Mackline Ninsiima

BScN (BSU), MHSR (MUK) & Advanced Field Epidemiology Fellow (UNIPH)
Email: nmackline@musph.ac.ug OR mninsiima@uniph.go.ug
Telephone: +256 787 819 496/+256 700 759 777

Host Site: Kampala Capital City Authority (KCCA)

Host Mentor: Dr. Daniel Okello Ayen/Dr. Alex Ndyabakira

ABOUT THE FELLOW

Mackline Ninsiima is an experienced epidemiologist and air quality scientist, holding a Bachelor of Nursing Science (BScN) and Master of Health Services Research (MHSR).

During the fellowship, she was hosted at Kampala Capital City Authority (KCCA) where she played a significant role in the operational aspects of air quality management, an opportunity that has been a game-changer for her career. She represented KCCA on various international platforms, including the launch of Clean Air Africa Network, East African air quality stakeholder workshop, air quality and health symposiums in Kenya, CAMS-Net and AfriqAir conference in Rwanda, and Air Sensors International Community (AISC) conference in Ghana.

She has demonstrated exceptional capabilities in emergency response, notably during the Sudan ebolavirus outbreak in Kampala City. Due to this outstanding performance, she was nominated among the key stakeholders engaged in drafting guidelines for responding to Ebola/ Marburg Virus disease outbreaks in Uganda. Additionally, she served as a secretariat member for various public health initiatives, including the COVID-19 Intra-Action Review, Ebola After-Action Review, Emergency Preparedness and Response flagship initiative’s scoping mission, and Uganda Joint External Evaluation.

She participated in the 2023 Joint External Evaluation in Zambia, demonstrating my commitment to evaluating and enhancing public health responses at both local and international levels.

Mackline’s expertise spans a diverse range of areas, including field epidemiology, Incident Management System, Integrated Disease Surveillance and Response, rapid risk assessments of public health events, Joint External Evaluation, After-Action Reviews, scientific writing, and air quality management. This diversity showcases a well-rounded professional dedicated to advancing public health and addressing emerging challenges.

  Achievements at the Host Site

• Participated in the following activities:

• • Air quality monitoring using PM2.5 concentrations generated by Clarity© Node Solar–Powered air quality monitors.
  • Public awareness and sensitization on air quality

• Coordinated the collaborative initiatives between Kampala Capital City Authority (KCCA) and Makerere University Lung Institute (MLI) to conduct source apportionment and emission inventory.
• Coordinated the air quality collaborative training for staff engaged in air quality management at National Environment Management Authority (NEMA), Kampala Capital City Authority (KCCA), AirQo Project, and Makerere University Lung Institute (MLI).
• Represented Kampala Capital City Authority (KCCA) as a technical delegate during several air quality meetings:

• • East African air quality stakeholder workshop organized by United Nations Environment Programme (UNEP).

• Represented KCCA at the Air Quality and Health symposium organized by GEOHealth Hub.
• Attended the air quality and health symposium organized by Health Effects Institute in partnership with the Stockholm Environment Institute – Africa Centre (SEI Africa), World Resources Institute (WRI Africa), Eastern Africa GEO Health Hub (Kenya) and AirQo.
• Participated in formulation of a policy brief for air quality in Uganda organized by National Environmental Management Authority (NEMA) in December 2023.
• Presented at local and international conferences: 8th and 9th National Field epidemiology conference (NFEC)

• • 17th Joint Annual Scientific Health Conference (JASHC).
  • CAMS-Net and AfriqAir Conference, Kigali, Rwanda (won Best Poster Award).
  • Air Sensors International Community (AISC) Conference, Accra, Ghana.
  • 8th African Field Epidemiology Network (AFENET) Scientific Conference, Mombasa, Keny

• Chief editor of Volume 1 Issue 4 June 2022 Kampala Capital City Authority (KCCA) Public Health and Environment bulletin.
• Authored air quality quarterly technical reports.
• Participated in the Ebola response:

• • Participated in drafting the KCCA Preparedness and Response Plan
  • Mobilizing resources from implementing partners
  • Authoring daily situation reports, and crafting the recovery plan

• Developed a signal/alert management algorithm for streamlining alert management at Kampala Metropolitan Area (KMA) Emergency Operations Centre.

Fellowship program specific achievements

• International deployment by World Health Organization Regional Office for Africa (WHO AFRO) as a member of the external team tasked with conducting the Joint External Evaluation in Livingstone, Zambia.
• Served as a secretariat member for pivotal public health initiatives including the COVID-19 Intra Action Review, Ebola After Action Review, Emergency Preparedness and Response flagship initiatives’ scoping mission, and Uganda Joint External Evaluation.
• Participated in capacity building activities:

• • Trained and mentored 4th Cohort of Intermediate FETP tier.
  • Trained Rapid Response Teams in Soroti, Rwenzori and Hoima sub regions.
  • Participated in the Integrated Disease Surveillance and Response (IDSR) training in Kampala Metropolitan Area.
  • Facilitated Chain Checker training sessions among laboratory personnel at the Uganda Virus Research Institute (UVRI).

