A student’s account of experiences from the Frontlines of the Rift Valley Fever Outbreak Investigation in Kabale District, Uganda

Monday, 4 April 2016 - 6:10am
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On 4 March 2016 Uganda’s first case of Rift Valley Fever (RVF) was reported in the Kabale District, about 400 km southwest of Kampala. Although only one other case has been confirmed in Kabale, RVF is a viral disease that can be easily transmitted through infected mosquitoes or contact with infected animals. Since 4 March 2016, rapid response teams have been deployed by the Ministry of Health to respond to the outbreak. Six One Health Student Club members at Makerere University were chosen to join the rapid response team and have been at the frontlines of the outbreak since 21/03/2016 to 24/03/2016.The One Health students have been trained to prevent, detect, and respond to infectious disease outbreaks by the One Health Central and Eastern Africa network with the support of the U.S. Agency for International Development’s One Health Workforce project. Upon selection, the Ministry of Health provided additional training to the students as part of its operational response.

On March 18th, 14 days since the first outbreak, students were called to urgently convene at 2pm to leave for Kabale at 6pm. Tonny Tindyebwa a member of the One Health Students’ Club, based at Makerere University School of Public Health, is one of the students who were part of this investigation. In this post, he shares his experiences.

The morning after we arrived, we had an early morning meeting with the District Task Force, followed by identification of activities to be done. These included mainly social mobilization and surveillance. Multi-sectoral teams were then constituted and assigned duties. We also created a communication platform using WhatsApp.

 

The next day, Tuesday 22nd we identified new cases including a truck driver from Burundi. Tis case caused a lot of panic among residents at the border who mistook the symptoms for those of Marburg. 

The rest of our time as part of the investigation team, we mainly took part in case tracking, sample collection, social mobilization, report writing, case management and records review. Illegal structures like slaughter houses/places were also visited and closed, while abattoirs were also inspected. 

In the course of executing this assignment, I realized that there are areas that could be improved in future, like the slow response on delivery of the supplies such as PPE which scared medical workers on attending to cases, delay of Laboratory results of the samples collected still put the DTF members in anxiety, slow response of the Alert desk team to requests.

There was also late dispatch of teams to the field, absence of key district political leaders and inadequate transportation facilities like cars, making it problematic for teams to get to the field in time

There were also challenges with some media houses misinforming communities on the progress of the outbreak investigation, treating suspected cases who had died as confirmed cases.

There are some good practices that I think can be used as lessons and strengthened for future outbreaks. For instance, the population exhibited eagerness to report any suspects basing on signs and symptoms of the disease they had, to the extent that some people just referred themselves to the health workers.

Social mobilization was done in creative ways, using currently popular technologies as well as reaching out to specific populations and communities like schools and training institutions.

Key populations we worked with like meat sellers were very responsive in providing information about their counterparts who had exhibited signs and symptoms of RVF. 

Students (Tonny Tindyebwa and Senyonjo Ronald) with members of the DTF on a case tracking mission at the foothills of Kabale

One of the Students Prisca Anyonga taking notes from a suspect’s home