Cholera
Cholera is an acute intestinal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. It has a short incubation period, from less than one day to five days, and produces an enterotoxin that causes a copious, painless, watery diarrhoea that can quickly lead to severe dehydration and kills a person within hours if treatment is not promptly given. Vomiting also occurs in most patients.
It can be spread through eating and drinking foods contaminated with faeces of an infected person. Other factors responsible for its spread include; draining latrines into drainage channels, defecating in open places, eating food or drinks prepared under unhygienic conditions and poor personal hygiene.
The Ministry of Health approaches to prevent the spread of cholera disease include the following:
- Stepping-up publicity campaigns to eradicate the spread of the disease.
- “Surveillance and Epidemiological programmes to detect cases for early treatment
- Promptly availing the necessary drugs to the affected areas.
- Intensifying public education programmes aimed at preventing disease outbreaks,
The following advice is given by MoH to prevent the spread of Cholera and other water-related diseases:
- Boil all drinking water;
- Cook food thoroughly and eat it while still hot;
- Wash hands with soap before eating food;
- Dispose all fecal material in latrines and
- Avoid foods and drinks sold on streets and along the roads.
Cholera and the other water-related diseases like Typhoid and Dysentery are more common during the rainy seasons.
Nodding disease (Situation as of 14 February, 2012)
The Uganda Ministry of Health reported a mysterious disease condition, referred to as “Nodding Syndrome”, in the Northern Uganda districts of Kitgum, Pader and Lamwo. The condition was first noticed in Kitgum district in 2003, and described as a progressive disease characterized by nodding of the head, mental retardation and stunted growth. The investigations revealed that the disease was a new type of epilepsy that was reported to have affected at least 3,000 children in the districts of Kitgum, Lamwo and Pader in Northern Uganda. As of February 14, it is estimated that a total to 3,094 suspected cases with 170 deaths have occurred.
The disease is mainly affecting children aged 5 to 15 years, with 54% of the affected children being males. Most of the affected children (93%) live in areas where Onchocerciasis (River Blindness) is prevalent. The disease presentation suggests that this is possibly a new type of epilepsy that is characterized by head nodding episodes that consist of repetitive dropping forward of the head. There is deterioration of brain function in some of the victims, and malnutrition with growth retardation; many children have dropped out of school.
The Ministry of Health with support from WHO, CDC and other partners conducted epidemiological investigations in 2009 and 2010. These investigations enabled exclusion of possible etiological agents such as infectious, toxic, or nutritional factors; however the cause of the illness remains unclear.
The association between Onchocerciasis and Nodding Syndrome requires further investigation. A modest deficiency of vitamin B6 and deficiencies of other micronutrients (Vitamin A, Seleniun and Zinc) was found in most cases. Investigations to date reveal that Nodding Syndrome is not transmissible from person to person.
The patients can be effectively treated with anti-epileptic drugs; however, further investigations into the cause of the disease and pathogenesis are planned. The MOH and partners developed a response plan to Nodding Syndrome which includes: case management to prevent deterioration of the cases, bi-annual mass treatment of Onchocerciasis, strengthening surveillance, and multivitamin and multi-nutrient supplementation.
In response to the request to WHO AFRO for technical and financial support, an epidemiologist from the regional office has been deployed to provide additional support to MoH to improve monitoring of nodding disease cases through strengthening surveillance.
The epidemiologist will also support training of health workers on case management in the affected districts and work with the nodding disease research sub-committee in identifying additional research priorities and contribute to finalisation of the existing protocols. Seed funds were provided by AFRO to support some of the key activities