• Participated in various rapid assessments and outbreak responses:

• • Syndromic Surveillance during the 2022 Uganda Martyrs’ Commemoration.
  • Sudan Virus Disease outbreak response, Kampala City, Uganda, 2022–2023
  • Methanol poisoning outbreak in Northwestern Uganda, August 2022.
  • COVID-19 outbreak at a Refugee Transit Centre, Kisoro District, Southwestern Uganda, June–July 2022.
  • Malaria outbreak in Namutumba District, Eastern Uganda, September 2021–February 2022
  • Editor of Volume 7 Issue 2 April–June 2022 Uganda National Institute of Public Health (UNIPH) Epidemiological bulletin.

• Published bulletin articles:

• • Spatio–temporal trends of air quality, Kampala City, Uganda, 2020–2022.
  • Effect of air pollution on preterm birth in Kampala City, Uganda, October 2021– September 2022.
  • Syndromic surveillance during 2022 Uganda martyrs’ commemoration.

• Air quality; the opportune sphere worth pursuit.
• 8th National Field Epidemiology Conference, Africana Hotel, Kampala, Uganda, February 12, 2023.
• 2022 Sudan Virus Disease outbreak, After Action Review, Speke Resort Munyonyo, Uganda, February 13–16, 2023
• Written 14 manuscripts; five as Lead author (listed below) and co-author on nine others

• • Spatio–temporal trends of air quality, Kampala City, Uganda, 2020–2022” “Effect of air pollution on preterm birth in Kampala City, Uganda, October 2021–September 2022.
  • Syndromic surveillance during 2022 Uganda martyrs’ commemoration.
  • Cost analysis of integrating hypertension and diabetes management into routine HIV care in Mbarara and Ibanda districts, Uganda.
  • Strategies utilized during Sudan virus disease response in Kampala City, Uganda, 2022−2023.
  • Evaluation of alert management system during Sudan virus disease response in Kampala Metropolitan Area, Uganda, September, 2022– January, 2023.

Summary of Epidemiological Study: 

 Title: Spatio–temporal trends of air quality, Kampala City, Uganda, 2020–2022

Background:  Fine particulate matter (PM2.5) is among the health damaging air pollutants; levels exceeding 15 μg/m³ are associated with adverse health effects. We assessed spatio– temporal trends of air quality based on PM2.5 concentration in Kampala City during January 2020–June 2022.

Methods:  We abstracted PM2.5 concentrations generated by twenty–four Clarity© Node Solar–Powered monitors from January 1, 2020, to June 30, 2022, from the Clarity© dashboard. We computed 24-hour average PM2.5 concentrations by combining data from all monitors. Average PM2.5 concentrations per hour were compared by hour of the day. Seasonal Mann–Kendall statistical test was applied to assess significance of observed trends.

Results: Overall, the 24-hour average PM2.5 concentration from January 1, 2020, to June 30, 2022, was 59 μg/m3 (range: 18–182 μg/ m3). A statistically significant decline in PM2.5 occurred throughout the assessment period from January 2020 to June 2022 (r = –0.27, p < 0.001). PM2.5 increased from April to June each year [2020 (55 μg/m3, r=0.56, p=0.006), 2021 (45 μg/m3, r=0.26, p=0.030), and 2022 (37 μg/m3, r=0.37, p=0.030)] and declined from July to September in 2021 (57 μg/m3, r=–0.43, p=0.008) and January to March in 2022 (60 μg/m3, r=–0.41, p=0.011). PM2.5 concentration peaked from 10am–midday (74–73 μg/m3) and 8pm–9pm (73–77 μg/m3).

Conclusion: PM2.5 concentrations in Kampala City exceeded the WHO targeted safe levels even during times of less vehicle traffic and economic activity. Studies are needed to identify sources of pollution in Kampala City to develop interventions to improve air quality.

Keywords: Particulate Matter, Fine Particulate Matter (PM2.5), Air Pollutants, Cities, Uganda

Key lessons learnt during the fellowship

• Air quality management.
• Response to public health emergencies.
• Evidence-based decision-making.
• Effective public communication.
• Workforce development.
• Healthcare systems strengthening.
• Manuscript writing

Next Steps

Presently, I am seeking an opportunity to pursue a Doctor of Philosophy (PhD) in Public Health, with a specific focus on evaluating the health implications of air pollution, particularly within the Ugandan context.

Leveraging on the expertise attained in field epidemiology, I am committed to strengthening public health systems and ensuring implementation of effective emergency preparedness and response strategies to public health emergencies..

Pictorial