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 Oct; Vol. 12 (10), pp. e1684-e1692. 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. (This is an Open Access article published under the CC BY NC ND 3.0 IGO license which permits users to download and share the article for non-commercial purposes, so long as the article is reproduced in the whole without changes, and provided the original source is properly cited. This article shall not be used or reproduced in association with the promotion of commercial products, services or any entity. There should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.)
Databáze:	MEDLINE
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