Kampala ‒ Uganda is witnessing an upsurge in mpox cases, with laboratory-confirmed cases increasing from 24 as of 21 September to 413 as of 7 November 2024.
Among the key measures to curb the spread of mpox, health authorities, with support from World Health Organization (WHO) and partners, are working closely with communities to raise awareness about the dangers of the disease, how to stay safe, address misinformation and stigma to ensure that affected communities are confident in seeking medical assistance to help halt the spread of the virus. Cases have been confirmed in 36 of the country’s 146 districts since 24 July 2024 when the first case was reported.
WHO supports the Ministry of Health to strengthen other crucial outbreak control measures including disease surveillance, testing and case management. More than 2000 health workers in the Kampala metropolitan area have been trained so far and WHO is actively reinforcing laboratory systems to accelerate sample collection and analysis.
Community health extension workers like Simon provide a critical connection to communities in Uganda’s most-affected districts, providing accurate health information and prevention messages to people who are most at risk of contracting the virus.
Nakasongola district in central Uganda lies on the shores of Lake Kyoga, where a large portion of the population make their living from fishing. The highly mobile nature of the fisherfolk here, coupled with close contact interactions within the community, has resulted in high levels of transmission. The district accounts for nearly 20% of Uganda’s mpox cases.
“The increase in the number of cases is largely driven by high transmission among sex workers, truck drivers, fishing communities and other informal occupations. The level of interaction among these groups is high, thereby increasing the likelihood of local mpox transmission in the communities,” says Dr Charles Okot, WHO Uganda’s mpox incident manager.
WHO is also helping to raise awareness among local communities of the risks posed by the mpox virus and preventive measures needed to stay safe.
The risk communication and community engagement team here has so far reached more than 100 fishmongers, fisherfolk, boda boda (motorbike taxi) riders, 8000 school children and 30 sex workers. In addition, 500 teachers in the district have been oriented on mpox.
The experts are helping the health authorities understand the cultural beliefs, practices and social norms that may influence people's attitudes towards mpox and their willingness to seek healthcare.
In Nakasongola, Dr Chris Opesen has conducted more than 10 social and cultural group dialogues, helping to inform surveillance and risk communication strategies.
In the Kampala metropolitan area, the anthropologist has reached about 1200 people, with emphasis on students and other high-risk groups.
“We have emphasised to the community to practice safe behaviours and to report all people with mpox signs and symptoms to the nearest health facility or village health team,” says Dr Opesen.
According to Dr Opesen, many people initially self-medicated for an extended period but as a result of engagement with WHO and health authorities, reported to health facilities for appropriate treatment and care. “The subsequent cases are now to the isolation or treatment centre in Nakasongola,” he adds.
This misconception leads some people to avoid seeking medical care, fearing stigma and discrimination. This has contributed to the cases of sporadic community transmissions and threatens the public health response.
“Some of the causes of the high number of mpox cases include lack of information and it is the reason why the risk communication team is on ground to see that we can sensitize people,” says Lydia Aliyenka, a Ministry of Health behaviour change communication officer in Nakasongola district.
With funding from United States Agency for International Development, WHO has contracted 10 regional radio stations and two national TV stations to raise awareness and promote preventative behaviour.
In addition, more than 173 000 posters and around 217 000 flyers in English and local languages have been printed and distributed by field teams to enhance awareness and behaviour change in 18 districts across Uganda.
By using different modes of risk communication, WHO and Ministry of Health officials are able to expand the reach of important preventative messages and tackle the stigma associated with mpox.
“With support from partners, we are doing our best to prevent and manage mpox infections in vulnerable populations, such as children, pregnant women and immunocompromised people, as well as to avert outbreaks in institutional settings like schools and refugee settlements,” says Dr Charles Njuguna, WHO Representative, a.i. to Uganda.
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