Reactive vaccination as a control strategy for pneumococcal meningitis outbreaks in the African meningitis belt: analysis of outbreak data from Ghana

Streptococcus pneumoniae is increasingly recognised as an important cause of bacterial meningitis in the African meningitis belt. The World Health Organization sets guidelines for response to outbreaks of meningococcal meningitis, but there are no current guidelines for outbreaks where S. pneumoniae is implicated. We aimed to evaluate the impact of using a similar response to target outbreaks of vaccine-preventable pneumococcal meningitis in the meningitis belt. Here, we adapt a previous model of reactive vaccination for meningococcal outbreaks to estimate the potential impact of reactive vaccination in a recent pneumococcal meningitis outbreak in the Brong-Ahafo region of central Ghana using weekly line list data on all suspected cases over a period of five months. We determine the sensitivity and specificity of various epidemic thresholds and model the cases and deaths averted by reactive vaccination. An epidemic threshold of 10 suspected cases per 100,000 population per week performed the best, predicting large outbreaks with 100% sensitivity and more than 85% specificity. In this outbreak, reactive vaccination would have prevented a lower number of cases per individual vaccinated (approximately 15,300 doses per case averted) than previously estimated for meningococcal outbreaks. Since the burden of death and disability from pneumococcal meningitis is higher than that from meningococcal meningitis, there may still be merit in considering reactive vaccination for outbreaks of pneumococcal meningitis. More outbreak data are needed to refine our model estimates. Whatever policy is followed, we emphasize the importance of timely laboratory confirmation of suspected cases to enable appropriate decisions about outbreak response.LVC is supported by a studentship from Trinity Hall College

Assessment of core capacities for the International Health Regulations (IHR[2005]) – Uganda, 2009

<p>Abstract</p> <p>Background</p> <p>Uganda is currently implementing the International Health Regulations (IHR[2005]) within the context of Integrated Disease Surveillance and Response (IDSR). The IHR(2005) require countries to assess the ability of their national structures, capacities, and resources to meet the minimum requirements for surveillance and response. This report describes the results of the assessment undertaken in Uganda.</p> <p>Methods</p> <p>We conducted a descriptive cross-sectional assessment using the protocol developed by the World Health Organisation (WHO). The data collection tools were adapted locally and administered to a convenience sample of HR(2005) stakeholders, and frequency analyses were performed.</p> <p>Results</p> <p>Ugandan national laws relevant to the IHR(2005) existed, but they did not adequately support the full implementation of the IHR(2005). Correspondingly, there was a designated IHR National Focal Point (NFP), but surveillance activities and operational communications were limited to the health sector. All the districts (13/13) had designated disease surveillance offices, most had IDSR technical guidelines (92%, or 12/13), and all (13/13) had case definitions for infectious and zoonotic diseases surveillance. Surveillance guidelines were available at 57% (35/61) of the health facilities, while case definitions were available at 66% (40/61) of the health facilities. The priority diseases list, surveillance guidelines, case definitions and reporting tools were based on the IDSR strategy and hence lacked information on the IHR(2005). The rapid response teams at national and district levels lacked food safety, chemical and radio-nuclear experts. Similarly, there were no guidelines on the outbreak response to food, chemical and radio-nuclear hazards. Comprehensive preparedness plans incorporating IHR(2005) were lacking at national and district levels. A national laboratory policy existed and the strategic plan was being drafted. However, there were critical gaps hampering the efficient functioning of the national laboratory network. Finally, the points of entry for IHR(2005) implementation had not been designated.</p> <p>Conclusions</p> <p>The assessment highlighted critical gaps to guide the IHR(2005) planning process. The IHR(2005) action plan should therefore be developed to foster national and international public health security.</p

Supporting Local Seed Businesses : A Training Manual for ISSD Uganda

The training manual is developed in Uganda to train partner organisations in coaching farmer groups to become sustainable local seed businesses. It introduces the Integrated Seed Sector Development Programme in Uganda and the concept of local seed businesses (LSBs). The manual has 5 modules covering selection, monitoring and sustaining local seed businesses; technically equipping local seed businesses, professionally organising LSBs; orienting LSBs to the market and strategically linking them to service providers

UPGro Hidden Crisis Research Consortium : project approach for defining and assessing rural water supply functionality and levels of performance

This technical brief is aimed at sharing the learning and approaches developed by the UPGro Hidden Crisis Research Project to look at how the functionality and performance levels of boreholes equipped with handpumps (HPBs), can be assessed using a common set of definitions and methods. A tiered approach to defining and measuring functionality is found to be useful to examining functionality for different scales and purposes of monitoring. This report is aimed at national and regional actors involved in the provision and monitoring of rural water supply functionality. The brief sets out the tiered functionality definitions, and accompanying survey methods, which were developed by the project and have been applied in functionality surveys across Ethiopia, Uganda and Malawi [5-7]. The brief provides a summary of: • The tiered approach to defining and measuring the functionality and performance levels of boreholes equipped with handpumps (HPBs). • A series of survey methods which were found to be useful by the Hidden Crisis project to collect sufficient data to assess HPB functionality across the tiered definition approach. • A series of guidelines which could form core criteria for assessing functionality and performance levels of water points . This summary should be read in conjunction with the appendices which provide details of the methods and approaches described

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

Diagnostic Appraisal of Sorghum Farming System in Sierra Leone

Data collection was through structured interviews, observations on sorghum fields, and discussions with focus groups. The semi-structured questionnaires were designed on topics related to the general socioeconomic characteristics of the respondents and household characteristics, farming system, sorghum genetic diversity, sorghum utilization and business performance, sorghum production constraints, and lastly, farmers’ preferred traits in sorghum for Sierra Leone. Sorghum traits were predefined from literature and through discussion with farmers.THIS DATASET IS ARCHIVED AT DANS/EASY, BUT NOT ACCESSIBLE HERE. TO VIEW A LIST OF FILES AND ACCESS THE FILES IN THIS DATASET CLICK ON THE DOI-LINK ABOV