Outbreak of beriberi among African union troops in Mogadishu, Somalia

Context and Objectives: In July 2009, WHO and partners were notified of a large outbreak of unknown illness, including deaths, among African Union (AU) soldiers in Mogadishu. Illnesses were characterized by peripheral edema, dyspnea, palpitations, and fever. Our objectives were to determine the cause of the outbreak, and to design and recommend control strategies. Design, Setting, and Participants: The illness was defined as acute onset of lower limb edema, with dyspnea, chest pain, palpitations, nausea, vomiting, abdominal pain, or headache. Investigations in Nairobi and Mogadishu included clinical, epidemiologic, environmental, and laboratory studies. A case-control study was performed to identify risk factors for illness. Results: From April 26, 2009 to May 1, 2010, 241 AU soldiers had lower limb edema and at least one additional symptom; four patients died. At least 52 soldiers were airlifted to hospitals in Kenya and Uganda. Four of 31 hospitalized patients in Kenya had right-sided heart failure with pulmonary hypertension. Initial laboratory investigations did not reveal hematologic, metabolic, infectious or toxicological abnormalities. Illness was associated with exclusive consumption of food provided to troops (not eating locally acquired foods) and a high level of insecurity (e.g., being exposed to enemy fire on a daily basis). Because the syndrome was clinically compatible with wet beriberi, thiamine was administered to ill soldiers, resulting in rapid and dramatic resolution. Blood samples taken from 16 cases prior to treatment showed increased levels of erythrocyte transketolase activation coefficient, consistent with thiamine deficiency. With mass thiamine supplementation for healthy troops, the number of subsequent beriberi cases decreased with no further deaths reported. Conclusions: An outbreak of wet beriberi caused by thiamine deficiency due to restricted diet occurred among soldiers in a modern, well-equipped army. Vigilance to ensure adequate micronutrient intake must be a priority in populations completely dependent upon nutritional support from external sources

Outbreak of Marburg hemorrhagic fever among miners in Kamwenge and Ibanda Districts, Uganda, 2007

Marburg hemorrhagic fever was detected among 4 miners in Ibanda District, Uganda, from June through September, 2007. Infection was likely acquired through exposure to bats or bat secretions in a mine in Kamwenge District, Uganda, and possibly human-to-human transmission between some patients. We describe the epidemiologic investigation and the health education response

The COVID-19 pandemic in the African continent.

In December 2019, a new coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and associated disease, coronavirus disease 2019 (COVID-19), was identified in China. This virus spread quickly and in March, 2020, it was declared a pandemic. Scientists predicted the worst scenario to occur in Africa since it was the least developed of the continents in terms of human development index, lagged behind others in achievement of the United Nations sustainable development goals (SDGs), has inadequate resources for provision of social services, and has many fragile states. In addition, there were relatively few research reporting findings on COVID-19 in Africa. On the contrary, the more developed countries reported higher disease incidences and mortality rates. However, for Africa, the earlier predictions and modelling into COVID-19 incidence and mortality did not fit into the reality. Therefore, the main objective of this forum is to bring together infectious diseases and public health experts to give an overview of COVID-19 in Africa and share their thoughts and opinions on why Africa behaved the way it did. Furthermore, the experts highlight what needs to be done to support Africa to consolidate the status quo and overcome the negative effects of COVID-19 so as to accelerate attainment of the SDGs

Private Sector Drug Shops in Integrated Community Case Management of Malaria, Pneumonia, and Diarrhea in Children in Uganda

We conducted a survey involving 1,604 households to determine community care-seeking patterns and 163 exit interviews to determine appropriateness of treatment of common childhood illnesses at private sector drug shops in two rural districts of Uganda. Of children sick within the last 2 weeks, 496 (53.1%) children first sought treatment in the private sector versus 154 (16.5%) children first sought treatment in a government health facility. Only 15 (10.3%) febrile children treated at drug shops received appropriate treatment for malaria. Five (15.6%) children with both cough and fast breathing received amoxicillin, although no children received treatment for 5–7 days. Similarly, only 8 (14.3%) children with diarrhea received oral rehydration salts, but none received zinc tablets. Management of common childhood illness at private sector drug shops in rural Uganda is largely inappropriate. There is urgent need to improve the standard of care at drug shops for common childhood illness through public–private partnerships

THEME ONE: Coping with armed conflict PLANNING HEALTH CARE FOR INTERNALLY DISPLACED PERSONS: EXPERIENCES IN UGANDA

A significant proportion of Ugandans have at one time or another been forced to flee their homes. In 1997 alone, point prevalence revealed that 2,000,000 persons were displaced and it is estimated that currently about 1.6 million Ugandan are internally displaced. The ten districts in the north and northeastern Uganda have the biggest problems of displacement with Gulu district having the highest number of IDPs. The status of IDPs is unpredictable. The objective of health care services for IDPs is to reduce excess mortality (currently twice that of districts without IDPs) and morbidity among the Internally Displaced Persons through interventions that target the most vulnerable (women, children, disabled) in these communities. The natural response in Uganda for the affected districts in the North and North- Eastern parts of the country has been multisectoral. This paper proposes how priority health interventions can be designed and delivered in IDP camps, above all stressing the role of coordination

Theme one: Coping with armed conflict \u2013 Planning health care for internally displaced persons: Experiences in Uganda

A significant proportion of Ugandans have at one time or another been forced to flee their homes. In 1997 alone, point prevalence revealed that 2,000,000 persons were displaced and it is estimated that currently about 1.6 million Ugandan are internally displaced. The ten districts in the north and northeastern Uganda have the biggest problems of displacement with Gulu district having the highest number of IDPs. The status of IDPs is unpredictable. The objective of health care services for IDPs is to reduce excess mortality (currently twice that of districts without IDPs) and morbidity among the Internally Displaced Persons through interventions that target the most vulnerable (women, children, disabled) in these communities. The natural response in Uganda for the affected districts in the North and North- Eastern parts of the country has been multisectoral. This paper proposes how priority health interventions can be designed and delivered in IDP camps, above all stressing the role of coordination

Community Perceptions and Experiences on the Use of Oil and Gas in Tanzania Mainland: A Triangulation Method Study

This paper employed a cross-sectional mixed design to explore community perceptions and experiences on the use of oil and gas through triangulation methods. Quantitative and qualitative research designs were adopted for data collection and analysis. The quantitative data collection strand comprised 403 individual respondents, while the qualitative part involved 8 focus group discussions. Village mapping was also undertaken to describe the community-level energy network and identify potential stakeholders. The paper applied the logistic regression model to convert response averages of selected impacts and contributions that reflect perceptions of oil and gas in the community. On the other hand, the study used a qualitative technique for theme identification. The results suggest  positive perceptions of respondents about the use of oil and gas. Specifically, sex, highest level of education, average expenditure per day, and region and government initiatives predicted peoples’ perceptions of continuous supply of electricity, conservation of the environment, and suitability on domestic use. Factors identified to be associated with contribution to employment and social  infrastructure include sex, age, highest level of education, region, government enforcement of openness, and people’s attendance ofvillage meetings. It is recommended that efforts be devoted to providing people with adequate and relevant information that will equip them with knowledge about oil and gas. and thus empower them to manage uses of modern energy. Keywords: perceptions, oil, gas, mixed approach, Mtwara and Pwan