Ebola Virus Disease in Uganda: A global emergency call

Rai, Anushree; Hamiidah, Nakyanzi; Abbass, Mortada; Masunga, Daniel Stephen; Shoumar, Hussein; Kantawala, Burhan; Wellington, Jack; Uwishema, Olivier

doi:10.1016/j.amsu.2022.104825

Cited by 5 publications

(5 citation statements)

References 13 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Such practices, according to community members, are highly valued because they are regarded as critical steps in the transition from the world of the living to the spiritual world, which must be facilitated by surviving relatives through specific rituals [2, 4, 13, 18]. Similar to other studies, we heard from participants that funeral practices contributed to the spread of SUDV in Uganda [14, 21, 27]. Other practices reported by study participants, such as exhumation, are related to the lack of acceptance of safe and dignified burials, and contributed to the spread of SUDV.…”

Section: Discussionsupporting

confidence: 70%

“…Other practices reported by study participants, such as exhumation, are related to the lack of acceptance of safe and dignified burials, and contributed to the spread of SUDV. The rapid burial of the deceased without allowing relatives to view the dead bodies gave rise to the suspicion that medical professionals were keeping the corpses in order to sell their relatives’ body parts [14]. During a SUDV outbreak in Northern Uganda in 2003, such mistrust was exacerbated by rumors that some Westerners were purchasing human body parts [8, 28].…”

Section: Discussionmentioning

confidence: 99%

“…On September 20, 2022, for the first time in over a decade, Uganda declared an outbreak of Sudan Virus Disease (SVD) caused by the Sudan virus (formerly called Sudan ebolavirus ). By the end of the outbreak, there were 142 confirmed cases and 22 probable cases from nine districts [14, 15]. Anecdotal reports from the epidemiologic investigations revealed that many patients had undergone treatment by traditional healers or religious leaders for their illnesses before they were diagnosed with SVD.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Role of Community Beliefs and Practices on the Spread of Ebola in Uganda, September 2022

Naiga,

Zalwango,

Kizito

et al. 2023

Preprint

View full text Add to dashboard Cite

BackgroundTraditional community beliefs and cultural practices can facilitate the spread of ebolaviruses during outbreaks. On September 20, 2022, Uganda declared a Sudan Virus Disease (SVD) outbreak after a case was confirmed in Mubende District. During September–November 2022, the outbreak spread to eight additional districts. We investigated the role of community beliefs and practices in the spread of SUDV in Uganda in 2022.MethodsA qualitative study was conducted in Mubende, Kassanda, and Kyegegwa districts in February 2023. We conducted nine focus group discussions (FGDs) and six key informant interviews (KIIs). FGDs included SVD survivors, household members of SVD patients, traditional healers, religious leaders, and community leaders. Key informants included community, political, and religious leaders, traditional healers, and health workers. We asked about community beliefs and practices to understand if and how they contributed to the spread of SUDV. Interviews were recorded, translated, transcribed, and analyzed thematically.ResultsFrequently-reported themes included beliefs that the community deaths, later found to be due to SVD, were the result of witchcraft or poisoning. Key informants reported that SVD patients frequently consulted traditional healers or spiritual leaders before seeking formal healthcare or visited them after formal healthcare failed to improve their health conditions. They also noted that traditional healers treated patients with signs and symptoms of SVD without protective measures. Additional themes included religious leaders conducting laying-on-of-hands prayers for SVD patients and symptomatic contacts, SVD patients and their symptomatic contacts hiding in friends’ homes, and exhumation of SVD patients originally buried in safe and dignified burials, to enable traditional burials.ConclusionVaried community beliefs and cultural practices likely promoted SVD outbreak spread during the 2022 outbreak in Uganda. Controlling ebolavirus outbreaks in Uganda could be aided by the involvement of formal public health systems, traditional healers, and religious leaders. Community engagement during inter-epidemic periods could aid in the effective management of future outbreaks in Uganda by identifying socially acceptable and scientifically supported alternatives for infection control.

show abstract

Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Role of Community Beliefs and Practices on the Spread of Ebola in Uganda, September 2022

Naiga,

Zalwango,

Kizito

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…On September 20, 2022, the Uganda Ministry of Health (MoH) declared an outbreak of Sudan virus disease (SVD) after a case was con rmed the previous day in a 26-year-old man living in Mubende District, Central Uganda (8,9). The response to the outbreak included immediate and intensive efforts to control the outbreak and stop transmission, including rapid identi cation, isolation, and treatment of cases, contact tracing and monitoring of contacts (10,11). On October 15, in response to the spread to other districts, the president of Uganda instituted a 21-day lockdown in Mubende and Kassanda districts, the epicentres of the outbreak (12).…”

Section: Introductionmentioning

confidence: 99%

Individual and household risk factors for Ebola disease among household contacts in Mubende and Kassanda districts, Uganda, 2022

