Reinforcing outbreak response systems to curb mpox in Uganda

Kampala ‒ When two cases identified in Uganda’s western Kasese district in late July 2024 were confirmed to be mpox, the health authorities soon declared an outbreak of the disease and launched measures to curb the spread of the virus.

As of 2 October 2024, the country had reported 51 confirmed cases in 11 districts. Of the reported cases, 24 had recovered. The Ministry of Health, with support from World Health Organization (WHO) and partners, are collaborating closely to strengthen key outbreak control measures including disease surveillance, active case finding, testing, clinical care, community engagement and public awareness efforts to promote protective measures.

WHO is also supporting the national authorities to reinforce the capacity of health workers manage mpox cases, reinforce laboratory systems to accelerate sample collection and testing. The Organization has trained field responders on electronic surveillance data systems in five districts. The electronic data gathering and management is crucial for contact tracing, monitoring of identified contacts as well as investigations of alerts and cases.
 

When 32-year-old forester Godwin Asimwe woke up one morning feeling weak, with a high fever and a skin rash, he immediately thought he had malaria.

His home remedies did nothing to reduce his fever, and when a malaria test at his local clinic tested negative, Asimwe travelled the 300km to the country’s capital Kampala in his search for an answer.
Shocked to receive a mpox diagnosis, Asimwe was then isolated in a treatment facility. “I was alone, afraid and suffering. The health workers kept reassuring me that I wasn’t going to die, but it was a very difficult time for me,” he recalls.

Now fully recovered, Asimwe could not be more relieved to be back with his family. But he says the experience has left him acutely mindful of hygiene and his interactions with others.

“I wash my hands more often, I don’t shake hands with strangers, am careful with suspicious animals and seek medical attention immediately if I feel unwell,” he says.
To effectively support the Ugandan government’s detection and response efforts, WHO donated sample collection kits to the Ministry of Health. Procured with funding from the Federal Republic of Germany, through WHO’s Contingency Fund for Emergencies, these are being utilized across the country to collect up to 5000 samples for laboratory testing.

With more than 800 samples tested to date, Dr Charles Olaro, Director of Curative Services at Uganda’s Ministry of Health, says the kits have been invaluable. “They are facilitating rapid detection and response to the mpox outbreak, by enabling us to make the right mpox diagnostics in order to recommend the appropriate treatment,” he says.
Risk communication and community engagement are an integral part to the country’s outbreak response and WHO and partners have provided around 226 000 posters and 280 000 flyers in 10 languages to help raise mpox awareness. These information, education and communication materials have been distributed in all 25 high-risk districts and in various workplaces.

As part of community sensitization efforts in Mayuge district, the district response team has also visited 142 primary schools and 28 places of worship to share mpox prevention and management messages.

“Through community sensitization, we are promoting awareness on prevention and management of mpox, while also dispelling stigma,” says Menya Simon, a community health extension worker in Mayuge district.
Simon also supports contact tracing teams, another key element of the response.

WHO has conducted training on the GoData application and electronic integrated disease surveillance and response (eIDSR) for 129 mpox responders in five districts, including the Kampala metropolitan area. The application supports contact tracing and follow-up, while the IDSR system enables case investigation and alerts management.

As of 4 October 2024, 263 contacts have so far been listed in GoData, significantly improving the contact follow-up when compared with the manual tools used previously.

“These tools have been critical in contributing to the interruption of the mpox transmission chain,” says Dr Charles Lukoya Okot, WHO’s mpox Incident Manager in Uganda.
WHO is also supporting affected districts to activate district taskforces to oversee the overall mpox response.

“As WHO, we remain fully committed to supporting Uganda through this crisis, and towards building a resilient health system capable of responding to public health threats such as mpox into the future,” says Dr Charles Njuguna, Acting WHO Representative in Uganda.
Like mpox survivor Asimwe, 24-year-old Esther Kisakye feels fortunate that she has made a full recovery.

Her illness was managed at home, with regular follow-up visits from health teams who helped allay her many fears.

“Along with the physical pain, I experienced a lot of stigma, especially from work colleagues. I got the reassurance I so desperately needed from WHO and the field teams that come to check on me,” she says.

It's been tough for Kisakye, but now her lesions have cleared and she is back at work, grateful to still be benefiting from the ongoing routine follow-up of survivors in the area.
For Additional Information or to Request Interviews, Please contact:
Anthony Bugembe

Communications Associate
WHO Uganda

Email: afwcougcom [at] who.int (afwcougcom[at]who[dot]int)

Collins Boakye-Agyemang

Communications and marketing officer
Tel: + 242 06 520 65 65 (WhatsApp)
Email: boakyeagyemangc [at] who.int (boakyeagyemangc[at]who[dot]int)