My Fellowship Achievements

Transcription

1 Public Health Fellowship Program Field Epidemiology Track Allen Eva Okullo, MPH, BSc. Zoo/Psy Fellow, Cohort 2015

2 Host Site: National Malaria Control Program Mandate: Direct and guide the day to day implementation of the National Malaria Control strategy Vision: A malaria free Uganda Mission: Provide quality assured services for malaria prevention and treatment to all people in Uganda 2

3 Response to Public Health Emergency Led an epidemiological investigation on a suspected guinea worm outbreak Co-investigator in 5 epidemiological outbreaks: Typhoid Malaria Acute Viral Hepatitis Cholera 3

4 Epidemiological Studies Factors associated with malaria illness in three districts of Northern Uganda, 2015 Assessment of risk factors for the malaria outbreak, Uganda

5 Public Health Surveillance Malaria incidence among <5yr olds in relation to malaria control interventions Led analysis of malaria indicators to inform programming and bulletin writing Mapped burden of malaria at sub county level by week in epidemic districts,

6 Public Health Surveillance Analysis of sub county data to estimate malaria incidence for all the sub counties in Uganda, 2015 Analysis on trends of malaria incidence in N. Uganda after provision of ACTs to communities by PMI/USAID Enhanced Yellow Fever Surveillance in Masaka & Mbarara Districts 6

7 Scientific Communication Lead Editor - Uganda National Malaria Quarterly Bulletin Oral presentation on development of an epidemic prediction tool at IMED2016, Austria Poster presentation on comparative cost analysis for cholera outbreak response at IMED2016 7

8 Scientific Communication 3 oral presentations at JASH & National Field Epidemiology Conference Malaria Incidence vis a vis control interventions Cholera comparative cost analysis Sub-editor - Ministry of Health Quarterly Epidemiological bulletin 8

9 Scientific Communication Published 2 articles in the MoH Quarterly Epidemiological bulletin Co-author in two publications: The challenge of using both long lasting insecticide bed nets and intermittent preventive therapy among pregnant women in Uganda A large typhoid outbreak in Kampala

10 Scientific Communication Authored 2 Newspaper articles on the malaria epidemic Submitted a manuscript to the Malaria Journal titled, Malaria incidence among children less than five years during and after cessation of Indoor Residual Spraying in Northern Uganda 10

11 Leadership and management Led analysis of data to estimate malaria incidence which informed the decision for LLIN provision 10.4 million LLINs donated by Against Malaria Foundation (AMF) based on this evidence Baseline for all future studies on effectiveness of mass distribution of LLINs in Uganda 11

12 Leadership and management Made a pitch at the IMED2016 Hackathon that led to devt Puddle Predict -a malaria epidemic prediction tool 12

13 Leadership and management Got second runner up prize at Hackathon IMED2016 pre-conference event for Puddle Predict Led team-puddle Predict that won the ProMED follow-up award for best progress among all projects developed at IMED2016 Coordinating the development of malaria epidemic prediction tool 13

14 Leadership and management An active team player in the development of the first ever Uganda Malaria portal Coordinated micro planning activities in 24 districts for LLIN mass campaign in Uganda Led response to the malaria epidemic as an Incident Mgt Team member of the NTF 14

15 Leadership and management Trained Fellows on map making using QGIS for epidemic investigations and health programming Made multiple maps for NMCP, FETP fellows, & UPHFP secretariat Quantified Anti malarial medicines with NMCP for response to malaria epidemic 15

16 Public Health Fellowship Program Field Epidemiology Track The cost of responding to a waterborne cholera outbreak in a village in Uganda compared to a simple hypothetical intervention

17 Cholera Outbreak- Hoima district, Sept 2015 Cholera outbreak- Kaiso fishing village, Hoima Rapid response team assembled by MoH, supported by WHO, CDC, and UNICEF to: establish Kaiso Cholera Treatment Centre investigate the outbreak implement control measures 120 cholera cases (4 deaths) identified Drinking contaminated water from lakeshore caused outbreak 17

18 Limited information on cholera cost analyses Repeated cholera outbreaks in Uganda Cholera imposes substantial economic burden Limited information on cost analyses for cholera outbreak response and control activities vis-a-vis preventive measures 18

19 To determine the cost of responding to and controlling the cholera outbreak Objectives To compare the cost to a would-be simple preventive measure constructing bore holes to provide cleaner water 19

20 Collection of cost data Cost data collected on: Medical Equipment and Supplies used Utilities Personnel Costs Person Hours Cost data from KCTC, health facilities, Hoima District Health Office, UPHFP, UNICEF, CDC,and WHO Cost of constructing a bore hole quoted by a U.S.- based NGO 20

21 Definitions & Analysis Direct cost- Expenditure on medications, medical equipment and supplies, utilities, allowances and transport for responders Indirect cost - Salary and other compensations for responders Not included- Vehicle depreciation, building maintenance, loss of productivity to case-persons due to illness and deaths 21

22 Cost of Response & Control= $71,769 Cost Category Cost In UgShs Cost in USD Medical Equipment &Supplies Utilities 5,942, ,000 1, Personnel Costs 64,403,935 19,225 Direct Costs 21,059 Person Hours 169,578,340 50,620 Indirect Costs 50,620 Overall Total 240,124,950 71,679 22

23 Cost of response was 24 times cost of constructing a bore hole Cost Category Cost In USD Control costs: Bore hole costs Response & Control 71,769 71,769:3000=~24 Direct Costs 21,059 21,059:3000=~7 Indirect Costs 50,620 50,620:3000=~17 Construction of a Bore Hole

24 Summary of results Constructing a bore hole to provide cleaner water would cost approximately $3000 Total cost incurred in response ~24 (=71769/3000) bore holes - Even the direct cost only ~7 (=21059/3000) bore holes Five such bore holes would have prevented this outbreak and averted future waterborne outbreaks 24

25 Conclusion A simple prevention measure such as constructing bore holes for village residents can be substantially cost-effective for preventing waterborne diseases such as cholera 25

26 Recommendation Governments should proactively implement prevention measures for waterborne outbreaks whenever possible, instead of passively responding to these outbreaks 26

27 Public Health Fellowship Program Field Epidemiology Track Acknowledgments The Uganda Public Health Fellowship Program National Malaria Control Program Dr. Opigo Jimmy Prof. Joan Kalyango USAID/PMI WHO Malaria Implementing Partners Dr. Bob Snow; Dr. Ambrose Talisuna; Dr. Albert Kilian