Ebola disease outbreak caused by the Sudan virus in Uganda, 2022: a descriptive epidemiological study.

Autor: Kabami Z; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda. Electronic address: zkabami@uniph.go.ug., Ario AR; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Harris JR; Division of Global Health Protection, Global Health Center, US Centers for Disease Control and Prevention, Kampala, Uganda., Ninsiima M; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Ahirirwe SR; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Ocero JRA; Office of the Minister of Health, Ministry of Health, Kampala, Uganda., Atwine D; Office of the Permanent Secretary, Ministry of Health, Kampala, Uganda., Mwebesa HG; Office of the Director General Health Services, Ministry of Health, Kampala, Uganda., Kyabayinze DJ; Office of the Director of Public Health, Ministry of Health, Kampala, Uganda., Muruta AN; Department of Integrated Epidemiology, Surveillance and Public Health Emergencies, Ministry of Health, Kampala, Uganda., Kagirita A; Department of the National Health Laboratory And Diagnostic Services, Ministry of Health, Kampala, Uganda., Tegegn Y; Office of the Country Representative, WHO, Kampala, Uganda., Nanyunja M; Emergency Preparedness and Response East and Southern Africa Hub, WHO AFRO Regional Office, Nairobi, Kenya., Kizito SN; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Kadobera D; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Kwesiga B; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Gidudu S; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Migisha R; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Makumbi I; National Public Health Emergency Operations Center, Uganda National Institute of Public Health, Kampala, Uganda., Eurien D; Global Health Security, Baylor College of Medicine Children's Foundation, Kampala, Uganda., Elyanu PJ; Global Health Security, Baylor College of Medicine Children's Foundation, Kampala, Uganda., Ndyabakira A; Directorate of Public Health and Environment, Kampala City Council Authority, Kampala, Uganda., Naiga HN; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Zalwango JF; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Agaba B; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Kawungezi PC; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Zalwango MG; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., King P; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Simbwa BN; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Akunzirwe R; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Wanyana MW; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Zavuga R; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda., Kiggundu T; Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda.
Jazyk: angličtina
Zdroj: The Lancet. Global health [Lancet Glob Health] 2024 Aug 30. Date of Electronic Publication: 2024 Aug 30.
DOI: 10.1016/S2214-109X(24)00260-2
Abstrakt: Background: Uganda has had seven Ebola disease outbreaks, between 2000 and 2022. On Sept 20, 2022, the Ministry of Health declared a Sudan virus disease outbreak in Mubende District, Central Uganda. We describe the epidemiological characteristics and transmission dynamics.
Methods: For this descriptive study, cases were classified as suspected, probable, or confirmed using Ministry of Health case definitions. We investigated all reported cases to obtain data on case-patient demographics, exposures, and signs and symptoms, and identified transmission chains. We conducted a descriptive epidemiological study and also calculated basic reproduction number (R o ) estimates.
Findings: Between Aug 8 and Nov 27, 2022, 164 cases (142 confirmed, 22 probable) were identified from nine (6%) of 146 districts. The median age was 29 years (IQR 20-38), 95 (58%) of 164 patients were male, and 77 (47%) patients died. Symptom onsets ranged from Aug 8 to Nov 27, 2022. The case fatality rate was highest in children younger than 10 years (17 [74%] of 23 patients). Fever (135 [84%] of 160 patients), vomiting (93 [58%] patients), weakness (89 [56%] patients), and diarrhoea (81 [51%] patients) were the most common symptoms; bleeding was uncommon (21 [13%] patients). Before outbreak identification, most case-patients (26 [60%] of 43 patients) sought care at private health facilities. The median incubation was 6 days (IQR 5-8), and median time from onset to death was 10 days (7-23). Most early cases represented health-care-associated transmission (43 [26%] of 164 patients); most later cases represented household transmission (109 [66%]). Overall R o was 1·25.
Interpretation: Despite delayed detection, the 2022 Sudan virus disease outbreak was rapidly controlled, possibly thanks to a low R o . Children (aged <10 years) were at the highest risk of death, highlighting the need for targeted interventions to improve their outcomes during Ebola disease outbreaks. Initial care-seeking occurred at facilities outside the government system, showing a need to ensure that private and public facilities receive training to identify possible Ebola disease cases during an outbreak. Health-care-associated transmission in private health facilities drove the early outbreak, suggesting gaps in infection prevention and control.
Funding: None.
Competing Interests: Declaration of interests We declare no competing interests.
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Databáze: MEDLINE
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