Browsing by Author "Okware, Sam"

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    Reconsidering Ebola virus nomenclature : a call for a stigma-free and precise terminology.
    (Elsevier Ltd., 2025) Olupot-Olupot, Peter; Mulongo, Muhamed; Taylor-Robinson, Simon D; Bwire, Godfrey; Okware, Sam
    Ebola virus disease is a severe, and very often fatal, emerging and re-emerging zoonotic infection that is a major threat to global health. Since its discovery along the Ebola River in the Democratic Republic of Congo in 1976, Orthoebolavirus, commonly known as Ebolavirus, has caused 42 outbreaks in 18 countries. Over 80% (34 of 42) of Ebola virus disease outbreaks have occurred in Africa.1 The most difficult to contain Ebola virus disease epidemic so far was in west Africa between December, 2013, and June, 2016, where 28610 cases were confirmed, with a case fatality rate of 40%.2 Uganda is highly prone to Ebola virus disease occurrence and has so far had seven outbreaks since 2000. Five of these were caused by Orthoebolavirus sudanense (Sudan ebolavirus).1 The most recent Ebola virus disease health-care emergency was declared in Uganda on Jan 30, 2025.
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    The Impact of Diagnostic Delays and Timeliness of Response on Ebola Disease outbreak-level case-fatality Ratios in Uganda (2000–2023) : a Rapid Systematic Review and meta-analysis
    (Springer, 2025) Paasi, George; Okware, Sam; Olupot-Olupot, Peter
    Background: Uganda has experienced seven laboratory-confirmed Ebola virus disease (EBOD) outbreaks from 2000 to 2022, with reported case‐fatality ratios (CFRs) varying widely. The influence of diagnostic and response delays on outbreak‐level mortality has not been systematically assessed. We conducted a rapid systematic review and meta-analysis to quantify the effect of diagnostic and response delays on outbreak-level mortality. Methods: We registered the review on OSF and adhered to PRISMA-2020 guidelines. We searched PubMed, Embase, Scopus, Web of Science, WHO Global Index Medicus, and grey literature through 30 April 2025. Eligible reports described laboratory-confirmed human EBOD in Uganda (2000–2022) and reported case counts, deaths, or quantitative timeliness metrics. Outbreak-level CFRs were meta-analyzed using random-effects models with Freeman–Tukey transformation (metafor package in R). Mixed-effects meta-regression assessed the association between continuous delay metrics and transformed CFR. Results: Fifteen reports met inclusion criteria, spanning 741 confirmed cases and 358 deaths. The pooled CFR was 45.4% (95% CI: 26.2%–65.2%; I² = 87.8%) across seven outbreaks. By species, Sudan ebolavirus outbreaks (n = 5) had a CFR of 44.6% (95% CI: 33.7%–55.6%), Bundibugyo ebolavirus (n = 1) 24.8% (95% CI: 18.2%–32.1%), and Zaire ebolavirus (n = 1) 100% (95% CI: 61.2%–100.0%). In meta-regression, each additional day from first case report to specimen collection was associated with a significant increase in CFR (β = 0.142 on the transformed scale; p = 0.025; R² = 62%), translating to an approximate absolute increase of 3.8% points in CFR per day at a baseline risk of 45%. Conversely, longer delays from symptom onset in the index case to national outbreak declaration were linked to a slight decrease in CFR (β = − 0.00765; p = 0.047). Conclusions Uganda’s EBOD outbreaks exhibit high and variable mortality, with diagnostic delays substantially amplifying case-fatality. Rapid specimen collection and prompt public health responses are critical to reducing EBOD mortality. Strengthening laboratory networks and accelerating declaration protocols should be central to future outbreak preparedness in Uganda and similar contexts. Keywords: Ebola virus disease • Case-fatality ratio • Uganda • Diagnostic timeliness • Outbreak response • Sudan ebolavirus (SUDV) • Bundibugyo ebolavirus (BDBV) • Zaire ebolavirus (EBOV) • Systematic review and meta‐analysis.