Evaluation of recharge areas of Arusha Aquifer, Northern Tanzania: application of water isotope tracers

This research article published by IWA Publishing, 2020In Arusha urban, northern Tanzania, groundwater contributes about 80% of the water supply. However, elevated fluoride levels and evidence of anthropogenic pollution have been reported in the groundwater around Mount Meru which is a water source for Arusha urban. This study aims at understanding the recharge areas and flow pathways of groundwater in what has been a poorly monitored area. The study uses the isotopic ratio of oxygen and hydrogen to estimate the groundwater recharge area and flow pathway. The results show the recharge elevation of groundwater is between 1,800 and 3,500 m above mean sea level on the slopes of Mount Meru. The average fluoride contents in the study area are 5.3 ± 0.4 mg/L greater than the limits of 1.5 mg/L set by the World Health Organization (WHO) and Tanzania. The nitrate concentration of 83.9 mg/L at the lower elevation areas (<1,400 m above mean sea level) exceeds the 50 mg/L WHO limit. The relationship of F− with δ18O and NO3− suggests the leaching of fluoride in high altitudes and dilution in lower altitudes

Marburg virus disease outbreak in Kween District Uganda, 2017: Epidemiological and laboratory findings.

INTRODUCTION: In October 2017, a blood sample from a resident of Kween District, Eastern Uganda, tested positive for Marburg virus. Within 24 hour of confirmation, a rapid outbreak response was initiated. Here, we present results of epidemiological and laboratory investigations. METHODS: A district task force was activated consisting of specialised teams to conduct case finding, case management and isolation, contact listing and follow up, sample collection and testing, and community engagement. An ecological investigation was also carried out to identify the potential source of infection. Virus isolation and Next Generation sequencing were performed to identify the strain of Marburg virus. RESULTS: Seventy individuals (34 MVD suspected cases and 36 close contacts of confirmed cases) were epidemiologically investigated, with blood samples tested for MVD. Only four cases met the MVD case definition; one was categorized as a probable case while the other three were confirmed cases. A total of 299 contacts were identified; during follow- up, two were confirmed as MVD. Of the four confirmed and probable MVD cases, three died, yielding a case fatality rate of 75%. All four cases belonged to a single family and 50% (2/4) of the MVD cases were female. All confirmed cases had clinical symptoms of fever, vomiting, abdominal pain and bleeding from body orifices. Viral sequences indicated that the Marburg virus strain responsible for this outbreak was closely related to virus strains previously shown to be circulating in Uganda. CONCLUSION: This outbreak of MVD occurred as a family cluster with no additional transmission outside of the four related cases. Rapid case detection, prompt laboratory testing at the Uganda National VHF Reference Laboratory and presence of pre-trained, well-prepared national and district rapid response teams facilitated the containment and control of this outbreak within one month, preventing nationwide and global transmission of the disease

Uganda's experience in Ebola virus disease outbreak preparedness, 2018-2019.

BACKGROUND: Since the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country. We describe Uganda's experience in EVD preparedness. RESULTS: On 4 August 2018, the Uganda Ministry of Health (MoH) activated the Public Health Emergency Operations Centre (PHEOC) and the National Task Force (NTF) for public health emergencies to plan, guide, and coordinate EVD preparedness in the country. The NTF selected an Incident Management Team (IMT), constituting a National Rapid Response Team (NRRT) that supported activation of the District Task Forces (DTFs) and District Rapid Response Teams (DRRTs) that jointly assessed levels of preparedness in 30 designated high-risk districts representing category 1 (20 districts) and category 2 (10 districts). The MoH, with technical guidance from the World Health Organisation (WHO), led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at Points of Entry (PoEs) and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms. CONCLUSION: As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significant and verifiable progress in EVD preparedness. There is a need to sustain these efforts, not only in EVD preparedness but also across the entire spectrum of a multi-hazard framework. These efforts strengthen country capacity and compel the country to avail resources for preparedness and management of incidents at the source while effectively cutting costs of using a "fire-fighting" approach during public health emergencies

The village health team strategy is a 'Most Innovative Community Practice' award winner: the experience OFA village volunteer programme in Yumbe District, Uganda

