Browsing by Author "Olupot-Olupot, Peter"

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    Capacity building in field epidemiology in Sub Saharan Africa : findings from Infectious Disease Field Epidemiology and Biostatistics in Africa (IDEA) Fellowship Program
    (Taylor & Francis Group, 2025) Alunyo, Patrick Jimmy; Paasi, George; Ario, Riolexus Alex; Olupot-Olupot, Peter
    Background: Emerging and re-emerging infectious diseases (EREIDs) remain a major public health threat globally, particularly in sub-Saharan Africa (SSA), where fragile health systems, inadequate infrastructure, and limited workforce training exacerbate vulnerabilities. Uganda, a recognised hotspot for outbreaks, faces increasing risk due to anthropogenic and environmental drivers. To address critical capacity gaps, the Infectious Disease Epidemiology and Biostatistics in Africa (IDEA) Fellowship was launched as Uganda’s first master’s-level programme in infectious disease field epidemiology. Led by Busitema University, in collaboration with national and international partners, the programme was funded through EDCTP-II (CSA2020E). Methods: The IDEA Fellowship combined theoretical instruction with fieldwork and research tailored to national health priorities. Activities included outbreak investigations, disease modelling, and surveillance, supported by Africa CDC, Uganda’s Ministry of Health, and UK institutions. A REDCap-based survey was administered to 202 public health professionals across SSA to assess training needs, skill gaps, and barriers. Data were analysed using descriptive statistics and thematic analysis. Results: The programme trained 15 master‘s-level fellows, strengthening Uganda’s capacity in surveillance, early detection, and outbreak response. Survey results showed that 55.4% of professionals required further training, with skill gaps in zoonotic disease management (64.4%), outbreak preparedness (64.9%), and data management (59.4%). Key barriers included limited diagnostic capacity (73.8%) and weak collaboration (49.5%). Qualitative findings highlighted inconsistent mentorship, restricted data access, and limited funding for fieldwork. Respondents advocated for structured mentorship, longer training durations (≥3–6 months), and hybrid delivery models (42.3%). Conclusion: The IDEA Fellowship demonstrates a scalable model for infectious disease capacity building in SSA. Training African scientists in local contexts promotes relevance, retention, and cost-effectiveness. Regional expansion, cross-sector collaboration, and systemic investment are essential for sustainable epidemic preparedness and global health security. Keywords: field epidemiology, capacity building, infectious disease training, Sub-Saharan Africa
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    Incidence and predictors of Sudan ebolavirus transmission among contacts in Uganda in 2022 : a retrospective cohort study
    (BMC Public Health, 2025) Mulongo, Muhamed; Matovu, K. B. Joseph; Lubaale, A. M. Yovani; Olupot-Olupot, Peter
    Background: Ebola disease (EBOD) is a highly lethal zoonotic viral hemorrhagic fever that is responsible for 41 outbreaks globally. Ebola transmission is a key driver of the magnitude and complexity of outbreaks, yet incidence rate during outbreaks is not fully studied. This study aimed to determine the incidence and predictors of Sudan Ebolavirus transmission during the 2022 outbreak in Uganda. Methods: We conducted a retrospective cohort study leveraging surveillance records for individuals identified as contacts, and collected between September and December 2022 during the Sudan Ebolavirus Disease (SUVD) outbreak in Uganda. Data were extracted and analyzed via Stata/SE 15. This analysis involved calculating incidence rates and assessing predictors of Ebola transmission through appropriate multivariable regression models, and controlling for potential confounders like sex, age, health worker, and place of contact. The study protocol was approved by the Busitema University Research Ethics Committee (BUFHS-2023-145). Individual informed consent was waived, and all the data were anonymized. Results: 3140 contacts were included in the study, with 50.6% being female and a mean age of 24 years. The incidence rate of SUVD was 1.6 cases per 1,000 person-days of follow-up. Kaplan Meier survival function showed that the risk for being diagnosed with SUVD extended beyond 21 days, up to the 28th day post exposure. The incidence of SUVD in secondary transmission settings was 1.8 times higher than that in primary transmission settings (IRR=1.81, 95% CI=1.202–2.735; P<0.001). After controlling for sex, age, health worker, and place of contact, the significant predictors of SUVD transmission were high-risk contact status (aHR=2.5, 95% CI: 1.68–3.72; P<0.001) and male sex in secondary transmission settings (aHR=2.14, 95% CI=1.15–4.01; P=0.02). Conclusions: This study revealed a high incidence of Ebola among contacts, with cases emerging beyond the standard 21-day follow-up period. The incidence was notably higher in secondary transmission settings, with high-risk contacts and males being particularly vulnerable. These findings suggest the need to revise contact tracing protocols (extend beyond 21 days), and prioritize follow-up on the basis of risk stratification. Further research is warranted to explore sex-related differences in secondary transmission dynamics. Keywords: Ebola transmission incidence, Predictors, Uganda, Sudan Ebola virus
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    Term stillbirths in Eastern Uganda: a community-based prospective cohort study
    (Taylor & Francis Group, 2025) Chebet, Martin; Olupot-Olupot, Peter; Weeks, D Andrew; Engebretsen, Marie S Ingunn; Okalany, Regina Akwi Noela; Okello, Francis; Tylleskär, Thorkild; Burgoine, Kathy; Mukunya, David
    Background: Every year, 1.9 million stillbirths occur worldwide, of whom 1.5 million occur in sub-Saharan Africa (SSA) and Southeast Asia. Objectives: This study aims to determine the incidence and risk factors and to describe underlying causes for term stillbirths in Eastern Uganda. Methods: This was a cohort study of pregnant women enrolled at 34 weeks of gestation or more and followed to birth between January 2021 and January 2024. Enrolment and follow-up were done in the community by trained midwives. Using structured questionnaires, details of maternal health, pregnancy and birth were captured. Results: We enrolled 6101 participants and analysed 5496 for incidence of term stillbirth and 5296 for risk factors. Of the participants, 4913/5296 (92.8%) were between 14 and 35 years, and 4456/5296 (84.1%) had a health facility birth. There were 101 term stillbirths (61 were intrapartum and 40 antepartum). The incidence of term stillbirth was 18.4 per 1000 births (95% CI 14.8 to 22.9). The most common underlying causes of stillbirth were prolonged or obstructed labour 32/101 (31.7%) and malaria 20/101 (19.8%). The factors associated with term stillbirths were caesarean birth (aRR 3.3; 95% CI 2.00 to 5.4), intimate partner violence (aRR 1.8; 95% CI 1.1 to 2.8) and maternal age above 35 years (aRR 2.2; 95% CI 1.2 to 3.9). Conclusion: Eastern Uganda has a high rate of term stillbirths with more than half occurring during labour. Efforts are needed to improve the quality of birth care and to prevent intimate partner violence.
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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.