My Fellowship Achievements Allen Eva Okullo, MPH, BSc. Zoo/Psy - - PowerPoint PPT Presentation

Public Health Fellowship Program – Field Epidemiology Track

My Fellowship Achievements

Allen Eva Okullo, MPH, BSc. Zoo/Psy Fellow, Cohort 2015

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My Fellowship Achievements

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

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My Fellowship Achievements

Response to Public Health Emergency

• Led an epidemiological investigation on a

suspected guinea worm outbreak

• Co-investigator in 5 epidemiological
• utbreaks:
• Typhoid
• Malaria
• Acute Viral Hepatitis
• Cholera

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My Fellowship Achievements

Epidemiological Studies

• Factors associated with malaria illness in

three districts of Northern Uganda, 2015

• Assessment of risk factors for the malaria
• utbreak, Uganda 2016

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My Fellowship Achievements

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, 2015

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My Fellowship Achievements

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

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My Fellowship Achievements

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

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My Fellowship Achievements

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

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My Fellowship Achievements

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 2015

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My Fellowship Achievements

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’

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My Fellowship Achievements

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

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My Fellowship Achievements

Leadership and management

• Made a pitch at the IMED2016 Hackathon

that led to devt ‘Puddle Predict’-a malaria epidemic prediction tool

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My Fellowship Achievements

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

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My Fellowship Achievements

• 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 Leadership and management

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My Fellowship Achievements

• 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 Leadership and management

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

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My Fellowship Achievements

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

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My Fellowship Achievements

Limited information on cholera cost analyses

• Repeated cholera outbreaks in Uganda
• Cholera imposes substantial economic burden
• Limited information on cost analyses for cholera
• utbreak response and control activities vis-a-vis

preventive measures

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My Fellowship Achievements

Objectives

• To determine the cost of responding to and

controlling the cholera outbreak

• To compare the cost to a would-be simple

preventive measure – constructing bore holes to provide cleaner water

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My Fellowship Achievements

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

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My Fellowship Achievements

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

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My Fellowship Achievements

Cost of Response & Control= $71,769

Cost Category Cost In UgShs Cost in USD Medical Equipment &Supplies Utilities 5,942,675 200,000 1,774 60 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

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My Fellowship Achievements

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 3000

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My Fellowship Achievements

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
• utbreak and averted future waterborne outbreaks

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My Fellowship Achievements

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

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My Fellowship Achievements

Recommendation

• Governments should proactively implement

prevention measures for waterborne outbreaks whenever possible, instead of passively responding to these outbreaks

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