Community participation in health has been an elusive concept since the days of the Alma Ata Declaration. Many faltering steps have been taken towards genuine community participation only to be retraced because the programmes were either ill-conceived or derailed by the loss of the spirit of voluntarism. In Yumbe District of north-western Uganda, Village Health Teams (VHT) have been established in line with the national strategy for community involvement in health. The Yumbe VHT programme has won an award for innovative support to strengthening decentralisation. This paper reviews aspects of the programme outlining its successes and challenges. Its success has been mainly due to integration of pre-existing volunteer cadres, intersectoral approach to the monitoring of the teams and involvement of the community in the selection of the top-up team members. Its challenges include the relatively young age of the majority of the volunteers and the likely loss of financial support for the activities of the volunteers. The paper concludes that the VHT programme is a delicate venture requiring both programme support through intersectoral inputs to the Community Action Plans developed by communities and sociological approaches to educate the communities to support the VHT for its sustainability

Coordinating Health Care During Humanitarian Emergency: Experience From Pader District, Northern Uganda

Coordination of humanitarian assistance has been a subject of concern for several decades. The humanitarian reforms initiated by United Nations following UN General Assembly resolution 46/182 and the subsequent reforms that introduced the Cluster Approach to humanitarian assistance offers some opportunities for improved coordination. The main challenges to these reforms remain their acceptance among the humanitarian community, mainly NGOs, and donor faith in providing funding through the structures. We conclude that offering a comprehensive package to coordination encompassing joint humanitarian planning, policy, financing and monitoring of interventions is a step towards holistically addressing the needs of the crisis-affected people. There is also need for the UN to intensify dissemination of the humanitarian reforms to key stakeholders to improve their acceptance in the field

Theme two: Managing health information - The curse of league tables: How Uganda missed the point

This paper examines the criteria used by the Ministry of Health to determine the performance of the different districts as presented in the annual National Health Sector Performance Report. Using the winner of the 2004/2005, it attempts to analyze the health situation in the district and challenges the reliability of using HSSP input, process and output indicators as a measure of sector performance. The paper proposes that outcome indicators, like health status indicators, are a better measure of sector performance and should be the ones used for rating district performance. It also suggests that process indicators be used for technical forums and not political forums like the National Health Assembly. It ends with a cautionary remark on the likely misinterpretation of process indicators by the general public in districts with poor health status

THE HEALTH SITUATION AT AWER INTERNALLY DISPLACED PERSONS' CAMP - GULU DISTRICT, UGANDA

Uganda's close to 2 decades long conflict has led to a humiliating humanitarian situation in the IDP camps created by the government. A senior UN official, Jan Egeland described the humanitarian situation as 'the worst in the world'. An assessment of the public health situation was done in one of the IDP camps (Awer camp) some 15 km West of Gulu town on the Gulu Adjumani highway from 28th may - 18th June 2004. The findings suggested that the sphere standards for humanitarian interventions were not being adhered to by the humanitarian agencies for all the most basic necessities such as water and sanitation, food, shelter, and health services

The Ten Beads method: a novel way to collect quantitative data in rural Uganda

This paper illustrates how locally appropriate methods can be used to collect quantitative data from illiterate respondents. This method uses local beads to represent quantities, which is a novel yet potentially valuable methodological improvement over standard Western survey methods

Effect of groundwater residence time on geogenic fluoride release into groundwater in the Mt. Meru slope area, Tanzania, the Great Rift Valley, East Africa

This research articles was published Journal of Contaminant Hydrology Volume 253,2023People living in the Great Rift Valley in East Africa suffer from fluorosis resulting from their consumption of groundwater. This paper shows that geogenic fluoride contamination in a natural water system has changed in the last two decades in the Mt. Meru slope area of northern Tanzania based on water quality, dating of the residence time, and stable isotopes of groundwater. The results demonstrate that 1) the average recharge altitude of groundwater with a high geogenic fluoride concentration is estimated to range from 1900 m to 3000 m on the southern slope of Mt. Meru, and the fluoride concentration tends to increase with an increase in the recharge altitude, 2) the fluoride concentration increases with increasing groundwater residence time for groundwater with a residence time of 20 years or longer, suggesting that water-rock interaction processes (weathering, dissolution, and ion exchange), which depend on the contact time between the volcanic aquifer and groundwater, have predominated for approximately 20 years or longer, and 3) the mixing of aerobic young water and old groundwater has been active for approximately 20 years, and the fluoride concentration is increasing in some shallower well waters. The mixing of fluoride-contaminated groundwater with aerobic water infiltrating the aquifer through pumping groundwater in the last two decades may increase the spread of groundwater contaminated with fluoride due to increased water demand caused by rapid population growth, and urbanization, industrial growth, and the expansion of irrigated agriculture