Caregivers' perceived treatment failure in home-based management of fever among Ugandan children aged less than five years

BACKGROUND: Home-based management of fever (HBMF) could improve prompt access to antimalarial medicines for African children. However, the perception of treatment failure by caregivers has not been assessed. METHODS: Caregiver's perceived treatment outcome in HBMF and in alternative sources of fever treatment was assessed in a rural Ugandan setting using nine hundred and seventy eight (978) caregivers of children between two and 59 months of age, who had reported fever within two weeks prior to the study. RESULTS: Lower caregivers' perceived treatment failure (15% and 23%) was observed in the formal health facilities and in HBMF, compared to private clinics (38%), drug shops (55%) or among those who used herbs (56%). Under HBMF, starting treatment within 24 hours of symptoms onset and taking treatment for the recommended three days duration was associated with a lower perceived treatment failure. Conversely, vomiting, convulsions and any illness in the month prior to the fever episode was associated with a higher perceived treatment failure. CONCLUSION: In this medium malaria transmission setting, caregiver's perceived treatment outcome was better in HBMF compared to alternative informal sources of treatment

Ebola Hemorrhagic Fever Associated with Novel Virus Strain, Uganda, 2007–2008

Case-fatality rate is lower for this strain than for the other 3 Ebola species known to be pathogenic to humans

The burden of cholera in Uganda.

IntroductionIn 2010, the World Health Organization released a new cholera vaccine position paper, which recommended the use of cholera vaccines in high-risk endemic areas. However, there is a paucity of data on the burden of cholera in endemic countries. This article reviewed available cholera surveillance data from Uganda and assessed the sufficiency of these data to inform country-specific strategies for cholera vaccination.MethodsThe Uganda Ministry of Health conducts cholera surveillance to guide cholera outbreak control activities. This includes reporting the number of cases based on a standardized clinical definition plus systematic laboratory testing of stool samples from suspected cases at the outset and conclusion of outbreaks. This retrospective study analyzes available data by district and by age to estimate incidence rates. Since surveillance activities focus on more severe hospitalized cases and deaths, a sensitivity analysis was conducted to estimate the number of non-severe cases and unrecognized deaths that may not have been captured.ResultsCholera affected all ages, but the geographic distribution of the disease was very heterogeneous in Uganda. We estimated that an average of about 11,000 cholera cases occurred in Uganda each year, which led to approximately 61-182 deaths. The majority of these cases (81%) occurred in a relatively small number of districts comprising just 24% of Uganda's total population. These districts included rural areas bordering the Democratic Republic of Congo, South Sudan, and Kenya as well as the slums of Kampala city. When outbreaks occurred, the average duration was about 15 weeks with a range of 4-44 weeks.DiscussionThere is a clear subdivision between high-risk and low-risk districts in Uganda. Vaccination efforts should be focused on the high-risk population. However, enhanced or sentinel surveillance activities should be undertaken to better quantify the endemic disease burden and high-risk populations prior to introducing the vaccine

Nodding syndrome may be only the ears of the hippo

Nodding Syndrome (NS) is a neurological disorder of unknown etiology and pathogenesis, reported to occur mainly in the Western Equatoria State in South Sudan, in several districts in northern Uganda, and in Mahenge district in Tanzania [1]. The characteristic clinical feature of NS is a paroxysmal spell where the head nods forwar

A non-random sample of outbreaks in Uganda, 2002–2010.

<p>A non-random sample of outbreaks in Uganda, 2002–2010.</p

Districts with reported cholera cases from 2005 to 2010 (endemic and non-endemic districts).

<p>Some districts may be considered endemic for cholera based on a history of cholera incidence during three of the five years from 2005–2010. Other districts have demonstrated cholera on a less consistent basis, while a few districts did not report any cases between 2005–2010.</p

Map of reported cholera incidence by district, hospitalized cases, 2005–10.

<p>The estimated incidence by district varies considerably in Uganda with a distinct pattern of low-incidence versus high incidence districts.</p

Annual number of cholera cases and deaths reported in Uganda 1997–2010.

<p>There was a major outbreak in 1998 and a fluctuating, but persistent burden of cholera in the years since the outbreak.</p