Continental concerted efforts to control the seventh outbreak of Ebola Virus Disease in Uganda: the first 90 days of the response

On 20th September 2022, Uganda declared the 7th outbreak of Ebola virus disease (EVD) caused by the Sudan Ebola strain following the confirmation of a case admitted at Mubende Regional Referral Hospital. Upon confirmation, the Government of Uganda immediately activated the national incident management system to initiate response activities. Additionally, a multi-country emergency stakeholder meeting was held in Kampala; convening Ministers of Health from neighbouring Member States to undertake cross-border preparedness and response actions. The outbreak spanned 69 days and recorded a total of 164 cases (142 confirmed, 22 probable), 87 recoveries and 77 deaths (case fatality ratio of 47%). Nine out of 136 districts were affected with transmission taking place in 5 districts but spilling over in 4 districts without secondary transmission. As part of the response the Government was able to galvanise robust community mobilisation and initiated assessment of medical counter measures including therapeutics, new diagnostics and vaccines. This paper highlights the response actions put in place that contributed to the containment of this outbreak in addition to the challenges faced with a special focus on key recommendations for better control of future outbreaks

Factors associated with late presentation to HIV/AIDS care in Harare City , 2015

Introduction: Despite widespread awareness and publicity concerning HIV care and advances in treatment, many patients still present late in their HIV disease. Preliminary review of the ART registers at Wilkins and Beatrice Road Hospitals indicated that 67% and 71% of patients enrolled into HIV/AIDS care presented late with baseline CD4 of <200 cells/uL and/or WHO stage 3 and 4 respectively. We therefore sought to explore factors associated with late presentation, with a view to encourage early health seeking behaviour. Methods: We conducted a 1:1 unmatched case control study in Harare City where a case was an HIV positive individual (>18 years) with a baseline CD4 of 18 years) who had a baseline CD4 of >200/uL or WHO clinical stage 1 or 2 at first presentation in 2014. Results: A total of 268 participants were recruited (134 cases and 134 controls). Independent risk factors for late presentation for HIV/AIDS care were illness being reason for test (AOR=7.68, 95% CI=4.08-14.75); Being male (AOR=2.84, 95% CI=1.50-5.40) and; experienced HIV stigma (AOR=2.99, 95% CI=1.54-5.79). Independent protective factors were receiving information on HIV (AOR=0.37, 95% CI=0.18-0.78) and earning more than US$250 per month (AOR=0.32, 95 30 days (Q1=3, Q3=75) among controls. Conclusion: Late presentation for HIV/AIDS care in Harare City was as a result of factors that relate to the patient‘s sex, illness as a reason for getting a test, receiving HIV related information, experiencing stigma and monthly income(>$250). Based on this evidence, we recommended targeted interventions to optimize early access to testing and enrolment into care

Factors associated with late presentation for HIV/AIDS care in Harare City, Zimbabwe, 2015

Abstract Background Despite widespread awareness and publicity concerning Human Immunodeficiency Virus (HIV) care and advances in treatment, many patients still present late in their HIV disease. Preliminary review of the Antiretroviral Therapy (ART) registers at Wilkins and Beatrice Road Hospitals, both located in Harare, indicated that 67 and 71 % of patients enrolled into HIV/AIDS care presented late with baseline CD4 of 18 years) with a baseline CD4 of 18 years) who had a baseline CD4 of >200/uL or WHO clinical stage 1 or 2 at first presentation in 2014. Written informed consent was obtained from all study participants. Results A total of 268 participants were recruited (134 cases and 134 controls). Independent risk factors for late presentation for HIV/AIDS care were illness being reason for test (Adjusted Odds Ratio [aOR] =7.68, 95 % CI = 4.08, 14.75); Being male (aOR = 2.84, 95 % CI = 1.50, 5.40) and; experienced HIV stigma (aOR = 2.99, 95 % CI = 1.54, 5.79). Independent protective factors were receiving information on HIV (aOR = 0.37, 95 % CI = 0.18, 0.78) and earning more than US$250 per month (aOR = 0.32, 95 % CI = 0.76, 0.67). Median duration between first reported HIV positive test result and enrolment into pre-ART care was 2 days (Q1 = 1 day; Q3 = 30 days) among cases and 30 days (Q1 = 3 days; Q3 = 75 days) among controls. Conclusion Late presentation for HIV/AIDS care in Harare City was a result of factors that relate to the patient’s sex, reason for getting a test, receiving HIV related information, experiencing stigma and monthly income. Based on this evidence we recommended targeted interventions to optimize early access to testing and enrolment into care