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Public Health Fellowship Program – Field Epidemiology Track My Fellowship Achievements Allen Eva Okullo, MPH, BSc. Zoo/Psy Fellow, Cohort 2015
Public Health Fellowship Program – Field Epidemiology Track
My Fellowship Achievements
Allen Eva Okullo, MPH, BSc. Zoo/Psy
Fellow, Cohort 2015
2
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
outbreaks: • 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
outbreak, 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
outbreak 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
outbreak 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
