda Cancer Institute where she gained skills/experience in community cancer screening and sensitization, leadership and public health response. The fellowship program has enabled Rose to gain technical expertise in field epidemiology skills that include: outbreak detection, investigations and response, evaluation of public health surveillance systems, project development and implementation, leadership and management, capacity building, scientific writing and communication skills.

  Achievements at the Host Site

• Analysed surveillance data for the Comprehensive Community Cancer Program (CCCP) at the Uganda Cancer Institute
• Participated in community cancer awareness programs of the CCCP on cervical and breast cancer.
• Trained the data team at the CCCP on cancer data management.
• Evaluated of the cancer surveillance system with the data staff at the CCCP.

Fellowship program specific achievements

Outbreak investigation and other projects

• Led 2 outbreak investigations

• • Hospitalized Covid-19 cases in Mulago Hospital, Dec –Jan, 2022.
  • Assessment of COVID-19 treatment availability and prescribing practices in Uganda, December 2021 to January 2022.

• Participated in other outbreak investigations:

• • Ebola outbreak in Mubende and Kassanda districts, October 2022.
  • Cholera Outbreak in Nakivale Refugee Settlement in Isingiro District.
  • Yellow Outbreak in Wakiso District, March 2021.

• Participated in other investigations of public health importance

• • Comparing hospitalized and non-hospitalized patients in wave1 verses wave 2 and verses wave 3.
  • Unusual deaths in Kijonjo Parish, Kyotera District.
  • baseline evaluation of Malaria Insecticide treated bed net ownership and utilisation in Mukono district following a mass distribution, March-2021

• Led the training District Health Teams (DHTs) on developing and interpreting malaria normal channels to detect malaria outbreaks in West Nile region, Uganda – 2021.
• Trained and mentored Cohort 17 and 18 Frontline-FETP participants
• Conceptualized and implemented an epidemiological study to assess the predictors of follow up for cervical cancer and cervical lesions treatment among women living with HIV in Uganda.
• Conducted a quality improvement project “Improving cervical cancer screening in Fort portal Regional Referral Hospital, 2022.”
• Conceptualised and implemented an HIV study entitled “Predictors of follow up for cervical cancer and cervical lesions treatment among women living with HIV in Uganda.”

• Unveiling Global Inequality in COVID-19 Treatment Availability and Prescribing Practices in Two Uganda General Hospitals, December 2021–January 2022: A Mixed Method Model.”
• “Factors associated with death among hospitalized COVID-19 patients in Mulago Hospital, Uganda Dec 2021 –Jan 2022”
• “Spatial and Temporal Trends of Cervical Cancer, Uganda, 2012- 2021: an Analysis of Surveillance Data”
• “Predictors of follow up for cervical cancer and cervical lesions treatment among women living with HIV in Uganda.”

Epidemiological bulletins

• ‘Factors associated with death among patients hospitalized with COVID-19 during Uganda’s third wave’
• ‘Spatial and Temporal Trends of Cervical Cancer, Uganda, 2012- 2021: an Analysis of Surveillance Data’

Newspaper articles in the New Vision

• “Continue the fight against cervical cancer”
• “Men go test for prostate cancer”

Conference presentations

• The 7th National Field Epidemiology conference: “Trends of cervical cancer 2017 –2020”
• The 8th National Field Epidemiology conference: “Trends of cervical cancer 2017 –2020”

Summary of Epidemiological Study: 

 Title: Factors associated with death among hospitalized COVID-19 patients in Mulago Hospital, Uganda Dec 2021 – Jan 2022

Background: 

On 7 December 2021, the first SARS-CoV-2 Omicron variant was confirmed in Uganda. By 14 December 2021, COVID-19 cases had risen sharply in Uganda’s third wave of COVID-19 cases, largely driven by the Omicron variant. Analysis of hospitalized patients in the first and second waves of COVID-19 in Uganda identified age and male sex to be associated with death. We described factors associated with death among hospitalized patients with COVID-19 in Mulago Hospital during W3 of the COVID-19 pandemic in Uganda.

Methods: We retrieved treatment files for all hospitalized patients with confirmed SARS-CoV-2 infection at Mulago Hospital in Kampala, Uganda from 14 December 2021 to 14 January 2022. We extracted data on age, sex, vaccination status, underlying conditions, and severity of COVID-19 disease, and interviewed patients or next-of-kin to obtain additional information. We used modified Poisson regression to identify factors associated with mortality.

Results: Among 206 patients, 112 (54%) were females and median age was 53 years (range, 0-98 years). In total, 127 (62%) had comorbidities, 38 (18%) were fully vaccinated (≥2 doses of SARS-CoV-2 vaccine), and 40 (20%) died. The median age of persons who died was 63 years (range, 23-88 years), compared with 51 years (0-98 years) in survivors. Seven (18%) persons who died were fully vaccinated, compared with 31 (19%) survivors (OR=0.90, 95%CI=0.43-1.9). Compared to patients aged 0-40 years, the odds of death were 4.1 (95%CI 1.4- 12) times higher among patients aged 45-65 years and 4.4 (95%CI 1.6-12) times higher for patients aged ≥66 years. The presence of comorbidities was not associated with death.

Conclusion: Among persons hospitalized with COVID-19 in Uganda’s third wave of infections, only increasing age was associated with death. There is need to continue to emphasize COVID-19 prevention and appropriate care for COVID-19 among older persons and continue studying new variants of COVID-19 independently.

Key lessons learnt during the fellowship

• Outbreak detection, investigation, response and control
• Scientific writing; concepts proposals, manuscripts, abstracts, policy briefs, epidemiological bulletins and newspaper articles
• Leadership and management skills acquired from various projects led and assigned
• Designing and implementation of continuous quality improvement projects
• Interpersonal skills with personnel of different cadres and race
• Communication skills including scientific presentation

Next Steps

• Publish pending work done during the fellowship in peer reviewed journals
• Use the knowledge, skills and experience gained to nurture a career in epidemiology and impact society nationally and internationally through available institutions of government and international organisations.

Pictorial