The burden of cholera in Uganda.

<h4>Introduction</h4>In 2010, the World Health Organization released a new cholera vaccine position paper, which recommended the use of cholera vaccines in high-risk endemic areas. However, there is a paucity of data on the burden of cholera in endemic countries. This article reviewed av...

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Autores principales:	Godfrey Bwire, Mugagga Malimbo, Brian Maskery, Young Eun Kim, Vittal Mogasale, Ann Levin
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/9b80e1176a1843799986812264bec4b9
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spelling	oai:doaj.org-article:9b80e1176a1843799986812264bec4b92021-11-18T09:16:38ZThe burden of cholera in Uganda.1935-27271935-273510.1371/journal.pntd.0002545https://doaj.org/article/9b80e1176a1843799986812264bec4b92013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24340106/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Introduction</h4>In 2010, the World Health Organization released a new cholera vaccine position paper, which recommended the use of cholera vaccines in high-risk endemic areas. However, there is a paucity of data on the burden of cholera in endemic countries. This article reviewed available cholera surveillance data from Uganda and assessed the sufficiency of these data to inform country-specific strategies for cholera vaccination.<h4>Methods</h4>The Uganda Ministry of Health conducts cholera surveillance to guide cholera outbreak control activities. This includes reporting the number of cases based on a standardized clinical definition plus systematic laboratory testing of stool samples from suspected cases at the outset and conclusion of outbreaks. This retrospective study analyzes available data by district and by age to estimate incidence rates. Since surveillance activities focus on more severe hospitalized cases and deaths, a sensitivity analysis was conducted to estimate the number of non-severe cases and unrecognized deaths that may not have been captured.<h4>Results</h4>Cholera affected all ages, but the geographic distribution of the disease was very heterogeneous in Uganda. We estimated that an average of about 11,000 cholera cases occurred in Uganda each year, which led to approximately 61-182 deaths. The majority of these cases (81%) occurred in a relatively small number of districts comprising just 24% of Uganda's total population. These districts included rural areas bordering the Democratic Republic of Congo, South Sudan, and Kenya as well as the slums of Kampala city. When outbreaks occurred, the average duration was about 15 weeks with a range of 4-44 weeks.<h4>Discussion</h4>There is a clear subdivision between high-risk and low-risk districts in Uganda. Vaccination efforts should be focused on the high-risk population. However, enhanced or sentinel surveillance activities should be undertaken to better quantify the endemic disease burden and high-risk populations prior to introducing the vaccine.Godfrey BwireMugagga MalimboBrian MaskeryYoung Eun KimVittal MogasaleAnn LevinPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 7, Iss 12, p e2545 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Godfrey Bwire Mugagga Malimbo Brian Maskery Young Eun Kim Vittal Mogasale Ann Levin The burden of cholera in Uganda.
description	<h4>Introduction</h4>In 2010, the World Health Organization released a new cholera vaccine position paper, which recommended the use of cholera vaccines in high-risk endemic areas. However, there is a paucity of data on the burden of cholera in endemic countries. This article reviewed available cholera surveillance data from Uganda and assessed the sufficiency of these data to inform country-specific strategies for cholera vaccination.<h4>Methods</h4>The Uganda Ministry of Health conducts cholera surveillance to guide cholera outbreak control activities. This includes reporting the number of cases based on a standardized clinical definition plus systematic laboratory testing of stool samples from suspected cases at the outset and conclusion of outbreaks. This retrospective study analyzes available data by district and by age to estimate incidence rates. Since surveillance activities focus on more severe hospitalized cases and deaths, a sensitivity analysis was conducted to estimate the number of non-severe cases and unrecognized deaths that may not have been captured.<h4>Results</h4>Cholera affected all ages, but the geographic distribution of the disease was very heterogeneous in Uganda. We estimated that an average of about 11,000 cholera cases occurred in Uganda each year, which led to approximately 61-182 deaths. The majority of these cases (81%) occurred in a relatively small number of districts comprising just 24% of Uganda's total population. These districts included rural areas bordering the Democratic Republic of Congo, South Sudan, and Kenya as well as the slums of Kampala city. When outbreaks occurred, the average duration was about 15 weeks with a range of 4-44 weeks.<h4>Discussion</h4>There is a clear subdivision between high-risk and low-risk districts in Uganda. Vaccination efforts should be focused on the high-risk population. However, enhanced or sentinel surveillance activities should be undertaken to better quantify the endemic disease burden and high-risk populations prior to introducing the vaccine.
format	article
author	Godfrey Bwire Mugagga Malimbo Brian Maskery Young Eun Kim Vittal Mogasale Ann Levin
author_facet	Godfrey Bwire Mugagga Malimbo Brian Maskery Young Eun Kim Vittal Mogasale Ann Levin
author_sort	Godfrey Bwire
title	The burden of cholera in Uganda.
title_short	The burden of cholera in Uganda.
title_full	The burden of cholera in Uganda.
title_fullStr	The burden of cholera in Uganda.
title_full_unstemmed	The burden of cholera in Uganda.
title_sort	burden of cholera in uganda.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/9b80e1176a1843799986812264bec4b9
work_keys_str_mv	AT godfreybwire theburdenofcholerainuganda AT mugaggamalimbo theburdenofcholerainuganda AT brianmaskery theburdenofcholerainuganda AT youngeunkim theburdenofcholerainuganda AT vittalmogasale theburdenofcholerainuganda AT annlevin theburdenofcholerainuganda AT godfreybwire burdenofcholerainuganda AT mugaggamalimbo burdenofcholerainuganda AT brianmaskery burdenofcholerainuganda AT youngeunkim burdenofcholerainuganda AT vittalmogasale burdenofcholerainuganda AT annlevin burdenofcholerainuganda
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The burden of cholera in Uganda.

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