Migamba,

Ardiet,

Migisha

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: In 2022, a Sudan virus disease (SVD) outbreak occurred in Uganda, resulting in 142 confirmed cases, most in Mubende and Kassanda districts. We determined risk factors for Sudan virus (SUDV) infection among household members (HHM) of cases. Methods: We conducted a case-control and retrospective cohort study in January 2023. Cases were RT-PCR-confirmed SUDV infection in residents of Mubende or Kassanda districts during the outbreak. Case-households housed a symptomatic, primary case-patient for ≥24 hours and had ≥1 secondary case-patient with onset <2 weeks after their last exposure to the primary case-patient. Control households housed a case-patient and other HHM but no secondary cases. A risk factor questionnaire was administered to the primary case-patient or another adult who lived at home while the primary case-patient was ill. We conducted a retrospective cohort study among case-household members and categorized their interactions with primary case-patients during their illnesses as none, minimal, indirect, and direct contact. We conducted logistic regression to explore associations between exposures and case-household status, and Poisson regression to identify risk factors for SUDV infection among HHM. Results: Case- and control-households had similar median sizes. Among 19 case-households and 51 control households, primary case-patient death (adjusted odds ratio [ORadj]=7.6, 95% CI 1.4-41) and ≥2 household bedrooms (ORadj=0.19, 95% CI 0.056-0.71) were associated with case-household status. In the cohort of 76 case-HHM, 44 (58%) were tested for SUDV <2 weeks from their last contact with the primary case-patient; 29 (38%) were positive. Being aged ≥18 years (adjusted risk ratio [aRRadj]=1.9, 95%CI: 1.01-3.7) and having direct or indirect contact with the primary case-patient (aRRadj=3.2, 95%CI: 1.1-9.7) compared to minimal or no contact increased risk of SVD. Access to a handwashing facility decreased risk (aRRadj=0.52, 95%CI: 0.31-0.88). Conclusion: Direct contact, particularly providing nursing care for and sharing sleeping space with SVD patients, increased infection risk among HHM. Risk assessments during contact tracing may provide evidence to justify closer monitoring of some HHM. Health messaging should highlight the risk of sharing sleeping spaces and providing nursing care for persons with Ebola disease symptoms and emphasize hand hygiene to aid early case identification and reduce transmission.

show abstract

“…Recently, the re-emergence of the Sudan strain has become a reminder of the need to be prepared on all levels for an appropriate response to alternative Ebola strains [ 7 ]. Indeed, the Ministry of Health of the Republic of Uganda declared an Ebola virus disease outbreak on 20th September 2022 after a patient died who was infected with the rare Sudan strain of Ebola virus [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Development and Clinical Evaluation of a Rapid Point of Care Test for Ebola Virus Infection in Humans

Wang

Bennett

Roehler

et al. 2023

Viruses

View full text Add to dashboard Cite

The genus Ebolavirus contains multiple species of viruses that are highly contagious and lethal, often causing severe hemorrhagic fever. To minimize the global threat from Ebola virus disease (EVD), sustainable, field-appropriate tools are needed to quickly screen and triage symptomatic patients and conduct rapid screening of cadavers to ensure proper handling of human remains. The OraQuick® Ebola Rapid Antigen Test is an in vitro diagnostic single-use immunoassay for the qualitative detection of Ebola virus antigens that detects all known species within the genus Ebolavirus. Here, we report the performance of the OraQuick® Ebola Rapid Antigen Test and provide a comparison of its performance with other rapid diagnostic tests (RDTs) for EVD. OraQuick® Ebola demonstrated clinical sensitivity of 84.0% in archived EVD patient venous whole-blood (WB) samples, 90.9% in Ebola virus-infected monkey fingerstick samples, and 97.1% in EVD patient cadaver buccal swabs, as well as clinical specificity of 98.0–100% in venous WB samples and 99.1–100% in contrived saliva samples. It is the only 510(k)-cleared Ebola rapid test, has analytical sensitivity as good as or better than all RDT comparators for EVD, and can detect the Sudan virus. Our data demonstrate that the OraQuick® Ebola Rapid Antigen Test is a sensitive and specific assay that can be used for rapid detection of EBOV in humans and could support efforts for EVD-specific interventions and control over outbreaks.

show abstract

Ebola Virus Disease in Uganda: A global emergency call

Cited by 5 publications

References 13 publications

The Role of Community Beliefs and Practices on the Spread of Ebola in Uganda, September 2022

The Role of Community Beliefs and Practices on the Spread of Ebola in Uganda, September 2022

Individual and household risk factors for Ebola disease among household contacts in Mubende and Kassanda districts, Uganda, 2022

Development and Clinical Evaluation of a Rapid Point of Care Test for Ebola Virus Infection in Humans

Contact Info

Product

Resources

About